Obsessive-Compulsive Disorder (OCD) is characterised by intrusions into conscious thinking by repetitive, personally abhorrent, absurd and alien thoughts (obsessions) which lead to endless repetitive acts or rehearsal of irrational and sometimes bizarre mental and behavioural rituals (compulsions). Although a number of clinical constructs have been proposed to have a causal influence on OC symptoms, extremely little research exists examining how these constructs are related to each other and, further, how the relationships between these constructs influences each constructs relationship with OC symptoms (e.g. does a given construct have an independent role in influencing OC symptoms or is the constructs influence on OC symptoms being mediated by its influence on another intervening construct or constructs?). In the current thesis, the relationships between 5 clinical constructs were examined, as well as how the pattern of these relationships may affect each constructs influence on OC symptoms. A large questionnaire study suggested that the five constructs are best seen as separate constructs rather than indicators of one underlying construct. Separate experimental studies in which all 5 constructs were manipulated individually suggest that whilst inflated responsibility, intolerance of uncertainty and negative mood, respectively, all causally influence every other construct focused on in this thesis, not just right experiences and as many as can stop rules, respectively, do not casually influence any other construct. Subsequent regression analyses suggest that whilst some constructs directly influence OC symptoms, other constructs influence on OC symptoms are mediated by intervening constructs in the final model, whilst some constructs have little to no influence on OC symptoms when the influence of other constructs in the final model are taken into account. Implications of these findings for existing models of OCD, for studies examining the relationship between multiple constructs and OC symptoms and for the treatment of OCD are discussed.

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The goal of this investigation was to marry two theories of supportive communication outcomes in order to test a comprehensive model of social support for people with obsessive-compulsive disorder (OCD). The theoretical frameworks utilized in this investigation were the theory of conversationally-induced reappraisals and the dual-process theory of supportive communication outcomes. These theoretical frameworks provide a foundation for the conversation of how social network members can help their loved ones with OCD manage their distressing symptoms as they explore the types of social support message features (verbal person-centeredness) that are most productive in achieving emotional improvement for those experiencing emotional distress. The union of these two theories in the context of social support and OCD management led to the testing of seven hypotheses. Participants (n = 168) who self-identified as living with OCD at some point in their life were recruited to fill out an online questionnaire. Results indicated support for the theory of conversationally-induced reappraisals, but not for the dual-process theory of supportive communication outcomes. Overall, the findings of this investigation highlighted the utility of emotional support messages high in verbal person-centeredness as they led those with OCD to reassess the intrusive nature of their symptoms, a process which promoted overall affective improvement. These associations suggest that social network members can help their loved ones with OCD manage their symptoms through supportive communication.

