1
|
García-Soriano G, Carrasco Á, Emerson LM. Obsessional intrusive thoughts in children: An interview based study. Psychol Psychother 2023; 96:249-262. [PMID: 36351751 PMCID: PMC10099857 DOI: 10.1111/papt.12437] [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: 07/15/2022] [Revised: 09/29/2022] [Accepted: 10/22/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES We aimed to investigate the experience of obsessional intrusive thoughts (OITs) in a sample of children aged 8 to 10 years old and to test the main tenets of the cognitive model of OCD. Specifically, we assessed: (1) the prevalence of OITs experienced by young children; (2) their frequency and content; (3) the emotions they evoke; (4) the reasons why they are upsetting; (5) how they are appraised (6) and what control strategies they use. METHODS Forty-nine children (28 girls, 21 boys; mean age 9.1 years) from the community completed two self-report questionnaires assessing anxiety and obsessive-compulsive symptoms. Children were interviewed using the Children's Anxious Thoughts Interview, which assessed their experiences of OITs. RESULTS From the 49 participants, 71.43% reported having experienced at least one OIT. The most frequent contents related to harm and doubt. Of the total sample, 28.6% reported having experienced one OIT recently with at least moderate frequency; these participants reported higher anxiety and obsessive-compulsive interference, described feeling nervous and anxious when experiencing their OIT, and rated their OIT as highly important and distracting. The most frequently reported control strategies were cognitive - suppression, distraction and thought replacement. CONCLUSIONS Almost two thirds of community children reported experiencing OITs. The findings from this study provide preliminary support for the application of the cognitive model of OCD in children. Subtle differences from previous research with adults are discussed.
Collapse
Affiliation(s)
- Gemma García-Soriano
- Dpto Personalidad, Evaluación y Tratamientos Psicológicos, Universitat de València, Valencia, Spain
| | - Ángel Carrasco
- U. de Salud Mental Infantil de Catarroja, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Lisa Marie Emerson
- Faculty of Health, School of Health Sciences, University of Canterbury, Christchurch, New Zealand
| |
Collapse
|
2
|
Pedersen H, Grønnæss I, Bendixen M, Hagen R, Kennair LEO. Metacognitions and brooding predict depressive symptoms in a community adolescent sample. BMC Psychiatry 2022; 22:157. [PMID: 35232425 PMCID: PMC8887018 DOI: 10.1186/s12888-022-03779-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/08/2022] [Indexed: 02/01/2023] Open
Abstract
Depressive symptoms are prevalent in adolescence, and girls have higher levels of depressive symptoms and depressive disorder than boys. Rumination and especially brooding, seem to be a central maintaining factor of depressive symptoms, where metacognitions about rumination play a prominent role in maintaining depressive rumination. There is a sex difference in adults in depressive disorder. The current investigation of a high school / community sample of adolescents aged 16-20 from Norway (N = 1198, 62.2% women) found that adolescent women had higher scores than men on all relevant measures: Depressive symptoms, negative and positive metacognitions, pondering, and brooding. A path model for predicting depressive symptoms showed that the major factors for both sexes were negative metacognitions and brooding. The predictors of depressive symptoms were invariant across sex and age groups, suggesting similar underlying mechanisms across these groups. The overall findings suggest that metacognitive therapy may be an efficient intervention for depressive symptoms among adolescents.
Collapse
Affiliation(s)
- Helene Pedersen
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ingrid Grønnæss
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mons Bendixen
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Roger Hagen
- grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway ,grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Oslo, Norway ,grid.5510.10000 0004 1936 8921Research institute, Modum Bad, Vikersund, Norway
| | | |
Collapse
|
3
|
Cervin M, Pozza A, Barcaccia B, Dèttore D. Internalized psychopathology dimensions in middle childhood: Cross-sectional and temporal associations. J Anxiety Disord 2020; 76:102300. [PMID: 32942083 DOI: 10.1016/j.janxdis.2020.102300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 06/18/2020] [Accepted: 08/30/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Anxiety, depression, and obsessive-compulsive symptoms often onset during middle childhood and are major causes of disability in young individuals. A better understanding of how these symptoms are linked and unfold over time is important to develop valid etiological models and effective prevention and treatment. METHODS In the present study, 950 community children (8-14 years) reported on a broad range of internalised symptoms at three time points over the course of a year. First, factor analysis was used to examine the overarching dimensions of these symptoms. Second, network analysis was used to examine unique cross-sectional associations among these empirically supported symptom dimensions. Last, longitudinal structural equation models (SEMs) were used to examine temporal associations among the symptom dimensions. RESULTS Six broad symptom dimensions fitted the self-report data well at all time points. These dimensions were conceptualized as depression, general anxiety, situational fears, compulsivity, intrusive thoughts, and somatic anxiety. Network analysis showed that these dimensions formed a highly interconnected network with general anxiety and somatic anxiety being most central (i.e., most strongly associated with other dimensions) at all time points. Longitudinal SEMs supported the central role played by general anxiety in the temporal associations among these dimensions. CONCLUSIONS Overarching expressions of internalized psychopathology are highly interconnected in middle childhood with possible central roles played by general and somatic anxiety. Interventions aimed at a general proneness for anxiety may be warranted in preventing and treating internalizing symptoms in middle childhood.
