不同强迫倾向个体信息加工方式的特点研究

采用Flanker范式,通过考察高低强迫倾向个体在Flanker任务上的差异,来研究强迫倾向个体信息加工方式的特点。研究结果显示,在Flanker任务中,高强迫倾向个体显示出较慢的反应速度,表现为更多的犹豫不觉的特性;高强迫倾向个体的信息加工方式以集中加工为主;高强迫倾向个体在信息加工的灵活性上存在不足,对情景的变化较不敏感。通过对强迫倾向个体的信息加工方式的研究,有助于丰富和发展强迫症的理论,同时为强迫症的临床治疗提供依据。     

Are obsessive-compulsive tendencies related to reliance on external proxies for internal states? Evidence from biofeedback-aided relaxation studies

This article presents two studies that examine the hypothesis that obsessive-compulsive (OC) tendencies are associated with a general deficiency in subjective conviction, which leads to seeking and reliance on external proxies to compensate for that deficiency. We examined this hypothesis using a biofeedback-aided relaxation procedure. In Study 1 low OC participants performed better on a relaxation task than high OC participants. More importantly, viewing the biofeedback monitor (an external proxy for the internal state of relaxation) had a different effect on the two groups: Whereas high OC participants performed better, low OC participants did not. In addition, when given the opportunity, high OC participants requested the biofeedback monitor more than did the low OC participants. In Study 2 high OC participants were more affected by false biofeedback when judging their level of relaxation compared to low OC participants. Real relaxation level differences between the two false biofeedback phases among the two groups were not found. These results provide preliminary support for the hypothesis that obsessive-compulsive disorder is associated with deficient subjective conviction in internal states and increased reliance on external proxies. Implications for the understanding of OCD-related rules and rituals as well as for cognitive therapy for OCD are discussed.     

Religiosity and obsessive-compulsive behavior in Israeli Jews

Individual differences in obsessive-compulsive (OC) behavior in various cultures correlate with religiosity. The current paper explored the so far unstudied relationship between religiosity and OC behavior in Israeli Jews. Two studies were conducted. Study 1 focused on the relationship between religiosity and OC behavior in a representative sample of Israeli students. Study 2 focused on religious change and OC behavior in a non-random sample of 31 individuals who had become more religious (the MR group), and 30 individuals who were less religious (the LR group) than their parents. Instruments used were the Maudsley obsessive-compulsive inventory (MOCI), the student religiosity questionnaire, and questions about parental home observance, upbringing, and changes in religiosity. In the first study, no association was found between religiosity and OC behavior. Religiosity was related to some degree to perfectionism and to the parental attitude to upbringing. In the second study, a significant difference was observed between the MR and the LR groups on OC behavior as measured by the MOCI. Conclusion, among Israeli Jews a lot of religious observance is non-reflective, and is not associated with individual differences in personality or OC symptoms. Those who undergo religious change may do so in response to their behavioral propensities. One such path is that the more OC become MR, and the less OC less religiously observant.     

The Sense of Incompleteness as a Motivator of Obsessive-Compulsive Symptoms: An Empirical Analysis of Concepts and Correlates

Contemporary models of obsessive-compulsive disorder emphasize the importance of harm avoidance (HA) and related dysfunctional beliefs as motivators of obsessive-compulsive (OC) symptoms. Recently, there has been a resurgence of interest in Janet’s (1908) concept of incompleteness (INC) as another potentially important motivator. Contemporary investigators define INC as the sense that one’s actions, intentions, or experiences have not been properly achieved. Janet defined INC more broadly to include alexithymia, depersonalization, derealization, and impaired psychological mindedness. We conducted two studies to address four issues: (a) the clinical correlates of INC; (b) whether INC and HA are distinguishable constructs; (c) whether INC predicts OC symptoms after controlling for HA; and (d) the relative merits of broad versus narrow conceptualizations of INC. Study 1 was a meta-analysis of the clinical correlates of narrowly defined INC (16 studies, N = 5,940). INC was correlated with all types of OC symptoms, and was more strongly correlated with OC symptoms than with general distress. Study 2 (N = 534 nonclinical participants) showed that (a) INC and HA were strongly correlated but factor analytically distinguishable; (b) INC statistically predicted all types of OC symptoms even after controlling for HA; and (c) narrow INC was most strongly correlated with OC symptoms whereas broad INC was most strongly correlated with general distress. Although the findings are limited by being correlational in nature, they support the hypothesis that INC, especially in its narrow form, is a motivator of OC symptoms.     

