Theories Of Obsessive-compulsive Disorder Research Articles

Review of Obsessive Compulsive Disorders Theories

The present review aimed to analyze the scientific literature untill 2010 about the theories of Obsessive Compulsive Disorder in order to make clear how a biological and cognitive hypotheses might be integrated in a comprehensive point of view.
 In the analysis, at biological level were included neuroanatomic and neurophysiologic models and animal models; instead at cognitive level were included different theories of Salwoskies, Van den Hout, Mancini e Rachman. Biological, cognitive, and behavioral elements of the theories have to be clearly distinguished between specific and general conditions, as do critical past events and current trigger conditions. The theories compared were drawn from the neurobiological, cognitive, and behavioral literature that proposed empirical supported models. We conclude that there are substantive differences among the cognitive theories and between the biological theories reviewed. However, cognitive and biological theories appear to be compatible in principle. It is not clear whether substantive differences among theories are due to the existence of subtypes of OCD or due to the predominance of multifactorial cause.
 It is argued that current treatment methods imply particular theories, and that particular patterns of success and failure can be understood in relation to theory through the methods we have employed.

Obsessive Compulsive Disorder Tokoh Sata Senda dalam Manga Keppeki Shounen Kanzen Soubi!! Karya Touya Tobina.

This research discusses about “Obsessive Compulsive Disorder Tokoh Sata Senda in Manga Keppeki Shounen Kanzen Soubi!! By Touya Tobina”. The research aims to provide psychology knowledge about Obsessive Compulsive Disorder (OCD). The research metdod used was descriptive analysis. There were five theories used in this research, they were the psychology literature theory by Wellek and Austin (1989), theory of OCD by Wilson (2001) ,Oltmanns and Emery (2003), theory of Cognitive therapy by Aron T Beck (1976) semiotics by Danesi (2007). The result obtained from this research , Sata Senda is suffer from OCD with behavior (1) , Washing and Cleaning, (2) Ordering, (3) Checking, (4) Ritual. Physiology, Sata Senda has a neat and reclusive appearance to avoid germ and disease. Psychology, Senda OCD can be seen from his excessive behavior like washing and cleaning, ordering all things around, over checking a things again and again, and do ritual repeatly everyday. Sociologically, Senda OCD can affect people around him like ordering his friends to washing everytime they touch something. The Obsessive Compulsive Disorder in Sata Senda caused by two factors there is internal factors that can from trauma ans stress and external factors that came from people around him. The efforts of Sata Senda figure to decrease his OCD behaviour is from internally is Senda has intention to be a normal person, which is make Senda trying to overcome his OCD by decreasing his anxiety from the things that are surrounding him. Except from Senda desired to control his OCD , his friends has important rule to overcame Senda OCD

The Psychopharmacology of Obsessive-Compulsive Disorder: A Preclinical Roadmap.

This review evaluates current knowledge about obsessive-compulsive disorder (OCD), with the goal of providing a roadmap for future directions in research on the psychopharmacology of the disorder. It first addresses issues in the description and diagnosis of OCD, including the structure, measurement, and appropriate description of the disorder and issues of differential diagnosis. Current pharmacotherapies for OCD are then reviewed, including monotherapy with serotonin reuptake inhibitors and augmentation with antipsychotic medication and with psychologic treatment. Neuromodulatory therapies for OCD are also described, including psychosurgery, deep brain stimulation, and noninvasive brain stimulation. Psychotherapies for OCD are then reviewed, focusing on behavior therapy, including exposure and response prevention and cognitive therapy, and the efficacy of these interventions is discussed, touching on issues such as the timing of sessions, the adjunctive role of pharmacotherapy, and the underlying mechanisms. Next, current research on the neurobiology of OCD is examined, including work probing the role of various neurotransmitters and other endogenous processes and etiology as clues to the neurobiological fault that may underlie OCD. A new perspective on preclinical research is advanced, using the Research Domain Criteria to propose an adaptationist viewpoint that regards OCD as the dysfunction of a normal motivational system. A systems-design approach introduces the security motivation system (SMS) theory of OCD as a framework for research. Finally, a new perspective on psychopharmacological research for OCD is advanced, exploring three approaches: boosting infrastructure facilities of the brain, facilitating psychotherapeutic relearning, and targeting specific pathways of the SMS network to fix deficient SMS shut-down processes. SIGNIFICANCE STATEMENT: A significant proportion of patients with obsessive-compulsive disorder (OCD) do not achieve remission with current treatments, indicating the need for innovations in psychopharmacology for the disorder. OCD may be conceptualized as the dysfunction of a normal, special motivation system that evolved to manage the prospect of potential danger. This perspective, together with a wide-ranging review of the literature, suggests novel directions for psychopharmacological research, including boosting support systems of the brain, facilitating relearning that occurs in psychotherapy, and targeting specific pathways in the brain that provide deficient stopping processes in OCD.

