0000000000993352
AUTHOR
Amparo Belloch
El carácter transdiagnóstico de las intrusiones mentales: una revisión y una propuesta basada en datos.
Abstract: The transdiagnostic nature of mental intrusions: A review and data-based proposal. The objective of a transdiagnostic perspective in psychopathology is to better understand the commonalities among clinically different mental disorders on the basis of a set of shared etiopathogenic dimensions and processes. Unwanted intrusive cognitions (UI) and their functional consequences had been proposed as symptom dimensions in Obsessive-Compulsive Disorder (OCD), Body Dysmorphic Disorder (BDD), Hypochondriasis (HYP) and Eating Disorders (EDs). In this article, we review the empirical data about the putative transdiagnostic nature of UI and their functional consequences in the four mentioned …
The rates of co-occurring behavioural addictions in treatment-seeking individuals with obsessive-compulsive disorder: a preliminary report
Objectives: To assess the rates of co-occurring putative ‘behavioural addictions’ in patients with obsessive-compulsive disorder (OCD). Methods: Twenty-three international centres specialising in the treatment of OCD were invited to participate in a survey of the rates of behavioural addictions and other relevant comorbidity within their samples. Results: Sixteen of 23 (69.6%) invited centres from 13 countries had sufficient data to participate in the survey. The use of validated diagnostic tools was discrepant, with most centres relying on a ‘clinical diagnosis’ to diagnose behavioural addictions. The final sample comprised of 6916 patients with a primary diagnosis of OCD. The reported rat…
Fases temporales y variables motivacionales: dos perspectivas complementarias en el proceso de búsqueda de ayuda por enfermedad mental
Resumen Introduccion La busqueda de ayuda profesional por enfermedad mental es un proceso complejo, con etapas y momentos temporales diferentes, en el que desempenan un papel especialmente relevante los aspectos motivacionales. Sin embargo, no hay instrumentos de evaluacion que permitan valorar tanto las variables temporales como las motivacionales. El objetivo de este estudio es ofrecer informacion detallada sobre ambos conjuntos de variables, mediante un instrumento especificamente disenado para ello, de tal manera que se pueda comprender mejor el proceso de busqueda de tratamiento. Material y metodos Participaron 152 pacientes ambulatorios que habian solicitado ayuda profesional en una u…
Incompleteness and not just right experiences in the explanation of Obsessive-Compulsive Disorder.
In the past decade, not just right experiences (NJRE) and incompleteness (INC) have attracted renewed interest as putative motivators of symptoms in obsessive-compulsive disorder (OCD), beyond harm avoidance (HA). This study examines, in 267 non-clinical undergraduates and 47 OCD patients, the differential contributions of HA, INC, and NJRE to the different OCD symptom dimensions and the propensity to have the disorder. The results indicate that although both the NJRE and INC range from normality to OCD, their number and intensity significantly increase as the obsessional tendencies increase, which suggests that they are vulnerability markers for OCD. Although they cannot be considered full…
Clinical obsessions in obsessive–compulsive patients and obsession-relevant intrusive thoughts in non-clinical, depressed and anxious subjects: Where are the differences?
Contemporary cognitive models of obsessive-compulsive disorder (OCD) assume that clinical obsessions evolve from some modalities of intrusive thoughts (ITs) that are experienced by the vast majority of the population. These approaches also consider that the differences between "abnormal" obsessions and "normal" ITs rely on quantitative parameters rather than qualitative. The present paper examines the frequency, contents, emotional impact, consequences, cognitive appraisals and control strategies associated with clinical obsessions in a group of 31 OCD patients compared with the obsession-relevant ITs in three control groups: 22 depressed patients, 31 non-obsessive anxious patients, and 30 …
Intrusive Thoughts in Obsessive-Compulsive Disorder and Eating Disorder Patients: A Differential Analysis
The present study aims to compare the unwanted intrusions experienced by obsessive–compulsive (OCD) and eating disorder (ED) patients, their appraisals, and their control strategies and analyse which variables predict the intrusions' disruption and emotional disturbance in each group. Seventy-nine OCD and 177 ED patients completed two equivalent self-reports designed to assess OCD-related and ED-related intrusions, their dysfunctional appraisals, and associated control strategies. OCD and ED patients experienced intrusions with comparable frequency and emotional disturbance, but OCD patients experienced greater disruption. Differences appeared between groups on some appraisals and control s…
Prevalence of Hyperventilation Syndrome in Patients Treated for Asthma in a Pulmonology Clinic
Objective Although the presence of hyperventilation syndrome can affect the symptoms of patients with asthma, there is very little information available regarding its frequency in Spain. The aim of this study was to investigate the prevalence of hyperventilation syndrome in the asthmatic population treated as outpatients and establish its relationship with anxiety disorders. Patients and methods We studied 157 consecutive asthmatic patients (61 men and 96 women; mean [SD] age, 45 [17] years; forced expiratory volume in the first second, 84% [21%] of the predicted value) treated in our outpatients clinic. The patients had stable disease with varying degrees of severity. After collecting demo…
The cross-cultural and transdiagnostic nature of unwanted mental intrusions
Unwanted mental intrusions (UMIs), typically discussed in relation to Obsessive-Compulsive Disorder (OCD), are highly prevalent, regardless of the specific nationality, religion, and/or cultural context. Studies have also shown that UMIs related to Body Dysmorphic Disorder (BDD), Illness anxiety/Hypochondriasis (IA-H), and Eating Disorders (EDs) are commonly experienced. However, the influence of culture on these UMIs and their transdiagnostic nature has not been investigated.Participants were 1,473 non-clinical individuals from seven countries in Europe, the Middle-East, and South America. All the subjects completed the Questionnaire of Unpleasant Intrusive Thoughts, which assesses the occ…
Confirmatory Factor Analysis of the White Bear Suppression Inventory and the Thought Control Questionnaire
The White Bear Suppression Inventory (WBSI) was developed to assess chronic thought suppression, whereas the Thought Control Questionnaire (TCQ) measures different strategies to suppress unpleasant intrusive thoughts. The present study examines the latent factor structure of these instruments in a sample of 540 normal subjects using confirmatory factor analyses (CFA). Regarding the WBSI, the CFAs indicated that the tested models did not provide a good fit for the data. Data analysis showed that the TCQ with five factors and 30 items did not reach a reasonable fit. Therefore, in order to present a five-factor structure with an adequate fit, those items with problematic factor loadings were …
Treatments used for obsessive-compulsive disorder-An international perspective.
Objective The objective of this study was to characterise international trends in the use of psychotropic medication, psychological therapies, and novel therapies used to treat obsessive–compulsive disorder (OCD). Methods Researchers in the field of OCD were invited to contribute summary statistics on the characteristics of their samples. Consistency of summary statistics across countries was evaluated. Results The study surveyed 19 expert centres from 15 countries (Argentina, Australia, Brazil, China, Germany, Greece, India, Italy, Japan, Mexico, Portugal, South Africa, Spain, the United Kingdom, and the United States) providing a total sample of 7,340 participants. Fluoxetine (n = 972; 13…
[Perception of dyspnea and treatment adherence in asthmatic patients].