Collapse
Affiliation(s)
- Matti Cervin
- Faculty of Medicine, Lund University, Lund, Sweden
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
| | - Barbara Barcaccia
- Department of Education, Roma Tre University, Rome, Italy; Associazione di Psicologia Cognitiva (APC) and Scuola di Psicoterapia Cognitiva srl (SPC), Rome, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
| |
Collapse
|
4
|
Myers SG, Solem S, Wells A. The Metacognitions Questionnaire and Its Derivatives in Children and Adolescents: A Systematic Review of Psychometric Properties. Front Psychol 2019; 10:1871. [PMID: 31551843 PMCID: PMC6737041 DOI: 10.3389/fpsyg.2019.01871] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 07/30/2019] [Indexed: 01/16/2023] Open
Abstract
Background: The Metacognitions Questionnaire (MCQ) and its derivatives have been instrumental in research examining the Self-Regulatory Executive Function Model in adults. Studies testing whether findings are applicable to children and adolescents have been increasing and several different measures adapting the MCQ for younger populations have been developed. The current study aimed to systematically review the psychometric properties of MCQ measures or derivatives used in young people (aged 18 or less), to help assess current findings in this population and to guide future research in this growing area of investigation. Method: Systematic searches were carried out on PubMed and PsycINFO of studies published up to June 2018. Additional studies were identified through Google Scholar and article references. Validity, reliability, range and responsiveness of measures were examined as well as analyses of age and gender differences on scores. Results: Forty-five articles were identified. The total sample consisted of 7,803 children and adolescents (6,922 non-clinical, 881 clinical) aged 7-18. Studies used one of seven versions of the questionnaire, five adapted from the MCQ for younger populations: (1) The Metacognitions Questionnaire-Adolescent version; (2) The Metacognitions Questionnaire-Child version; (3) The Metacognitions Questionnaire-Child Version-Revised; (4) The Metacognitions Questionnaire-Child-30; and (5) The Metacognitions Questionnaire-65 Positive Beliefs Scale Revised; and two adult versions used without adaptation: (1) The Metacognitions Questionnaire-30 and (2) The Cognitive Self Consciousness Scale-Expanded. The validity and reliability of the Metacognitions Questionnaire-Adolescent version had the most extensive support. Other questionnaires had either mixed psychometrics or promising initial findings but more limited data. Conclusions: It is recommended that studies using adolescents (age 12-18) consider using the Metacognitions Questionnaire-Adolescent version. Based on initial data, it is suggested studies using younger populations should consider the Metacognitions Questionnaire-Child-30 but further psychometric research into this and other measures is needed.
