1
|
Mavrogiorgou P, Becker S, Juckel G. Guilt and Shame in Patients with Obsessive-Compulsive Disorders. Psychopathology 2024:1-11. [PMID: 38657572 DOI: 10.1159/000537996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/21/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Obsessive-compulsive disorder (OCD) is a tremendous psychiatric illness with a variety of severe symptoms. Feelings of shame and guilt are universal social emotions that fundamentally shape the way people interact with each other. Mental illness is therefore often related to pronounced feelings of shame and guilt in a maladaptive form. METHODS A total of 62 participants (38 women and 24 men) were clinically and psychometrically investigated. RESULTS The OCD patients (n = 31) showed a maladaptive guilt and shame profile, characterized by increased interpersonal feelings of guilt accompanied by a stronger tendency to self-criticism and increased punitive sense of guilt with a simultaneous prevailing tendency to perfectionism, as well as an increased concern for the suffering of others. The proneness to profuse shame in OCD patients seems to be in the context of the violation of inner values and a negative self-image with persistent self-criticism. CONCLUSION Although there are limitations with a small sample size in this monocentric approach, our study underlines the importance of an individual consideration of the leading obsessive-compulsive symptomatology, especially in the context of very personal feelings of guilt and shame. Further multidimensional studies on guilt and shame could contribute to their implementation more strongly in individualized psychotherapy.
Collapse
Affiliation(s)
- Paraskevi Mavrogiorgou
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital of Ruhr, University Bochum, Bochum, Germany
| | - Sarah Becker
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital of Ruhr, University Bochum, Bochum, Germany
| | - Georg Juckel
- Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital of Ruhr, University Bochum, Bochum, Germany
| |
Collapse
|
2
|
Öztürk Y, Özyurt G, Turan S, Tufan AE, Akay AP. Emotion dysregulation and social communication problems but not ToM properties may predict obsessive-compulsive disorder symptom severity. Nord J Psychiatry 2023; 77:778-787. [PMID: 37665655 DOI: 10.1080/08039488.2023.2251953] [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: 03/30/2023] [Revised: 07/06/2023] [Accepted: 08/16/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE Studies have shown that theory of mind, emotion regulation and pragmatic abilities are negatively affected in people with obsessive-compulsive disorder (OCD). We aimed to investigate theory of mind (ToM) abilities, social responsiveness, pragmatic language, and emotion regulation skills in children with OCD and to compare them to healthy controls. METHODS This study was designed as a single-center, cross-sectional, case-control study. ToM abilities were evaluated via "Reading the Mind in the Eyes Test" (RMET), "Faces Test", "Faux-Pas Test", "Comprehension Test" and "Unexpected Outcomes Test". Social responsiveness, pragmatic language and emotion regulation were evaluated by Social Responsiveness Scale (SRS), Children's Communication Checklist- Second Edition (CCC-2), Difficulties in Emotion Regulation Scale (DERS) and Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Within the study period, we enrolled 85 adolescents (42 with OCD and 43 controls). RESULTS The OCD group performed significantly lower than healthy controls in the Faux Pass and Comprehension tests (p = 0.003 for both). We found a statistically significant difference between groups in terms of the goal, strategy, non-acceptance subscales of the DERS (p < 0.001, p = 0.006, p = 0.008, respectively) as well as the total DERS score (p < 0.001). CY-BOCS total scores correlated significantly and negatively with Comprehension, Faux Pas and Unexpected Outcomes tests, and positively with CCC total, SRS total and DERS total scores. In regression analysis the DERS, SRS and CCC tests emerged as significant predictors of CY-BOCS total score. CONCLUSION Addressing ToM, pragmatic, and ER difficulties when planning the treatment of young people with OCD may contribute to positive outcomes.
Collapse
Affiliation(s)
- Yusuf Öztürk
- Department of Child and Adolescent Psychiatry, Bolu Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - Gonca Özyurt
- Department of Child and Adolescent Psychiatry, Izmir Katip Çelebi University Medical Faculty, İzmir, Turkey
| | - Serkan Turan
- Department of Child and Adolescent Psychiatry, Uludağ University Medical Faculty, Bursa, Turkey
| | - Ali Evren Tufan
- Department of Child and Adolescent Psychiatry, Bolu Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - Aynur Pekcanlar Akay
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Medical Faculty, Izmir, Turkey
| |
Collapse
|
4
|
Pereira AT, Araújo A, Azevedo J, Marques CC, Soares MJ, Cabaços C, Marques M, Pereira D, Pato M, Macedo A. The Postpartum Obsessive-Compulsive Scale: Psychometric, Operative and Epidemiologic Study in a Portuguese Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10624. [PMID: 36078340 PMCID: PMC9517828 DOI: 10.3390/ijerph191710624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Although obsessive-compulsive (OC) symptoms are common in the perinatal period, measures to comprehensively assess their presence, frequency, interference and severity are lacking. The Perinatal Obsessive-Compulsive Scale (POCS) is the only self-report questionnaire with context-specific items. It includes items to assess perinatal-specific obsessions and compulsions, a severity scale and an interference scale. OBJECTIVES (1) to analyze the validity and reliability of the Portuguese version of the POCS; (2) to find Obsessive-Compulsive Disorder (OCD) prevalence in postpartum and determine the POCS cut-off scores and its accuracy (sensitivity, specificity and predictive values) in screening for OCD according to DSM-5 criteria; (3) to describe the prevalence, content, severity, interference and onset of OC symptoms in the postpartum. METHODS 212 women in postpartum filled in a booklet, including the POCS Portuguese preliminary version, the Perinatal Anxiety Screening Scale and the Postpartum Depression Screening Scale; they were interviewed with the Diagnostic Interview for Psychological Distress-Postpartum. RESULTS Confirmatory Factor Analysis revealed that POCS presented acceptable fit indexes (χ2/df = 2.2971; CFI= 0.9319; GFI = 0.8574; TLI = 0.9127; RMSEA = 0.860, p < 0.001). The Cronbach's alphas were all > 0.800. The POCS cut-off point that maximized the Youden Index (J = 0.86, 95% CI [0.94-0.99]) was 20, corresponding to an Area Under the Curve of 0.970 (p < 0.001; Standard Error = 0.031; 95% CI: 0.937 to 0.988). The prevalence of postpartum OCD was 3.30%. The severity of thoughts and behaviors was moderate to severe for approximately 15% of women. For thirty-five percent of women, the onset of symptoms was in the first three months postpartum. CONCLUSIONS The Portuguese version of POCS has good validity, reliability and accuracy and may be considered ready for use in both clinic and research fields. POCS provides specific information regarding symptoms and individual patterns experienced by each woman, which allows normalization, destigmatization and personalized intervention.
Collapse
Affiliation(s)
- Ana Telma Pereira
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Ana Araújo
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- Department of Psychiatry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
| | - Julieta Azevedo
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, s/n, 3000-115 Coimbra, Portugal
| | - Cristiana C. Marques
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, s/n, 3000-115 Coimbra, Portugal
| | - Maria João Soares
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
| | - Carolina Cabaços
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Department of Psychiatry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
| | - Mariana Marques
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Department of Psychiatry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive-Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, s/n, 3000-115 Coimbra, Portugal
| | - Daniela Pereira
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Department of Psychiatry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
| | - Michele Pato
- Keck School of Medicine of the University of Southern California, 1975 Zonal Ave., Los Angeles, CA 90033, USA
| | - António Macedo
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Rua Larga, 3004-504 Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal
- Department of Psychiatry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, 3004-561 Coimbra, Portugal
| |
Collapse
|