The Association of Trait Mindfulness and Self-compassion with Obsessive-Compulsive Disorder Symptoms: Results from a Large Survey with Treatment-Seeking Adults

Tamara Leeuwerik,Kate Cavanagh,Clara Strauss

doi:10.1007/s10608-019-10049-4

Abstract

Little is known about the role of mindfulness and self-compassion in obsessive-compulsive disorder. This cross-sectional study examined associations of mindfulness and self-compassion with obsessive-compulsive disorder symptoms and with the obsessive beliefs and low distress tolerance thought to maintain them. Samples of treatment-seeking adults (N = 1871) and non-treatment-seeking adults (N = 540) completed mindfulness, self-compassion, obsessive-compulsive disorder, anxiety, depression, obsessive beliefs and distress tolerance questionnaires. Participants with clinically significant obsessive-compulsive disorder symptoms reported lower trait mindfulness and self-compassion compared to participants with clinically significant anxiety/depression and to non-clinical controls. Among the clinical sample, there were medium-large associations between mindfulness and self-compassion and obsessive-compulsive disorder symptoms, obsessive beliefs and distress tolerance. Mindfulness and self-compassion were unique predictors of obsessive-compulsive disorder symptoms, controlling for depression severity. Once effects of obsessive beliefs and distress tolerance were controlled, a small effect remained for mindfulness (facets) on obsessing symptoms and for self-compassion on washing and checking symptoms. Directions for future research and clinical implications are considered in conclusion.

Highlights

Obsessive-compulsive disorder (OCD) is a debilitating mental health condition characterised by obsessions, i.e. persistent unwanted intrusive thoughts, images or urges that can cause significant distress, and compulsions, i.e. repetitive, ritualistic behaviours aimed at alleviating distress and/ or preventing negative outcomes (APA 2013)
The current study aimed to address these evidence gaps to gain a better understanding of whether mindfulness and self-compassion skills are unique predictors of OCD symptoms
As mindfulness experience enhances mindfulness skills (e.g. Baer et al 2008), all analyses were repeated without participants with mindfulness experience as a sensitivity analysis to establish whether statistical significance and size of effects remained unchanged

Summary

Introduction

Obsessive-compulsive disorder (OCD) is a debilitating mental health condition characterised by obsessions, i.e. persistent unwanted intrusive thoughts, images or urges that can cause significant distress, and compulsions, i.e. repetitive, ritualistic behaviours aimed at alleviating distress and/ or preventing negative outcomes (APA 2013). While obsessive-compulsive symptoms lie on a continuum (Abramowitz et al 2014), OCD affects 2–3% of the population Whilst obsessive beliefs play a central role in the cognitive model of OCD, they do not explain all the variance in OCD symptoms(s) (subtypes) in nonclinical and/or OCD samples Belloch et al 2010; Steketee et al 1998; OCCWG 2005; Taylor et al 2006; Tolin et al 2006; Viar et al 2011; Wu and Carter 2008) This reflects the heterogeneity of OCD and suggests other theoretical constructs play a role in the maintenance of OCD symptoms

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