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Tempia Valenta S, Campanile G, Albert U, Marcolini F, Faedi G, De Ronchi D, Atti AR. Beyond the surface: Understanding obsessive symptoms and body perceptions, from shape concerns to fear of blushing. Compr Psychiatry 2024; 132:152481. [PMID: 38552348 DOI: 10.1016/j.comppsych.2024.152481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/16/2024] [Accepted: 03/25/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Recent reclassifications have expanded the understanding of Obsessive-Compulsive Disorders (OCDs), now incorporated into a broader category known as Obsessive-Compulsive Disorder and Related Disorders (OCRDs). This study sought to assess obsessive-compulsive symptoms and body uneasiness among outpatients seeking treatment for Eating Disorders (ED). Additionally, we aimed to explore associations and potential mediation effects between obsessive-compulsive symptoms and body uneasiness. This investigation extended beyond concerns related solely to body shape and weight, encompassing fears associated with specific body components (such as facial features, abdominal region, and limbs) or functions (including sweating, blushing, emitting noises, and releasing odors). METHODS Psychometric assessments included the Obsessive-Compulsive Inventory-Revised (OCI-R) and the Body Uneasiness Test (BUT). Statistical analyses involved bivariate correlations, linear regression, and mediation analysis to explore the associations and potential mediation effects between obsessive-compulsive symptoms and different manifestations of body uneasiness. RESULTS The sample (N = 210) demonstrated substantial obsessive-compulsive symptoms and notable body discomfort. OCI-R scores positively correlated with various dimensions of body dissatisfaction, including shape, weight, and specific body components or functions. Linear regression revealed significant associations between OCI-R scores and overall body uneasiness (BUT-A) as well as concerns about body components or functions (BUTB). Mediation analysis indicated that BUT-A mediated the relationship between obsessive-compulsive symptoms and BUTB. CONCLUSION This study offers new insights into the comprehensive landscape of OCRDs. It specifically emphasizes the association between obsessive-compulsive symptoms and body uneasiness, embracing not only concerns about body shape and weight but also extending to body components and functions.
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Affiliation(s)
- S Tempia Valenta
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - G Campanile
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - U Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - F Marcolini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - G Faedi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - D De Ronchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - A R Atti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Aljhani S. Fluoxetine for the treatment of onychotillomania associated with obsessive–compulsive disorder: a case report. J Med Case Rep 2022; 16:431. [DOI: 10.1186/s13256-022-03652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022] Open
Abstract
Abstract
Background
Obsessive–compulsive disorder is a condition in which patients experience an obsession and/or a compulsion. It has a high impact on the quality of life, and is associated with an increased prevalence of psychiatric comorbidities in patients. Onychotillomania is an underestimated psychodermatosis caused by repeated self-inflicted damage to the nail unit. In patients, it is characterized by an obsessive or irrepressible impulse to repeatedly damage their own nails, resulting in their destruction. It is a chronic condition that is difficult to manage, largely because of its psychocutaneous character, as well as its high tendency to interact with underlying neuropsychiatric diseases or other behavioral disorders. Only a few studies have reported an association between obsessive–compulsive disorder and onychotillomania, which typically presents with therapeutic challenges. Cognitive behavioral therapy, physical-barrier approaches, and pharmaceutical treatments have been reported to be beneficial in the management of onychotillomania; however, no major clinical studies have investigated the effectiveness of these therapies. Onychotillomania remains a clinical and therapeutic issue owing to the lack of evidence-based treatment techniques.
Case presentation
We report a case of an 18-year-old, middle-eastern female patient who developed onychotillomania when she was being treated with paroxetine for obsessive–compulsive disorder and was showing partial improvement. The patient developed side effects from paroxetine, and was switched to fluoxetine. Thereafter, improvement in her obsessive–compulsive disorder was observed, which relapsed when treatment was discontinued. However, the onychotillomania symptoms did not reemerge.
Conclusion
Onychotillomania typically presents both diagnostic and therapeutic challenges. Fluoxetine plays an important role in the treatment of onychotillomania and other psychiatric disorders. However, large-scale studies should be conducted before these outcomes can be generalized.
