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Friedman-Ezra A, Keydar-Cohen K, van Oppen P, Eikelenboom M, Schruers K, Anholt GE. Loneliness in OCD and its determinants. Psychiatry Res 2024; 337:115963. [PMID: 38788555 DOI: 10.1016/j.psychres.2024.115963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 05/04/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024]
Abstract
Obsessive-compulsive disorder (OCD) is a psychiatric condition characterized by intrusive thoughts and repetitive behaviors, affecting approximately 1.3 % of the population. Loneliness has serious consequences for future health outcomes. Although it has been extensively studied in depression, its prevalence in obsessive-compulsive disorder (OCD) has hardly been investigated. The current study sought to examine the association between loneliness and OCD, through an exploratory investigation of their demographic and clinical correlates. This cross-sectional study utilized data from the Netherlands Obsessive-Compulsive Disorder Association (NOCDA) study, designed to investigate determinants, course, and consequences of OCD in a large clinical sample. In this data base, a cohort of 363 OCD adult patients underwent assessment for loneliness severity, OCD symptomatology, comorbid conditions, and demographic variables. Findings reveal a high prevalence of loneliness among OCD patients, with nearly three-quarters (73.6 %) experiencing elevated levels. Loneliness was associated with greater depression severity and specific demographic factors such as gender, age, and education level. However, the relationship between OCD severity and loneliness was explained by depression severity. Clinical and theoretical implications are discussed as well as limitations and directions for future research.
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Affiliation(s)
- Adi Friedman-Ezra
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Karin Keydar-Cohen
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Patricia van Oppen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and GGZ inGeest Specialized Mental Health Care, the Netherlands
| | - Merijn Eikelenboom
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and GGZ inGeest Specialized Mental Health Care, the Netherlands
| | - Koen Schruers
- Department of Psychiatry and Research School for Mental Health and Neuroscience, Maastricht University, Mondriaan Mental Health Center, Maastricht, the Netherlands
| | - Gideon E Anholt
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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2
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Chiang B, Purdon C. A study of doubt in obsessive-compulsive disorder. J Behav Ther Exp Psychiatry 2023; 80:101753. [PMID: 37247970 DOI: 10.1016/j.jbtep.2022.101753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/19/2022] [Accepted: 05/19/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND AND OBJECTIVES Obsessive-compulsive disorder (OCD) has been referred to as the "doubting disease," yet there has been little foundational research on its phenomenology and characteristics. Studies of doubt have relied on researchers' idiosyncratic conceptualizations of the construct, resulting in varied assessment methods and different prevalence rates (11-75%). We examined the nature and characteristics of doubt in people with clinical and subclinical OCD so as to identify its nature and characteristics, and factors that may be unique to OCD. METHODS A semi-structured interview about doubt was administered to people with OCD (N = 44) and with subclinical OCD (N = 21). RESULTS Doubt was highly prevalent and manifested as a form of obsession, uncertainty about whether a task was done properly, and/or lack of confidence in memory and perceptions. All participants took action to resolve doubt and/or proactively pre-empt or reduce future doubt. Doubt was deeply connected to negative core beliefs about the self. The groups did not differ on their experience of doubt, except that greater symptom severity was associated with greater interference from doubt, less ability to resist it, and less success of proactive, but not reactive, strategies to manage it. LIMITATIONS We relied on retrospective report, and the subclinical group was relatively small. CONCLUSIONS In subclinical and clinical OCD, doubt is pervasive, manifests in three domains, is connected to negative core beliefs, and is highly aversive. Continued empirical study of doubt is essential to proper assessment and to development of theories and treatment of OCD.
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Affiliation(s)
- Brenda Chiang
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada; Parkwood Institute, Operational Stress Injury Clinic - GTA Site, Toronto, ON, Canada.
| | - Christine Purdon
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada.
