Are responsibility attitudes related to obsessive-compulsive symptoms in schoolchildren?

In spite of a growth in cognitive conceptualizations of obsessive-compulsive symptoms, relatively little has been done to extend such concepts to childhood. This study investigated the relationship between responsibility attitudes and obsessive-compulsive symptoms in normal children. A measure of responsibility attitudes in children was constructed on the basis of Salkovskis' Responsibility Attitudes Scale. This measure (Responsibility Attitudes Scale for Children) was administered together with the Leyton Obsessive Inventory Child Version and the Children's Depression Inventory to a sample of two hundred and two 10-14-year-old schoolchildren in Iceland. The responsibility measure correlated moderately and similarly with the Leyton Obsessive Inventory Child Version and the Children's Depression Inventory. In a hierarchical regression analysis predicting Leyton Obsessive Inventory Child Version scores, age and gender were entered in the equation first, followed by Children's Depression Inventory scores and, finally, Responsibility Attitudes Scale for Children scores. It was shown that Responsibility Attitudes Scale for Children scores added significantly to the prediction of Leyton Obsessive Inventory Child Version over and above the other variables. It is concluded that the study of the role of responsibility attitudes in children's obsessive-compulsive symptoms is at least promising.     

Behavior analysis and the primary prevention of occupational injuries

Contemporary cognitive models of obsessive‐compulsive disorder emphasize the importance of various types of dysfunctional beliefs, such as beliefs about inflated responsibility, perfectionism and the importance of controlling one's thoughts. These beliefs have been conceptualized as main effects, each influencing obsessive‐compulsive symptoms independent of the contributions of other beliefs. It is not known whether beliefs interact with one another in their influence on obsessive‐compulsive symptoms. To investigate this issue, data from 248 obsessive‐compulsive disorder patients were analyzed. Dependent variables were the factor scores on the 4 Padua Inventory subscales. Predictor variables were the factor scores from the 3 factors (inflated responsibility, perfectionism and controlling one's thoughts) of the Obsessive Beliefs Questionnaire and their 2‐ and 3‐way interactions. Regression analyses revealed significant main effects; in almost all analyses one or more of inflated responsibility, perfectionism, and controlling one's thoughts factors predicted scores on the Padua factors even after controlling for general distress. There was no evidence that beliefs interact in their effects on obsessive‐compulsive symptoms, thereby providing a relatively unusual instance in which a simpler explanation (main effects only) is just as powerful as a more complex model.     

A Norwegian version of the Obsessive‐Compulsive Inventory–Revised: Psychometric properties

Solem, S., Hjemdal, O., Vogel, P.A. & Stiles, T.C. (2010). A Norwegian version of the Obsessive‐Compulsive Inventory–Revised: Psychometric properties. Scandinavian Journal of Psychology 51, 509–516. The aims of this study were to test the psychometric properties of the Norwegian version of the Obsessive‐Compulsive Inventory–Revised (OCI‐R). The study included a student/community control sample (N = 1167) and a clinical sample (N = 72) with a diagnosis of obsessive‐compulsive disorder (OCD). The results indicated a good fit for the six‐factor structure of the OCI‐R. The mean scores and standard deviations were similar to that of studies from other countries as was the internal consistency. The OCI‐R scores were significantly higher in the OCD sample compared to the control sample. All the subscales, except hoarding, were significant predictors of obsessive‐compulsive severity, and the OCI‐R subscales seemed to be in agreement with the different subtypes of OCD according to DSM‐IV. The OCI‐R showed meaningful correlations with measures related to obsessive compulsive symptoms. As expected, it showed the strongest correlation with the Yale‐Brown Obsessive Compulsive Scale, followed by measures of worry, anxiety, and depression. In summary, the Norwegian OCI‐R showed adequate psychometric properties suggesting it could be a suitable measure of obsessive‐compulsive symptoms.     

