Abstract not available

The pivotal role of inflated responsibility beliefs in the maintenance and treatment of obsessive-compulsive disorder (OCD) has been clearly demonstrated (Rachman, 1993; Salkovskis, 1998; Shafran, 1997; van Oppen & Arntz, 1994). Yet little is known about the origins of these beliefs, their contribution to a sense of inflated responsibility or the symptoms of OCD, or the contribution of personality to inflated responsibility and to OCD, The aims of this thesis were to investigate a model of the inter-relationships among the personality dimensions of neuroticism and psychoticism, inflated responsibility and OCD, and the origins of inflated responsibility to inflated responsibility and to OCD. In order to achieve these aims, a scale was developed to assess the origins of inflated responsibility based upon the five pathways proposed by Salkovskis, Shafran, Rachman, and Freeston (1999) and the additional domains of guilt, vigilance and thought-action fusion (Shafran, Thordarson, & Rachman, 1996; Shafran, Watkins & Charman, 1996; Tallis, 1994). Eighty-four participants with OCD (age M = 43.36) and 74 control participants (age M =37.14) volunteered to participate in the two studies of this thesis. The aim of Study 1 was to develop and validate a measure of the Origins of Inflated Responsibility (OIR). The results of the first study yielded a 25-ttem scale, the Origins of Inflated Responsibility Questionnaire (OIRQ) with five independent factors: responsibility, strictness, protection from responsibility, critical incidents, and peer blame which demonstrated both internal reliability and temporal stability over a 2-week period. In Study 2, participants also completed the Responsibility Attitudes Scale (Salkovskis, Wroe, Gledhill, Morrison, Forrester, Richards, ct al. (2000) (a measure of inflated responsibility), the Padua Inventory (Sanavio, 1988) (to measure of the symptoms of OCD)y and the Eysenck Personality Inventory-Revised (Eysenck & Eysenck, 1991). Multivariatc Analysis of Variance revealed that the OCD group scored higher on all variables than the control group except for strictness where the groups were not different, and psychoticism where the OCD group scored lower. A series of Multiple Regression analyses revealed that both group and the OIR contributed to inflated responsibility (R2 = .56). When all variables, OIR, inflated responsibility and neuroticism were entered as predictors of OCD, 60% of the variance in OCD was explained however, 49% of the variance was shared by the independent variables suggesting the presence of some underlying construct. Structural Equation Modelling, where all the constructs in the model were examined simultaneously, revealed that neuroticism contributed to the OIR, inflated responsibility and OCD. The OIR were also significant predictors of inflated responsibility and indirectly through inflated responsibility predictive of OCD. The OIR also directly predicted OCD and when the total effects are considered, their contribution was greater than the total effect for inflated responsibility alone. The results of these studies provide good support for the origins of inflated responsibility proposed by Salkovskis et al. (1999), as measured by the OIRQ developed for use in the current thesis. The results also support the contribution of inflated responsibility and neuroticism, as well as the OIR, to OCD, The large amount of variance shared by the OIR, inflated responsibility and neuroticism suggest that there might be some underlying construct, perhaps of a biopsychosocial nature, that requires further investigation for its role in the onset and maintenance of OCD. The clinical relevance of these findings is discussed in terms of early prevention strategies and interventions.

