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Kahya Y, Inozu M, Clark DA. Thematic Content Analysis of Repugnant Intrusions in Highly Religious Canadian and Turkish Samples. JOURNAL OF RELIGION AND HEALTH 2024; 63:2821-2846. [PMID: 36737537 DOI: 10.1007/s10943-023-01747-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
The degree of religiosity, a culturally relevant concept, has been associated with obsessive phenomena such as obsessional symptoms, the nature of unwanted intrusive thoughts, and responses to intrusive thoughts. Although previous research reported that repugnant (i.e., sexual and religious) intrusions had the lowest endorsement rates, these were also the most difficult to control and more likely to turn into obsessions. Highly religious individuals are more likely to be distressed by repugnant intrusions as the repugnant nature of intrusive thoughts critically threatens the perceived self. Thus, individuals with high religiosity may be more likely to respond to repugnant intrusions with dysfunctional strategies and thus become more vulnerable to OCD. This study presents the endorsement rates and qualitative features of sexual and religious intrusions among highly religious Canadian and Turkish samples. Highly religious participants were interviewed using the International Intrusive Thoughts Interview Schedule (IITIS). Thematic content analysis of the IITIS data was conducted with MAXQDA. Sexual intrusion themes of Forceful Sex, Gay Sex, Immoral Sex, and Sex with Undesirable People were identified in both samples. Religious intrusion themes of Questioning, How They Are Perceived by God, Violating Religious Doctrines, Punishment by God, and Worship also emerged in both samples. The percentages of these themes suggested the presence of cross-cultural qualitative similarities and differences.
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Affiliation(s)
- Yasemin Kahya
- Department of Psychology, Faculty of Social Sciences and Humanities, Social Sciences University of Ankara, Hükümet Meydanı No: 2, 06050, Ulus, Altındağ, Ankara, Turkey.
| | - Mujgan Inozu
- Department of Psychology, Hacettepe University, Ankara, Turkey
| | - David A Clark
- Department of Psychology, University of New Brunswick, Fredericton, Canada
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Weiss F, Schwarz K, Endrass T. Exploring the relationship between context and obsessions in individuals with obsessive-compulsive disorder symptoms: a narrative review. Front Psychiatry 2024; 15:1353962. [PMID: 38419899 PMCID: PMC10899460 DOI: 10.3389/fpsyt.2024.1353962] [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: 12/11/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
Obsessions in obsessive-compulsive disorder (OCD) have long been proposed to differ from intrusive thoughts in unaffected individuals based on appraisal of the thoughts. However, more recent research indicates that cognitive processes behind obsessions may differ significantly from those in healthy individuals concerning their contextual relationship. This narrative literature review summarizes current evidence for the role of context-relatedness for obsessions in OCD and intrusive thoughts in affected and unaffected individuals. The review encompasses a total of five studies, two of which include individuals diagnosed with OCD (one study also includes a group of unaffected control individuals), while the other three studies investigate the relationship between OCD symptoms and context in unaffected individuals. As assessed by mainly self-reports, the review examines the connection between thoughts and their context, shedding light on how the repetition and automaticity of thoughts, as well as their detachment from context over time contribute to defining obsessions in contrast to intrusive thoughts. However, the link with context depends on the content of the obsessions. We propose the term "decontextualization of thoughts" to describe the phenomenon that obsessions gradually lose their connection with external context during the development of OCD. Future research should investigate whether this hypothesis can be supported by experimental evidence and identify whether this shift might be more likely a cause or a consequence of the disorder.
