The role of responsibility and threat appraisals in contamination fear and obsessive-compulsive tendencies at the implicit level

Development of a scale to assess obsessive-compulsive tendencies among Japanese university students

Obsessive-compulsive (OC) tendencies refer to obsessions and compulsions in a nonclinical group, which are risk factors for obsessive-compulsive disorder (OCD). OC tendencies and OC symptoms are mainly assessed using five factors: ordering, obsessions, cleaning, hoarding, and checking. However, since hoarding is now classified as an independent diagnosis in the DSM-V, this factor was not included and was instead replaced by indecisiveness. Furthermore, many established scales used for measuring OC tendencies were originally created for OCD patients; thus, they cannot adequately capture OC tendencies. Therefore, this study aimed to develop a scale to assess OC tendencies among Japanese university students with a revised five-factor structure: ordering, obsessions, cleaning, indecisiveness, and checking. We examined the factor structure, reliability, criterion-related validity, and convergent validity of the OC tendencies scale by administering two surveys. In Survey 1 (N = 216), an exploratory factor analysis (EFA) was conducted to examine the criterion-related and convergent validity and reliability of the OC tendencies scale. In Survey 2 (N = 202), a confirmatory factor analysis (CFA) was conducted. EFA and CFA utilized a five-factor structure comprising checking, ordering, indecisiveness, cleaning, and obsessions. Correlations with other scales indicated that the OC tendencies scale had efficient convergent validity, criterion-related validity, internal consistency, and test-retest reliability. This study validated the five-factor structure of OC tendency in Japanese university students. However, indecisiveness was also strongly correlated with trait-anxiety. As this scale is easy to administer among large groups, it has the potential to contribute to mental health support for university students by measuring OC tendencies experienced on a daily basis, which have not been adequately measured in the past.

Assessment of medical student burnout: toward an implicit measure to address current issues

The feasibility of implicitly assessing medical student burnout was explored, using the Implicit Relational Assessment Procedure (IRAP), to measure longitudinal student burnout over the first two years of medical school and directly comparing it with an existing explicit measure of burnout (Maslach Burnout Inventory; MBI). Three successive cohorts of medical students completed both implicit and explicit measures of burnout at several time points during their first two years of medical school. Both assessments were conducted via the internet within a one-week period during the first week of medical school, the end of the first year of medical school, and the end of the second year, though not all cohorts were able to complete the assessments at all time points. Mixed linear models were used to compare the two measures directly, as well as to evaluate changes over time in each measure separately. Minimal correspondence was observed between the implicit and explicit measures of burnout on a within-subject basis. However, when analyzed separately, all subscales of both measures detected significant change over time in the direction of greater levels of burnout, particularly during the first year of medical school. These results provide preliminary evidence the IRAP is able to assess implicit attitudes related to burnout among medical students, though additional research is needed. The IRAP detected consistent improvements in positive implicit attitudes toward medical training during students' second year of medical school, which was not detected by the MBI. Possible implications of these findings are discussed.

Implicit Cognition and Psychopathology: Looking Back and Looking Forward

Implicit cognitive processing is theorized to have a central role in many forms of psychopathology. In the current review, we focus on implicit associations, by which we mean evaluative representations in memory that are difficult to control and do not require conscious reflection to influence affect, cognition, or behavior. We consider definitional and measurement challenges before examining recent empirical evidence for these associations in anxiety, obsessive–compulsive, posttraumatic stress, depressive, and alcohol use disorders. This examination is framed by a brief review of the ways that prominent models of psychopathology represent biased implicit processing of disorder-relevant information. We consider to what extent models reflect more traditional automatic/implicit versus strategic/explicit dual-process perspectives or reflect more recent dynamical systems perspectives in which mental representations are iteratively reprocessed, evolving continuously. Finally, we consider the future research needed to better understand the interactive and temporal dynamics of implicit cognition in psychopathology.

