Strategies used with intrusive thoughts: a comparison of OCD patients with anxious and community controls

Models of intrusive thoughts attribute a key role to strategies used by people to cope with their unwanted cognitions. In an extension of previous work, the authors conducted structured interviews with 38 people with obsessive-compulsive disorder, 38 people with another anxiety disorder, and 19 healthy volunteers. The interview identified the repertoire of strategies used with the participant's most troubling thought. The 2 clinical groups reported significantly more strategies than the nonclinical group. The clinical groups also reported significantly greater intensity of the thought and their emotional response and lower efficacy for the strategies. People with OCD reported a significantly higher proportion of strategies that were specifically linked to the thought content (as distinct from nonspecific strategies that were only linked sequentially in time). The results identify both common and differential characteristics of intrusive cognition in anxiety disorders.     

Validity of three measures of communication for predicting relationship adjustment and stability among a sample of young couples

The goal of this study was to examine whether data from 3 different measures of communication (i.e., self-report, quasi-observational, and observational) can predict relationship adjustment and stability 1 year later when used conjointly in a sample of 62 young couples. The 3 measures of communication were the Communication Skills Test--Revised (CST-R), the Communication Box (CB), and the Demand/Withdraw Pattern Questionnaire (DWPQ). Through hierarchical multiple regression analyses, results revealed that the CST-R and the DWPQ predict both genders' relationship adjustment 1 year later when used conjointly. Logistic regression analyses revealed that none of the measures of communication significantly predicted relationship stability. In conclusion, the combination of the CST-R and the DWPQ appears to be useful for longitudinally predicting relationship adjustment.     

Personality and executive functioning as risk factors in recidivists

The classification of an inmate population at a maximum security jail in Canada was undertaken to study factors correlated with recidivism. A total of 12 recidivists and 12 nonrecidivists were classified according to their index offenses, and a Criminal Record search was completed to verify their statements. A total of 15 non-offenders who had also undergone a criminal record check were included as controls. All participants were administered the Minnesota Multiphasic Personality Inventory-168, Violence Risk Scale-Experimental Version, Coopersmith Self-esteem Inventory, and the Wisconsin Card Sorting Task. Statistical analysis showed significant differences between the groups on scores for the Hypochondriasis, Psychopathic Deviate, and Hypomania scales of the MMPI-168. Significant differences were noted for the Wisconsin Card Sorting Task and the Violence Risk Scale. Discriminant analysis of the recidivists and nonrecidivists correctly classified at a 91.3% level.     

Beyond the Score: Clinical Evaluation Through Formal Psychological Assessment

Questionnaires generate numerical scores, but endorsing different sets of items could produce the same score despite reflecting qualitatively different configurations of clinical features. Formal psychological assessment (FPA) attempts to overcome this by identifying the clinical features entailed by observed response patterns. This study illustrates an application of FPA to the cleaning subscale of a questionnaire assessing obsessive–compulsive symptoms and DSM–IV–TR diagnostic criteria for obsessive–compulsive disorder. A deterministic model of the items–criteria relationships was constructed by mapping each item to each diagnostic criterion. The resulting model was tested on a large community sample (N = 4,412). Results indicate that the theoretical model has adequate fit; item error rates and probabilities for each of the criteria are examined. Clinically relevant examples of the items–criteria relationships are discussed. Possible applications of FPA to personality assessment are also discussed, including long multidimensional questionnaires and questionnaires that use subtle item content.     

Fear,worry, and ritualistic behaviour in childhood: developmental trends and interrelations

Previous studies of childhood fear, worry, and ritualistic behaviour have been limited by restricted age ranges, narrow ranges of anxiety phenomena, non‐comparable methodologies, and assessment of typical behaviour within a pathological context. Content and intensity of fear, worry, and ritualistic behaviour, and associations among these variables, were assessed through a semi‐structured interview individually administered to 142 children aged 7–16 years. Common themes in the content of fear, worry, and ritualistic behaviour varied predictably with age. Intensity ratings for all three phenomena decreased with age, although this decline was only significant between 7 and 10 years. Levels were higher in girls than boys. Fear and worry were positively related, and the regular performance of rituals was related to anxiety across the age range. Worry was more strongly related than fear to engagement in ritualistic behaviour. We consider implications for the understanding of anxiety and ritualistic behaviour in typical and atypical development. Copyright © 2009 John Wiley & Sons, Ltd.     

Multiple pathways to inflated responsibility beliefs in obsessional problems: possible origins and implications for therapy and research.

The purpose of this paper is to consider the possible origins of an inflated sense of responsibility which occupies an important place in the cognitive theory of obsessive compulsive disorder (Rachman, S. (1993). Obsessions, responsibility, and guilt. Behaviour Research and Therapy, 31, 149-154. Salkovskis, P. M. (1985). Obsessional-compulsive Problems: A cognitive-behavioural analysis. Behaviour Research and Therapy, 23 (5), 571-583). Clinical experience and consideration of current cognitive conceptualisations of obsessions and obsessive compulsive disorder suggest a number of possibilities, each of which is described after a brief introduction to the concept itself. While there are reasons to believe that some general patterns can be identified, the origins of obsessional problems are best understood in terms of complex interactions specific to each individual.     

Beliefs about obsessional thoughts

Recent cognitive-behavioral formulations of obsessive-compulsive disorder postulate that intrusive or obsessional thoughts are subject to appraisal. Extreme beliefs about the occurrence and meaning of intrusive thoughts direct appraisal, thus causing marked distress and subjective responsibility which may lead to neutralizing activity. A brief self-report belief inventory was developed from a 92-item pool to assess extreme beliefs concerning intrusive thoughts and responsibility, the control of such thoughts and their possible consequences, and the appropriateness of guilt and neutralizing behavior as a response. The inventory was developed sequentially on two nonclinical samples (N=125, N=265) to distinguish between neutralizing and nonneutralizing subjects. Initial psychometric data for the final instrument were obtained for two further nonclinical samples (N=61, N=50) along with a sample of OCD patients and a matched control group. The instrument showed satisfactory reliability and evidence of criterion, convergent, discriminant, and factorial validity. Finally, data from a heterogeneous outpatient medical sample (N=299) was used to test the relationship among obsessive-compulsive symptoms, mood state, and beliefs. The implications of these results for contemporary models of obsessive-compulsive disorder are discussed.     

Characteristics of illness intrusions in a non-clinical sample

This study examines whether illness intrusions can be distinguished from obsessional intrusions and worries. It also assesses the relationship between strategies, thought characteristics, and appraisal of illness intrusions. Two hundred and forty-three non-clinical participants identified an obsessive intrusive thought, a worry, and an illness intrusion. They evaluated each thought using items from the Cognitive Intrusions Questionnaire. The comparisons of intrusions showed that illness intrusions share characteristics of worries and obsessional intrusions, but also have their own characteristics. Illness intrusions seem to be particularly egosyntonic. The relationships between the strategies used to counter illness intrusions and their appraisal were also tested. Results support the idea that there are specific links between the evaluation of cognitive intrusions and the way they are processed. It demonstrated that escape/avoidance strategies are associated with the egodystonic nature of the thought and that problem-focused strategies are associated with the thought's basis in reality. Illness intrusions may be conceptualised as either obsessions or worries. This study demonstrated that the category of an intrusive thought might not be as important as the way it is processed. It seems more important to consider appraisal of the disturbing thought and the way in which the person subsequently reacts and behaves.