The development and validation of the Beliefs About Losing Control Inventory (BALCI)

ABSTRACTCognitive theory of obsessive-compulsive disorder (OCD) proposes that maladaptive beliefs play a pivotal role in the development and maintenance of symptoms. Clinical reports as well as recent psychometric and experimental investigations suggest that control-related beliefs in OCD may benefit from expansion to include aspects of losing control. However, currently available measures either focus on other facets of control (e.g., sense of control) or do not put emphasis on beliefs about losing control (e.g., beliefs about control over thoughts). The current study aimed to develop and validate the Beliefs About Losing Control Inventory (BALCI), a self-report measure of negative beliefs about losing control, in a sample of undergraduate participants (N= 488). An exploratory factor analysis revealed that the BALCI’s 21 items capture negative beliefs about losing control over one’s thoughts, behaviour, and emotions (Factor 1), beliefs about the importance of staying in control (Factor 2), and beliefs about losing control over one’s body/bodily functions (Factor 3). The BALCI was also found to have good convergent and divergent validity and to be associated with elevated OCD symptoms above and beyond previously identified obsessive beliefs. Theoretical implications and recommendations for the field of cognitive-behaviour therapy are discussed.

Symptom-Specific Threat Perception Mediates the Relationship Between Obsessive Beliefs and OCD Symptoms

Cognitive theories of obsessive compulsive disorder (OCD) propose that obsessive beliefs bias individuals’ perception of OC-relevant threats, which in turn maintain OCD symptoms. However, no prior research has directly tested this mediational model in a clinical sample. The current study bridges this gap in the literature. Sixty adults with OCD completed a diagnostic interview, self-report questionnaires and a threat perception task. More specifically, participants rated the perceived threat associated with (a) OC-specific stimuli (e.g., toilet) that matched their most interfering symptom dimension (e.g., contamination) and (b) generally negative terms (e.g., pain). Results supported hypotheses, in that the threat associated with OC-specific—but not generally negative—terms significantly mediated the relationship between obsessive beliefs and the severity of participants’ most interfering OCD symptom dimension. Findings underscore the importance of targeting inflated perceptions of OC-specific threats in the treatment of OCD. Limitations and future directions are discussed.