OBJECTIVE: The majority of studies show that treatment adherence in chronic diseases such as asthma does not exceed 50%. Although the reasons may vary, it is clear that lack of treatment adherence is a determining factor in poor disease control. An association has also been observed between lack of perception of dyspnea and difficult-to-control asthma and with the occurrence of fatal or near-fatal asthma attacks. In this study we therefore attempted to demonstrate that one of the reasons that asthmatic patients do not adhere to treatment is a failure to perceive dyspnea associated with bronchial obstruction. PATIENTS AND METHODS: We analyzed 2 groups of patients with moderate persistent ast…
The HEXACO–100 Across 16 Languages
The HEXACO Personality Inventory–Revised (HEXACO–PI–R) has become one of the most heavily applied measurement tools for the assessment of basic personality traits. Correspondingly, the inventory has been translated to many languages for use in cross-cultural research. However, formal tests examining whether the different language versions of the HEXACO–PI–R provide equivalent measures of the 6 personality dimensions are missing. We provide a large-scale test of measurement invariance of the 100-item version of the HEXACO–PI–R across 16 languages spoken in European and Asian countries (N = 30,484). Multigroup exploratory structural equation modeling and confirmatory factor analyses revealed …
Dysfunctional beliefs about health and illness: a family study
espanolLos modelos cognitivos sobre la hipocondria postulan que las experiencias tempranas con la enfermedad promueven el desarrollo de creencias disfuncionales sobre la enfermedad. Estas creencias pueden permanecer latentes y activarse ante un incidente critico. Los estudios publicados aportan datos que avalan de manera indirecta estos planteamientos. Teniendo en cuenta que en el nucleo familiar primario se comparten experiencias sobre la enfermedad, examinamos la relacion entre las creencias disfuncionales que los progenitores y sus descendientes mantienen sobre la enfermedad y los pensamientos, tales como la intolerancia a la incertidumbre y la sobreestimacion de la amenaza, y las relaci…
Induced not just right and incompleteness experiences in OCD patients and non-clinical individuals: An in vivo study
Abstract Background and objectives Research on incompleteness and not-just right experiences, (INC/NJREs) indicate that some OCD symptom dimensions are motivated by these experiences rather than by anxiety. Most published data are correlational, using non-clinical individuals. This study sought to examine INC/NJREs in vivo in non-clinical and OCD individuals. Methods Study 1: Ninety-three undergraduates were randomly assigned to a INC/NJREs induction (n=44) or non-induction task (n=47). Scores on self-reports assessing INC, NJREs, OCD, Anxiety, and Depression were also recorded. Study 2: Twenty adults with OCD performed the induction task and completed the same questionnaire-packet as the n…
Dysfunctional beliefs as mediators between illness-related intrusive thoughts and health anxiety symptoms.
AbstractBackground:Cognitive behavioural models of hypochondriasis assume that dysfunctional illness-related beliefs are involved in the genesis and maintenance of the disorder. The role that other more general dysfunctional beliefs about thoughts play in this disorder has also been highlighted. Internal triggers such as illness-related intrusive thoughts could activate these beliefs.Aim:The present paper examines whether general dysfunctional beliefs about distressing thoughts, such as intolerance of uncertainty, over-estimation of threat, and thought-action fusion-likelihood, mediate between illness-related intrusive thoughts and health anxiety symptoms.Method:A group of participants comp…
International prescribing practices in obsessive-compulsive disorder (OCD)
Objectives To assess rates of psychotropic medication use in patients with obsessive–compulsive disorder (OCD) in seven different countries on five continents and to compare these with international treatment guidelines. Methods Researchers in the field of OCD were invited to contribute summary statistics on the characteristics of their patients with OCD and on their incidence of psychotropic use. Consistency of summary statistics across countries was evaluated. Results The data came from Brazil (n = 955), Italy (n = 750), South Africa (n = 555), Japan (n = 382), Australia (n = 213), India (n = 202) and Spain (n = 82). The majority (77.9%; n = 2445) of the total sample of 3139 participants …
Illness‐related intrusive thoughts and illness anxiety disorder
Introduction Intrusive thoughts about health threats (illness-ITs) are a potential cognitive risk factor for the development and maintenance of illness anxiety disorder (IAD). This study analyzes the dimensionality of illness-ITs from normalcy to psychopathology, and it evaluates whether the appraisals instigated by the Its mediate between these thoughts and IAD symptoms. Methods Two groups of individuals participated in the study and completed the Illness Intrusive Thoughts Inventory and the Whiteley Index. The first group was composed of 446 non-clinical community participants. Of them, 264 individuals (68.6% women; Mage = 30.03 [SD = 13.83]) reported having experienced an upsetting illne…
Transdiagnóstico de las obsesiones y las compulsiones: una propuesta/ The transdiagnostic nature of obsessions and compulsions: a proposal
El propósito de adoptar un enfoque transdiagnóstico en psicopatología es comprender las comunalidades entre trastornos mentales clínicamente diferentes sobre la base de un rango de dimensiones y procesos etiopatogénicos compartidos. Este enfoque es radicalmente diferente al adoptado en los sistemas de diagnóstico psiquiátrico vigentes, basados en ideas y conceptos categoriales que se han mostrado ineficaces en los mismos ámbitos en los que surgieron, es decir, en las ciencias biológicas. En este trabajo revisamos la información empírica disponible sobre la utilidad de enfocar las diferentes psicopatologías del espectro obsesivo, adoptando un planteamiento transdiagnóstico. Para ello, escogi…
Dimensions of the self-consciousness scale and their relationship with psychopathological indicators
The current study has two specific aims: one is to examine the levels of self-consciousness in patients with different mental disorders (social phobia, panic disorder, major depression, dysthymia and generalized anxiety) as well as in a group with no mental disorder; another aim is to provide data for external validation of the different components of the self-consciousness scale using anxiety and depression measures. To do this, we considered the Fenigstein, Scheier, and Buss (1975) dimensions of self-consciousness (public self-consciousness, private self-consciousness and social anxiety), the private sub-scales proposed by Burnkrant and Page (1984) (Self-reflectiveness and Internal State …
Functional links of obsessive, dysmorphic, hypochondriac, and eating-disorders related mental intrusions.
Unwanted mental intrusions (UMIs) are the normal variants of obsessions in Obsessive-Compulsive Disorder (OCD), preoccupations about defects in Body Dysmorphic Disorder (BDD), images about illness in Hypochondriasis (HYP), and thoughts about eating in Eating Disorders (EDs). The aim was to examine the similarities and differences in the functional links of four UMI contents, adopting a within-subject perspective.Las intrusiones mentales no deseadas (IM) son la variante normativa de obsesiones en el Trastorno Obsesivo-Compulsivo (TOC), preocupaciones por defectos en el Trastorno Dismórfico Corporal (TDC), imágenes sobre enfermedad en Hipocondría (TH) y pensamientos sobre alimentación en los …
The Revised Asthma Problem Behavior Checklist: Adaptation for Use in Spanish Asthmatic Patients
Behavioral problems associated with asthma management were examined in a group of 100 adult Spanish outpatients with asthma (57 women, 43 men; 17-69 years of age). All of them completed a Spanish version of the Revised Asthma Problem Behavior Checklist (RAPBC). Data about duration, severity, and self-management of asthma (self-efficacy expectancies and health care utilization), as well as dyspnea and FEV1, were also recorded. The highest-reliability Cronbach alpha indices were for the criteria related to emotions and behaviors that could precipitate asthma attacks. Concurrent criterion validity was examined first by Pearson correlations between the RAPBC scores and clinical data about asthm…
Mental health literacy and stigma associated with obsessive-compulsive content dimensions: effectiveness of an intervention via smartphone.
Introduction. Obsessive-compulsive disorder (OCD) is a serious and disabling mental illness that presents a high delay in help seeking. Various studies suggest that stigma and mental health literacy (MHL) are two very important factors that favour this delay and that they vary depending on OCD symptoms. Considering that, the aim of this study is to, firstly, analyze the stigma and OCD literacy in relation to the different obsessive-compulsive symptom contents in the general population and, secondly, assess the impact of an intervention carried out through a mobile application (esTOCma) that has been gamified to decrease stigma and increase OCD literacy. Method. A group of 357 people (39.66 …
Subjective symptomatology of asthma: validation of the asthma symptom checklist in an outpatient Spanish population.