Hierarchical Structure of Dysfunctional Beliefs in Obsessive‐Compulsive Disorder

The Obsessive Beliefs Questionnaire was developed as a comprehensive measure of dysfunctional beliefs, which cognitive models consider to be etiologically related to obsessive‐compulsive disorder. Obsessive Beliefs Questionnaire subscales tend to be highly correlated, which raises the question of whether obsessive‐compulsive‐related beliefs are hierarchically structured, consisting of lower‐order factors loading on 1 or more higher‐order factors. To investigate the nature and relative importance of these factors, a hierarchical factor analysis was conducted (n = 202 obsessive‐compulsive disorder patients), using a Schmid‐Leiman transformation. Results indicated a higher‐order (general factor) and 3 lower‐order factors: (i) responsibility and overestimation of threat, (ii) perfectionism and intolerance of uncertainty and (iii) importance and control of thoughts. The high‐order factor accounted for more variance in Obsessive Beliefs Questionnaire scores (22%) than did the lower‐order factors (6–7%), thereby underscoring the importance of the higher‐order factor. Despite the importance of the higher‐order factor, the lower‐order factors significantly predicted unique variance in measures of obsessive‐compulsive symptoms, including severity ratings of compulsions. These finding suggest that cognitive models of obsessive‐compulsive disorder should take into consideration the hierarchic structure of obsessive‐compulsive‐related beliefs.     

The presence of magical thinking in obsessive compulsive disorder

Two research groups have raised the possibility that magical ideation may be a fundamental feature of obsessive-compulsive disorder. It has been proposed to underlie thought action fusion and superstitious beliefs. In this study, the Magical Ideation scale, the Lucky Behaviours and Lucky Beliefs scales, the Thought Action Fusion-Revised scale, the Padua Inventory, and the Obsessive Compulsive Inventory-Short Version were completed by 60 obsessive compulsive patients at a hospital clinic. Of all the measures, the Magical Ideation (MI) scale was found to be the most strongly related to obsessive compulsive symptoms. Large and significant relationships between MI scores and the measures of OCD were obtained even when alternative constructs (Lucky Behaviours, Lucky Beliefs, Thought Action Fusion-Revised scales) were held constant. No other variable remained significantly related to the Obsessive Compulsive Inventory-Short Version when magical ideation scores were held constant. The findings suggest that a general magical thinking tendency may underpin previous observed links between superstitiousness, thought action fusion and OCD severity.     

An investigation into the psychosocial functioning of creative children: The impact of ADHD symptomatology

This study examined the relationship among creativity, ADHD symptomatology, temperament, and psychosocial functioning by comparing four groups of children aged 10–12 years: (1) 29 ADHD children without creativity, (2) 16 highly creative children displaying ADHD symptomatology, (3) 18 highly creative children without ADHD symptomatology, and (4) 30 normal controls. Children completed the TTCT, Child Depression Inventory, Revised Child Manifest Anxiety Scale, and Rosenberg Self‐Esteem Scale. Parents completed the Junior Temperament and Character Inventory, Family Environment Scale, and the parent version of the Kastan Children's Attributional Style Questionnaire. Parents completed the Conner's Rating Scales and Child Behavior Checklist, and teachers completed the Child Behaviour Checklist. Results showed that the presence of ADHD symptomatology in creative children was related to their temperamental characteristics, and parent reports of children's levels of anxiety and depression. However, family environment and mother's attributions did not appear to be related to the presence of ADHD symptomatology in creative children. These findings have implications for the development and management of creative children.     

The relationship of the Yale-Brown Obsessive Compulsive Scale (YBOCS) to other measures of obsessive compulsive symptoms in a nonclinical population

The Yale-Brown Obsessive Compulsive Scale (YBOCS; Goodman, Price, Rasmussen, & Mazure, 1989a) is an interview-based rating scale measuring severity of obsessive compulsive disorder (OCD). Because it is independent of the number and type of OCD symptoms and minimizes confounding with other types of symptoms, it has become the "gold standard" for assessing the outcome of behavioral and pharmacological treatments. This study was designed to further validate the YBOCS in relation to self-report measures of obsessive compulsive phenomena in a nonclinical population. Among a group of 45 female college students, the three primary YBOCS measures (obsessions, compulsions, and total score) were internally consistent and correlated moderately to strongly with self-report measures of obsessive compulsive phenomena that have been used in previous research. The compulsive subscale of the YBOCS showed the lowest correlation with self-report measures sharing only 25% of the common variance. This measure is appropriate for use with nonclinical samples and may prove superior to other instruments for detecting the presence and severity of obsessive and compulsive symptoms.     