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Affiliation(s)
- Franziska Weiss
- Chair of Addiction Research, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Audet JS, Bourguignon L, Aardema F. What makes an obsession? A systematic-review and meta-analysis on the specific characteristics of intrusive cognitions in OCD in comparison with other clinical and non-clinical populations. Clin Psychol Psychother 2023; 30:1446-1463. [PMID: 37482945 DOI: 10.1002/cpp.2887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023]
Abstract
The Diagnostic and Statistical Manual 5th ed. defines obsessions in obsessive-compulsive disorder (OCD) as frequent, persistent, intrusive, unwanted thoughts that provoke anxiety and distress and lead to attempts to neutralize them with either thoughts or actions. However, no systematic review has yet evaluated characteristics that are specific to obsessions occurring in OCD. The aim of the current systematic review and meta-analysis was to investigate the specific features of obsessions occurring in OCD by comparing them to both obsessionally and non-obsessionally-themed intrusions in non-clinical and other clinical populations. Based on a registered protocol, 832 records were found, of which 15 were included in the systematic review and meta-analysis, with a total of 1891 participants. Obsessionally-themed intrusions that occur among those with OCD caused more distress, guilt, negative emotion and interference as compared to similarly-themed intrusions that occur within the general population. The distinction between obsessionally-themed intrusions among those with OCD as compared to those occurring in anxiety and depressive disorder primarily revolves around a higher level of persistence, pervasiveness and distress associated with their occurrence. Further, unacceptability, uncontrollability, ego-dystonicity, alienness, guilt, the form of the intrusion, association with the self and lack of any basis in reality also differentiates between obsessions and intrusions occurring in other disorders. Obsessions share many characteristics with thoughts occurring in other disorders and can be distinguished using a combination of characteristics specific to individual disorders.
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Affiliation(s)
- Jean-Sébastien Audet
- Montreal Mental Health University Institute Research Center, Montreal, Quebec, Canada
- Department of Psychiatry and Addictology, University of Montréal, Montreal, Quebec, Canada
| | - Lysandre Bourguignon
- Montreal Mental Health University Institute Research Center, Montreal, Quebec, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Frederick Aardema
- Montreal Mental Health University Institute Research Center, Montreal, Quebec, Canada
- Department of Psychiatry and Addictology, University of Montréal, Montreal, Quebec, Canada
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Doonan A, Buchanan TW. Unheard risk: considering the role of intrusive cognitions in relapse. ADDICTION RESEARCH & THEORY 2023; 31:239-249. [DOI: 10.1080/16066359.2022.2140145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/07/2022] [Accepted: 10/21/2022] [Indexed: 01/04/2025]
Affiliation(s)
- Ashley Doonan
- Department of Psychology, Saint Louis University, Saint Louis, MO, USA
| | - Tony W. Buchanan
- Department of Psychology, Saint Louis University, Saint Louis, MO, USA
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Llorens-Aguilar S, García-Soriano G, Arnáez S, Aardema F, O'Connor K. Is context a crucial factor in distinguishing between intrusions and obsessions in patients with obsessive-compulsive disorder? J Clin Psychol 2020; 77:804-817. [PMID: 32946616 DOI: 10.1002/jclp.23060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 09/05/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Some cognitive models of obsessive-compulsive disorder (OCD) posit that intrusions exist on a continuum with obsessions; others consider that they may be unrelated phenomena that differ in the context where they occur. We aimed to examine and compare, at two different moments, the context of the occurrence of intrusions and obsessions. METHOD Sixty-eight patients with OCD completed an interview appraising their most upsetting obsession and intrusion. RESULTS At their onset, the obsessions/intrusions were associated with experiencing negative emotional states and life events, and they were more likely to appear in "inappropriate" contexts. The context of the obsessions/intrusions differed the last time they were experienced. Autogenous obsessions/intrusions occurred more frequently in contexts with an indirect link. CONCLUSIONS The context distinguishes between intrusions and obsessions, not when they emerge, but when the obsession is already established. The results support that there is a continuum or progression from intrusions to obsessions.