The objective of this study was to validate the Asthma Symptom Checklist (ASC) so that it could be reliably used to assess the subjective symptomatology of asthma attacks in our context. Subjective symptomatology of asthma was examined in a group of 100 adult Spanish outpatients (57 women, 43 men; 17-69 years of age) with asthma. All of them completed the modified version of the ASC as well as questionnaires of depression, anxiety, and self-management of asthma (self-efficacy expectancies and health care utilization). Data about duration and severity of asthma, as well as dyspnea and %FEV1, were also recorded. The highest reliability Cronbach alpha indexes were for the panic-fear and fatigu…
Can Brief, Daily Training Using a Mobile App Help Change Maladaptive Beliefs? Crossover Randomized Controlled Trial
BackgroundObsessive-compulsive disorder (OCD) is a disabling condition with a wide variety of clinical presentations including contamination fears, fear of harm, and relationship-related obsessions. Cognitive behavioral models of OCD suggest that OC symptoms result from catastrophic misinterpretations of commonly occurring intrusive experiences and associated dysfunctional strategies used to manage them. OCD-related maladaptive beliefs including inflated responsibility, importance and control of thoughts, perfectionism, and intolerance for uncertainty increase the likelihood of such misinterpretations. ObjectiveConsidering accumulating evidence suggesting that mobile health (mHealth) apps b…
Are the dysfunctional beliefs that predict worry different from those that predict obsessions?
Chronic worry present in Generalized Anxiety Disorder (GAD) and obsessions characteristic of the Obsessive–Compulsive Disorder (OCD) are cognitive phenomena that share some features, but they also differ on others. Based on current cognitive approaches, dysfunctional meta-cognitive beliefs underlie the development and/or maintenance of both GAD and OCD. However, to date, there has been little empirical evidence about the differences between the beliefs that predict the occurrence of obsessions and those that predict worry. This study focuses on the search for these differences and examines to what extent worry and obsessions are associated with a similar or different pattern of dysfunctiona…
Does Experience Influence Perception of Dyspnea?
OBJECTIVE: The perception of somatic sensations like dyspnea can be influenced by such factors as an individuals personality, experiences, or ability to adapt to stimuli. Our aim was to determine whether the perception of acute bronchoconstriction is different for patients with asthma and patients who have never experienced an episode of airway obstruction. PATIENTS AND METHOD: We studied 2 groups of patients. The first consisted of 24 subjects with intermittent rhinitis and asthma (10 females and 14 males) with a mean (SD) age of 25 (7) years. All reported not feeling dyspnea at rest on a Borg scale. The second group consisted of 24 subjects who only had rhinitis but no lung disease (no ep…
Part 2. They scare because we care: The relationship between obsessive intrusive thoughts and appraisals and control strategies across 15 cities
Abstract Cognitive models of Obsessive Compulsive Disorder (OCD) purport that obsessions are normal intrusive thoughts that are misappraised as significant, leading to negative emotional responses and maladaptive attempts to control the thoughts and related emotions. This paper utilised a large multi-national dataset of interview data regarding intrusive thoughts, to investigate three questions related to the cognitive model of OCD and to its stability across cultures. First, the paper aimed to investigate the implicit yet-hitherto-untested assumption of cognitive models that misappraisals and control strategies for intrusive thoughts relate similarly across cultures. Second, this study aim…
Dysmorphic and illness anxiety‐related unwanted intrusive thoughts in individuals with obsessive–compulsive disorder
Background/objective Unwanted intrusive thoughts (UITs) are considered normal variants of the obsessions found in obsessive-compulsive disorder (OCD). Similarly, intrusive and persistent preoccupations about appearance defects in body dysmorphic disorder (BDD) and images and thoughts about illness in illness anxiety disorder (IAD) are abnormal variants of the thoughts and concerns about appearance and health found in non-clinical individuals. This study examines whether patients with OCD have frequent and distressing UITs with contents related to BDD and IAD, in addition to OCD-related UITs. Method Thirty-nine participants with OCD (Mage = 32.45, standard deviation [SD] = 11.57; 63% men) co…
Dysfunctional belief domains related to obsessive-compulsive disorder: a further examination of their dimensionality and specificity
International consensus has been achieved on the existence of several dysfunctional beliefs underlying the development and/or maintenance of the Obsessive-Compulsive Disorder (OCD). Nevertheless, questions such as the dimensionality of the belief domains and the existence of OCD-specific dysfunctional beliefs still remain inconclusive. The present paper addresses these topics through two different studies. Study 1: A series of confirmatory factor analyses (N= 573 non-clinical subjects) were carried out on the Obsessive Beliefs Spanish Inventory-Revised (OBSI-R), designed to assess dysfunctional beliefs hypothetically related to OCD. An eight-factor model emerged as the best factorial soluti…
Ego-syntonicity and ego-dystonicity of eating-related intrusive thoughts in patients with eating disorders.
Abstract The main objective of the present study was to analyse the role of the ego-dystonicity and ego-syntonicity of eating disorder intrusive thoughts (EDITs) in the genesis and maintenance of eating disorders (EDs). Participants were 98 female patients with EDs, 56 Spanish and 42 English (27.19±9.59 years; body mass index (BMI): 18.72±2.87). All of them completed the eating attitudes test, the Eating Attitudes Test, the Eating Intrusive Thoughts Inventory, the Ego-Dystonicity Questionnaire-Reduced version, and the Ego-Syntonicity Questionnaire. Patients indicated that their EDITs were rational and also undesirable and immoral, suggesting that EDITs are not fully ego-syntonic or ego-dyst…
El Trastorno Dismórfico Corporal: un problema infra-diagnosticado
Resumen: Aunque el Trastorno Dismorfico Corporal (TDC) es conocido desde hace siglos, solo hasta hace poco se ha intensificado su estudio e investigacion. En los ultimos anos se han hecho avances importantes para comprender los distintos aspectos relacionados con el TDC, aun infradiagnosticado. El proposito de este trabajo es presentar una actualizacion sobre el estatus del TDC. Se examinan, entre otros aspectos, la etiopatogenia, la epidemiologia, las complicaciones asociadas y la explicacion cognitivo-conductual del trastorno. Tambien se analizan los cambios recientes en su clasificacion y las implicaciones derivadas. Desde esta perspectiva se aportan algunos datos provenientes de nuestra…
¿Puede una aplicación móvil disminuir el estigma asociado al Trastorno Obsesivo-Compulsivo y aumentar la intención de búsqueda de ayuda?
Introducción: El Trastorno Obsesivo-Compulsivo (TOC) causa gran malestar e interferencia en la vida de las personas, sin embargo, existe una elevada demora en la búsqueda de ayuda profesional. Entre las principales causas de dicha demora destacan la falta de conocimientos sobre el trastorno (Mental Health Literacy) y el estigma asociado al mismo. Objetivo: Explorar si tras el uso de una aplicación móvil (app) de e-salud llamada esTOCma se modifican los niveles de estigma asociados al TOC, la distancia social, e intención de búsqueda de ayuda profesional. Método: 36 personas (Edad M=32,67; DT=12,26; 54,8% mujeres) completaron los siguientes instrumentos de evaluación antes y después del uso …
Contenidos obsesivos, miedo a la enfermedad y asco
Recently, data about the associations between disgust and obsessive-compulsive disorder (OCD) have show some inconsistencies, which might be due to the differential role of disgust sensitivity and propensity, the infl uence of other variables, or the heterogeneity of OCD contents. This study examines the relationships among disgust sensitivity and propensity, fear of illness, and different obsessional contents in university students (N = 114). Disgust propensity was the most relevant variable in predicting Doubt/checking contents (19% of explained variance, EV), and fear of illness and disgust sensitivity were the most relevant variables predicting Contamination (EV: 21% and 8%, respectivel…
[Evolution over time in over perceivers of dyspnea in asthma].