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3
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Dostal AL, Pilkington PD. Early maladaptive schemas and obsessive-compulsive disorder: A systematic review and meta-analysis. J Affect Disord 2023; 336:42-51. [PMID: 37217101 DOI: 10.1016/j.jad.2023.05.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/10/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a condition with poor treatment outcomes. Improved understanding of the aetiology can inform prevention and treatment approaches; hence several studies have assessed early maladaptive schemas (EMSs) in OCD. This systematic review and meta-analysis aimed to synthesise the evidence on relationships between the 18 EMSs and OCD. METHODS The study was conducted according to PRISMA guidelines and registered on PROSPERO (CRD42022329337). A systematic search of PubMed, PsycINFO, and CINAHL Complete was conducted on 4 June 2022. Studies in peer-reviewed journal articles were included if they assessed EMSs and OCD (diagnosis or symptom severity) in adults with a mean age of 18 years or older. Studies were excluded if they were not in English, did not include original quantitative data, or reported on case studies. Study details were tabulated and the meta-analysis findings were presented using forest plots. Methodological quality was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS). RESULTS Based on 22 studies (pooled N = 3699), all 18 EMSs were positively correlated with OCD. The largest associations were with the dependence/incompetence (r = 0.40 95 % CI [0.32, 0.47]), vulnerability to harm or illness (r = 0.40 95 % CI [0.32, 0.48]), and negativity/pessimism schemas (r = 0.42 95 % CI [0.22, 0.58]). LIMITATIONS Several meta-analyses showed considerable heterogeneity and publication bias. CONCLUSIONS The findings suggest all EMSs, particularly those relating to disproportionate negative expectations and a perceived inability to cope, are implicated in OCD. Psychological prevention and treatment for OCD may benefit from targeting these schemas.
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Affiliation(s)
- Amy L Dostal
- School of Behavioural and Health Sciences, Australian Catholic University, Australia.
| | - Pamela D Pilkington
- School of Behavioural and Health Sciences, Australian Catholic University, Australia
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Stalias-Mantzikos ME, Barahmand U, Aguero K, Peters L, Shamsina N. Early maladaptive schemas in misophonia. CLIN PSYCHOL-UK 2023. [DOI: 10.1080/13284207.2023.2171786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023]
Affiliation(s)
- Maria E. Stalias-Mantzikos
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
- Westchester Community College, SUNY, New York, NY, USA
| | - Usha Barahmand
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
| | - Kerry Aguero
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
| | - Laurisa Peters
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
| | - Naila Shamsina
- Department of Psychology, City University of New York, Queens College, New York, NY, USA
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Purdon C. Dr. Jack Rachman's contributions to our understanding and treatment of obsessive-compulsive disorder. J Behav Ther Exp Psychiatry 2023; 78:101773. [PMID: 36194913 DOI: 10.1016/j.jbtep.2022.101773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/09/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVES This paper reviews the development of the cognitive-behavioural model of obsessive-compulsive disorder (OCD) through the work of Dr. Jack Rachman and the research his ideas inspired or shaped. METHODS A narrative review of Rachman's work and important developments in related areas was conducted. RESULTS Rachman was highly responsive to theoretical and empirical developments in the field, and continuously developed his model of OCD over the course of his career. Key developments in his thinking and of those in related areas are described. LIMITATIONS This is a narrative review that highlights important developments in the cognitive behavioural model of OCD only. CONCLUSIONS The CBT model of OCD has strong empirical support and CBT treatment is the most effective psychotherapy. Continued development in our understanding of attachment and in the persistence of compulsions is warranted.
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Sideli L, Santoro G, Fontana A, Guglielmucci F, Caretti V, Schimmenti A. The Relationship Between Obsessive-Compulsive Symptoms and Dissociation: A Systematic Review and Meta-Analysis. J Trauma Dissociation 2023; 24:362-379. [PMID: 36820493 DOI: 10.1080/15299732.2023.2181477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
This systematic review and meta-analysis aimed to investigate the relationship between dissociation and obsessive-compulsive symptoms (OCS) and disorder (OCD). Specifically, the study aimed to (a) estimate the pooled prevalence of dissociative disorders among individuals with OCD; (b) systematically review the prevalence of OCD among individuals with dissociative disorders; (c) compare the severity of dissociative symptoms between individuals with OCD and non-clinical controls; (d) estimate the association between OCS and dissociative symptoms in the clinical and non-clinical populations. A systematic search was carried out in biomedical databases from inception to January 2022 according to PRISMA guidelines. A total of 41 studies met inclusion criteria (n = 9,438, 34.3% males). The pooled prevalence of dissociative disorders in adult samples with OCD was 8% (95% CI [3, 15], k = 5). Studies on adolescent and adult patients with dissociative disorders found that 17-32% reported comorbid OCD, while a prospective study of patients with early-onset dissociative disorders found no evidence of association with OCD. Individuals affected by OCD reported more dissociative symptoms than non-clinical controls (g = .67, 95% CI [.18, 1.16], k = 9). A moderate correlation between dissociative symptoms and OCS was detected (r = .43, 95% CI [.36, .51], k = 18). Sensitivity analyses showed small/moderate correlations between dissociative experiences and specific types of obsessions and compulsions. Findings suggest that dissociative symptoms are moderately related to OCS in both clinical and non-clinical populations. Interventions aimed to reduce dissociation might improve treatment response of patients suffering from OCD.