The current coginitive models of the Obsessive-Compulsive Disorder (OCD) symptoms focuses on the different cognitive factors. Like other nonspecific and noncognitive variables, these factors may also function as vulnerability factors. However, they have been mostly studied separately and majority of the findings in the literature come from the Western samples. Accordingly, the studies examining these factors together and the impact of the culture in these studies are sparse in number. The present study suggested a comprehensive cognitive model for OCD symptoms, including several distal and proximal vulnerability factors. It was aimed to adapt three instruments to examine the interrelationships among the vulnerability factors and OCD symptoms in different cultures. Relevant ten instruments were administered to the university students from Turkey and Canada. The analyses showed that Turkish versions of three instruments had satisfactory psychometric properties for Turkish students. These analyses also revealed some cross-cultural similarities and differences in these factors and OCD symptoms. Neuroticism, age, introversion, OCD beliefs on responsibility/threat estimation, perfectionism/certainty and thought-action fusion in likelihood dimension were found to be associated with the OCD symptoms in both Turkish and Canadian samples. The relational paths between non-specific, appraisal and control factors, and OCD symptoms were also significant in both samples. However, religiousness was only significant factor in OCD symptoms and contributed to several belief and control factors toward these symptoms, only for Turkish subjects. The analyses of the religiousness differences indicated that psychological fusion in general and in morality was more related to the religiosity for Canadian Christians. Besides, Turkish students seemed to utilize worry more for OCD symptoms / whereas, Canadian participants used self-punishment. These common and unique patterns of the relationships were discussed within relevant findings about characteristics of the religion and culture.

The purpose of the present study was to examine the underlying mechanism of memory distrust as a function of repeated checking in a nonclinical student sample. Recent literature proposes that repeated checking increases familiarity with the material checked. Then, familiarity makes the recollections less vivid and detailed. Afterwards, this condition promotes distrust in memory. Before the experimental phase of the study, Padua Inventory- Washington State University Revision (PI-WSUR) and demographic information form were applied to the 381 students (232 female, 149 male) university students. Then, 84 students were selected according to their PI-WSUR scores. The students scored half standard deviation below the mean of the group were assigned to the low OCD group (N= 42) and the students scored half standard deviation above the mean were assigned to the high OCD group (N= 42). In the experimental phase of the study, an interactive computer animation was developed to test repeated checking behavior. Before the experiment, participants were randomly assigned to two groups: primed with feedback group and primed with no feedback group. In the experiment, participants were all asked to carry out checking rituals on a virtual gas ring. Each participant performed turning on, turning off and checking processes for 15 trials. However, half of the participants in the primed with feedback group were given feedback indicating that the checking activity was successful and complete and half of the participants in the primed with no feedback group were not given any feedback. The data are analyzed by 2 (Group: Low OCD group - High OCD Group) X 2 (Feedback condition: Primed with Feedback Group - Primed with no Feedback Group) Between Subjects ANOVA. Results showed that participants in the primed with feedback group had significantly higher scores on both memory confidence for the last checking trial of the gas rings and overall outcome confidence for all fifteen checking trials than participants in the primed with no feedback group. There was no significant group main effect and interaction effect (group x feedback condition) for the level of memory confidence and overall outcome confidence. There were also no significant group and feedback condition main effects and interaction effect for the level of vividness and detail of the recollections of the last checking behavior. Results are discussed in the light of the related literature.

Title from title page of PDF (University of Missouri--St. Louis, viewed February 23, 2010). Includes bibliographical references (p. 53-60).

Family accommodation of symptoms conflicts with the primary goals of cognitive-behavioral therapy for pediatric obsessive-compulsive disorder (OCD) and can be an obstacle to positive outcomes. This study examined a structural equation model of parent and child variables related to family accommodation using a sample of 65 parent-child dyads recruited from a university-based clinic. Additionally, parents' motivations for engaging in accommodation were explored. Results generally supported the hypothesized model. Family accommodation mediated the relationship between OCD symptom severity and parent-rated functional impairment, child internalizing problems mediated the relationship between parent anxiety and family accommodation, and parent empathy and consideration of future consequences interacted to predict accommodation. Child externalizing problems significantly influenced family accommodation but neither of these two variables was affected by parent depression. Excessive reassurance seeking and cleaning/washing compulsions were relatively likely to be accommodated. Implications for clinical practice and directions for future research are discussed.