OBJECTIVE: In previous studies we identified a subgroup of patients whose perception of breathlessness was exaggerated during acute bronchoconstriction and who were termed “over perceivers” or “hyperperceivers.” In this study we aimed to determine whether such over perception is sporadic or stable over time. We also examined whether there is an association between over perception of dyspnea and hyperventilation syndrome. PATIENTS AND METHODS: The subjects were 22 stable asthmatics (11 men, 11 women) who had been over perceivers of dyspnea in a study 9 years earlier. After a medical history was taken, a patient performed forced spirometry and a severity classification was made according to t…
Assessment of the reliability, validity, and responsiveness of a Spanish Asthma Quality of Life questionnaire.
A Spanish-language questionnaire designed for measuring the impact of asthma on quality of life in adults was developed. It was derived, by the application of a rigorous translation protocol, from a previously validated, English-language Asthma Quality of Life (AQL) questionnaire which had been developed in Australia. The aim of this study was to evaluate the psychometric properties of the Spanish AQL questionnaire using a cross-sectional and longitudinal design. Two hundred ninety-four clinically stable subjects with asthma (168 women, mean baseline forced expiratory volume in 1 sec [FEV1] = 85% predicted), aged 17-70, attended for the initial baseline assessment. All subjects completed th…
Part 1—You can run but you can't hide: Intrusive thoughts on six continents
Abstract Most cognitive approaches for understanding and treating obsessive-compulsive disorder (OCD) rest on the assumption that nearly everyone experiences unwanted intrusive thoughts, images and impulses from time to time. These theories argue that the intrusions themselves are not problematic, unless they are misinterpreted and/or attempts are made to control them in maladaptive and/or unrealistic ways. Early research has shown unwanted intrusions to be present in the overwhelming majority of participants assessed, although this work was limited in that it took place largely in the US, the UK and other ‘westernised’ or ‘developed’ locations. We employed the International Intrusive Thoug…
Self-consciousness Scale: a study of Spanish housewives.
The purpose of this study was to examine the applicability with 93 Spanish housewives of the translated Self-consciousness Scale. We present reliability measures and normative data, and we also include data for two clinical samples (31 depressive and 31 asthmatic women patients).
Somatosensory amplification in hypochondriasis and panic disorder
The aim of this study is to explore the differences and similarities of Somatic Amplification (SA) in both panic and hypochondriasis disorders. An additional objective is to validate the Somatosensory Amplification Scale (SSAS) for use in our cultural context. For these purposes, 34 patients (17 with hypochondriasis and 17 with panic disorder; DSM-III-R criteria) completed the following questionnaires: SSAS, State–Trait Anxiety Inventory, Beck Depression Inventory, MMPI Hypochondriasis Scale, Illness Attitude Scales and Illness Behaviour Questionnaire. The SSAS showed a satisfactory internal consistency (Cronbach's α=0·83), and revealed two components: ‘Internal Stimulus Amplification’ and …
La opinión negativa del sí-mismo en los trastornos depresivos
According to cognitive theory of depression (Beck, 1967, 1976), negatively biased information processing is responsible for maintenance, severity and duration of depressive affect. However, the evidence does not consistently support this assumption. The present study was designed to ascertain if depressed patients have access not only to negative information about the self, but also to positive one. Twenty patients with major depressive disorder, 18 with distimic disorder, and 20 nonpsychiatric controls completed a self-referent task. Instructions to perform the task were manipulated in order to fulfill it taking into account three different time-periods: present, past, and future. Data sho…
Consequências mal adaptativas de invasões mentais com conteúdos relacionados a transtornos obsessivos, dismórficos, hipocondríacos e alimentares: diferenças transculturais
Unwanted mental intrusions (UMIs) with contents related to Obsessive-Compulsive Disorder (OCD), Body Dysmorphic Disorder (BDD), Illness Anxiety Disorder (IAD), and Eating Disorders (EDs) are highly prevalent, independently of the cultural and/or social context. Cognitive-behavioral explanations for these disorders postulates that the escalation from common UMIs to clinically relevant symptoms depends on the maladaptive consequences (i.e., emotions, appraisals, and control strategies) of experiencing UMIs. This study examines, from a cross-cultural perspective, the cognitive-behavioral postulates of the maladaptive consequences of having UMIs.Non-clinical 1,473 participants from Europe, the …
The Spanish version of the Obsessive-Compulsive Inventory-Revised (OCI-R): Reliability, validity, diagnostic accuracy, and sensitivity to treatment effects in clinical samples
Abstract This study examines the psychometric properties of the Obsessive-Compulsive Inventory-Revised (OCI-R) in Spanish and Argentinean samples. 90 OCD patients, 31 with non-OCD anxiety disorders and 84 non-clinical individuals completed the Spanish version of the OCI-R along with other OCD, depression, anxiety, and OCD-related cognition measures. The OCI-R showed significant associations with both OCD severity and other OCD symptom measures, beyond the relationships with depression, anxiety, and worry. The questionnaire also differentiated OCD from other anxiety disorders, except on the ordering and hoarding subscales. The relationships between the OCI-R subscales and dysfunctional belie…
Discovering what is hidden: The role of non-ritualized covert neutralizing strategies in Obsessive–Compulsive Disorder
Abstract Background and objectives Neutralizing strategies are secondary to obsessions and an additional cause of distress and interference, but they have received little attention in theories and research, especially the non-ritualized covert strategies. This study focuses on the comparative impact of non-ritualized covert and compulsive-overt strategies in the course of OCD. Methods Eighty-two OCD adult patients completed measures assessing distress, interference, appraisals and overt and covert neutralizing strategies to control obsessions. Thirty-eight patients who had completed cognitive therapy were assessed again after treatment. Results Only overt compulsions are associated with OCD…
Determinants of Dyspnea in Patients with Different Grades of Stable Asthma
Dyspnea is a main feature of symptomatology in asthma, and its perception does not necessarily correlates well with airway obstruction. The aim of this study was twofold: (1) to identify factors determining the subjective degree of dyspnea in patients with different grades of stable bronchial asthma and (2) to compare various clinical methods existing for grading dyspnea. The investigation comprised 153 outpatients with stable asthma. The parameters studied were the following: demographic characteristic of subjects, baseline dyspnea score by means of three clinical instruments (baseline dyspnea index [BDI], Medical Research Council [MRC] scale, and modified Borg scale), asthma severity, sta…
How do children interpret and manage their disturbing obsessive intrusive thoughts?