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Affiliation(s)
- Lucia Sideli
- Department of Human Science, LUMSA University, Rome, Italy
| | - Gianluca Santoro
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Enna, Italy
| | - Andrea Fontana
- Department of Human Science, LUMSA University, Rome, Italy
| | - Fanny Guglielmucci
- Department of Philosophy, Communication and Arts, University of Rome 3, Roma, Italy
| | | | - Adriano Schimmenti
- Faculty of Human and Social Sciences, UKE - Kore University of Enna, Enna, Italy
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Cui J, Zhu K, Wen J, Nie W, Wang D. The relationship between moral judgment ability, parenting style, and perfectionism in obsessive-compulsive disorder patients: A mediating analysis. Front Psychol 2023; 14:1133880. [PMID: 36923138 PMCID: PMC10009154 DOI: 10.3389/fpsyg.2023.1133880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 02/07/2023] [Indexed: 03/02/2023] Open
Abstract
Introduction Guilt is an important part of obsessive-compulsive disorder. The abnormal moral cognition of obsessive-compulsive disorder patients may be closely related to their high level of guilt. The purpose of this study was to explore the development level of moral judgment in patients with obsessive-compulsive disorder and the role of parenting style and perfectionism in moral judgment development. Method A cross-sectional study was conducted in the clinical psychology department of a Class III hospital in Beijing. The patients with obsessive-compulsive disorder were recruited, and the healthy control subjects were recruited at the same time. Questionnaires were used to collect data, including the Yale-Brown Compulsion Scale, the Moral Judgment Test, the Parenting Style Evaluation Scale, and the Frost Multidimensional Perfectionism Scale. Result A total of 231 patients with obsessive-compulsive disorder and 246 healthy controls were included. The results showed that, first, the obsessive-compulsive group scored significantly lower on moral judgment than the healthy control group. Second, the tendency of non-adaptive perfectionism was significantly higher in the obsessive-compulsive group than in the healthy control group. Third, parents' excessive control, denial, punishment, and other parenting styles and non-adaptive perfectionism are higher than those of healthy people. Fourthly, the mother of obsessive-compulsive disorder patients is overly interference and protective. Rejection, denial, punishment, harshness, and father's rejection and denial play a partial mediating role in moral judgment ability through the degree of non-adaptive perfectionism. Conclusion The development level of moral judgment ability of patients with obsessive-compulsive disorder was significantly lower than that of the normal group, and the level of non-adaptive perfectionism was significantly higher than that of the normal group. Parents of obsessive-compulsive patients use more high-pressure control education. Parenting style partially affects the moral judgment of obsessive-compulsive patients through the degree of non-adaptive perfectionism.
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Affiliation(s)
- Jiacheng Cui
- Department of Applied Psychology, Binzhou Medical University, Yantai, China
| | - Kongmei Zhu
- Third Hospital of Beijing Chaoyang, Beijing, China
| | - Jianglin Wen
- Department of Applied Psychology, Binzhou Medical University, Yantai, China
| | - Wanjie Nie
- Department of Applied Psychology, Binzhou Medical University, Yantai, China
| | - Dong Wang
- Department of Clinical Psychology, Beijing Chaoyang Hospital, Beijing, China
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8
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Wu D, Jiang M, Tian Y, Zhao F, Jia Y. Morita therapy for obsessive-compulsive disorder: A systematic review and meta-analysis. Australas Psychiatry 2022; 30:436-443. [PMID: 35285288 DOI: 10.1177/10398562211070151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the clinical efficacy of Morita therapy in combination with pharmacotherapy in adults who were diagnosed with current OCDs. METHODS We searched 10 databases to identify articles written in English or Chinese that were published until 15 April 2021. Randomized controlled trials were included. Two authors of this review independently selected the studies, assessed the risk of bias, and extracted the data. RESULTS Twenty-one studies with a total of 1604 participants met the inclusion criteria. Morita therapy plus pharmacotherapy was significantly superior to pharmacotherapy alone in the efficiency of OCD (RR = 1.34, 95% CI: 1.26 to 1.44, I2 = 0%), and better in reducing OCD severity symptoms (MD = -3.55, 95% CI: -4.34 to -2.75, I2 = 80%). CONCLUSION Our meta-analysis and systematic review suggest that Morita therapy may be an effective approach to improve OCDs.