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Mitra S, Bult-Ito A. Bidirectional Behavioral Selection in Mice: A Novel Pre-clinical Approach to Examining Compulsivity. Front Psychiatry 2021; 12:716619. [PMID: 34566718 PMCID: PMC8458042 DOI: 10.3389/fpsyt.2021.716619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) and related disorders (OCRD) is one of the most prevalent neuropsychiatric disorders with no definitive etiology. The pathophysiological attributes of OCD are driven by a multitude of factors that involve polygenic mechanisms, gender, neurochemistry, physiological status, environmental exposures and complex interactions among these factors. Such complex intertwining of contributing factors imparts clinical heterogeneity to the disorder making it challenging for therapeutic intervention. Mouse strains selected for excessive levels of nest- building behavior exhibit a spontaneous, stable and predictable compulsive-like behavioral phenotype. These compulsive-like mice exhibit heterogeneity in expression of compulsive-like and other adjunct behaviors that might serve as a valuable animal equivalent for examining the interactions of genetics, sex and environmental factors in influencing the pathophysiology of OCD. The current review summarizes the existing findings on the compulsive-like mice that bolster their face, construct and predictive validity for studying various dimensions of compulsive and associated behaviors often reported in clinical OCD and OCRD.
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Affiliation(s)
- Swarup Mitra
- Department of Pharmacology and Toxicology, State University of New York at Buffalo, Buffalo, NY, United States
| | - Abel Bult-Ito
- Department of Biology and Wildlife, University of Alaska Fairbanks, Fairbanks, AK, United States
- OCRD Biomed LLC, Fairbanks, AK, United States
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Sil A, Priyam P, Mondol DK. NAIL BITER'S WART: HANDS THAT FEED THE MOUTH. J Paediatr Child Health 2020; 56:991. [PMID: 32567776 DOI: 10.1111/jpc.14920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/23/2020] [Accepted: 04/14/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Abheek Sil
- Department of Dermatology, Venereology, and Leprosy, R.G. Kar Medical College, Kolkata, India
| | - Pallavi Priyam
- Department of Psychiatry, R.G. Kar Medical College, Kolkata, India
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Storch EA, Gregory S, Salloum A, Quast T. Psychopharmacology Utilization Among Children with Anxiety and Obsessive-Compulsive and Related Disorders Following Hurricane Katrina. Child Psychiatry Hum Dev 2018; 49:632-642. [PMID: 29299728 PMCID: PMC11189098 DOI: 10.1007/s10578-017-0779-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This study aimed to examine the impact of Hurricane Katrina exposure on medication utilization among children with pre-existing anxiety and obsessive-compulsive and related disorders (OCRDs). Medicaid claims data from 2004 to 2006 were analyzed. Children with pre-existing anxiety/OCRDs were compared as a function of those living in a Louisiana disaster area, Louisiana non-disaster area, or Texas in terms of filled prescriptions and average days medication supply. This was further examined as a function of disorder/medication type. Prescriptions filled and average days medication supply were lower for those who resided in the disaster area of Louisiana relative to non-disaster zones in Texas (but not Louisiana). Children with OCD who lived in a disaster zone in Louisiana had 16.6 fewer days supply of antidepressants relative to youth in Texas. Similarly, children with PTSD who lived in a disaster zone in Louisiana had approximately 7 fewer days supply of stimulant medication relative to those who lived in Texas. Medication utilization was reduced for those youth directly exposed to Katrina relative to children in Texas, suggesting potential service disruption. Children with OCD and PTSD may be more likely to experience treatment disruption. Following disasters, particular attention should be given to ensuring continued treatment access for youth with pre-existing anxiety and OCRDs (as well as other conditions).
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Affiliation(s)
- Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, USA.
| | | | - Alison Salloum
- School of Social Work, University of South Florida, Tampa, USA
| | - Troy Quast
- Department of Psychiatry & Behavioral Neurosciences, University of South Florida, Tampa, USA
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Koo MS, Kim EJ, Roh D, Kim CH. Role of dopamine in the pathophysiology and treatment of obsessive–compulsive disorder. Expert Rev Neurother 2014; 10:275-90. [DOI: 10.1586/ern.09.148] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Exposure and Response Prevention and Habit Reversal Training: Commonalities, Differential Use, and Combined Applications. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2013. [DOI: 10.1007/s10879-013-9234-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Karakaş Uğurlu G, Uğurlu M, Cayköylü A. The emergence of obsessive compulsive and compulsive buying symptomatology after acute stress and short-term use of ribavirin: case reports. Ther Adv Psychopharmacol 2013; 3:246-50. [PMID: 24167697 PMCID: PMC3805427 DOI: 10.1177/2045125312467346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Görkem Karakaş Uğurlu
- Ministry of Health Ankara Atatürk Training and Research Hospital, Bilkent road, Number: 3 Bilkent / Ankara 06800, Turkey
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Prazeres AM, Nascimento AL, Fontenelle LF. Cognitive-behavioral therapy for body dysmorphic disorder: a review of its efficacy. Neuropsychiatr Dis Treat 2013; 9:307-16. [PMID: 23467711 PMCID: PMC3589080 DOI: 10.2147/ndt.s41074] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to review the efficacy of different methods of cognitive and/or behavioral therapies used to treat body dysmorphic disorder. We evaluated all case series, open studies, controlled trials, and meta-analyses of cognitive and/or behavioral treatment approaches to body dysmorphic disorder published up to July 2012, identified through a search in the PubMed/Medline, PsycINFO, ISI Web of Knowledge, and Scopus databases. Our findings indicate that individual and group cognitive behavioral therapies are superior to waiting list for the treatment of body dysmorphic disorder. While the efficacy of cognitive therapy is supported by one controlled trial, utility of behavioral therapy is suggested by one open study and one controlled relapse prevention follow-up study. There is a pressing need to conduct head-to-head studies, with appropriate, active, control treatment groups, in order to examine further the efficacy of cognitive and/or behavioral therapies for body dysmorphic disorder.