Introduction. Cognitive models of obsessive-compulsive disorder rest on three main assumptions: a) obsessive intrusive thoughts (OITs) are almost universal; b) negative appraisals of OITs lead to emotional distress and interference; and c) unhelpful control strategies contribute to the escalation of OITs into clinical obsessions. These assumptions have received ample empirical support from research with adult samples, while studies in children are promising but scarce. The aim of this study was to describe the emotional distress, interference, negative appraisals and control efforts of those children that report having experienced recent and frequent OITs. Method. 49 children (28 girls, mea…
The Spanish validation of the Short Health Anxiety Inventory: Psychometric properties and clinical utility
The Short Health Anxiety Inventory (SHAI) is a widely used self-report instrument to evaluate health anxiety. To assess the SHAI's factor structure, psychometric properties, and accuracy in differentiating Spanish non-clinical individuals from patients with severe health anxiety or hypochondriasis.A total of 342 community participants (61.6% women;The original two-factor structure was selected as the best structure, based on its parsimony and empirical support (Factor 1: Illness likelihood; Factor 2: Negative consequences of illness). Moreover, the Spanish version of the SHAI demonstrated good construct and concurrent and discriminant validity, and internal consistency. A cutoff of 40.5 (to…
Part 3. A question of perspective: The association between intrusive thoughts and obsessionality in 11 countries
Abstract A key assumption of contemporary cognitive-behavioral models of obsessive–compulsive disorder (OCD) is that obsessional thoughts exist on a continuum with “normal” unwanted intrusive thoughts. Recently, however, some authors have challenged this notion. The present study aimed to clarify (a) the extent that different types of intrusive thoughts in nonclinical individuals are associated with obsessionality, (b) the relative contribution of frequency, distress and control ratings to obsessionality, and (c) the extent that existing findings (primarily from North American or European samples) generalize to other countries in the world. Five hundred and fifty-four non clinical individua…
Concordancia entre la percepción de disnea del asmático durante la obstrucción aguda y crónica
Objetivo Durante la estabilidad clinica se pueden distinguir 3 tipos de asmaticos: hipoperceptores, normoperceptores e hiperperceptores. Cuando a esos mismos pacientes se les provoca una broncoconstriccion aguda, tambien existen hipo, normo e hiperperceptores de disnea. El objetivo del presente trabajo ha sido comprobar la concordancia entre ambas situaciones. Pacientes y metodos Se ha estudiado a 93 pacientes con asma persistente moderada (36 varones y 57 mujeres; edad media de 40 anos). Se les pidio que estimaran su disnea (escala modificada de Borg) en situacion de estabilidad y despues de cada dosis de histamina en una prueba de broncoprovocacion. Cuando la puntuacion de Borg en situaci…
Evolución temporal de la percepción exagerada de disnea en los pacientes con asma
Objetivo: En investigaciones previas para estudiar la percepcion de disnea de los asmaticos durante la broncoconstriccion aguda, encontramos un subgrupo de pacientes que presentaban una percepcion exagerada (hiperperceptores). En el presente trabajo hemos querido comprobar si esta alteracion perceptiva es un fenomeno esporadico o mantenido en el tiempo. Asimismo nos planteamos conocer si existe una asociacion entre la hiperpercepcion de la disnea y el sindrome de hiperventilacion. Pacientes y metodos: Se incluyo en el estudio a 22 asmaticos estables que en un estudio realizado 9 anos antes se habian mostrado hiperperceptores de disnea (11 varones y 11 mujeres). Tras una espirometria forzada…
Group Versus Individual Cognitive Treatment for Obsessive-Compulsive Disorder: Changes in Severity at Post-Treatment and One-Year Follow-up
Background: Very few studies have compared the efficacy of individual and group cognitive behaviour therapy (CBT) for the treatment of Obsessive-Compulsive Disorder (OCD) by taking into consideration the change in OCD severity in both the short and long term. Aims: To conduct an open trial of individual versus group CBT for OCD, comparing the clinical and statistically significant changes in severity both at post-treatment and one year later. Method: Forty-two OCD subjects were assigned to individual (n = 18) or group CBT (n = 24, in four groups). Sixteen and 22 subjects completed the treatment in the individual and group conditions, respectively. The Yale-Brown Obsessive Compulsive Scale w…
Cognitive therapy for autogenous and reactive obsessions: Clinical and cognitive outcomes at post-treatment and 1-year follow-up
This study provides data about the differential effectiveness of cognitive therapy (CT) for obsessive-compulsive disorder (OCD) symptom presentation. Two OCD manifestations, autogenous and reactive, are considered. Seventy OCD patients started CT; 81.40% completed it and 72.85% were available 1 year later. Fifteen of the 57 treatment completers had autogenous obsessions, whereas 33 had reactive obsessions. Nine patients had both obsession modalities. Reactive patients were more severe, as they scored higher on thought suppression and on the dysfunctional beliefs of intolerance to uncertainty and perfectionism. Autogenous patients scored higher on the over-importance of thoughts beliefs. Alt…
Sensación de inacabado y experiencias “not just right” como motivadoras de los síntomas obsesivo-compulsivos
The sense of incompleteness, “not just right” experiences and “just right” symptoms are considered motivational variables of obsessive-compulsive symptoms. This study examines the relationships between these “new” constructs and Obsessive-Compulsive Disorder (OCD) related variables (symptoms, dysfunctional beliefs, perfectionism, and intolerance to uncertainty), in comparison to its association with emotional non-OCD psychopathology. The results from 267 individuals who completed self-reports indicate that individuals at risk of developing OCD score higher on the main constructs of the study than those not at risk. Only the variables incompleteness, not just right experiences and just right…
Pensamientos intrusos en obsesivos subclínicos : contenidos, valoraciones, estrategias de control
Recent cognitive theories of obsessions consider that they differ from unwanted intrusive thoughts (IT) in terms of frequency of ocurrence, valorative appraisals, and thought control strategies. This paper examines that assumption comparing the responses provided by normal (N= 239) and subclinical (N=28) subjects to the following instruments: Revised Obsessional Intrusions Inventory (ROII), Maudsley Obsessive Compulsive Inventory (MOCI), BDI, and STAIS. Significant relationships were obtained among all the instruments, and the association between ROII and MOCI was maintained when depression scores were partialled out. Subclinically obsessive scored higher than normals on depressive, anxious…
Eating-related Intrusive Thoughts Inventory: exploring the dimensionality of eating disorder symptoms.
The aims of this study were, first, to examine the structure and validity of the Eating-related Intrusive Thoughts Inventory (INPIAS), a self-report questionnaire designed to assess eating disorders related to intrusive thoughts (EDITs), and second, to explore the existence of a continuum ranging from normal to abnormal thought intrusions related to eating, weight, and shape. Participants were 574 (408 women) nonclinical community individuals. Analyses revealed that EDITs can be clustered into three sets: appearance-dieting, need to exercise, and thoughts-impulses related to eating disorders. EDITs' consequences showed a two-factor structure: emotional consequences/personal meaning and tho…
Inventario Clark-Beck de Obsesión-Compulsión (C-BOCI) : validación para su uso en población española
The Clark-Beck Obsessive-Compulsive Inventory (C-BOCI) is a new self-administered inventory (Clark & Beck, 2002), designed to offer a valid, specifi c and reliable tool for the screening of the Obsessive-Compulsive Disorder (OCD): it assesses symptoms, their consequences, and takes into account the assumptions of current cognitive models about the disorder. The aim of this study has been to examine the usefulness of the C-BOCI in Spanish population. The questionnaire was completed together with other OCD, depression, and anxiety instruments by 506 adults without mental disorders and 44 OCD patients. The α values were ≥ 0.80 except for the obsessions subs- cale in the OCD group. Concurrent a…
Schizophrenia and automatic processing: an exploratory study.
This study deals with the schizophrenic deficit as one of automatic processing. To test the idea, a special experimental task was designed on which 21 schizophrenics, 21 depressives, and 21 normal subjects had to complete a series of simple geometric figures. When the subjects had thoroughly learned this activity, another information source, a brief story, was introduced, and the subjects had to pay attention to the story while they did the task. Two dependent variables were considered, execution time and performance. There were no differences among the three groups in the first experimental condition; but in the second condition, when the distractor was introduced, schizophrenics needed m…
Temporary stages and motivational variables: Two complementary perspectives in the help-seeking process for mental disorders
Abstract Introduction Help-seeking for mental disorders is a complex process, which includes different temporary stages, and in which the motivational variables play an especially relevant role. However, there is a lack of instruments to evaluate in depth both the temporary and motivational variables involved in the help-seeking process. This study aims to analyse in detail these two sets of variables, using a specific instrument designed for the purpose, to gain a better understanding of the process of treatment seeking. Material and methods A total of 152 patients seeking treatment in mental health outpatient clinics of the NHS were individually interviewed: 71 had Obsessive-Compulsive Di…
¿Influye la experiencia en la percepción de disnea?