Danger ideation reduction therapy for obsessive-compulsive checking: preliminary findings

Danger Ideation Reduction Therapy (DIRT) is a cognitive treatment package developed in the mid-1990s to treat obsessive-compulsive (OC) washing. DIRT is solely directed at decreasing threat expectancies and does not involve direct or indirect exposure. The effectiveness of the DIRT package for OC washers has been examined, and to date a number of publications, including two randomised controlled trials, support its efficacy. Recently, the DIRT package was modified to treat people with the OC checking subtype. In the current study, three adult OC checkers received DIRT in 12 to 14 individual 1-hr sessions conducted by a clinical psychologist. At posttreatment, substantial and clinically significant reductions in scores on a range of standardized outcome measures of obsessive-compulsive disorder symptom severity were apparent for all three participants. Crucially, these improvements were maintained at 4-month follow-up. Although further research is clearly warranted, these preliminary findings suggest that DIRT for checkers may prove as effective as DIRT for OC washers.     

Symptom dimensions in obsessive-compulsive disorder: implications for the DSM-V

In the absence of definitive etiological markers of vulnerability or a unitary profile of pathophysiology for obsessive-compulsive disorder (OCD), obsessive-compulsive (OC) symptom dimensions seem to offer a fruitful point of orientation. The complex clinical presentation of OCD can be summarized using a few consistent and temporally stable symptom dimensions. These can be understood as a spectrum of potentially overlapping features that are likely to be continuous with "normal" worries and extend beyond the traditional nosological boundaries of OCD. Although the understanding of the dimensional structure of obsessive-compulsive symptoms (OCS) is still imperfect, this quantitative approach to phenotypic traits has the potential to advance our understanding of OCD and may aid in the identification of more robust endophenotypes. Preliminary data suggest that these dimensional phenotypes may be useful in studies of the natural history, genetics, neurobiology, and treatment outcome of OCD. A dimensional approach is not mutually exclusive of other methods to parse the larger spectrum of disorders related to OCD. Thus far, age-of-onset of OCS and the individual's "tic-related" status seem to be particularly useful categorical distinctions. Finally, existing assessment methods are inadequate and new dimensional scales are needed to take full advantage of a dimensional approach in clinical and population-based studies.     

Religiousness and obsessive-compulsive cognitions and symptoms in an Italian population

Fifty-four individuals with a high degree of religiosity, 47 with a medium degree of religiosity and 64 with low religiosity completed anonymously the Italian versions of well-established measures of obsessive-compulsive (OC) cognitions and symptoms, depression and anxiety. After controlling for anxiety and depression, religious groups scored higher than individuals with a low degree of religiosity on measures of obsessionality, overimportance of thoughts, control of thoughts, perfectionism and responsibility. Moreover, measures of control of thoughts and overimportance of thoughts were associated with OC symptoms only in religious subjects. It is concluded that religion might play a role in obsessive-compulsive disorder phenomenology. Additional research is warranted because it is plausible that only a few aspects of religious teachings (e.g., inflexibility and prohibition) are linked to OC phenomena.     

Do obsessional beliefs discriminate OCD without tic patients from OCD with tic and Tourette's syndrome patients?