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Affiliation(s)
- Angélica M Prazeres
- Anxiety and Depression Research Program, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Abstract
This case report describes a 20-year-old man with trichotillomania (TTM). The patient was first treated with paroxetine and carbocisteine without response. Following the addition of aripiprazole (3 mg/d) to the other medications, the TTM was fully alleviated. After stopping treatment, 1.5 to 3.0 mg/d of aripiprazole alone improved TMM symptoms upon recurrence. These findings indicate that further investigation of low-dose aripiprazole for the treatment of TTM is warranted.
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Correlates of obsessive-compulsive disorder in a sample of HIV-positive, methamphetamine-using men who have sex with men. AIDS Behav 2011; 15:1153-60. [PMID: 20532606 PMCID: PMC2978745 DOI: 10.1007/s10461-010-9719-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Substance use has been identified as a risk factor for elevated levels of obsessive-compulsive disorder (OCD). This study examined methamphetamine use and sexual risk behaviors as correlates of OCD in a sample of 245 HIV-positive men having sex with men (MSM) in San Diego, CA. In a logistic regression analysis, OCD was associated with greater frequency of methamphetamine use, more depressive symptoms, seeking out risky venues and risky sexual partners when "high" on methamphetamine, and reporting fewer sex acts in the past 2 months. These data suggest the need for increased awareness and understanding of the role that OCD may play in the drug use behaviors and risky sexual practices of methamphetamine users.
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Letourneau G, Stip E. Plea to establish a registry of clinical trials on cognitive-behavioural therapies and cognitive remediation. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2011; 56:189; author reply 189-90. [PMID: 21560784 DOI: 10.1177/070674371105600311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Affiliation(s)
- Gen Kanayama
- Department of Psychiatry, Harvard Medical School, Biological Psychiatry Laboratory, McLean Hospital, Belmont, MA 02478, USA
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Current world literature. Curr Opin Psychiatry 2011; 24:78-87. [PMID: 21116133 DOI: 10.1097/yco.0b013e3283423055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
PURPOSE OF REVIEW Controversy exists about the diagnostic grouping of obsessive-compulsive spectrum disorders (OCSDs) - conditions that are to some extent related to obsessive-compulsive disorder (OCD). This review will re-examine OCSDs in light of the currently available evidence. RECENT FINDINGS It appears that OCSDs will not constitute a separate nosological group and, if this term is accepted, OCSDs may be grouped together with the anxiety disorders. Much needs to be done to refine the criteria for membership in the OCSDs. In contrast to previous proposals, only a few disorders may be included in the spectrum. The most likely candidates for membership are body dysmorphic disorder and hoarding disorder, if the latter becomes an independent condition. Mixed, but relatively strong, support for inclusion also exists for Tourette's disorder and trichotillomania. SUMMARY The concept of OCSDs is largely a product of an unbridled nosographical activity, resulting from a selective focus on the similar clinical features and an oversight of the important differences. While the links between some of the putative OCSDs seem important, the question remains as to whether the introduction of the spectrum to a diagnostic and classification system would significantly improve our understanding of these links.