Inflammation in the Neurocircuitry of Obsessive-Compulsive Disorder

For a small percentage of obsessive-compulsive disorder (OCD) cases exhibiting additional neuropsychiatric symptoms, it was proposed that neuroinflammation occurs in the basal ganglia as an autoimmune response to infections. However, it is possible that elevated neuroinflammation, inducible by a diverse range of mechanisms, is important throughout the cortico-striato-thalamo-cortical circuit of OCD. Identifying brain inflammation is possible with the recent advance in positron emission tomography (PET) radioligands that bind to the translocator protein (TSPO). Translocator protein density increases when microglia are activated during neuroinflammation and the TSPO distribution volume (VT) is an index of TSPO density. To determine whether TSPO VT is elevated in the dorsal caudate, orbitofrontal cortex, thalamus, ventral striatum, dorsal putamen, and anterior cingulate cortex in OCD. This case-control study was conducted at a tertiary care psychiatric hospital from May 1, 2010, to November 30, 2016. Participants with OCD (n = 20) and age-matched healthy control individuals (n = 20) underwent a fluorine F 18-labeled N-(2-(2-fluoroethoxy)benzyl)-N-(4-phenoxypyridin-3-yl)acetamide PET scan. It is a high-quality second-generation TSPO-binding PET radiotracer. All participants were drug and medication free, nonsmoking, and otherwise healthy. The TSPO VT was measured in the dorsal caudate, orbitofrontal cortex, thalamus, ventral striatum, dorsal putamen, and anterior cingulate cortex. Compulsions were assessed with the Yale-Brown Obsessive Compulsive Scale. In the OCD and healthy groups, the mean (SD) ages were 27.4 (7.1) years and 27.6 (6.6) years, respectively, and 11 (55%) and 8 (40%) were women, respectively. In OCD, TSPO VT was significantly elevated in these brain regions (mean, 32%; range, 31%-36% except anterior cingulate cortex, 24%; analysis of variance, effect of diagnosis: P < .001 to P = .004). Slightly lower elevations in TSPO VT (22%-29%) were present in other gray matter regions. The Yale-Brown Obsessive Compulsive Scale measure of distress associated with preventing compulsive behaviors significantly correlated with TSPO VT in the orbitofrontal cortex (uncorrected Pearson correlation r = 0.62; P = .005). To our knowledge, this is the first study demonstrating inflammation within the neurocircuitry of OCD. The regional distribution of elevated TSPO VT argues that the autoimmune/neuroinflammatory theories of OCD should extend beyond the basal ganglia to include the cortico-striato-thalamo-cortical circuit. Immunomodulatory therapies should be investigated in adult OCD, rather than solely childhood OCD, particularly in cases with prominent distress when preventing compulsions.

Obsessive-compulsive disorder patients with washing symptoms show a specific brain network when confronted with aggressive, sexual, and disgusting stimuli

Psychoanalytic theories of obsessive-compulsive disorder (OCD) suggest that underlying conflicts about aggression or sexuality drive a variety of obsessive-compulsive behaviors. This study aimed to explore the possible neural correlates of these processes in OCD patients in response to emotion-evoking stimulus material. A total of 15 unmedicated OCD patients primarily with washing symptoms and 15 healthy control participants underwent functional magnetic resonance imaging analysis while confronted with neutral pictures and emotion-evoking pictures (aggression, disgust, water, sexuality). The choice of the stimuli explicitly took into account the psychoanalytical model of OCD. While viewing aggressive pictures compared to neutral stimuli, OCD patients demonstrated greater activation than controls in the right frontal gyrus, posterior cingulate cortex, insula, claustrum, and in parietal areas of the left hemisphere. In the disgust condition OCD patients demonstrated greater activation than controls in right frontal gyrus, right precentral gyrus, and in left inferior parietal lobule. These results furnish evidence that OCD patients with washing symptoms show a different pattern of processing of aggressive and disgusting stimuli at the brain level. The implicated networks involved suggest that OCD patients have a more self-referential response than in healthy controls. Focusing on the processing of specific negative emotions may help in the enhancement of psychotherapy for OCD.

Priming Moral Self-Ambivalence Heightens Deliberative Behaviour in Self-Ambivalent Individuals