Objetivo: En la percepcion de las sensaciones somaticas, como la disnea, pueden influir factores tales como la propia personalidad del individuo, su experiencia previa o su capacidad de adaptacion a los estimulos. El objetivo del presente estudio ha sido conocer si los pacientes con asma perciben una situacion de broncoconstriccion aguda de forma diferente de los pacientes que nunca han sufrido un episodio previo de obstruccion de la via aerea. Pacientes y metodo: Estudiamos 2 grupos de pacientes. El primero estaba formado por 24 sujetos con rinitis y asma intermitente (10 mujeres y 14 varones, con una edad media ± desviacion estandar de 25 ± 7 anos), que no referian sentir disnea basal en …
Empirically Grounded Clinical Interventions: Cognitive Versus Behaviour Therapy in the Individual Treatment of Obsessive-Compulsive Disorder: Changes in Cognitions and Clinically Significant Outcomes at Post-Treatment and One-Year Follow-Up
Clinical significance analyses of controlled studies comparing Exposure and Response Prevention (ERP) and Cognitive Therapy (CT) in the treatment of Obsessive-Compulsive Disorder (OCD) are scarce. The objective of this study is to compare the clinical efficacy of ERP and CT for OCD patients, and the usefulness of each in changing dysfunctional beliefs and thought control strategies at post-treatment and at a one-year follow-up. The two treatments were delivered on the basis of a routine clinical practice in a public-mental health service. Thirty-three OCD patients were randomly assigned to ERP or CT, and 29 completed the treatments (13 in ERP and 16 in CT). The ERP applied was in vivo, grad…
Symptom dimensions in obsessive-compulsive disorder: differences in distress, interference, appraisals and neutralizing strategies.
Abstract Background and objectives Cognitive proposals about the mediating role of misinterpretations, emotional reactions, and control strategies in the escalation of obsessional intrusive thoughts (OIT) to clinical obsessions have received only partial support. This study aims to examine these variables, taking into account the obsession/OIT contents and the severity of the Obsessive-Compulsive Disorder (OCD). Methods After identifying their most upsetting OIT/obsession, 61 OCD patients and 61 non-clinical individuals assessed the associated distress, interference and appraisals, and the strategies used to control the obsession/OIT. Results Compared with the nonclinical subjects, OCD indi…
EsTOCma: An App to fight against stigma associated with Obsessive-Compulsive Disorder (OCD)
Introduction: Stigmatizing attitudes is a problem associated to mental disorders. In obsessive-compulsive disorder (OCD) stigma has been associated to shame, guilty and delay asking for help. Objective: To present the design of a mobile health application (app), named EsTOCma, with the objective to increase OCD mental health literacy, help seeking attitudes, and reduce stigmatizing/ self-stigmatizing attitudes and social distance associated with OCD in adult population (non-clinical and OCD population and their relatives). Method: Method: The requirements have been developed based on a literature review on mental health antistigma interventions, OCD stigma research, and serious games resear…
Obsession subtypes : relationships with obsessive-compulsive symptoms, dysfunctional beliefs and thought control strategies
Obsessive themes can be classified into two main categories: autogenous obsessions and reactive obsessions. The first comprise highiy unacceptable and unrealistic thoughts, including aggressive, sexual and repulsive concerns. that can be conceptualised as «pure obsessions» (PO), whereas the second relate to relatively realistic doubts or thoughts with common themes dealing with contamination, mistakes or accidents, associated with overt actions taken to prevent the occu- rrence of negative outcomes, that can be conceptualised as obsessions plus compulsions (O-C). In this study, the ditTerences bctween PO and O-C in 39 Obsessive-Compulsive Disordered (OCD) outpatients are examined. Results: …
Percepción de la disnea durante la broncoconstricción aguda en los pacientes con asma
El objetivo del estudio fue analizar las variaciones de la percepcion de obstruccion bronquial aguda en los asmaticos de nuestra poblacion e intentar definir las variables que condicionan dichas diferencias interindividuales. Se estudio a 153 asmaticos en situacion estable, midiendo la disnea que percibian en una escala de Borg durante la realizacion de una prueba de provocacion bronquial con histamina. Para el analisis de la percepcion individual se valoraron tanto la PS20 (disnea en la escala de Borg al caer el FEV 1 un 20%) como la diferencia matematica entre la PS20 y la disnea ba-sal (”cambio en Borg“ [CB]). Segun nuestros resultados: a) el conjunto de factores que determinan la PS20 (…
Bronchial asthma and personality dimensions: a multifaceted association.
Personality dimensions seem to play an important role in chronic diseases by maintaining or increasing the patient's physical complaints. This study examines in bronchial asthma: (a) the relationships among clinical data, baseline lung function, and personality traits; and (b) the patient's characteristics related to the physician's judgement about his or her asthma severity. Five questionnaires measuring anxiety, depression, self-consciousness, and subjective symptoms were completed by 51 asthmatic patients. Responses to questionnaires and clinical and demographic data were factor-analyzed. Factor analysis revealed that the physician's severity judgement is based on elderly age, high score…
The Appearance Intrusions Questionnaire
Abstract. This study aims to examine whether Body Dysmorphic Disorder (BDD) related preoccupations might consist of unwanted intrusive cognitions, and if so, their degree of universality, its dimensionality from normality to BDD psychopathology, and their associations with symptom measures. The Appearance Intrusions Questionnaire (AIQ) was designed to assess intrusive thoughts related to appearance defects (AITs). A sample of 410 undergraduate university students completed a former 54-item version of the AIQ. Principal Components Analyses (PCA) and Parallel Analysis yielded a five-factor structure and a reduction to 27 items. The 27-items AIQ was examined in a new sample of 583 non-clinica…
Percepción de mejoría en los pacientes con asma
Objetivo Investigar la capacidad de los pacientes con asma estable de reconocer la mejoria de su obstruccion bronquial con el tratamiento Metodo Seleccionamos a 75 asmaticos estables (44 mujeres y 31 varones, con una media de edad de 43 ± 17 anos), que referian sentir disnea basal en la escala modificada de Borg, y les provocamos en el laboratorio una broncodilatacion aguda del 15%; en esta situacion los pacientes fueron interrogados acerca del cambio de disnea experimentado Resultados 1. Globalmente, 19 asmaticos (25%) no percibieron mejoria de su disnea con la broncodilatacion. 2. La media del cambio en el nivel de disnea fue de 1,17 ± 1,11; sin embargo, este cambio fue mayor en los pacie…
esTOCma, an app developed to dismiss self-stigma and increase mental health literacy about obsessive-compulsive disorder: how does it perform in a clinical sample?
Introduction. Obsessive-compulsive disorder (OCD) is a disabling condition that can be treated successfully. However, individuals with OCD often fail to seek or delay seeking treatment. In order to overcome this gap and increase the intention to seek for help, a gamified mental health mobile application (app) called esTOCma has been developed with a focus on offering information about OCD and on discussing stigmatizing attitudes toward the disease. The general aim of this study is to analyze the impact of the intervention through esTOCma in a clinical OCD sample. The objective of the study was two-fold. First, to analyze if the intervention changes the following variables in a clinical OCD …
Escalation from normal appearance related intrusive cognitions to clinical preoccupations in Body Dysmorphic Disorder: A cross-sectional study
Abstract Current cognitive approaches to Body Dysmorphic Disorder (BDD) assume that appearance-related intrusive cognitions and their functional consequences characterize the disorder, in a similar way that obsessive intrusive thoughts characterize the Obsessive-Compulsive Disorder (OCD). This study explores whether normal but unwanted appearance-related intrusive thoughts (AITs), escalate to clinical AITs when they are dysfunctionally appraised and instigate counterproductive neutralizing strategies. From a sample of 344 non-clinical individuals who reported a highly upsetting AIT during the past three months two subgroups were extracted according to their high (n = 68) and low (n = 276) v…
The long and complex road in the search for treatment for mental disorders: An analysis of the process in five groups of patients
Seeking treatment for mental-health problems is a complex process, with different underlying motives in each stage. However, the entire process and these motives have hardly been investigated. This study aims to analyze the different stages of the help-seeking process and their underlying motives in five groups of patients with different mental disorders. In all, 156 patients seeking treatment in outpatient mental health clinics were individually interviewed: 71 had Obsessive-Compulsive Disorder (OCD), 21 had Agoraphobia (AGO), 18 had Major Depressive Disorder (MDD), 20 had Anorexia Nervosa (AN), and 22 had Cocaine Dependence (COC). The AGO and MDD patients delayed significantly less time i…
Agreement in Asthmatics' Perception of Dyspnea During Acute and Chronic Obstruction
Objective Three types of asthmatic patients can be identified during periods of clinical stability: “poor perceivers,” “normal perceivers,” and “over perceivers.” When asthmatics undergo bronchial challenge in the laboratory, the same distinctions in type of perception can be observed. The aim of the present study was to determine the level of agreement between the 2 situations. Patients and methods A total of 93 patients with persistent moderate asthma (36 men and 57 women; mean age 40 years) were studied. We asked them to assess their dyspnea on a modified Borg scale when stable and after each histamine dose in a bronchial provocation test. When a patient's Borg scale assessment in stable…
Prevalencia del síndrome de hiperventilación en pacientes tratados por asma en una consulta de neumología
Objetivo Aunque la presencia del sindrome de hiperventilacion (SH) puede influir en los sintomas de los pacientes con asma, existe escasa informacion acerca de su frecuencia en nuestro medio. Nuestro objetivo ha sido investigar la prevalencia de SH entre la poblacion asmatica controlada ambulatoriamente y establecer su relacion con los trastornos de ansiedad. Pacientes y metodo Con este proposito hemos estudiado a 157 asmaticos consecutivos (61 varones, 96 mujeres; edad media ± desviacion estandar de 45 ± 17 anos; volumen espiratorio forzado en el primer segundo: 84 ± 21%), controladosen nuestras consultas externas, en situacion estable y con diferentes grados de gravedad. Tras recoger los …
Exploring the role of obsessive-compulsive relevant self-worth contingencies in obsessive-compulsive disorder patients.