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Affiliation(s)
- Di Wu
- Invasive Technology Nursing Platform, 117971the First Hospital of Jilin University, Changchun, China
| | - Meina Jiang
- Invasive Technology Nursing Platform, 117971the First Hospital of Jilin University, Changchun, China
| | - Yixin Tian
- School of Public Health, 220738Jilin University, Changchun, China
| | - Fengjun Zhao
- School of Nursing, 12510Jilin University, Changchun, China
| | - Yong Jia
- School of Nursing, 12510Jilin University, Changchun, China
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9
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Yilmaz Z, Larsen JT, Nissen JB, Crowley JJ, Mattheisen M, Bulik CM, Petersen LV. The role of early-life family composition and parental socio-economic status as risk factors for obsessive-compulsive disorder in a Danish national cohort. J Psychiatr Res 2022; 149:18-27. [PMID: 35219872 PMCID: PMC9627644 DOI: 10.1016/j.jpsychires.2022.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/02/2022] [Accepted: 02/14/2022] [Indexed: 01/16/2023]
Abstract
Research on early-life family environment on obsessive-compulsive disorder (OCD) risk is limited, and sex differences have not been sufficiently studied. We investigated early-life family composition and parental socio-economic status (SES) as OCD risk factors while stratifying for sex in a sample of 1,154,067 individuals from the Danish population (7550 of whom had OCD). Data on early-life family composition (birth order, number of siblings, number of parents in household at proband age 6), parental SES at age 6 (parental income, occupation, and education level), history of parental psychiatric illness, and parental age at birth on OCD risk (i.e., an ICD-10 diagnosis of F42.x) were obtained from Danish population registers. Survival analyses using Cox regression were performed with age as the underlying time variable. Analyses were adjusted for calendar time, and differential effect by sex was tested for exposures. We found that birth order and advanced maternal age were risk factors for OCD in males, and being an only child was associated with increased OCD risk in both sexes. Early childhood SES variables including parental education, occupation, and income were associated with OCD risk, and these effects were more pronounced in females. Significant interaction effects for parental education/occupation and the presence of non-OCD psychiatric diagnoses in the proband also emerged. Our results suggest that early-life SES and family composition may be important risk factors for OCD, and heterogeneity in OCD cases in terms of psychiatric comorbidities, as well as sex differences should be carefully examined in relation to risk factors.
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Affiliation(s)
- Zeynep Yilmaz
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, 8210, Denmark; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 27599-7160; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 77, Sweden.