Recent work on cognitive-behavioural models of obsessive-compulsive disorder has focused on the roles played by various aspects of self-perception. In particular, moral self-ambivalence has been found to be associated with obsessive-compulsive phenomena. In this study we used an experimental task to investigate whether artificially priming moral self-ambivalence would increase participants' deliberation on ethical problems, an index that might be analogous to obsessive-compulsive behaviour. Non-clinical participants completed two online tasks designed to prime either moral self-ambivalence, general uncertainty, or neither. All participants then completed a task requiring them to consider solutions to moral dilemmas. We recorded the time participants took to respond to the dilemmas and the length of their responses; we then combined these variables to create a measure of deliberation. Priming moral self-ambivalence led to increases in deliberation, but this was only significant among those participants who scored highly on a baseline measure of moral self-ambivalence. Priming general uncertainty had no significant effect upon deliberation. The results suggest that moral self-ambivalence may play a role in the maintenance of obsessive-compulsive behaviour. We propose that individuals who are morally self-ambivalent might respond to situations in which this ambivalence is made salient by exhibiting behaviour with obsessive-compulsive characteristics. These findings have implications for the incorporation of ideas about self-concept into theories of obsessive-compulsive disorder.

The influence of confidence in memory on checking behaviours

Recent theories of Obsessive Compulsive Disorder have suggested that meta-cognitive beliefs, particular confidence in memory, may relate to the maintenance of symptoms. For example, individuals who worry that their memory is deficient may check in order to ensure that the doors are locked, regardless of their actual memory ability. While studies have related meta-memory beliefs to OCD symptoms, and have found that memory is affected by checking behaviours; to date, no experimental literature has attempted to ascertain whether lowered confidence in memory directly leads to greater checking behaviours. In the current study 46 non-clinical participants completed a battery of questionnaires measuring these constructs, before undertaking a “memory task” designed to manipulate their level of confidence in their memory. The effect of the manipulation on the level of checking on a visuomemory task was subsequently assessed. The questionnaires indicated that cognitive confidence predicted variation in obsessive-compulsive symptoms over-and-above the influence of depressive symptoms and other OCD-related beliefs. However, while confidence in memory was successfully manipulated, the group with increased memory confidence was not found to have lower checking behaviours. Limitations of the study are discussed and directions for further research are suggested.

How Does Thought-Action Fusion Relate to Responsibility Attitudes and Thought Suppression to Aggravate the Obsessive-Compulsive Symptoms?

Comprehensive cognitive theories of obsessive compulsive disorder (OCD) propose that clinical obsessions and compulsions arise from specific sorts of dysfunctional beliefs and appraisals, such as inflated sense of responsibility, thought-action fusion (TAF), and thought suppression. The present study aimed to examine the mediator roles of responsibility and thought suppression between TAF and obsessive-compulsive symptoms. Specifically, it aimed to explore the relative effects of TAF factors (i.e. morality and likelihood) on inflated sense of responsibility and on thought suppression to increase the obsessive qualities of intrusions. Two hundred and eighty-three Turkish undergraduate students completed a battery of measures on responsibility, thought suppression, TAF, OC symptoms, and depression. A series of hierarchical regression analyses, where depressive symptoms were controlled for, indicated that TAF-morality and TAF-likelihood follow different paths toward OC symptoms. Although TAF-morality associated with inflated sense of responsibility, TAF-likelihood associated with thought suppression efforts, and in turn these factors increased OC symptoms. These findings provide support for the critical role of sense of responsibility and thought suppression between the relationship of TAF and OC symptoms. Findings were discussed in line with the literature.

Sensitivity of self-beliefs in obsessive compulsive disorder

Aspects of self-concept have been implicated in recent cognitive theories of obsessive compulsive disorder (OCD). It has been proposed that OCD is associated with perceptions of incompetence in self-domains considered important by the individual. A previous study in nonclinical individuals found that such "sensitivity of self" in the areas of job competence, morality and social acceptability was associated with elevated OCD symptoms and related beliefs. This study examined whether self-sensitivity is related to higher OCD symptoms and cognitions in individuals with OCD, and whether such self-sensitivity is specific to OCD versus other anxiety disorders. Clinical samples with OCD (N=30), other anxiety disorders (N=20) and a community control sample (N=32) participated in the study. It was found that in the OCD group, sensitivity in moral domains, but not job competence or social acceptability, was associated with higher levels of OCD symptoms and OCD-related beliefs. Sensitivity in the domains of morality and job competence was found in the OCD cohort, whereas individuals with other anxiety disorders did not show such sensitivity, suggesting some specificity of relationships to OCD. Implications for theory and therapy are discussed.