myo-lnositol (mIns), a natural component of the human diet and essential precursor of several signalling pathways, including that of G protein-coupled receptors, has also been shown to be effective in the treatment of psychiatric disorders such as depression, obsessive compulsive disorder and panic disorder. Most likely since mlns is a simple isomer of glucose, no serious side effects have been reported with its use, even at high oral doses of mlns. Previous studies suggest that the therapeutic action of mlns may include reduced serotonin 5HTzA and muscarinic acetylcholine receptor function. An important signal transduction system that may possibly be involved in the mechanism of action of antidepressants is phosphoinositide (PI) turnover. In this signalling system PI-phospholipase C (PLCpl), that is implicated in the in the mechanism of action of antidepressants and anxiolytics, is activated. The mechanism of action of mlns, however, still remains elusive and needs further investigation. In this study a possible modulatory role of 24-hour pre-treatment of human neuroblastoma cell line (SH-SY5Y) with mlns on mRNA levels and protein expression of phospholipase C-p1 (PLCP1) and glycogen synthase kinase 3P (GSK3p) was investigated. The effects of mlns were also compared to that of other prototype antidepressants, such as fluoxetine (a selective serotonin reuptake inhibitor), imipramine (a tricyclic antidepressant), lithium and another drug with potential antidepressant effects, sildenafil (phosphodiesterase 5-type (PDE5) inhibitor). Real-time reverse transcription Polymerase Chain Reaction (RTPCR) was performed in order to investigate the mRNA levels, while protein expression in membranes and the cytosol fraction of cells were quantified with Western blots. The expression of PLCPl was decreased after pre-treatments with imipramine or myoinositol in combination with fluoxetine. In addition, sildenafil alone or in combination with myo-inositol, also decreased the expression of membrane-bound PLCp1. However, a 24- hour pre-treatment with lithium did not alter PLCPl expression significantly. Determined mRNA levels for the expression of PLCPl were consistent in these findings, except for the inhibition of the mRNA for the expression of PLCPl also after lithium treatment. The reduced PLCpl mRNA levels after lithium pre-treatment may suggest the involvement of posttranscriptional modification (or delayed translational effects) of PLCpl after lithium treatment. The data from the current study suggest that antidepressant action may include downregulation of PLCPl expression and that modulators of the nitric oxidecGMP pathway (e.g. sildenafil as a PDE5 inhibitor) may exhibit similar properties. / Thesis (M.Sc. (Pharmacology))--North-West University, Potchefstroom Campus, 2005.

This qualitative study was aimed at examining which therapeutic attitudes and procedures it is possible to find regarding obsessive-compulsive disorder (OCD), to see if there are any specific factors that crystallizes as particularly important for this disorder. A total of ten therapists with different background and experiences concerning OCD participated in the study where semi-structured interviews was used to collect the data. To analyze the data thematic analysis was used. Three main-themes grew from the analysis, which were all related to the study’s overall purpose. The first main-theme was general therapeutic attitudes. Under this theme, there are two sub-themes, personal characteristics of the therapist and degree of knowledge. The second main-theme, therapeutic approaches regarding OCD, also includes two sub-themes, degree of therapeutic distinctiveness and specific treatment interventions. The third main-theme was the treatment results components. This theme also includes two sub-themes, therapeutic factors and choice of method. In the participants’ stories about which therapeutic attitudes and procedures that are important regarding the treatment of people suffering from OCD, several factors became visible. These are connected to a general therapeutic attitude across diagnosis, such as warmth, empathy, and the ability to form an alliance, in addition to several therapeutic factors which are important to OCD specifically, such as experience and maturity, and being creative. The participants also emphasizes to a large degree ERP as the first choice in regards to treatment. Specifically for this study is that one participant emphasizes ACT as the preferred treatment intervention, where ERP did not result in a satisfactory treatment outcome.