There is considerable overlap in symptomatology between Tourette's syndrome (TS) and obsessive-compulsive disorder (OCD). Increased rates of tics are found in OCD and up to 60% obsessive-compulsive symptoms in TS. However, in OCD obsessive-compulsive symptoms are more often anxiety-related and, as a consequence, aimed at anxiety-reduction, whereas in TS these symptoms are more stimulus-bound. Therefore, it is of clinical interest to study whether these phenomenological differences are reflected in differences between dysfunctional cognitions accompanying OC symptoms in OCD with or without tics and TS. Current cognitive theory of OCD ascertains that specific dysfunctional beliefs are important in the etiology and maintenance of OCD. To assess these beliefs, the obsessive-compulsive beliefs questionnaire-87 (OBQ-87) has been developed. In the present study, OBQ-87 scores of OCD patients without tics, OCD with tics, and TS (without OCD) patients were compared to those of normal controls. Results: OCD without tic patients exhibited higher OBQ-87 scores than TS patients. No differences were found between OCD with or without tic patients on any of the OBQ-87 subscales. These results suggest that: (1) dysfunctional beliefs have no discriminative power with respect to OCD with or without tic patients; (2) the direct relationship between types of OC symptoms and specific dysfunctional beliefs is questionable. Therefore, one can doubt the specificity of cognitive theory of OCD to explain specific OC behavior.     

Do patients with OCD and pathological gambling have similar dysfunctional cognitions?

The obsessive-compulsive spectrum disorder (OCSD) theory postulates that a wide range of disorders is closely related to OCD. Current cognitive models ascertain that certain beliefs leading to misinterpretation of the significance of intrusions are important in the etiology and maintenance of OCD. This study examined whether pathological gambling, a disorder belonging to the OC spectrum, is characterized by similar dysfunctional cognitions as OCD. Dysfunctional beliefs of OCD patients were compared to those of patients with pathological gambling, panic disorder and normal controls. These beliefs were measured by the Obsessive-compulsive Beliefs Questionnaire-87 (OBQ-87), which was developed by a group of leading OCD researchers [Behav. Res. Ther. 35 (1997) 667]. It was hypothesized that according to the OCSD theory, pathological gamblers would exhibit similar cognitions to OCD patients, as well as increased levels of OCD symptoms. Analysis showed that OCD patients exhibited higher OBQ-87 scores than both panic patients and normal controls, but equal to pathological gambling patients. Pathological gamblers exhibited, however, no increase in OCD symptoms. These mixed results do not seem to support the OC spectrum theory for pathological gambling, moreover being contradictory to contemporary cognitive OCD models.     

Realism of confidence in obsessive-compulsive checkers

The study examined whether obsessive-compulsive (OC) checkers have reduced confidence in their knowledge. OC checkers were compared with panic disorder (PD) patients and nonpatient controls using a calibration-of-knowledge procedure. Participants completed a general knowledge questionnaire, rated their confidence in each answer, and estimated the total number of correct answers. These responses were converted to 2 measures of confidence relative to performance--over/underconfidence and over/underestimation. OC checkers had lower scores than nonpatients did on both measures, whereas the PD patients did not differ from either group. For the OC checkers, relative confidence was inversely related to the severity of obsessions. The authors speculate that confidence may depend on a confirmation bias in testing hypotheses and that the reduced confidence in OC checkers may reflect a disconfirmation bias in this population.     

Inflated perceptions of responsibility and obsessive-compulsive symptoms

In Salkovskis' [Salkovskis, P. (1985). Obsessional-compulsive problems: a cognitive-behavioural analysis. Behaviour Research and Therapy, 28, 571-588; Salkovskis P. (1989) Cognitive-behavioural factors and the persistence of intrusive thoughts in obsessional problems. Behaviour Research and Therapy, 27, 677-682] cognitive model for obsessive-compulsive disorder (OCD), inflated perception of responsibility is highlighted as the critical feature that maintains the disorder. In the current study, the relationship between responsibility and obsessive-compulsive (OC) symptoms was examined. Specifically, three measures of responsibility were evaluated for their psychometric properties. These measures were then used to test Salkovskis's model by examining the relationships among pervasive responsibility, automatic thoughts related to causing harm, and OC symptom severity. Findings provide partial support for the validity and reliability of the measures and for the model as a whole. Based on regression analyses, data support that pervasive responsibility significantly contributes to the prediction of OC symptoms. Furthermore, this relationship appears to be mediated by automatic thoughts related to causing harm in OCD contexts.     