Exploring the Possibility of Shared Familial Diathesis for Personality in OCD Probands

The present study aims to probe into the status of the big five personality factors in the OCD probands and their first degree relatives (FDR) viz a viz community controls and also look into the association of the big five factors with symptom severity and obsessive personality traits. Fifty dyads of probands and FDR and community controls matched on the basis of age, sex and education were assessed on NEO Five Factor Inventory, Yale Brown Obsession Compulsion Scale, Beck Depression Inventory and Leyton Obsessional Inventory to fulfill the aims of the study. The findings reveal higher neuroticism and lower extroversion and conscientiousness in the OCD group as compared to controls, endorsement of greater conscientiousness among the FDR as compared to the case-probands, with Agreeableness and Conscientiousness emerging as predictors associated with obsessive symptoms among OCD probands.     

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.     

Self-Report,Peer-Report,and Teacher-Report Measures of Childhood Depression: An Analysis by Item

We explored the low correlation among different types of childhood depression measures at the item level. The items from the Children's Depression Inventory (CDI), Peer Nomination Inventory of Depression (PNID), and the Child Behavior Checklist-Teacher Report Form (CBCL-T) were combined, and both first- and second-order factor analyses were conducted. Results indicate that self-report, peer-report, and teacher-report assessments of depression measure generally uncorrelated constructs. Second-order analysis suggests that depression as a global construct is being measured to some degree by items from all three instruments. Canonical analysis was employed to identify items that best predicted CDI, PNID, and CBL-T summary scores simultaneously. Also, the relationship between specific items with similar content was investigated. Results from these analyses generally supported a conclusion that the three types of measures yield scores that are primarily independent and that the use of summary scores is not masking stronger relationships within measures. These findings have implications for clinical practice and construct elaboration.     

Change in metacognitions predicts outcome in obsessive–compulsive disorder patients undergoing treatment with exposure and response prevention

Wells' (Wells, A. (1997). Cognitive therapy of anxiety disorders: a practice manual and conceptual guide. Chichester, UK: Wiley) metacognitive model of obsessive–compulsive disorder (OCD) predicts that metacognitions must change in order for psychological treatment to be effective. The aim of this study was to explore: (1) if metacognitions change in patients undergoing exposure treatment for OCD; (2) to determine the extent to which cognitive and metacognitive change predicts symptom improvement and recovery. The sample consisted of 83 outpatients with a diagnosis of OCD who completed exposure and response prevention treatment. The Yale–Brown Obsessive–Compulsive Scale (Y-BOCS), the Metacognitions Questionnaire (MCQ-30) and the Obsessive Beliefs Questionnaire (OBQ-44) were administered before treatment, after treatment, and at 12-month follow-up. Treatment resulted in significant changes in symptoms, metacognition score, responsibility and perfectionism. Regression analysis using post-treatment Y-BOCS as the dependent variable indicated that when the overlap between predictors was controlled for, only changes in metacognition were significant. Changes in metacognitions explained 22% of the variance in symptoms at post-treatment when controlling for pre-treatment symptoms and changes in mood. A further regression revealed that two MCQ-30 subscales made individual contributions. The patients had significantly higher scores compared to community controls on the MCQ-30. Patients who achieved clinical significant change had lower scores on the MCQ-30 compared to patients who did not change. The results did not change significantly from post-treatment to follow-up assessment. These findings provide further support for the importance of metacognitions in treating OCD.     

The relationship between Turkish children's perceptions of marital conflict and their internalizing and externalizing problems

The present study investigated the relationship between children's perceptions of marital conflict and children's internalizing and externalizing problems. Additionally, investigating gender and age differences in children's perceptions and the type of problems they exhibited were the other purposes of the study. The sample consisted of 9‐ to 12‐year‐old, nonclinical children from intact families (N = 232), one of their parents, and teachers. The data were gathered by administering the Child Behavior Checklist for Ages 4–18 and the Teacher's Report Form to adult participants and the Children's Perception of Interparental Conflict Scale and the Children's Depression Inventory to the child participants. Findings indicated that there was a significant relationship between children's perceptions of marital conflict and their internalizing and externalizing problems. More specifically, children's perceptions of conflict properties were associated with their internalizing problems in parents', teachers', and children's reports. Children's perceptions of threat were associated with child‐reported depression. Children's perceptions of self‐blame were associated with child‐reported depression, parent‐reported internalizing and externalizing problems, and teacher‐reported externalizing problems. Furthermore, it was found that there were gender and age differences in children's perceptions of marital conflict and their internalizing and externalizing problems. Findings indicated that boys have higher self‐blame scores and teacher‐reported externalizing problems than girls and that girls have more parent‐ and teacher‐reported internalizing problems than boys. Additionally, it was found that 9‐year‐old children have more teacher‐reported internalizing and externalizing problems than 12‐year‐old children. Also, 9‐year‐old boys have higher parent‐reported externalizing problems than 9‐year‐old girls and 9‐year‐old boys have higher parent‐reported externalizing problems than 12‐year‐old boys.     