Cognitive mechanisms of disgust in the development and maintenance of psychopathology: A qualitative review and synthesis

A growing body of research has implicated disgust in various psychopathologies, especially anxiety-related disorders. Although the observed role of disgust in many disorders is robust, the mechanisms that may explain this role are unclear. Cutting-edge research in cognitive science has the potential to elucidate such mechanisms and consequently improve our understanding of how disgust contributes to the etiology and maintenance of psychopathology. In this qualitative review, we systematically assess cognitive bias mechanisms that have been linked to disgust and its disorders. This review suggests that disgust-related biases may be observed in memory, interpretation, judgment of expectancies, and attention, as well as at implicit levels. Of these cognitive domains, the most robust bias appears to be observed at the level of attention. However, reliable moderators of attentional biases for disgust have not yet been identified, and this bias has not been systematically linked to other levels of analysis. Despite these limitations, the available research indicates that attentional avoidance rather than orienting or maintenance may be the most characteristic of disgust. Attentional avoidance of disgust may have important implications for etiological and treatment models of disorders characterized by excessive disgust reactions. The implications for advancing such models are discussed in the context of a combined cognitive bias hypothesis.

Predicting Contamination Aversion Using Implicit and Explicit Measures of Disgust and Threat Overestimation

Explicit measures of disgust and threat overestimation have consistently been found to be involved in contamination aversion. However, evidence of the involvement of these factors at the implicit level is mixed, and the role of both responses has not been looked at concurrently. This study aimed to compare the ability of implicit and explicit measures of disgust and threat overestimation to predict contamination aversion and whether this depends on the type of contaminant. Sixty-five participants completed explicit and implicit measures of disgust and threat overestimation, as well as several measures of contamination aversion, including obsessive-compulsive tendencies, and contamination fear and avoidance of contaminants directly associated with disease (direct contaminants) and harmful substances (harm contaminants). It was found that both explicit disgust and explicit threat overestimation predicted contamination-fear obsessive-compulsive tendencies. Explicit disgust predicted contamination fear and avoidance of direct contaminants, whereas explicit threat overestimation predicted contamination fear and avoidance of harm contaminants. The involvement of implicit processes was weak, with some suggestion of difficulty disengaging predicting avoidance of contaminants. Implications for understanding dysfunctional contamination aversion are discussed.

A meta-analysis of criterion effects for the Implicit Relational Assessment Procedure (IRAP) in the clinical domain

BACKGROUND AND OBJECTIVES

The Implicit Relational Assessment Procedure (IRAP) is a technique that is attracting a substantial body of research literature, particularly within the clinical domain.

METHOD

In response, the present paper outlines a meta-analysis of clinically-focused IRAP effects (N = 494) to provide the first estimate of how well such effects validate against their respective criterion variables in general.

RESULTS

The meta-analysis incorporated clinically-focused IRAP effects from 15 studies yielding a large effect size, r¯ = .45, with a desirably narrow 95% credibility interval (.23, .67). The funnel plot and subsequent sensitivity analyses indicated that this meta-effect was not subject to publication bias.

LIMITATIONS

The present meta-effect is an estimate based upon an IRAP literature that is still evolving rapidly in the clinical domain, and so as per its accompanying credibility interval, all conclusions that follow are necessarily provisional even if bounded. Apart from the fact that the current meta-effect might be subject to inadvertent under- and/or over-estimations of the current literature, the present meta-effect might strengthen with further refinements of the IRAP.

CONCLUSIONS

The current meta-effect provides the means to calculate what sample size would be required to achieve a statistical power of .80 when testing the criterion validity of clinically-focused IRAP effects using a given parametric statistic. For example, first-order Pearson correlations would hypothetically require an N of 29-37 for such purposes depending upon how conservatively over-estimation of the present meta-effect is controlled for. Overall, the IRAP compares favourably with alternative implicit measures in clinical psychology.

To be or want to be: disentangling the role of actual versus ideal self in implicit self-esteem

A growing body of work suggests that both depressed and non-depressed individuals display implicit positivity towards the self. In the current study, we examined whether this positivity can be underpinned by two qualitatively distinct propositions related to actual ('I am good') or ideal ('I want to be good') self-esteem. Dysphoric and non-dysphoric participants completed a self-esteem Implicit Association Test (IAT) as well an Implicit Relational Assessment Procedure (IRAP) targeting their actual self-esteem and an IRAP targeting ideal self-esteem. Both groups demonstrated similar and positive IAT effects. A more complex picture emerged with regard to the IRAP effects. Whereas non-dysphorics did not differ in their actual and ideal self-esteem, their dysphoric counterparts demonstrated lower actual than ideal self-esteem. Our results suggest that closer attention to the role of propositional processes in implicit measures may unlock novel insight into the relationship between implicit self-esteem and depression.