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Ravindran AV, Al-Subaie A, Abraham G. Quetiapine: novel uses in the treatment of depressive and anxiety disorders. Expert Opin Investig Drugs 2010; 19:1187-204. [DOI: 10.1517/13543784.2010.515586] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Mueller A, Mitchell JE, Black DW, Crosby RD, Berg K, de Zwaan M. Latent profile analysis and comorbidity in a sample of individuals with compulsive buying disorder. Psychiatry Res 2010; 178:348-53. [PMID: 20471099 DOI: 10.1016/j.psychres.2010.04.021] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2009] [Revised: 01/27/2010] [Accepted: 04/18/2010] [Indexed: 10/19/2022]
Abstract
The aims of this study were to perform a latent profile analysis in a sample of individuals with compulsive buying, to explore the psychiatric comorbidity, and to examine whether or not more severe compulsive buying is associated with greater comorbidity. Compulsive buying measures and SCID data obtained from 171 patients with compulsive buying behavior who had participated in treatment trials at different clinical centers in the U.S. and Germany were analyzed. Latent profile analysis produced two clusters. Overall, cluster 2, included subjects with more severe compulsive buying, and was characterized by higher lifetime as well as current prevalence rates for Axis I and impulse control disorders. Nearly 90% of the total sample reported at least one lifetime Axis I diagnosis, particularly mood (74%) and anxiety (57%) disorders. Twenty-one percent had a comorbid impulse control disorder, most commonly intermittent explosive disorder (11%). Half of the sample presented with at least one current Axis I disorder, most commonly anxiety disorders (44%). Given the substantial psychiatric comorbidity, it is reasonable to question whether or not compulsive buying represents a distinct psychiatric entity vs. an epiphenomenon of other psychiatric disorders.
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Affiliation(s)
- Astrid Mueller
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Germany.
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Phillips KA, Stein DJ, Rauch SL, Hollander E, Fallon BA, Barsky A, Fineberg N, Mataix-Cols D, Ferrão YA, Saxena S, Wilhelm S, Kelly MM, Clark LA, Pinto A, Bienvenu OJ, Farrow J, Leckman J. Should an obsessive-compulsive spectrum grouping of disorders be included in DSM-V? Depress Anxiety 2010; 27:528-55. [PMID: 20533367 PMCID: PMC3985410 DOI: 10.1002/da.20705] [Citation(s) in RCA: 139] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The obsessive-compulsive (OC) spectrum has been discussed in the literature for two decades. Proponents of this concept propose that certain disorders characterized by repetitive thoughts and/or behaviors are related to obsessive-compulsive disorder (OCD), and suggest that such disorders be grouped together in the same category (i.e. grouping, or "chapter") in DSM. This article addresses this topic and presents options and preliminary recommendations to be considered for DSM-V. The article builds upon and extends prior reviews of this topic that were prepared for and discussed at a DSM-V Research Planning Conference on Obsessive-Compulsive Spectrum Disorders held in 2006. Our preliminary recommendation is that an OC-spectrum grouping of disorders be included in DSM-V. Furthermore, we preliminarily recommend that consideration be given to including this group of disorders within a larger supraordinate category of "Anxiety and Obsessive-Compulsive Spectrum Disorders." These preliminary recommendations must be evaluated in light of recommendations for, and constraints upon, the overall structure of DSM-V.
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Ille R, Dietmaier G, Müller S, Schienle A. Die Bedeutung von Ekel- und Angstsensitivität bei Personen mit der Verdachtsdiagnose einer Hypochondrie. ACTA ACUST UNITED AC 2010. [DOI: 10.1024/1661-4747.a000030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zentrales Merkmal bei der hypochondrischen Störung ist die Befürchtung, an einer schweren Erkrankung zu leiden. Dies führt zur Fehlinterpretation normaler Körperfunktionen. Neben dysfunktionalen Angstzuständen ist auch stark ausgeprägte Angstsensitivität störungsrelevant. Das aktuelle Hypochondriekonzept ist vorwiegend angstfokussiert, während die Bedeutung anderer Emotionen wie zum Beispiel von Ekel bisher kaum untersucht wurde. Ziel dieser Untersuchung war es herauszufinden, ob die habituelle Ekelneigung einen zusätzlichen Prädiktor für die Vorhersage von Hypochondrie darstellt. Nach einem Screening mit einem standardisierten klinischen Interview wurden 27 Personen mit und 27 Personen ohne Verdachtsdiagnose Hypochondrie in die Studie eingeschlossen und getestet. Mittels Diskriminanzanalyse wurde überprüft, ob Ekelempfindlichkeit (Neigung einer Person, mit Ekel zu reagieren) und Ekelsensitivität (Neigung, Ekelempfindungen als bedrohlich zu bewerten) für die Gruppentrennung in Personen mit und ohne Verdachtsdiagnose Hypochondrie (Kriterium: Whitely Index) relevant sind. Es zeigte sich, dass habituelle Angst, Ekelsensitivität und spezifische Bereiche der Ekelempfindlichkeit (z. B. Abneigung vor mangelhafter Hygiene) zwischen den beiden Gruppen differenzierten. Domänenspezifische Beziehungen zwischen Ekelempfindlichkeit und Hypochondrie werden diskutiert.
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Affiliation(s)
- Rottraut Ille
- Institut für Psychologie, Karl-Franzens-Universität Graz
| | | | | | - Anne Schienle
- Institut für Psychologie, Karl-Franzens-Universität Graz
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