Association between Protestant religiosity and obsessive-compulsive symptoms and cognitions

There is evidence that religion and other cultural influences are associated with the presentation of obsessive-compulsive symptoms, as well as beliefs and assumptions presumed to underlie the development and maintenance of these symptoms. We sought to further examine the relationship between Protestant religiosity and (1) various symptoms of obsessive-compulsive disorder (OCD) (e.g., checking, washing) and (2) OCD-related cognitions. Using self-report questionnaires, we compared differences in these OCD-related phenomena between highly religious Protestants, moderately religious Protestants, and atheist/agnostic participants drawn from an undergraduate sample. Highly religious versus moderately religious Protestants reported greater obsessional symptoms, compulsive washing, and beliefs about the importance of thoughts. Additionally, the highly religious evinced more obsessional symptoms, compulsive washing, intolerance for uncertainty, need to control thoughts, beliefs about the importance of thoughts, and inflated responsibility, compared to atheists/agnostics. Results are discussed in terms of the relationship between religion and OCD symptoms in the context of the cognitive-behavioral conceptualization of OCD.     

Obsessions and worry beliefs in an inpatient OCD population

Dysfunctional beliefs in obsessive–compulsive disorder (OCD) and worry are thought to contribute to vulnerability and maintenance of pathological anxiety. In this study, five belief domains concerning responsibility/threat estimation, perfectionism, intolerance of uncertainty, importance/control of thoughts and thought–action fusion were examined to see whether they differentially predicted worry and obsession severity in patients with severe OCD. Correlational analysis revealed that perfectionism and intolerance of uncertainty were associated with worry, whereas beliefs in the importance and control of thoughts and thought–action fusion were associated with obsession severity when obsession severity and worry, respectively, were controlled. In regression analyses, thought–action fusion and intolerance of uncertainty predicted OCD severity. The relation between dysfunctional beliefs and specific subtypes of OCD symptoms was also examined. Specific relationships were identified, including perfectionism with ordering, obsessions with control/importance of thoughts and checking and washing with threat estimation.     

The Relationships Between Obsessive–Compulsive Symptom Dimensions and Cognitions in Obsessive–Compulsive Disorder

Several studies have linked obsessive–compulsive symptoms to specific obsessive–compulsive cognitions, however methodologies have varied, and no study has determined obsessive–compulsive symptoms using the most widely used clinician rating scale, the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS). Considering that almost all studies that used factor analysis to ascertain OCD symptom dimensions were based on the Y-BOCS and that self-report instruments assessing obsessive–compulsive symptoms correlate poorly with the Y-BOCS, there is a need to use the Y-BOCS to examine the relationship between obsessive–compulsive cognitions and obsessive–compulsive symptom dimensions. This study examined the relationship between five Y-BOCS-derived obsessive–compulsive symptom dimensions and the three obsessive–compulsive cognitive domains identified by the obsessive-beliefs questionnaire (OBQ). The symmetry/ordering symptom dimension was associated with increased perfectionism/intolerance of uncertainty, the unacceptable/taboo thoughts symptom dimension was associated with increased importance/control of thoughts and the doubt/checking symptom dimension was associated with increased responsibility/threat estimation. There was no statistical evidence of an association between any OBQ belief sub-scale and the hoarding symptom dimension nor the contamination/cleaning symptom dimension. The findings encourage symptom-based approaches to cognitive-behavioural therapy for some OCD symptoms and call for further research on cognitions associated with contamination/cleaning symptoms and hoarding.     

The interaction between Comt and Bdnf variants influences obsessive–compulsive-related dysfunctional beliefs

Cognitive models emphasize the importance of dysfunctional beliefs as overimportance/need to control thoughts, perfectionism, intolerance of uncertainty, responsibility, and overestimation of threat in obsessive–compulsive disorder (OCD). Twin studies suggest that these beliefs are significantly heritable, but candidate genes associated with them have not been analyzed. We genotyped the Val158Met in the COMT gene and Val66Met variant in the BDNF gene in 141 OCD patients and analyzed their single and interactive effects on the obsessive beliefs questionnaire (OBQ-44). Variability in dysfunctional beliefs was not affected by the COMT or BDNF genotype in isolation, but we detected a significant COMT × BDNF interaction effect on responsibility/overestimation of threat and overimportance/need to control thoughts scores. Subjects with the BDNF Met-present and the COMT Met-present genotype showed higher scores on responsibility/overestimation of threat. An interaction between dopaminergic and neurotrophic functional gene variants may influence dysfunctional beliefs hypothesized to contribute to the development of OCD.     