| | - Janne Tidselbak Larsen
- National Centre for Register-based Research, Aarhus BSS,
Aarhus University, Aarhus, Denmark, 8210,Lundbeck Foundation Initiative for Integrative Psychiatric
Research (iPSYCH), Aarhus University, Aarhus, Denmark, 8000,Centre for Integrated Register-based Research (CIRRAU),
Aarhus University, Aarhus, Denmark, 8210
| | - Judith Becker Nissen
- Department of Child and Adolescent Psychiatry, Aarhus
University Hospital, Aarhus, Denmark, 8200
| | - James J. Crowley
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA, 27599-7160,Department of Genetics, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA, 27599-7264,Department of Clinical Neuroscience, Karolinska Institutet,
Stockholm, Sweden, 171 77
| | - Manuel Mattheisen
- Lundbeck Foundation Initiative for Integrative Psychiatric
Research (iPSYCH), Aarhus University, Aarhus, Denmark, 8000,Department of Clinical Neuroscience, Karolinska Institutet,
Stockholm, Sweden, 171 77,Department of Biomedicine, Aarhus University, Aarhus,
Denmark, 8000,Department of Psychiatry, Dalhousie University, Halifax,
Nova Scotia, Canada, B3H 2E2
| | - Cynthia M. Bulik
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA, 27599-7160,Department of Medical Epidemiology and Biostatistics,
Karolinska Institutet, Stockholm, Sweden, 171 77,Department of Nutrition, University of North Carolina at
Chapel Hill, Chapel Hill, North Carolina, USA, 27599-7400
| | - Liselotte Vogdrup Petersen
- National Centre for Register-based Research, Aarhus BSS,
Aarhus University, Aarhus, Denmark, 8210,Lundbeck Foundation Initiative for Integrative Psychiatric
Research (iPSYCH), Aarhus University, Aarhus, Denmark, 8000,Centre for Integrated Register-based Research (CIRRAU),
Aarhus University, Aarhus, Denmark, 8210
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Dessoki HH, Sadek MN, Abd Elrassol HA, El-Sayed SG, Soltan MR. Gender-related romantic attachment and serum oxytocin level difference in adult patients with obsessive compulsive disorder. Middle East Curr Psychiatry 2021. [DOI: 10.1186/s43045-021-00159-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Given the scarcity of data on gender-related romantic attachment changes and the potential role of oxytocin (OT) in the pathophysiology of obsessive-compulsive illness (OCD), the current study aimed to assess gender-related differences in romantic attachment characteristics and their relationship to serum oxytocin in a set of forty OCD cases compared with a similar group of healthy controls .Simultaneously examining the gender differences in serum oxytocin levels in OCD patients, the diagnosis of OCD patients was determined using DSM-5 criteria, and the severity of OCD was determined using the Y-BOCS rating scale. All of the patients were drug-free and not depressed. The romantic attachment was assessed using the “Experiences in Close Relationship” Questionnaire. Standard ELISA kits were used to assess plasma OT levels.
Results
Regarding romantic attachments, patients with obsessive compulsive disorder scored higher on the anxiety and avoidance domains than controls with no significant gender difference. Serum oxytocin was higher in patients with OCD than in healthy controls, indicating a possible underlying pathophysiology of the illness. Also, there was a significant gender difference, with female patients having higher serum oxytocin and symptoms severity being negatively associated.
Conclusions
Taken together, these findings propose that OT may play a role in OCD pathophysiology with gender specificity. Also, OCD associated with insecure romantic attachment.
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Pozza A, Dèttore D, Marazziti D, Doron G, Barcaccia B, Pallini S. Facets of adult attachment style in patients with obsessive-compulsive disorder. J Psychiatr Res 2021; 144:14-25. [PMID: 34592507 DOI: 10.1016/j.jpsychires.2021.09.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 08/25/2021] [Accepted: 09/22/2021] [Indexed: 12/11/2022]
Abstract
Literature data did not show univocal evidence in discriminating which form of attachment insecurity is involved in obsessive-compulsive disorder (OCD): both anxiety and avoidance was related to OCD symptomatology. No study used the Attachment Style Questionnaire (ASQ) that allows for investigation of differentiated facets of attachment anxiety and of avoidance. We investigated: (1) whether individuals with OCD differed from controls in the facets of attachment security (anxiety and avoidance), (2) which attachment facets predicted a diagnosis of OCD, controlling for socio-demographics and obsessive beliefs, (3) which attachment facets predicted specific OCD symptoms, controlling for socio-demographics and obsessive beliefs. Two hundred seventy participants (135 OCD patients and 135 matched controls) completed the Obsessive-Compulsive Inventory-Revised, Obsessive Beliefs Questionnaire-46 and ASQ. OCD patients reported respectively lower and higher levels on confidence and attachment anxiety than controls. Higher need of approval was the most important predictor of OCD diagnosis beyond the other attachment facets, and even of the obsessive beliefs. Using multivariate generalised linear models, the two facets of attachment anxiety, the need for approval (that predicted higher levels of obsessing and ordering symptoms), and preoccupation with relationships (that predicted higher hoarding symptoms) seemed to explain variance over and above OCD-related beliefs and socio-demographics. Discomfort with closeness contributed to the predictions of ordering symptoms. In conclusion, the interpersonal dynamics related to attachment in OCD patients should be carefully considered during assessment and treatment of OCD patients in clinical practice.