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Affiliation(s)
- Sara Llorens-Aguilar
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Gemma García-Soriano
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Sandra Arnáez
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Frederick Aardema
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Quebec, Canada
| | - Kieron O'Connor
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Valencia, Spain.,Department of Psychiatry and Addictology, University of Montreal, Montreal, Quebec, Canada
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Relationships between Probabilistic Inferences, Meta-Cognitions, Obsessional Beliefs, Dissociative Experiences and Obsessive-Compulsive Symptoms: a Mixture Structural Equation Modeling Approach. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-00681-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Boysan M, Yıldırım A, Beşiroğlu L, Kefeli MC, Kağan M. Development and Preliminary Psychometric Properties of an Instrument for the Measurement of Obsessional Dissociative Experiences: The Van Obsessional Dissociation Questionnaire (VOD-Q). Psychiatr Q 2018; 89:549-568. [PMID: 29302772 DOI: 10.1007/s11126-017-9555-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A growing body of research evidence documents the substantial associations between obsessive-compulsive disorder (OCD) and dissociation. This article describes the development and preliminary psychometric properties of the Van Obsessional Dissociation Questionnaire (VOD-Q). Obsessional dissociation is defined as a tendency to dissociate in reaction to distressing, unwanted and intrusive thoughts, images and impulses. The screening tool is conceptualized to tap obsessional dissociation across three dimensions: obsessional absorption, obsessional depersonalization/ derealization and obsessional amnesia. The VOD-Q, the Padua Inventory-Revised (PI-R), the Dissociative Experiences Scale (DES), and the Obsessive Belief Questionnaire (OBQ-44) were administered in this study. The results showed that the VOD-Q had excellent test-retest reliability (ranging from 0.73 to 0.90) and internal consistency (ranging from 0.90 to 0.97). The VOD-Q total and subscale scores were significantly associated with measures of obsessive-compulsive symptoms and dissociative experiences. OCD patients scored significantly higher on the VOD-Q than community participants. Based on the present findings, the VOD-Q appears to be a reliable and valid instrument for the measurement of obsessional dissociative experiences.
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Affiliation(s)
- Murat Boysan
- Department of Psychology, Yüzüncü Yıl University Faculty of Social Sciences, Van, Turkey
| | - Abdullah Yıldırım
- Department of Psychiatry, Yüzüncü Yıl University School of Medicine, Van, Turkey.
| | - Lütfullah Beşiroğlu
- Department of Psychiatry, Kâtip Çelebi University School of Medicine, İzmir, Turkey
| | - Mehmet Celal Kefeli
- Department of Psychiatry, Yüzüncü Yıl University School of Medicine, Van, Turkey
| | - Mücahit Kağan
- Department of Psychological Counseling, Erzincan University Faculty of Education, Erzincan, Turkey
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O'Connor K. Hans Eysenck and the Individual Differences Paradigm in the clinical setting. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.03.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sica C, Bottesi G, Caudek C, Orsucci A, Ghisi M. "Not Just Right Experiences" as a psychological endophenotype for obsessive-compulsive disorder: Evidence from an Italian family study. Psychiatry Res 2016; 245:27-35. [PMID: 27526314 DOI: 10.1016/j.psychres.2016.08.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 07/25/2016] [Accepted: 08/04/2016] [Indexed: 01/01/2023]
Abstract
The heart of the obsessional process may be considered the subject's underlying impression that "something is wrong" or "that something is not just as it should be". This phenomenon, labeled "not just right experiences" (NJREs), has increasingly been receiving attention as a possible marker of obsessive-compulsive disorder (OCD). The present study sought to add to the evidence that NJREs may be a putative endophenotype of obsessional symptoms. To this aim, measures of NJREs, obsessive-compulsive (OC) symptoms and psychological distress were compared in offspring of parents with and without OC symptoms. The offspring of parents with OC symptoms (N=120) reported higher frequency and severity of NJREs compared to offspring of parents without OC symptoms (N=106). Such differences remained significant for NJREs frequency and close to significance for NJREs severity, when general distress (i.e., anxiety and depression) was controlled. The possible role of NJREs as an endophenotype for OCD is discussed in reference to Gottesman and Gould criteria and the National Institute of Mental Health RDoC initiative.