Controlled scientific research into obsessive-compulsive disorder (OCD) in adulthood has considerably progressed over the past two decades; however, current research into childhood OCD is still in its infancy by comparison. As a result, current psychological conceptualisations of OCD during childhood, including approaches to treatment, are almost entirely based on adult models of the disorder. Previous research however, examining the clinical phenomenology of OCD has provided some evidence that OCD might be associated with different clinical correlates at different stages of development. In particular, there appears to be a bimodal distribution in terms of the age of onset of the disorder, a male predominance during childhood and adolescence compared to adulthood, stronger familial aggregation of OCD in early onset cases, and differences in the types of symptoms and the patterns of comorbidity across age groups. The first study aimed to assess the developmental continuity in clinical correlates of OCD across 3 distinct age groups, including; children (n = 40), adolescents (n = 44) and adults (n = 41). It was hypothesised that the sample of children would be predominantly male, and would have a higher familial aggregation of OCD and/or anxiety/depression in first-degree relatives. It was further hypothesised that there would be significant age-related differences in terms of specific symptoms, patterns of comorbidity, OCD severity, functional impairment, and level of insight and distress. The results of this study supported the developmental heterogeneity hypothesis, with significant differences occurring across age groups on a number of clinical features of OCD including age at onset, symptoms experienced, comorbidity, severity, insight and impairment. The recognition of developmental differences in clinical features of OCD will assist in the accurate assessment and diagnosis of the disorder, and will allow for refinement of current treatment strategies to ensure treatments effectively target features of the disorder as it presents at different developmental stages. While the cognitive theory of OCD is one of the most widely accepted accounts of the maintenance of the disorder in adults, no study to date has systematically evaluated this theory across children, adolescents and adults with the disorder. Until empirical investigation examines the applicability of this theory to children and adolescents, we know very little about the cognitive processes associated with OCD during childhood or adolescence. The second study investigated developmental differences in the cognitive processing of threat in a sample of children (n = 34), adolescents (n = 39) and adults (n = 38) with OCD. Using an idiographic assessment approach, as well as self-report questionnaires, this study evaluated cognitive appraisals of responsibility, probability, severity, thought-action fusion (TAF), thought-suppression, self-doubt and cognitive control. It was hypothesised that there would be age related differences in reported responsibility for harm, probability of harm, severity of harm, thought suppression, TAF, self-doubt and cognitive control. Results demonstrated that children with OCD reported experiencing fewer intrusive thoughts, which were less distressing and less uncontrollable than those experienced by adolescents and adults with OCD. Furthermore, responsibility attitudes, probability biases and thought suppression strategies were significantly higher in adolescents and adults with OCD, compared to children. Cognitive processes of TAF, perceived severity of harm, self-doubt and cognitive control were found to be comparable across age groups. These findings suggest that some cognitive biases associated with OCD in adults, are in fact also associated with OCD during childhood and adolescence, however there remains some discontinuity across specific cognitive processes. For a developmentally sensitive theory of OCD, further investigation is clearly warranted into other possible age related maintenance factors of this disorder. Implications of these 2 empirical investigations are highlighted and directions for future research are discussed.

Ortorexia Nervosa (ON) är ett idag relativt okänt fenomen och detfinns skilda åsikter angående vilken typ av problem det är. Det finns desom menar på att det kan vara en ätstörning eller ett tvångssyndrom.Studien genomfördes med syfte att undersöka hur utbrett ON är hosträningsintresserade människor samt undersöka om bassjälvkänsla ochförvärvad självkänsla kunde relateras på olika sätt till graden av ONsamt se ifall kön och ålder har någon inverkan på detta.Undersökningen genomfördes med enkäter som mätte graden av ONoch självkänsla på 102 deltagare. Det visade sig att 33% av antaletdeltagare hade poäng över tröskelvärdet för ON. Studiens äldre ochyngre deltagare visade sig vara de som fick högst poäng på testet förON, dock hittades ingen skillnad beträffande kön. Inga signifikantasamband mellan ON och de två typerna av självkänsla kunde hittas.Idag är forskningen bristfällig inom ON och fler studier behövs.

Although research supports cognitive behaviour therapy (CBT) as the treatment of choice for childhood obsessive compulsive disorder (OCD) and recommends family involvement (e.g., AACAP, 1998; Barrett, Healey-Farrell, & March, 2004a), little is known about the role of the family in the development, maintenance, and treatment of childhood OCD. Furthermore, although significant improvements are found in treatment response, many children remain symptomatic (de Haan, 2006). Objective: The aims of the study were to examine (1) the perceptions of the family environment among family members and if child perceptions change with treatment and (2) treatment response and child and family characteristics that may predict treatment response. Gender differences were also examined. Method: This study involved 82 children (ages 8 to 17 years) receiving CBT for OCD and a concurrent parent program. Children and parents were assessed at initial, pre-, and post-treatment with questionnaires, a symptom severity interview, a family environment questionnaire, and child self-report measures of anxiety and depression. Pre-treatment data were used for the prediction of treatment response. Results: Child and parent perceptions of the family environment differ in terms of family expressiveness, with children perceiving their family as being ‘distressed.’ Although girls and boys had similar perceptions of their family environment, girls’ perceptions were more in agreement with their parents than boys. Children’s ratings of family cohesiveness were ‘normal’ at pre-treatment, and increased significantly at post-treatment; however, this was not meaningful when gender was considered. We found a similar treatment response to past research. Different characteristics were found to predict treatment response for boys and girls, with more predictors being identified for girls. Conclusions: Results emphasize the importance that families may have in the treatment of OCD and in our attempt to find predictors, as well as the need to examine boys and girls separately. This research is critical to refine and tailor treatment techniques to match child and family characteristics.