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Affiliation(s)
- Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Pisa, Italy; Unicamillus University, Rome, Italy; Brain Research Foundation, Lucca, Italy
| | - Guy Doron
- Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC), Herzliya, Israel
| | - Barbara Barcaccia
- Department of Education, Roma Tre University, Rome, Italy; Associazione di Psicologia Cognitiva APC and Scuola di Psicoterapia Cognitiva srl SPC, Rome, Italy
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Mota-Rojas D, Mariti C, Zdeinert A, Riggio G, Mora-Medina P, del Mar Reyes A, Gazzano A, Domínguez-Oliva A, Lezama-García K, José-Pérez N, Hernández-Ávalos I. Anthropomorphism and Its Adverse Effects on the Distress and Welfare of Companion Animals. Animals (Basel) 2021; 11:3263. [PMID: 34827996 PMCID: PMC8614365 DOI: 10.3390/ani11113263] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 01/08/2023] Open
Abstract
Anthropomorphic practices are increasing worldwide. Anthropomorphism is defined as the tendency to attribute human forms, behaviors, and emotions to non-human animals or objects. Anthropomorphism is particularly relevant for companion animals. Some anthropomorphic practices can be beneficial to them, whilst others can be very detrimental. Some anthropomorphic behaviors compromise the welfare and physiology of animals by interfering with thermoregulation, while others can produce dehydration due to the loss of body water, a condition that brings undesirable consequences such as high compensatory blood pressure and heat shock, even death, depending on the intensity and frequency of an animal's exposure to these stressors. Malnutrition is a factor observed due to consumption of junk food or an imbalance in caloric proportions. This can cause obesity in pets that may have repercussions on their locomotor apparatus. Intense human-animal interaction can also lead to the establishment of attachment that impacts the mental state and behavior of animals, making them prone to develop aggression, fear, or anxiety separation syndrome. Another aspect is applying cosmetics to pets, though scientific studies have not yet determined whether cosmetic products such as coat dyes, nail polish, and lotions are beneficial or harmful for the animals, or to what extent. The cohabitation of animals in people's homes can also constitute a public health risk due to infectious and zoonotic diseases. In this context, this paper aims to analyze the adverse effects of anthropomorphism on the welfare of companion animals from several angles-physiological, sanitary, and behavioral-based on a discussion of current scientific findings.
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Affiliation(s)
- Daniel Mota-Rojas
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Unidad Xochimilco, Mexico City 04960, Mexico; (A.Z.); (A.d.M.R.); (A.D.-O.); (K.L.-G.); (N.J.-P.)
| | - Chiara Mariti
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (C.M.); (G.R.); (A.G.)
| | - Andrea Zdeinert
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Unidad Xochimilco, Mexico City 04960, Mexico; (A.Z.); (A.d.M.R.); (A.D.-O.); (K.L.-G.); (N.J.-P.)
| | - Giacomo Riggio
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (C.M.); (G.R.); (A.G.)
| | - Patricia Mora-Medina
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México (UNAM), Cuautitlán Izcalli 54714, Mexico; (P.M.-M.); (I.H.-Á.)
| | - Alondra del Mar Reyes
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Unidad Xochimilco, Mexico City 04960, Mexico; (A.Z.); (A.d.M.R.); (A.D.-O.); (K.L.-G.); (N.J.-P.)
| | - Angelo Gazzano
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (C.M.); (G.R.); (A.G.)
| | - Adriana Domínguez-Oliva
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Unidad Xochimilco, Mexico City 04960, Mexico; (A.Z.); (A.d.M.R.); (A.D.-O.); (K.L.-G.); (N.J.-P.)
| | - Karina Lezama-García
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Unidad Xochimilco, Mexico City 04960, Mexico; (A.Z.); (A.d.M.R.); (A.D.-O.); (K.L.-G.); (N.J.-P.)
| | - Nancy José-Pérez
- Neurophysiology, Behavior and Animal Welfare Assessment, DPAA, Universidad Autónoma Metropolitana (UAM), Unidad Xochimilco, Mexico City 04960, Mexico; (A.Z.); (A.d.M.R.); (A.D.-O.); (K.L.-G.); (N.J.-P.)
| | - Ismael Hernández-Ávalos
- Facultad de Estudios Superiores Cuautitlán, Universidad Nacional Autónoma de México (UNAM), Cuautitlán Izcalli 54714, Mexico; (P.M.-M.); (I.H.-Á.)