Persistence of Obsessive Compulsive Symptoms: Similarities and Contrasts with Symptoms of Depression in a Turkish Sample

AbstractContemporary cognitive theories of obsessive-compulsive disorder (OCD) propose that certain types of dysfunctional beliefs and assumptions play a salient role in the genesis and persistence of OCD (e.g., Clark, 2004; Rachman, 1993, 1997; Salkovskis, 1985). The present study aimed to examine whether the three proposed dysfunctional beliefs — inflated sense of responsibility, thought suppression, and thought-action fusion — play a significant role particularly on the persistence of obsessive–compulsive (OC) symptoms, as compared to other emotional disorders, such as symptoms of depression. The participants of the present study were 109 undergraduate university students, who completed a set of questionnaires, including The Responsibility Attitude Scale (RAS), The Thought Action Fusion Scale (TAF), The White Bear Suppression Inventory (WBSI), The Maudsley Obsessive–Compulsive Inventory (MOCI), and The Beck Depression Inventory (BDI). After a 4-week interval, participants were again asked to complete the MOCI and BDI. Two separate hierarchical regression equations were formulated to examine the factors significantly accounting for the residual changes from Time 1 to Time 2 assessments of OC and depressive symptomatologies. Results of these analyses indicated that while thought suppression (WBSI scores) played a significant role on the persistence of both OC and depressive symptoms across time, the role of inflated sense of responsibility (RAS scores) was specific to the persistence of OC symptoms.

Obsessive–Compulsive Symptoms and the Expression of Anger

The present study investigates the association between Obsessive–Compulsive (OC) symptoms and the expression of anger in a sample of 131 undergraduates. Participants were divided into two groups based on their self-reported OC symptoms and compared on their tendency to suppress anger inwardly, express anger outwardly, and control their anger. In addition, the associations between anger and specific OC symptoms were investigated. Results indicated that individuals high in OC symptoms tended to experience more anger, be more likely to suppress it inwardly, and report more difficulty controlling their anger than individuals low in OC symptoms. However, these differences appear to be attributable to the presence of depressive symptoms in the participants with high levels of OC symptoms. In addition, OC checking was found to be weakly associated with anger independent of depressive symptoms. These results were discussed within the framework of the cognitive theory of obsessive compulsive disorder.

Cognitive approaches to obsessive-compulsive disorder

In his reply to Salkovskis and Freeston (2001), O'Kearney (2001) has focused on two issues, namely motivation and the role of emotion, that he believes were not addressed by the cognitive theory of obsessions. It would now seem that cognitive theory does address these issues, but not in the way that he would like. Further, there seems to be some misunderstanding about the nature and applications of cognitive models. We look forward to the emergence of more comprehensive psychological theories of obsessive-compulsive disorder, theories that make testable predictions. The way is and was always open for those who wish to progress.

Obsessions, compulsions, motivation, and responsibility for harm

In a recent critique of current cognitive approaches to obsessional problems, O'Kearney (1998) suggests that there are significant problems with the theory and seeks to propose an alternative conceptualisation. Cognitive theories of obsessive-compulsive disorder (OCD) are criticised because he believes them (a) to be silent on motivational components specific to the disorder, (b) to not adequately explain why people are upset by their negative evaluation of intrusive thoughts, (c) to not provide an adequate account of the compulsive and repetitive quality of obsessional symptoms, and (d) to disregard the emotional concerns of the sufferer as influential factors in the etiology and maintenance of the disorder. We argue in this paper that O'Kearney's critique is mistaken as all of these issues are adequately addressed by current cognitive theorising. Specifically, we point out that (a) motivation is a central and crucial aspect of cognitive theories of anxiety disorders, (b) the link between responsibility beliefs concerning subjectively crucial negative events and distress is understandable, (c) compulsiveness and repetitiveness are readily accounted for by the cognitive theory, and (d) the cognitive theory regards the emotional concerns of the sufferer as central issues in both the etiology and maintenance of obsessional problems. Careful examination of O'Kearney's alternative theory suggests that it is inconsistent with both research evidence and the phenomenology of OCD. Further, as a heuristic for the treatment of OCD his account is, at best, of no value in bringing about change in the way in which patients react to their problems, and at worst may lead the therapists in directions that may prove to be counterproductive for their patients.