Randomized,placebo-controlled trial of cognitive-behavioral therapy alone or combined with sertraline in the treatment of pediatric obsessive–compulsive disorder

Background

To examine the efficacy of sequential sertraline and cognitive-behavioral therapy (CBT) treatment relative to CBT with pill placebo over 18 weeks in children and adolescents with obsessive–compulsive disorder (OCD).

Methods

Forty-seven children and adolescents with OCD (Range = 7–17 years) were randomized to 18-weeks of treatment in one of three arms: 1) sertraline at standard dosing + CBT (RegSert + CBT); 2) sertraline titrated slowly but achieving at least 8 weeks on the maximally tolerated daily dose + CBT (SloSert + CBT); or 3) pill placebo + CBT (PBO + CBT). Assessments were conducted at screening, baseline, weeks 1–9, 13, and 17, and post-treatment. Raters and clinicians were blinded to sertraline (but not CBT) randomization status. Primary outcomes included the Children's Yale-Brown Obsessive–Compulsive Scale, and response and remission status. Secondary outcomes included the Child Obsessive Compulsive Impact Scale–Parent/Child, Children's Depression Rating Scale-Revised, Multidimensional Anxiety Scale for Children, and Clinical-Global Impressions-Severity.

Results

All groups exhibited large within-group effects across outcomes. There was no group by time interaction across all outcomes suggesting that group changes over time were comparable.

Conclusions

Among youth with OCD, there was no evidence that sequentially provided sertraline with CBT differed from those receiving placebo with CBT.

ClinicalTrials.gov Identifier

NCT00382291.     

Rearing practices and impulsivity/hyperactivity symptoms in relation to inflated responsibility and obsessive‐compulsive symptoms

Smári, J., Rúrik Martinsson, D., & Einarsson, H. (2010). Rearing practices and impulsivity/hyperactivity symptoms in relation to inflated responsibility and obsessive‐compulsive symptoms. Scandinavian Journal of Psychology, 51, 392–397. The aim of the study was to investigate potential precursors of inflated responsibility (responsibility attitudes) and obsessive‐compulsive (OCD) symptoms. It was argued that both parental overprotection and impulsivity, separately and in interaction with each other, contribute to inflated responsibility and OCD symptoms. In a large sample of young adults (N = 570), self‐report measures of OCD symptoms (OCI‐R), responsibility attitudes (RAS), anxiety/depression (HADS), rearing practices (EMBU), present and past impulsivity/hyperactivity symptoms (IMP/HY) were administered. Overprotection as well as IMP/HY were found to predict OCD symptoms as well as inflated responsibility. Finally, a significant interaction was found between IMP/HY and overprotection with regard to both OCD symptoms and inflated responsibility. This effect reflected that IMP/HY was more strongly related to OCD symptoms and responsibility in people who had not been overprotected than in people who had been. Conversely overprotection was related to OCD symptoms and responsibility in people low but not in people high in IMP/HY. The results seem to indicate that the inadequacy between offer and need for parental control may play a role in the development of OCD symptoms.     

Depression and self-esteem in academically gifted and nongifted children: A comparison study

The present investigation examined depression and self-esteem in a sample of 145 gifted and nongifted fourth and fifth grade children. Self-esteem was assessed by the Coopersmith Self-Esteem Inventory. Depression was measured by Kovacs' Children's Depression Inventory, the Reynolds' Child Depression Scale, and teachers' global ratings of depression. As a group, gifted children did not differ on levels of self-esteem or depression from their nongifted peers. However, when grade and gender differences were examined, it was found that gifted boys tended to report lower levels of self-esteem and more depression than gifted girls. Teachers also judged boys to be more depressed than girls. Furthermore, fifth-graders were rated by teachers to be more depressed than fourth-graders. Overall, this investigation did not find major differences in affective characteristics between gifted and nongifted children.     