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Affiliation(s)
- Claudio Sica
- Department of Health Sciences, University of Firenze, Italy.
| | - Gioia Bottesi
- Department of General Psychology, University of Padova, Italy
| | - Corrado Caudek
- Department of Neurosciences, Psychology, Drug Research, and Child Health, University of Firenze, Italy
| | | | - Marta Ghisi
- Department of General Psychology, University of Padova, Italy
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Julien D, O'Connor K, Aardema F. The inference-based approach to obsessive-compulsive disorder: A comprehensive review of its etiological model, treatment efficacy, and model of change. J Affect Disord 2016; 202:187-96. [PMID: 27262641 DOI: 10.1016/j.jad.2016.05.060] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 05/23/2016] [Accepted: 05/25/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The inference-based approach (IBA) postulates that individuals with obsessive-compulsive disorder (OCD) confuse a possibility with reality (inferential confusion) according to specific inductive reasoning devices and act as if this possibility were true. A new treatment modality, the inference-based therapy (IBT), was developed. The aim of this study was to critically review empirical evidence regarding the etiological model, treatment efficacy, and model of change of IBA. METHODS A search of the literature was conducted using PsycINFO and Medline. RESULTS Thirty-four articles were included in the review. The review reveals that intrusive thoughts of non-clinical and OCD individuals may occur in different contexts. There is support for a specific inductive reasoning style in OCD. Inferential confusion is associated with OCD symptoms. There is good evidence that IBT is an efficacious treatment for OCD, including two randomized controlled trials showing that IBT was as efficacious as cognitive-behavior therapy. There is some but limited evidence that the process of change during treatment is coherent with IBA's assumptions. LIMITATIONS Key premises were investigated in only a few studies. Some of these studies were conducted in non-clinical samples or did not include an anxious control group. CONCLUSIONS IBA's etiological model, treatment modality, and model of change make a significant contribution to OCD.
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Affiliation(s)
- Dominic Julien
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Université de Montréal, Canada; Département de Psychologie, Université de Montréal, Canada.
| | - Kieron O'Connor
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Université de Montréal, Canada; Département de Psychiatrie, Université de Montréal, Canada
| | - Frederick Aardema
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Université de Montréal, Canada; Département de Psychiatrie, Université de Montréal, Canada
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Aardema F, O`Connor KP, Delorme ME, Audet JS. The Inference-Based Approach (IBA) to the Treatment of Obsessive-Compulsive Disorder: An Open Trial Across Symptom Subtypes and Treatment-Resistant Cases. Clin Psychol Psychother 2016; 24:289-301. [DOI: 10.1002/cpp.2024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 02/10/2016] [Accepted: 04/28/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Frederick Aardema
- Department of Psychiatry; University of Montreal; Montréal Canada
- Mental Health University Institute of Montreal; Montréal Canada
| | - Kieron P. O`Connor
- Department of Psychiatry; University of Montreal; Montréal Canada
- Mental Health University Institute of Montreal; Montréal Canada
| | | | - Jean-Sebastien Audet
- Department of Psychiatry; University of Montreal; Montréal Canada
- Mental Health University Institute of Montreal; Montréal Canada
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Abramowitz JS, Fabricant LE, Taylor S, Deacon BJ, McKay D, Storch EA. The relevance of analogue studies for understanding obsessions and compulsions. Clin Psychol Rev 2014; 34:206-17. [DOI: 10.1016/j.cpr.2014.01.004] [Citation(s) in RCA: 246] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 12/18/2013] [Accepted: 01/13/2014] [Indexed: 11/16/2022]
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O'Connor K. Introduction to the Special Issue: Behavioral, Cognitive, and Emotional Processes and Symptom Change during Inference-Based Therapy for Obsessional Compulsive Disorder. Int J Cogn Ther 2014. [DOI: 10.1521/ijct.2014.7.1.1] [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: 11/20/2022]