Abstract This article examines whether self-worth contingencies in the personal domains of cleanliness, morality, hoarding, certainty, accuracy, religion and respect for others have specific associations with obsessive symptoms and cognitions in individuals with obsessive–compulsive disorder (OCD). Fifty-seven patients with a primary diagnosis of OCD completed the Obsessional Concerns and Self Questionnaire (OCSQ), designed to assess the extent to which respondents consider OCD content domains relevant to their self-worth, along with a battery of other instruments. Results indicate that the OCSQ is more associated with OCD than with non-OCD anxiety symptoms, and that it is also associated w…
EsTOCma: A Mental Health Application for Enhancing Mental Health Literacy About Obsessive-compulsive Disorder and Reduce Stigma: Protocol for a Randomized Controlled Trial.
Introduction: Obsessive-compulsive disorder (OCD) is a debilitating heterogeneous condition and one of the 10 leading causes of disability worldwide, affecting approximately 2%-2.3% of the population. However, there is a long delay in seeking treatment, and between 38% and 89.8% of OCD sufferers neither ask for nor receive treatment for their symptoms. Studies on OCD report that insufficient mental health literacy about OCD and the associated stigma would explain the delayed treatment-seeking behavior of OCD patients. With the aim of increasing OCD mental health literacy and reducing the associated stigma, a gamified mental health mobile application (app) called esTOCma was developed. The o…
Percepción de la disnea y cumplimiento terapéutico en pacientes con asma
Objetivo El cumplimiento terapeutico en una enfermedad cronica como el asma no supera el 50% en la mayoria de las series. Aunque las razones sean de muy diversa indole, es evidente que el incumplimiento es un factor determinante en el mal control de la enfermedad. Por otra parte, la falta de percepcion de la disnea se ha asociado con el asma de control dificil y con la aparicion de crisis de asma fatal o casi fatal. Asi pues, el objetivo del presente estudio ha sido intentar demostrar que una de las razones por las cuales los asmaticos no toman su medicacion es que no tienen percepcion de disnea cuando sus bronquios se obstruyen. Pacientes y metodos Hemos estudiado a 2 grupos de pacientes c…
Comorbidity, age of onset and suicidality in obsessive–compulsive disorder (OCD): An international collaboration
Made available in DSpace on 2018-12-11T17:11:30Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-07-01 Objectives To collate data from multiple obsessive–compulsive disorder (OCD) treatment centers across seven countries and five continents, and to report findings in relation to OCD comorbidity, age of onset of OCD and comorbid disorders, and suicidality, in a large clinical and ethnically diverse sample, with the aim of investigating cultural variation and the utility of the psychiatric diagnostic classification of obsessive–compulsive and related disorders. Methods Researchers in the field of OCD were invited to contribute summary statistics on current and lifetime psychiatric comor…
Modelo de personalidad HEXACO: Relaciones con psicopatología emocional en una muestra española [HEXACO personality model: Relationships with emotional psychopathology in a Spanish sample]
This study examines the relationships between personality dimensions and obsessive-compulsive and depressive psychopathology signs, on the basis of the new 6-dimension HEXACO personality model:Honesty-Humility, Emotionality, eXtraversion, Agreeableness, Conscientiousness, and Openness to Experience. Participants were 354 individuals from the general population, from which 21 were at risk of depression (r-DEP) and 29 at risk of obsessive-compulsive disorder (r-OCD). Jointly, the 6 personality dimensions explained 42% of the BDI-II score in the r-DEP group, and 37% of the C-BOCI score in the r-OCD group. The two at-risk groups differed from the no-risk participants in all the personality dime…
To achieve a sense of rightness: The joint role of Not Just Right Experiences and Intolerance of Uncertainty in Obsessive-Compulsive Disorder
Abstract Background/Objective Not Just Right Experiences (NJREs) are currently considered as one of the motivators of Obsessive-Compulsive Disorder (OCD), but the ways through which NJREs affect OCD symptoms remains unclear. The aim of the present study was to examine the putative mediational role of Intolerance of Uncertainty (IU) in the association between NJRE severity and OCD symptoms in patients with OCD. Method Sixty-two patients with OCD completed self-report measures of NJREs, OCD symptoms, and IU. Results IU mediated the relationship between NJRE severity and OCD symptoms. Furthermore, NJRE severity emerged as moderator of the path, suggesting that the mediational role of IU is str…
Gender Differences in Health‐Related Quality of Life Among Patients with Asthma
This study has a twofold objective: 1) to explore to what extent suffering from asthma affects the HRQL of men and women differently at several stages of disease severity and 2) to analyze whether the informed poorer HRQL of asthmatic women is related to their higher scores on instruments measuring emotionally disordered symptoms. One hundred fifty-one outpatient asthmatics (84 women and 67 men) completed the Spanish versions of the Asthma Quality of Life questionnaire (AQL), as well as anxiety and depression inventories. A full history, physical examination, and pulmonary function test were performed on all subjects. Patients were classified into one of four asthma severity categories foll…
Self-worth contingencies and obsessionality: A promising approach to vulnerability?
Abstract Cognitive behavioral theories (CBT) posit deficiencies in selfhood processes as possible vulnerability factors for obsessive–compulsive disorder (OCD). This paper presents two psychometric studies on the development of the Obsessional Concerns and Self Questionnaire (OCSQ), a measure of failure to attain self-worth in personal domains relevant to obsessionality. In the first study based on 563 community Spaniards, principal factor analysis of an 80 item pool resulted in a three factor solution and a final 35 item version (OCSQ-r). In the second study self-worth and symptom measures were administered to 152 Spanish, 142 Argentinean and 112 Canadian nonclinical samples. Group compari…
Effects of suppressing neutral and obsession-like thoughts in normal subjects: beyond frequency
Abstract Recent cognitive-behavioral theories on obsessive–compulsive disorder (OCD) show that deliberate attempts to suppress intrusive and undesirable thoughts lie at the genesis of clinical obsessions. In this paper the results of an experimental study on the suppression of neutral and obsession-like thoughts in normal subjects are presented. Eighty-seven university students performed in three experimental periods: (1) base-line monitoring, (2) experimental instruction, and (3) monitoring. For each of these periods, the frequency of the occurrence of a “white bear” thought or a personally relevant intrusive thought was registered. Half of the subjects received instructions to suppress th…
La evaluación del perfeccionismo: utilidad de la Escala Multidimensional de Perfeccionismo en población española
La Escala Multidimensional de Perfeccionismo (MPS) de Frost et al. (1990) es uno de los instrumentos con más tradición empírica y mayor influencia en el estudio del perfeccionismo. El objetivo de este trabajo es traducir y validar la MPS para su uso en población española. Para ello, 434 participantes (77% mujeres; edad media: 23,38 años), completaron la versión española de la MPS junto con cuestionarios de obsesividad, trastornos alimentarios, y preocupaciones ansiosas, para evaluar la validez convergente de la MPS. El análisis de componentes principales (varianza explicada: 56%), reveló una estructura de 4 factores en lugar de los 6 originales: Miedo a los errores, Influencias paternas, Ex…
Symptom dimensions in obsessive-compulsive disorder: from normal cognitive intrusions to clinical obsessions.