Obsessive-compulsive tendencies may be associated with attenuated access to internal states: Evidence from a biofeedback-aided muscle tensing task

The present study was motivated by the hypothesis that inputs from internal states in obsessive-compulsive (OC) individuals are attenuated, which could be one source of the pervasive doubting and checking in OCD. Participants who were high or low in OC tendencies were asked to produce specific levels of muscle tension with and without biofeedback, and their accuracy in producing the required muscle tension levels was assessed. As predicted, high OC participants performed more poorly than low OC participants on this task when biofeedback was not available. When biofeedback was provided, the difference between the groups was eliminated, and withdrawing the monitor again reversed this effect. Finally, when given the opportunity, high OC participants were more likely than low OC participants to request biofeedback. These results suggest that doubt in OCD may be grounded in a real and general deficiency in accessing internal states.     

A cognitive behavioral workshop for subclinical obsessions and compulsions

The present study investigates the effectiveness of a 3-h cognitive behavioral workshop for individuals, ages 18-22, with subclinical obsessions and compulsions. It was hypothesized that, compared to individuals in an assessment-only waitlist group (n = 42), individuals assigned to the workshop group (n = 43) would experience a significant decrease in obsessive-compulsive (OC) symptomatology, comorbidity, and thought action fusion endorsement at 1-month and 5-month follow-up assessments. An additional outcome of interest was the number of incident cases of obsessive-compulsive disorder (OCD) over the course of the study. The results indicated that the workshop group reported a significantly fewer number of OC symptoms at 5-month follow-up and endorsed significantly less thought action fusion at both follow-up points. However, there were no differences between groups in severity of OC symptoms and number of comorbid diagnoses endorsed. Only one incident case of OCD was observed during the study, from a participant in the waitlist group. These results are discussed in reference to treatment of subclinical anxiety symptoms.     

Treatment of Obsessive Compulsive Disorder in Young Children: An Intervention Model and Case Series

This article presents an intervention model for young children with obsessive-compulsive disorder (OCD). The intervention, designed to reduce compulsive behavior and improve parenting practices, was tested using a multiple baseline design with 7 children (M = 6 years old; 57% female) in which participants were randomly assigned to 1, 2, or 3 weeks of baseline (i.e., no treatment). All children were diagnosed with OCD using a semi-structured diagnostic interview. Baseline and weekly ratings of obsessive-compulsive (OC) symptoms and family accommodation were obtained. In addition, at pre- and post-treatment and 1-month follow-up, independent evaluators and/or parents completed measures assessing the severity and impact of OC symptoms and child and family functioning. Findings revealed that participants had a 33–66% reduction in OC symptoms (as measured by the Children's Yale-Brown Obsessive Compulsive Scale; CYBOCS) at posttreatment and 6 of the 7 children were rated as treatment responders on the Clinical Global Impression-Improvement (CGI-I) Scale. At the 1-month follow-up, participants had a 17–82% reduction in OC symptoms. Treatment was also effective in reducing parental accommodation of child OC behaviors. Overall treatment satisfaction was high and parents found most core treatment ingredients (e.g., psychoeducation, exposure and ritual prevention, contingency management) very helpful. Implications for further developing and testing psychosocial treatments for young children are discussed.     

Obsessive Compulsive Symptoms Predict Posttraumatic Growth: A Longitudinal Study

Although posttraumatic growth (PTG) has received growing attention, the relationship between PTG and distress remains unclear. This longitudinal study examines the relationship between posttraumatic obsessive-compulsive (OC) symptoms and PTG. Israeli veterans were followed over 17 years using self-report questionnaires of OC symptoms, posttraumatic stress disorder (PTSD), and PTG. Hierarchical regression analyses demonstrated that OC symptoms predicted PTG, even when initial PTG levels and PTSD symptoms were controlled for in the combatants group. These preliminary findings suggest that OC symptoms may play an important role in facilitating psychological growth. Future research is warranted to explore the mechanisms responsible for this relationship.     