Collapse
Affiliation(s)
- Samuel G. Myers
- Division of Psychology, Bar Ilan University, Ramat-Gan, Israel
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Adrian Wells
- Division of Clinical and Health Psychology, The University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Prestwich, United Kingdom
| |
Collapse
|
5
|
Riesel A, Klawohn J, Kathmann N, Endrass T. Conflict monitoring and adaptation as reflected by N2 amplitude in obsessive-compulsive disorder. Psychol Med 2017; 47:1379-1388. [PMID: 28095945 DOI: 10.1017/s0033291716003597] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Feelings of doubt and perseverative behaviours are key symptoms of obsessive-compulsive disorder (OCD) and have been linked to hyperactive error and conflict signals in the brain. While enhanced neural correlates of error monitoring have been robustly shown, far less is known about conflict processing and adaptation in OCD. METHOD We examined event-related potentials during conflict processing in 70 patients with OCD and 70 matched healthy comparison participants, focusing on the stimulus-locked N2 elicited in a flanker task. Conflict adaptation was evaluated by analysing sequential adjustments in N2 and behaviour, i.e. current conflict effects as a function of preceding conflict. RESULTS Patients with OCD showed enhanced N2 amplitudes compared with healthy controls. Further, patients showed stronger conflict adaptation effects on reaction times and N2 amplitude. Thus, the effect of previous compatibility was larger in patients than in healthy participants as indicated by greater N2 adjustments in change trials (i.e. iC, cI). As a result of stronger conflict adaptation in patients, N2 amplitudes were comparable between groups in incompatible trials following incompatible trials. CONCLUSIONS Larger N2 amplitudes and greater conflict adaptation in OCD point to enhanced conflict monitoring leading to increased recruitment of cognitive control in patients. This was most pronounced in change trials and was associated with stronger conflict adjustment in N2 and behaviour. Thus, hyperactive conflict monitoring in OCD may be beneficial in situations that require a high amount of control to resolve conflict, but may also reflect an effortful process that is linked to distress and symptoms of OCD.
Collapse
Affiliation(s)
- A Riesel
- Department of Psychology,Humboldt-Universität zu Berlin,Berlin,Germany
| | - J Klawohn
- Department of Psychology,Humboldt-Universität zu Berlin,Berlin,Germany
| | - N Kathmann
- Department of Psychology,Humboldt-Universität zu Berlin,Berlin,Germany
| | - T Endrass
- Department of Psychology,Humboldt-Universität zu Berlin,Berlin,Germany
| |
Collapse
|
6
|
Specificity of performance monitoring changes in obsessive-compulsive disorder. Neurosci Biobehav Rev 2014; 46 Pt 1:124-38. [DOI: 10.1016/j.neubiorev.2014.03.024] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 01/10/2014] [Accepted: 03/21/2014] [Indexed: 12/30/2022]
|
7
|
Coles ME, Ravid A, Franklin ME, Storch EA, Khanna M. Obsessive-Compulsive Symptoms and Beliefs in Adolescents: A Cross-Sectional Examination of Cognitive Models. J Cogn Psychother 2014; 28:251-263. [PMID: 32759123 DOI: 10.1891/0889-8391.28.4.251] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cognitive models of obsessive-compulsive disorder (OCD) posit that particular beliefs transform normal intrusions into disturbing obsessions. A wealth of data shows that such beliefs and obsessive-compulsive (OC) symptoms are related in adults. However, there is markedly less information regarding OCD-related beliefs in youth. The purpose of this study was to assess the relation between OCD-related beliefs and OC symptoms in unselected adolescents (ages 13-18 years; N = 159). Findings from questionnaires completed on the Internet were consistent with previous findings in adults. Increased levels of OCD-related beliefs were related to increased levels of OC symptoms. Perfectionism and certainty beliefs had a specific relation with symmetry and ordering symptoms. Contrary to expectation, levels of OCD-related beliefs in this unselected sample were similar to those found in prior studies of youth diagnosed with OCD. Implications, limitations, and future directions for the study of OCD-related beliefs in youth are discussed.
Collapse
Affiliation(s)
| | | | | | | | - Muniya Khanna
- Children's and Adult Center for OCD and Anxiety, Philadelphia, Pennsylvania
| |
Collapse
|
8
|
Abstract
This article presents an overview of the existing, as well as newly developed, cognitive behavior therapy methods for treating the child anxiety triad (separation anxiety disorder, generalized anxiety disorder, and social phobia). For each disorder of the triad, the authors review diagnostic criteria, clinical presentation, disorder-specific treatment methods and innovations, and future directions for research.
Collapse
Affiliation(s)
- Martin E Franklin
- Department of Psychiatry, University of Pennsylvania School of Medicine, 3535 Market Street, 6th Floor, Philadelphia, PA 19104, USA.