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Contextual and behavioral influences on uncertainty in obsessive-compulsive disorder. Cortex 2012; 62:1-10. [PMID: 23318087 DOI: 10.1016/j.cortex.2012.12.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 10/22/2012] [Accepted: 12/10/2012] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Behavioral adaptation generally follows the contextual changes arising from the consequences (rewards and punishments) of an action. According to the reciprocal determinism model, there is a mutual influence between external context, cognitive processes and behavior. The maladaptive behaviors observed in obsessive-compulsive disorder (OCD) have been hypothesized to result from the disruption of the interactions between these three entities. For this, we assessed the influence of error signals and checking behavior on prefrontal cortical functions during decision-making in 14 OCD patients and 14 matched healthy participants. METHODS We used a behavioral task designed to elicit intolerance of uncertainty (IU) followed by the free expression of checking behaviors, which was coupled with functional magnetic resonance imaging. RESULTS At the behavioral level, IU intensity was correlated to the number of checking behaviors in both checking OCD patients and healthy controls during decision-making. However, external error signals did not influence checking behaviors in OCD patients, whereas they appeared to trigger checking behaviors in healthy subjects. At the neural level, IU intensity was positively correlated with activation in the orbitofrontal cortex (OFC) in both the OCD and control groups. At the region of interest (ROI) level, error signals increased IU-related OFC activations; in contrast, checking behaviors contributed to decreasing these neural activations in the healthy subjects, but no such modulation was observed in the OCD patients. CONCLUSIONS Our results show that IU-related OFC dysfunctions are not under the influence of the context and the behavioral response in OCD, suggesting that alterations of the dynamic features for this neural network may contribute to the expression of OCD symptoms.
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Lack CW. Obsessive-compulsive disorder: Evidence-based treatments and future directions for research. World J Psychiatry 2012; 2:86-90. [PMID: 24175173 PMCID: PMC3782190 DOI: 10.5498/wjp.v2.i6.86] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 09/14/2012] [Accepted: 09/21/2012] [Indexed: 02/05/2023] Open
Abstract
Over the past three decades, obsessive-compulsive disorder (OCD) has moved from an almost untreatable, life-long psychiatric disorder to a highly manageable one. This is a very welcome change to the 1%-3% of children and adults with this disorder as, thanks to advances in both pharmacological and psychological therapies, prognosis for those afflicted with OCD is quite good in the long term, even though most have comorbid disorders that are also problematic. We still have far to go, however, until OCD can be described as either easily treatable or the effective treatments are widely known about among clinicians. This review focuses on the current state of the art in treatment for OCD and where we still are coming up short in our work as a scientific community. For example, while the impact of medications is quite strong for adults in reducing OCD symptoms, current drugs are only somewhat effective for children. In addition, there are unacceptably high relapse rates across both populations when treated with pharmacological alone. Even in the cognitive-behavioral treatments, which show higher effect sizes and lower relapse rates than drug therapies, drop-out rates are at a quarter of those who begin treatment. This means a sizable portion of the OCD population who do obtain effective treatments (which appears to be only a portion of the overall population) are not effectively treated. Suggestions for future avenues of research are also presented. These are primarily focused on (1) increased dissemination of effective therapies; (2) augmentation of treatments for those with residual symptoms, both for psychotherapy and pharmacotherapy; and (3) the impact of comorbid disorders on treatment outcome.
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Affiliation(s)
- Caleb W Lack
- Caleb W Lack, Department of Psychology, University of Central Oklahoma, Edmond, OK 73034, United States
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Aardema F, O'Connor K. Dissolving the tenacity of obsessional doubt: implications for treatment outcome. J Behav Ther Exp Psychiatry 2012; 43:855-61. [PMID: 22217423 DOI: 10.1016/j.jbtep.2011.12.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 12/01/2011] [Accepted: 12/12/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Previous research has found that a high impact of possibility based information during reasoning prevents the resolution of doubt among those with Obsessive-Compulsive Disorder (OCD). It was expected that the ability of those with OCD to resolve obsessional doubt would improve following Inference Based Treatment (IBT). METHODS The ability to resolve doubt, including the relative impact of reality and possibility based information, was measured before and after treatment with the Inference Processes Task in a group of 35 participants diagnosed with OCD. RESULTS Results confirmed that IBT improved the participants' ability to resolve obsessional doubt. Those who improved their ability to resolve doubt showed a significantly better treatment outcome. Improvements appeared mostly due to a lowered impact of possibility based information following treatment. LIMITATIONS The study did not include a control condition although results clearly indicate that the ability to resolve obsessional is closely linked to the most relevant quantifiers of treatment outcome. In addition, relatively small sample sizes prevented more powerful multiple comparisons between groups. CONCLUSIONS Results suggest treatment implications and the relevance of dissolving the tenacity of obsessional doubt in OCD.