Motivation and emotions in the cognitive theory of obsessive-compulsive disorder

Salkovskis and Freeston (2001) dismiss the conceptual challenges presented in my critique (O'Kearney, 1998) by asserting that the issues I identified as problems “are adequately addressed” by the cognitive theory. While their rejoinder has helped clarify some aspects of the theory, its arguments offer no good reasons to alter my main criticisms. More importantly, the perceived need to defend the theory's account of the appraisal of intrusions has taken precedence over any measured consideration of the important emotional/motivational issues outlined in my paper. In order to prevent these factors from becoming further marginalised in psychological theorising about obsessive-compulsive disorder, my reply focuses on motivational problems and the role of emotion, rather than taking up the individual points where Salkovskis and Freeston's arguments can be questioned.

Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder

The cognitive–behavioural theory of Obsessive Compulsive Disorder (OCD) proposes that a key factor influencing obsessional behaviour is the way in which the intrusive cognitions are interpreted. The present paper reports an investigation of links between clinical symptoms (of anxiety, depression and obsessionality) and responsibility beliefs. These beliefs include not only measures of general responsibility attitudes (assumptions) but also more specific responsibility appraisals consequent on intrusive cognitions. The characteristics of two new questionnaires specifically designed to measure these beliefs were assessed in patients suffering from Obsessive Compulsive Disorder, in patients suffering from other anxiety disorders and in non-clinical controls. The scales measuring negative beliefs about responsibility were found to have good reliability and internal consistency. Comparisons between criterion groups indicate considerable specificity for both assumptions and appraisals with respect to OCD. There was also good evidence of specificity in the association between responsibility cognitions and obsessional symptoms across groups, and that this association was not a consequence of links with anxiety or depressive symptoms. Although the two measures were correlated, they each made unique contributions to the prediction of obsessional symptoms. Overall, the results are consistent with the hypothesis that responsibility beliefs are important in the experience of obsessional problems.

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.

Responsibility appraisals and obsessive-compulsive disorder: A critique of salkovskis's cognitive theory

Salkovskis's cognitive theory of obsessive-compulsive disorder proposes that interpretations of the occurrence of intrusive thoughts as indicative of personal responsibility for some harmful outcome to oneself or others are causally linked to the features of the disorder. Such beliefs about responsibility are hypothesised to result in increased anxiety or discomfort, increased efforts to exert control over cognition, and the overt and covert neutralising activity which characterises the disorder. This paper presents a critical examination of this formulation, outlining its insufficiencies as an explanation of obsessional problems. These limitations include (a) its lack of any explicit motivational principle, (b) its reliance on a purely self-evident connection between the crucial responsibility beliefs and anxiety or distress, (c) its omission of a plausible account of important qualities of obsessive-compulsive phenomena, such as their compulsiveness and repetitiveness, and (d) its disregard for proximal etiological factors in the occurrence of the intrusive thoughts. The paper also discusses the need for consideration of affective components in any adequate psychological account. It argues for a psychological model of obsessional problems which incorporates not only propositions about responsibility beliefs but also statements concerning beliefs about “thought-action fusion”, self-doubt, and the ambivalent affective relationship between the individual and the object of his or her intrusive thoughts.

Fluvoxamine confirms the serotonergic theory of obsessive-compulsive disorder

Fluvoxamine confirms the serotonergic theory of obsessive-compulsive disorder