| | | | | |
Collapse
|
9
|
Gill AH, Papageorgiou C, Gaskell SL, Wells A. Development and Preliminary Validation of the Thought Control Questionnaire for Adolescents (TCQ-A). COGNITIVE THERAPY AND RESEARCH 2012. [DOI: 10.1007/s10608-012-9465-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
10
|
McGuire JF, Lewin AB, Horng B, Murphy TK, Storch EA. The nature, assessment, and treatment of obsessive-compulsive disorder. Postgrad Med 2012; 124:152-65. [PMID: 22314125 DOI: 10.3810/pgm.2012.01.2528] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Obsessive-compulsive disorder (OCD) is an anxiety disorder that affects between 1% to 2% of individuals and causes considerable impairment and disability. Although > 50% of individuals experience symptom onset in childhood, symptoms can continue to develop throughout adulthood. Accurate and timely assessment of clinical presentation is critical to limit impairment and improve prognosis. Presently, there are 2 empirically supported treatments available for OCD in children and adults, namely cognitive-behavioral therapy and pharmacotherapy with serotonin reuptake inhibitors. This article provides an introduction to the phenomenology, etiology, and clinical course of OCD. Assessment practices used to evaluate symptom severity are described, and evidence-based treatment options are reviewed, with appropriate distinctions drawn between children and adults. Finally, recommendations for assessment and treatment practices for OCD are explicated.
Collapse
Affiliation(s)
- Joseph F McGuire
- Department of Psychology, University of South Florida, St. Petersburg, FL 33701, USA
| | | | | | | | | |
Collapse
|
11
|
Fontenelle LF, Lin A, Pantelis C, Wood SJ, Nelson B, Yung AR. Markers of vulnerability to obsessive-compulsive disorder in an ultra-high risk sample of patients who developed psychosis. Early Interv Psychiatry 2012; 6:201-6. [PMID: 22510335 DOI: 10.1111/j.1751-7893.2012.00357.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS The study aims to identify markers of vulnerability to obsessive-compulsive disorder (OCD) in an ultra-high risk sample of patients who developed psychosis. METHODS Three hundred and eleven patients at ultra-high risk for psychosis were examined at baseline and after a mean of 7.4 years follow-up. Patients who developed psychosis with OCD (PSY + OCD; n = 13) and psychosis without OCD (PSY - OCD; n = 45) were compared in terms of socio-demographic and clinical features. RESULTS PSY + OCD patients displayed greater severity of depression before and after conversion to PSY + OCD, and increased rates of depressive disorders before exhibiting PSY + OCD. However, they only displayed greater severity of anxiety and increased rates of non-OCD anxiety disorders after psychosis. Further, PSY + OCD patients were more likely to report a positive family history for anxiety disorders than PSY - OCD. CONCLUSION Although depression and a family history of anxiety disorder may act as vulnerability markers for OCD in psychosis, the resulting anxiety may be a correlate or a consequence of PSY + OCD.
Collapse
Affiliation(s)
- Leonardo F Fontenelle
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Australia.
| | | | | | | | | | | |
Collapse
|
12
|
Wolters LH, Hogendoorn SM, Oudega M, Vervoort L, de Haan E, Prins PJM, Boer F. Psychometric properties of the Dutch version of the Meta-Cognitions Questionnaire-Adolescent Version (MCQ-A) in non-clinical adolescents and adolescents with obsessive-compulsive disorder. J Anxiety Disord 2012; 26:343-51. [PMID: 22197341 DOI: 10.1016/j.janxdis.2011.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2011] [Revised: 11/03/2011] [Accepted: 11/28/2011] [Indexed: 12/18/2022]
Abstract
Although the meta-cognitive model (Wells, 1997, 2000) for obsessive-compulsive disorder (OCD) has clearly influenced research and treatment of OCD, little research has been performed in youth samples. In the present study the psychometric properties of the Dutch Meta-Cognitions Questionnaire-Adolescent Version (MCQ-A; Cartwright-Hatton et al., 2004) were examined in a clinical sample of adolescents with OCD (N = 40, 12-18 years) and a non-clinical sample (N = 317; 12-18 years). Results provided support for the 5-factor structure, and showed fair to good internal consistency and generally good retest reliability. Overall, adolescents with OCD reported more meta-cognitive beliefs than non-clinical adolescents. Several subscales were associated with self-reported obsessive-compulsive symptoms, anxiety and depression, but not with clinician-rated OCD severity. In conclusion, results suggest that the Dutch MCQ-A is a reliable and valid questionnaire to examine meta-cognitive beliefs in adolescents.
Collapse
Affiliation(s)
- Lidewij H Wolters
- Academic Medical Center, Department of Child and Adolescent Psychiatry, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
13
|
Affiliation(s)
- Martin E. Franklin
- Child/Adolescent OCD, Tics, Trichotillomania and Anxiety Group, Department of Psychiatry, University of Pennsylvania School of Medicine, and Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104
| | - Edna B. Foa
- Center for the Treatment and Study of Anxiety, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104;
| |
Collapse
|