Le dégoût dans le trouble obsessionnel compulsif,mécanismes, évaluation,implications pour des pistes thérapeutiques

IntroductionAlthough considered a basic emotion, disgust has received little attention from research from the psychology of emotions compared to other emotions such as fear or sadness.Literature findingsMany empirical and experimental data suggest, however, that disgust plays a determining role not only in our ability to adapt to our environment but also in the maintenance and development of certain psychopathological states such as obsessive-compulsive disorders. The purpose of this article is to review the literature on the construct of disgust, including its two basic dimensions of disgust and disgust. A first part will be dedicated to the acquisition of disgust in the framework of evaluative and Pavlovian learning, we will then describe in detail the assessment tools available in the literature allowing to evaluate the different dimensions, then we will address the continuum. Experience of disgust, from normal disgust to pathological disgust, and will particularly target its role in dysfunctional obsessions of contamination and emotional distress.DiscussionIf, from a theoretical point of view, the understanding of the underlying mechanisms of pathological disgust reactions improves, the proposals for treatment to mitigate these reactions are rare. New approaches to care will be described to allow the development of empirically based psychological interventions.ConclusionThe recognition of emotional influences beyond anxiety in obsessive-compulsive disorder (OCD) stems from the fundamental importance of a dimensional approach to psychopathology and support. The accumulated data suggest that the inclusion of disgust in the theoretical models of OCD, in particular those with contamination concern, will thus improve our understanding and treatment of this disorder.     

Evaluating Supervision Models in Functional Family Therapy: Does Adding Observation Enhance Outcomes?

This study examined the effects of observation‐based supervision Building Outcomes with Observation‐Based Supervision of Therapy (BOOST therapists = 26, families = 105), versus supervision as usual (SAU therapists = 21, families = 59) on (a) youth externalizing behavior problems and (b) the moderating effects of changes in family functioning on youth externalizing behaviors for adolescents receiving Functional Family Therapy (FFT). Exploratory analyses examined the impact of supervision conditions on youth internalizing problems. In 8 community agencies, experienced FFT therapists (M = 1.4 years) received either BOOST or SAU supervision in a quasi‐experimental design. Male (59%) or female (41%) adolescents were referred for the treatment of behavior problems (e.g., delinquency, substance use). Clients were Hispanic (62%), African American (19%), Non‐Hispanic White (12%), or Other (7%) ethnic/racial origins. Therapists (female, 77%) were Hispanic 45%, African American (19%), White Non‐Hispanic (30%), or other (4%) ethnic/racial backgrounds. Analyses controlled for the presence or absence of clinically elevated symptoms on outcome variables. Clinical outcomes were measured at baseline, 5 months, and 12 months after treatment initiation. Clients with externalizing behavior above clinical thresholds had significantly greater reductions in problem behaviors in the BOOST versus the SAU conditions. Clients below thresholds did not respond differentially to conditions. Supervisors in BOOST had more experience with the FFT model; as such, the observed results may be a result of supervisor experience. The BOOST supervision was associated with improved outcomes on problem behaviors that were above clinical thresholds. The findings demonstrate the importance of addressing client case mix in implementation studies in natural environments.