Reliability Generalization Study of the Yale–Brown Obsessive–Compulsive Scale for Children and Adolescents

The Yale–Brown Obsessive–Compulsive Scale for children and adolescents (CY–BOCS) is a frequently applied test to assess obsessive–compulsive symptoms. We conducted a reliability generalization meta-analysis on the CY–BOCS to estimate the average reliability, search for reliability moderators, and propose a predictive model that researchers and clinicians can use to estimate the expected reliability of the CY–BOCS scores. A total of 47 studies reporting a reliability coefficient with the data at hand were included in the meta-analysis. The results showed good reliability and a large variability associated to the standard deviation of total scores and sample size.     

Risk,Resilience, and the Rorschach: A Longitudinal Study of Children Who Experienced Sexual Abuse

Experiencing sexual abuse increases the risk that children will report or otherwise demonstrate problems with emotion, behavior, and health. This longitudinal study of 44 children who experienced sexual abuse examined whether information processing as assessed via the Rorschach Inkblot Test was associated with child-reported depression symptoms assessed via the Children's Depression Inventory (Kovacs, 1992) concurrently and an average of 15 months later. Children whose Rorschach protocols were relatively free of scores suggesting intense distress, complex processing, and sexual content were more likely to experience remission of depression symptoms at follow-up. Findings provide incremental validity for certain Rorschach indexes to inform prognosis regarding depression symptoms and perhaps their treatment.     

Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory--Part 2: Factor analyses and testing of a brief version

The Obsessive Belief Questionnaire (OBQ) and the Interpretation of Intrusions Inventory (III) were designed to assess beliefs and appraisals considered critical to the pathogenesis of obsessions. In previous reports we have described the construction and psychometric properties of these measures. In this study a battery of questionnaires assessing anxiety, depression, and obsessive compulsive symptoms was completed by 410 outpatients diagnosed with obsessive compulsive disorder, 105 non-obsessional anxious patients, 87 non-clinical adults from the community, and 291 undergraduate students. Items from 6 theoretically derived subscales of the OBQ were submitted to factor analysis. Three factors emerged reflecting (1) Responsibility and threat estimation, (2) Perfectionism and intolerance for uncertainty, and (3) Importance and control of thoughts. A 44-item version (OBQ-44) composed of high-loading items from the 3 factors showed good internal consistency and criterion-related validity in clinical and non-clinical samples. Subscales showed less overlap than original scales. Factor analysis of the III yielded a single factor, suggesting the total score be used in lieu of the 3 rationally derived subscales. The scales performed well on tests of convergent validity. Discriminant validity was promising; hierarchical regression analyses indicated that the OBQ subscales and III generally predicted OC symptoms after controlling for general distress. A revision of the OBQ, the OBQ-44, is included in the appendix.     

Obsessive beliefs and uncertainty in obsessive compulsive and related patients

Background/objectiveThe aim of the present study was to examine obsessive beliefs and intolerance of uncertainty differences among patients Obsessive compulsive disoreder (OCD), trichotillomania, excoriation, generalized anxiety disorder (GAD) and a control group healthy.Method130 participants between the ages of 17 and 62 years (Mean = 29.56, SD = 11.81) diagnosed with OCD (n = 36), trichotillomania (n = 18), excoriation (n = 17), GAD (n = 31) and a healthy control group (n = 28) were evaluated by Obsessive Beliefs Spanish Inventory-Revised and Intolerance of Uncertainty Scale.ResultsThe trichotillomania group presented one of the highest obsessive beliefs highlighting over-importance of thoughts, thought action fusion-moral, importance of controlling one's thoughts. The OCD group also had higher scores in inflated responsibility and thought action fusion-likelihood. The GAD group excelled in inhibitory and prospective uncertainty. The level of depression influenced obsessive beliefs while anxiety affected inhibitory and prospective uncertainty.ConclusionsCognitive variables such as obsessive beliefs and Intolerance of Uncertainty should be considered in the prevention and intervention of obsessive and anxiety disorders.     

A Counselor's Guide to the Assessment of Depression

This article discusses various methods and procedures for assessing depression in clients. The following eight clinician rating and client self-report measures of depression are reviewed on the basis of their psychometric properties and applied pragmatic utility: the Hamilton Rating Scale for Depression, the Beck Depression Inventory, the Minnesota Multiphasic Personality Inventory-Scale 2 (Depression), the Depression Adjective Checklists, the Multiple Affect Adjective Checklist, the Zung Self-Rating Depression Scale, the Hopkins Symptom Checklist-90, and the Children's Depression Inventory.