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Meehan S, O'Connor J, Keogh K. Beauty and the beast: A psychoanalytically oriented qualitative study detailing mothers' experience of perinatal obsessive‐compulsive disorder. Int J Appl Psychoanal Studies 2021. [DOI: 10.1002/aps.1732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Sofie Meehan
- School of Psychology Trinity College Dublin Dublin Ireland
| | - John O'Connor
- School of Psychology Trinity College Dublin Dublin Ireland
| | - Karen Keogh
- Adult Community Psychology, Health Service Executive Wicklow Ireland
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Löffler-Stastka H, Steinmair D. Future of processing and facilitating change and learning. World J Psychiatry 2021; 11:507-516. [PMID: 34631456 PMCID: PMC8474993 DOI: 10.5498/wjp.v11.i9.507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/24/2021] [Accepted: 08/02/2021] [Indexed: 02/06/2023] Open
Abstract
The field of the sciences of the mind is evolving fast. With the diversification of knowledge and accumulation of data, often lacking integration and reproducibility, questions arise. The role of critical thinking and research is evident. As the science of the unconscious, psychoanalysis provides a method and theory to understand human minds and mentalities, helping the patient know his mind and transform action into reflection. Mental activities, including social skills, develop in the social context, depending on the social environment’s demands and resources put onto the individual. Encoding emotional signals, markers of meaning for the individual, is ontogenetically necessary and has influences on memory encoding. Beyond theoretical understanding, implicit relational knowledge is actualized in the therapeutic setting. With a strong focus on experiencing emotional reconsolidation of memories, previous relationships’ repercussions are enriched with broadening viewpoints in the analytic environment. The long-term effects of psychotherapeutic treatments have been examined. A sufficient explanation of the specific factors contributing to success or an answer when an impact is lacking is still under investigation. When investigating subliminal and implicit mechanisms leading to memory reconsolidation and the formation of functional object relations and interaction patterns, the focus is set on affective interplay and processing prior/during and after social interactions. The present paper discusses which parameters might contribute to the reshaping of memories and the linkage of memory with the emotional load of experience. Providing insights into such dynamic mental phenomena could enhance process research by investigating moment by moment interactions in psychoanalysis, treatment, and learning processes. Due to the research subject’s complexity, different research methods and integration of associated research fields are required.
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Affiliation(s)
| | - Dagmar Steinmair
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna 1090, Austria
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Tibi L, Asher S, van Oppen P, van Balkom AJLM, Eikelenboom M, Visser HA, Penninx BW, Anholt GE. The correlates of social phobia in OCD: Findings from a large clinical sample. Br J Clin Psychol 2021; 60:312-332. [PMID: 33870535 DOI: 10.1111/bjc.12292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 03/18/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder, often complicated with comorbidities. Social phobia (SP) is the most frequent co-occurring anxiety disorder in OCD, associated with increased clinical severity. However, no study had examined the relevance of interpersonal processes in this comorbidity, which are at the core of SP. This study characterized the clinical (i.e., symptom profile, age of onset, chronicity, and comorbidity), vulnerability (i.e., childhood trauma, negative life events), and interpersonal (attachment style, expressed emotion, and social support) correlates of comorbid SP in a large sample of OCD patients. METHODS We analysed the data of 382 OCD patients participating in the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. We examined the correlates of SP in OCD using self-report questionnaires and structured clinical interviews. In addition, data of 312 non-OCD SP patients were drawn from the Netherlands Study of Depression and Anxiety (NESDA), to compare the age of onset of SP between groups. Descriptive univariate analyses were followed by backward stepwise logistic regression analyses. RESULTS Social phobia was present among approximately 20% of OCD patients. Social phobia in OCD was associated with increased depression severity and decreased ratings of secure attachment style. Among OCD patients, SP had a significantly earlier age onset as compared to SP in non-OCD patients. CONCLUSION Social phobia in OCD might render a vulnerable clinical picture, characterized with early onset of SP symptoms, insecure attachment style, and increased depressive symptoms. Future studies should use prospective designs to better understand the nature of comorbid SP in OCD. PRACTITIONER POINTS Approximately one fifth of OCD patients were diagnosed with comorbid social phobia in a large representative clinical sample. OCD patients with comorbid social phobia presented with a vulnerable clinical picture, characterized with increased depression severity and decreased ratings of secure attachment style. Social phobia in OCD was associated with an earlier AOO as compared to the AOO of social phobia without OCD. The findings are limited by a cross-sectional design; thus, causality could not be assessed. Research is needed to further examine the mechanisms of comorbid social phobia in OCD.