Although research supports cognitive behaviour therapy (CBT) as the treatment of choice for childhood obsessive compulsive disorder (OCD) and recommends family involvement (e.g., AACAP, 1998; Barrett, Healey-Farrell, & March, 2004a), little is known about the role of the family in the development, maintenance, and treatment of childhood OCD. Furthermore, although significant improvements are found in treatment response, many children remain symptomatic (de Haan, 2006). Objective: The aims of the study were to examine (1) the perceptions of the family environment among family members and if child perceptions change with treatment and (2) treatment response and child and family characteristics that may predict treatment response. Gender differences were also examined. Method: This study involved 82 children (ages 8 to 17 years) receiving CBT for OCD and a concurrent parent program. Children and parents were assessed at initial, pre-, and post-treatment with questionnaires, a symptom severity interview, a family environment questionnaire, and child self-report measures of anxiety and depression. Pre-treatment data were used for the prediction of treatment response. Results: Child and parent perceptions of the family environment differ in terms of family expressiveness, with children perceiving their family as being ‘distressed.’ Although girls and boys had similar perceptions of their family environment, girls’ perceptions were more in agreement with their parents than boys. Children’s ratings of family cohesiveness were ‘normal’ at pre-treatment, and increased significantly at post-treatment; however, this was not meaningful when gender was considered. We found a similar treatment response to past research. Different characteristics were found to predict treatment response for boys and girls, with more predictors being identified for girls. Conclusions: Results emphasize the importance that families may have in the treatment of OCD and in our attempt to find predictors, as well as the need to examine boys and girls separately. This research is critical to refine and tailor treatment techniques to match child and family characteristics.

A growing literature suggests that individuals repeatedly check in part because they lack confidence in their memories for previously-completed actions. It has also been hypothesized that the cognitive distrust demonstrated by individuals with OCD extends beyond memory to related factors such as attention and perception; however, the relation between distrust in attention, perception and memory has yet to be examined. The present study examined the extent to which distrust in attention and perception relate to memory distrust and compulsive checking in participants ranging in OCD symptom severity. A measure of distrust in attention and perception was developed for this purpose. Initial psychometric results indicated that distrust in attention and perception can be measured reliably and that it is related to previously-established metacognitive factors (e.g., distrust in memory) and OCD-relevant beliefs (e.g., inflated sense of responsibility). Importantly, the present results also indicated that distrust in attention and perception contributed to checking symptoms beyond memory distrust, baseline negative mood and neuroticism, and previously-established OCD beliefs (i.e., inflated sense of responsibility). Taken together, these findings suggest that distrust in attention and perception may be an important mechanism in the persistence of compulsive checking.

A growing literature suggests that individuals repeatedly check in part because they lack confidence in their memories for previously-completed actions. It has also been hypothesized that the cognitive distrust demonstrated by individuals with OCD extends beyond memory to related factors such as attention and perception; however, the relation between distrust in attention, perception and memory has yet to be examined. The present study examined the extent to which distrust in attention and perception relate to memory distrust and compulsive checking in participants ranging in OCD symptom severity. A measure of distrust in attention and perception was developed for this purpose. Initial psychometric results indicated that distrust in attention and perception can be measured reliably and that it is related to previously-established metacognitive factors (e.g., distrust in memory) and OCD-relevant beliefs (e.g., inflated sense of responsibility). Importantly, the present results also indicated that distrust in attention and perception contributed to checking symptoms beyond memory distrust, baseline negative mood and neuroticism, and previously-established OCD beliefs (i.e., inflated sense of responsibility). Taken together, these findings suggest that distrust in attention and perception may be an important mechanism in the persistence of compulsive checking.

No description available.