The aim of the present study was to examine the prevalence of eating disorder symptoms in patients with obsessive-compulsive disorder (OCD). Additional aims were to assess whether having comorbid eating disorders could influence the treatment outcome for OCD, and if symptoms of eating disorders were reduced after treatment for OCD. The sample consisted of 93 patients with a primary diagnosis of OCD. The patients underwent assessment with the Yale-Brown Obsessive-Compulsive Scale, Beck Depression Inventory, and Eating Disorder Inventory both prior to and after treatment. First, the analysis showed that the sample of OCD patients had higher prevalence of eating disorders than a population of physically active students. Moreover, the women in the sample had significantly more symptoms of eating disorders than the men. Correlational analysis showed that eating disorders did not affect the treatment outcome for OCD; the patients generally had a significant improvement of OCD symptoms. On the other hand, symptoms of eating disorders were not significantly reduced after treatment. Summarized, this study concludes that there is a high prevalence of eating disorder symptoms among patients with OCD. It further shows that comorbid eating disorders does not hinder the effect of treatment for OCD. However, as the symptoms of eating disorders persist after such treatment, an implication of the present study is that these symptoms may need closer attention.

Two decades of research on obsessive-compulsive disorder (OCD) has helped us develop a strong understanding of why obsessions are often followed by the performance of a compulsive act. What we have understood less well is why that act is repeated, even though it often results in an increase, rather than decrease, in discomfort. Emergent research on compulsive checking implicates a number of beliefs—including perceived responsibility, perceived harm, need for certainty, and beliefs about one’s memory— that may influence behavioural parameters (e.g., check duration) of checking episodes. Furthermore, it has also been suggested that the act of compulsive checking may recur in part because of a self-perpetuating mechanism in which checking has paradoxical effects on these beliefs. Finally, some researchers have proposed that attentional focus (e.g., focus on threat) during checking may be related these paradoxical outcomes. At present, these ideas are mostly speculative, in part because there have been so few detailed studies of the actual phenomenology of compulsive rituals. The purpose of the present research was to gather phenomenological data on compulsions as performed by a clinical sample under ecologically valid conditions. Study 1 extended emergent research suggesting that compulsions may persist because the act of checking has a number of ironic effects on beliefs. Individuals with a diagnosis of obsessive-compulsive disorder (OCD) and anxious controls (AC) completed a naturalistic stove task in our laboratory kitchen. Participants were fitted with portable eyetracking equipment and left on their own to boil a kettle, turn the stove off, and check to ensure that the stove is safe before leaving the kitchen. Surrounding the stove were household items that are “threatening” (e.g., matches) or “non-threatening” (e.g., mugs). Ratings of mood, responsibility, harm (severity, probability) and memory confidence were taken pre- and post-task and a portable eyetracker was used to monitor attention throughout the stove task. We examined the relations between behavioural indices (check duration, attentional focus) and pre- and post-task ratings of responsibility, perceived harm, mood, and memory confidence. Although we found that OCD (as compared to AC) participants took significantly longer to leave the kitchen after using the stove, we found no evidence that stronger pre-task ratings of responsibility, perceived harm, or memory confidence were associated with longer check duration. However, we found some evidence of an ironic effect whereby greater check duration was associated with greater perceived harm and decreased certainty about having properly ensured the stove was off. Of note, these ironic effects were not unique to participants with OCD, but were also observed in the AC group. With respect to the eyetracking data, we found minimal evidence linking threat fixations and beliefs in participants with OCD. In contrast, a number of interesting relations emerged in the eyetracking data of our anxious control participants. For AC participants, a greater proportion of time spent looking at the stove was associated with greater post-task sense of responsibility for preventing harm, greater post-task harm estimates, decreased certainty (about having ensured the stove was off), and decreased confidence in memory for the task. In Study 2, individuals with a diagnosis of OCD completed a structured diary of their compulsions as they occurred naturally over a three˗day period. Participants recorded the circumstances leading to each compulsion and reported on the acts involved in the compulsive ritual, the duration and repetitiveness of the ritual, and the criteria used to determine completeness of the ritual. The findings of this study suggest that unsuccessful compulsions (i.e., compulsions in which certainty was not achieved) were associated with a longer duration (trend), more repetitions, a higher standard of evidence, and offered little in the way of distress reduction. These findings are discussed within the theoretical context of cognitive˗behavioural model of obsessive˗compulsive disorder and clinical implications are offered.