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Affiliation(s)
- Lee Tibi
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Sapir Asher
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Patricia van Oppen
- Amsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health research institute and GGZ inGeest Specialized Mental Health Care, the Netherlands
| | - Anton J L M van Balkom
- Amsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health research institute and GGZ inGeest Specialized Mental Health Care, the Netherlands
| | - Merijn Eikelenboom
- Amsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health research institute and GGZ inGeest Specialized Mental Health Care, the Netherlands
| | - Henny A Visser
- Innova Research Centre, Mental Health Care Institute GGZ Centraal, Ermelo, The Netherlands
| | - Brenda W Penninx
- Amsterdam UMC, Location VUmc, Department of Psychiatry, Amsterdam Public Health research institute and GGZ inGeest Specialized Mental Health Care, the Netherlands
| | - Gideon E Anholt
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Pozza A, Casale S, Marazziti D, Albert U, Mucci F, Berti E, Grassi G, Prestia D, Dèttore D. Attachment styles and propensity for sexual response in adult obsessive-compulsive disorder. Sexual and Relationship Therapy 2021. [DOI: 10.1080/14681994.2021.1900805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Silvia Casale
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
- UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Federico Mucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| | - Erika Berti
- School of Psychology, University of Florence, Florence, Italy
| | | | - Davide Prestia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Infant-Maternal Science, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
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Dèttore D, Angelo NL, Marazziti D, Mucci F, Prestia D, Pozza A. A Pilot Study of Gender Differences in Sexual Arousal of Patients With OCD: The Moderator Roles of Attachment and Contamination Symptoms. Front Psychiatry 2021; 11:609989. [PMID: 33643081 PMCID: PMC7902707 DOI: 10.3389/fpsyt.2020.609989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/30/2020] [Indexed: 11/25/2022] Open
Abstract
Sexual arousal is often impaired in patients with obsessive-compulsive disorder (OCD). However, little is known about the factors related to this impairment: no study focused on the role of gender-based effects of attachment styles and contamination symptoms. The Dual Control Model assumes three processes driving sexual arousal: sexual excitation (SE), sexual inhibition (SI) due to threat of performance failure, and SI due to threat of performance consequences (e.g., getting contaminated with sexually transmitted diseases). In a group of OCD patients, we hypothesized that (a) women report lower SE and higher SI than men; (b) patients with insecure (both anxious and avoidant) attachment styles show lower SE and higher SI; (c) attachment styles moderate the relation between gender and sexual arousal (respectively, for women, higher attachment anxiety, and for men higher attachment avoidance were related to impaired sexual arousal (higher SE and SI) controlling for OCD severity); and (d) contamination symptoms moderate the relation between gender and sexual impairment (women with contamination symptoms show impaired sexual arousal). Seventy-two OCD patients (37.50% women) completed the Obsessive-Compulsive Inventory-Revised, Attachment Styles Questionnaire and Sexual Inhibition/Sexual Excitation Scales. In contrast with our hypotheses, women reported higher SE and lower SI due to threat of performance consequences than men. Patients with higher attachment avoidance (discomfort with intimacy) but also confidence in self and others had higher SE. Women with attachment avoidance (i.e., discomfort with intimacy) had lower SE, while women with attachment anxiety (i.e., preoccupations with relationships) had higher SI due to negative performance consequences. Women with contamination symptoms had higher SI due to performance failure but lower SI due to performance consequences. The present preliminary findings suggest that sexual arousal impairment should be evaluated during the assessment of OCD patients, and gender-based effects of attachment styles and contamination symptoms should be considered during personalized treatment planning.
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Affiliation(s)
- Davide Dèttore
- Department of Health Sciences, University of Florence, Florence, Italy
| | | | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
- UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Federico Mucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy
| | - Davide Prestia
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Infant-Maternal Science, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Andrea Pozza
- Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy
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