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Affiliation(s)
- Frederick Aardema
- University of Montreal, Fernand-Seguin Research Center, 7331 Hochelaga, Montréal, Québec H1N 3V2, Canada.
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Barrera TL, Norton PJ. The Appraisal of Intrusive Thoughts in Relation to Obsessional–Compulsive Symptoms. Cogn Behav Ther 2011; 40:98-110. [DOI: 10.1080/16506073.2010.545072] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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OCD in the Perinatal Period: Is Postpartum OCD (ppOCD) a Distinct Subtype? A Review of the Literature. Behav Cogn Psychother 2011; 39:285-310. [DOI: 10.1017/s1352465810000718] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: It has been suggested that the perinatal period is a period of increased risk for the development and/or exacerbation of OCD and that postpartum OCD (ppOCD) presents a distinct clinical picture. This raises the possibility that ppOCD might be a distinct subtype of OCD. This review examines this contention. Method: A search using Ovid (Medline, PsycINFO and Embase), EBSCO, Cochrane Library, Web of Science (ISI), Pubmed databases and Google Scholar was carried out using the key words: “obsessive compulsive disorder” (and derivatives), “perinatal”, “pregnancy”, “postnatal”, “postpartum”, “mothers” (and derivatives), “anxiety disorders” and “subtypes.” These articles and their references were reviewed. Results: The majority of studies reviewed were retrospective, which makes it impossible to infer causality. Two prospective studies found a higher incidence of OCD in the postpartum period. These were carried out in Turkey and Brazil and, as such, may be limited in their applicability to other cultural groups. Conclusion: The concept of ppOCD as a specific subtype has not been robustly demonstrated. The evidence that OCD is more prevalent in the postpartum period is mixed. The evidence that OCD in the postpartum period presents a distinctive clinical picture with specific symptomatology and course is more compelling. In view of the impact of culture and religion on the expression of OCD, collaborative, international, prospective studies that take into account the methodological and definitional issues raised in this review are necessary to provide clarification.
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Aardema F, Wu KD. Imaginative, dissociative, and schizotypal processes in obsessive-compulsive symptoms. J Clin Psychol 2010; 67:74-81. [PMID: 20939020 DOI: 10.1002/jclp.20729] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This study investigates imaginative, dissociative, and schizotypal processes that are potentially relevant to obsessive-compulsive (OC) symptoms. Students (n = 377) completed questionnaires that assessed inferential confusion, absorption, schizotypal personality, and other domains. Hierarchical regression revealed that inferential confusion and absorption were the most consistent predictors of OC symptoms; other content predicted variance for specific OC symptoms. For example, schizotypal personality predicted checking and hoarding symptoms, but not cleanliness or ordering rituals. Immersive tendencies predicted cleanliness and hoarding but not checking or ordering rituals. Results are consistent with an inference-based model of OC, in which an overreliance on imagination during reasoning gives rise to experiences that are inconsistent with reality. This study suggests additional domains that may help explain why intrusive thoughts become obsessions.
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Affiliation(s)
- Frederick Aardema
- University of Montreal, Fernand-Seguin Research Center, Montréal, Québec, Canada.
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O'Connor K, Koszegi N, Aardema F, van Niekerk J, Taillon A. An Inference-Based Approach to Treating Obsessive-Compulsive Disorders. COGNITIVE AND BEHAVIORAL PRACTICE 2009. [DOI: 10.1016/j.cbpra.2009.05.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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The Expanded Version of the Inferential Confusion Questionnaire: Further Development and Validation in Clinical and Non-Clinical Samples. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2009. [DOI: 10.1007/s10862-009-9157-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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