The mediating effects of misinterpretation of intrusive thoughts on obsessive-compulsive symptoms

Perfectionism and inflated responsibility have both been identified as risk factors for the development and maintenance of obsessive-compulsive (OC) symptoms. The aim of the present study was to test whether the relationships between these two variables and OC symptoms are mediated by the misinterpretation of intrusive thoughts (MIT). Three hundred and three university students completed the Frost Multidimensional Perfectionism Scale, the Maudsley Obsessional Compulsive Inventory, the Responsibility Attitude Scale, and the Responsibility Interpretations Questionnaire. MIT was found to partially mediate the relationship between responsibility attitudes and OC symptoms. MIT also partially mediated the relationship between concern over mistakes and OC symptoms, even after controlling for responsibility attitudes. Both concern over mistakes and responsibility attitudes were significant predictors of MIT and OC symptoms, but responsibility was the stronger predictor when all of the variables were included in the model. Clinical implications for the treatment of OCD are discussed.     

The cognitive mediation of thought-control strategies

Research suggests that people use various strategies to control their normally occurring intrusive thoughts. Strategies that involve worrying about the thought and self punishment appear to be associated with certain forms of psychopathology, such as obsessive-compulsive (OC) symptoms. The present study sought to examine whether dysfunctional beliefs associated with OC symptoms (e.g., beliefs that intrusive thoughts are highly significant) underlie the use of such thought control strategies. Ninety-three non-clinical participants completed self-report questionnaires measuring cognitive variables, thought-control strategies, and OC symptoms. Analyses revealed that overestimates of threat and responsibility, beliefs about the significance and need to control intrusions, the need for perfection and certainty, and scrupulosity were associated with the use of punishment, but not worry thought control strategies. These cognitive phenomena also mediated the relationship between OC symptoms and the use of punishment as a thought-control strategy. Results are discussed in terms of cognitive models of OC symptoms and their implications for cognitive-behavioral therapy.     

强迫倾向、内心体验的信心水平与知道感缺乏的关系

为探讨强迫倾向、内心体验的信心水平与知道感缺乏的关系,采用虚假生物反馈为内在状态的外部线索,以指导语操控被试内心体验的信心水平,考察高、低强迫倾向（high/low obsessive-compulsive tendencies, HOC/LOC）组在不同信心水平下依赖外部线索评价内在状态的情况。结果：(1)HOC组的知道感存在缺陷,表现为比LOC组更依赖外部线索评价内在状态;(2)HOC组的知道感缺乏受其信心水平的影响,低信心会加剧HOC组的知道感缺乏。本研究结果能为缓解HOC个体的怀疑及相关强迫症状提供帮助,并或许能为OCD认知和元认知治疗提供思路。     

Does obsessive-compulsive personality disorder belong within the obsessive-compulsive spectrum?

It has been proposed that certain Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I disorders share overlapping clinical features, genetic contributions, and treatment response and fall within an "obsessive-compulsive" spectrum. Obsessive-compulsive personality disorder (OCPD) resembles obsessive-compulsive disorder (OCD) and other spectrum disorders in terms of phenomenology, comorbidity, neurocognition, and treatment response. This article critically examines the nosological profile of OCPD with special reference to OCD and related disorders. By viewing OCPD as a candidate member of the obsessive-compulsive spectrum, we gain a fresh approach to understanding its neurobiology, etiology, and potential treatments.     

Efficacy of telephone-administered cognitive behaviour therapy for obsessive-compulsive spectrum disorders: case studies

Cognitive behaviour therapy is effective for obsessive-compulsive disorder and for obsessive-compulsive spectrum disorders such as trichotillomania. Unfortunately, many people with these disorders, especially those living in rural areas, have limited access to treatment. Telephone-administered cognitive behaviour therapy may help address this problem. In a recent study of telephone treatment for obsessive-compulsive disorder, we found that such treatment was often effective (42% in remission at post-treatment, and 47% in remission at 12-week follow-up). This article presents 2 case reports of the same treatment, applied to obsessive-compulsive spectrum disorders (trichotillomania and compulsive skin picking). Treatment was associated with symptom reduction for both participants, although one subsequently relapsed. Possible reasons for relapse are discussed. The findings encourage further studies to identify the characteristics of people most likely to benefit from telephone treatment for spectrum disorders.