Abstract Cognitive behavioral models of obsessive–compulsive disorder (OCD) assume continuity between normal obsessional intrusive thoughts (OITs) and obsessions. However, this assumption has recently been criticized. This article examines this issue using a new instrument (the Obsessional Intrusive Thoughts Inventory, INPIOS) specifically designed to assess the frequency and content of 48 OITs, which was completed by 734 community subjects and 55 OCD patients. Confirmatory factor analysis suggests six first-order factors included in two second-order factors, one containing aggressive, sexual, religious, immoral and repugnant OITs, and the other containing contamination, doubts and checking…
Psicopatología de las compulsiones de lavado en el trastorno obsesivocompulsivo: no todos los pacientes lavan por los mismos motivos
Abstract: Psychopathology of washing compulsions in obsessive-compulsive disorder: Not all patients wash for the same reasons. Obsessive-compulsive disorder (OCD) is a heterogeneous disorder in terms of the contents of obsessions and compulsions. Washing, being one of the most frequent compulsion modalities, has been associated with different variables such as: physical or mental contamination fears, fears associated with negative affect (including disgust) and the loss of control, a high level of perfectionism, or the avoidance of a sense of dirtiness or incompleteness. In this study, these variables are examined through the descriptive analysis of the psychopathological symptoms and tr…
Dysfunctional beliefs about health and illness: a family study
Los modelos cognitivos sobre la hipocondría postulan que las experiencias tempranas con la enfermedad promueven el desarrollo de creencias disfuncionales sobre la enfermedad. Estas creencias pueden permanecer latentes y activarse ante un incidente crítico. Los estudios publicados aportan datos que avalan de mane- ra indirecta estos planteamientos. Teniendo en cuenta que en el núcleo familiar primario se comparten experiencias sobre la enfer- medad, examinamos la relación entre las creencias disfuncionales que los progenitores y sus descendientes mantienen sobre la en- fermedad y los pensamientos, tales como la intolerancia a la incer- tidumbre y la sobreestimación de la amenaza, y las relac…
Calidad de vida en el asma: validación del cuestionario AQLQ para su utilización en población española
The study of morbidity in asthma requires consideration not only of standard physiopathologic and function parameters, but also of the impact the disease has on the patient's life-style as he or she perceives it and evaluates it. The quantification of this factor, known as health-related quality of life (HRQL), is achieved by administering questionnaires specially designed for the purpose. We analyzed the reliability, content validity and construct validity (convergence and divergence) of one instrument, the Asthma Quality of Life Questionnaire (AQLQ) designed by Marks and colleagues. This questionnaire covers 4 dimensions (breathlessness, mood, social limitation and worrying) and gives a t…
Obsessional and Eating Disorder-related Intrusive Thoughts: Differences and Similarities Within and Between Individuals Vulnerable to OCD or to EDs
Unwanted intrusive cognitions constitute the normal variant of clinically significant intrusive cognitions found in disorders such as obsessive-compulsive disorder (OCD) and eating disorders (EDs). This study investigates whether individuals who are vulnerable to OCD or EDs experience more intrusions than people with no vulnerability to these disorders, and it examines the consequences of obsessional (OITs) and eating disorder (EDITs) intrusions in the same individuals, taking into account their susceptibility to OCD, EDs or neither of the two. From a sample of 922 participants, three groups were formed: risk of OCD (n = 92), risk of EDs (n = 41) and a no-risk group (n = 100). EDITs were mo…
Intrusive thoughts in non-clinical subjects: the role of frequency and unpleasantness on appraisal ratings and control strategies
This study explores the frequency of the appearance of intrusive thoughts in normal people, as well their association with cognitive appraisals and control strategies. A total of 336 subjects completed the Spanish adaptation of the Obsessional Intrusions Inventory-Revised (ROII), designed by Purdon and Clark (1993, 1994a, 1994b). Most of the subjects (99.4%) reported experiencing intrusive thoughts occasionally, but only 13% reported having them with some frequency. The intrusions were included in two factors: aggression, sexually and socially inappropriate behaviours, and doubts, checking, and cleanliness. The frequency of appearance of the most upsetting intrusive thought was associated w…
Virtual reality exposure for OCD: Is it feasible? [Exposición mediante realidad virtual para el TOC: ¿Es factible?]
Virtual reality exposure therapy (VRET) is receiving increased attention, especially in the fields of anxiety and eating disorders. This study is the first trial examining the utility of VRET from the perspective of OCD patients. Four OCD women assessed the sense of presence, emotional engagement, and reality judgment, and the anxiety and disgust levels they experimented in four scenarios, called the Contaminated Virtual Environment (COVE), in which they had to perform several activities. The COVE scenarios were presented on a Full HD 46” TV connected to a laptop and to a Kinect device. Results indicate that the COVE scenarios generated a good sense of presence. The anxiety and disgust leve…
Assisting relapse prevention in OCD using a novel mobile app-based intervention: A case report.
Mobile health apps increase the accessibility of cognitive-behavioral–based interventions before, during, or following treatment. GGOC is a mobile app designed to challenge maladaptive beliefs in obsessive-compulsive disorder (OCD). This single-case study assesses the usefulness of GGOC as a relapse prevention tool for OCD. The patient was a 26-year-old woman with severe contamination and washing/cleaning OCD symptoms (Y-BOCS = 33). GGOC was used for relapse prevention following CBT treatment. The patient completed 47 levels dedicated to OCD-relevant maladaptive beliefs. Before and after GGOC, the Y-BOCS, Obsessive-Compulsive Inventory (OCI-R), Obsessive Beliefs Questionnaire (OBQ-20), and…
A novel approach to challenging OCD related beliefs using a mobile-app: An exploratory study
Abstract Background and objectives According to cognitive models, obsessive compulsive symptoms result from catastrophic misinterpretations of commonly occurring intrusive experiences and the use of counterproductive strategies to manage them. Obsessive Compulsive Disorder (OCD) related beliefs such as inflated responsibility, importance of thoughts and perfectionism increases the likelihood of such misinterpretations. Consistent with a growing body of literature supporting the usefulness of mobile delivered technologies in fostering cognitive behavior change, the present study assessed the effectiveness of a novel cognitive training exercise designed to challenge OCD-related beliefs. This …
Group versus individual cognitive treatment for Obsessive-Compulsive Disorder: Changes in non-OCD symptoms and cognitions at post-treatment and one-year follow-up
Current cognitive approaches postulate that obsessions and compulsions are caused and/or maintained by misinterpretations about their meaning. This assumption has led to the development of cognitive therapeutic (CT) procedures designed to challenge the dysfunctional appraisals and beliefs patients have about their obsessions. Nonetheless, few studies have compared the efficacy of individual and group CT in changing the dysfunctional cognitions that hypothetically underlie Obsessive-Compulsive Disorder (OCD). In this study, 44 OCD patients were assigned to individual (n = 18) or group (n = 24) CT. Sixteen completed the individual CT, and 22 completed the group CT. The effects of the two CT c…