Development and temporal organization of compulsive checking induced by repeated injections of the dopamine agonist quinpirole in an animal model of obsessive-compulsive disorder

Rats treated chronically with the dopamine D2/D3 receptor agonist quinpirole develop locomotor sensitization and exhibit compulsive checking of specific places in an open-field arena, a behavioral profile that may represent an animal model of obsessive-compulsive disorder. However, it is not known how compulsive checking develops across quinpirole injections nor whether checking behavior possesses a particular temporal structure. Male rats received quinpirole (0.5mg/kg, twice weekly x 10) or an equivalent regimen of saline and were placed in a large open field for 55 min where their behavior was digitally tracked for subsequent analysis of checking behavior using existing and newly developed computer software. Results showed that the measures of compulsive checking did not follow a singular profile across injections: some remained constant and others changed monotonically reaching their near-maximum levels after about 5-7 quinpirole injections. Moreover, results showed that checking behavior was organized into bouts of checking, with the number of bouts, as well as the rate of checking within a bout, increasing across injections to reach near maximal levels after about 5-7 administrations of quinpirole. Finally, quinpirole-treated rats showed a paucity of long inter-bout intervals. These results suggest that (a) compulsive checking emerges from the operation of at least two underlying processes: a regulated process and a process of sensitization that intensifies the performance of checking behavior; and (b) quinpirole treatment may attenuate a sense of satiety that could underlie the compulsive nature of checking. Finally, because key variables measured using the newly developed algorithms showed the expected profile, the present study provides validation for the use of this methodology for the analysis of checking behavior.     

The role of perfectionism in obsessive–compulsive symptoms: “Not just right” experiences and checking compulsions

Perfectionism has long been considered an important cognitive variable in obsessive–compulsive disorder (OCD). However, little research has examined the components of perfectionism and their role in specific OCD symptoms. The current study is the first to examine the role of maladaptive perfectionism in predicting checking compulsions and “not just right” (NJR) obsessions. Using an undergraduate sample, linear structural relations were applied to these constructs. A mediational model was tested, where trait anxiety was hypothesized to mediate the relationship between obsessive–compulsive symptoms, as assessed with the Vancouver Obsessive–Compulsive Inventory (VOCI) and maladaptive perfectionism, as measured by four subscales of the Frost Multidimensional Perfectionism Scale (FMPS). Trait anxiety was assessed with the Spielberger State-Trait Anxiety Inventory (STAI). The results support the fully mediated model for checking and NJR compulsions. These findings suggest that perfectionism plays a specific role in certain forms of obsessive–compulsive symptoms, and that the model of OCD requires adjustment to account for this specificity.     

Intolerance of uncertainty,not just right experiences,and compulsive checking: Test of a moderated mediation model on a non-clinical sample

ObjectiveIntolerance of uncertainty (IU) and not just right experiences (NJREs) have been claimed putative vulnerability factors for obsessive–compulsive disorder (OCD). The aim of the present study was to test whether IU could represent a trans-diagnostic construct accountable for OC checking behaviors and whether NJREs could embody an OCD-specific criterion through which IU operates.MethodOne hundred and eighty-eight Italian community individuals completed self-report measures of IU, NJREs, OC symptoms, worry, anxiety, and depression. Mediation and moderated mediation models were tested using a bootstrapping approach, wherein IU was included as the independent variable as well as the moderator; checking behaviors were entered as the dependent variable; and NJRE severity was included as a mediator.ResultsThe main findings highlighted that NJREs were a mediator of the relationship between IU and checking behaviors; nonetheless, in connection with medium levels of IU, NJREs no longer mediated the path. Furthermore, IU did not emerge to moderate the mediation.ConclusionDespite their preliminary nature, the present results might be a hint for future research, as theoretical integration may represent a way to go for better understanding OCD etiology and phenomenology.     

Why are religious individuals more obsessional? The role of mental control beliefs and guilt in Muslims and Christians

Background and objectives

The cognitive-behavioural perspective on obsessions recognizes that certain cultural experiences such as adherence to religious beliefs about the importance of maintaining strict mental control might increase the propensity for obsessional symptoms via the adoption of faulty appraisals and beliefs about the unacceptability and control of unwanted intrusive thoughts. Few studies have directly investigated this proposition, especially in a non-Western Muslim sample.

Method

In the present study high religious, low religious and religious school Canadian Christian and Turkish Muslim students were compared on measures of OCD symptoms, obsessive beliefs, guilt, religiosity, and negative affect.

Results

Analysis revealed that religiosity had a specific relationship with obsessional but not anxious or depressive symptoms in both samples, although the highly religious Muslim students reported more compulsive symptoms than highly religious Christians. In both samples the relationship between religiosity and obsessionality was mediated by importance/control of thoughts and responsibility/threat beliefs as well as generalized guilt.

Limitations

The sample composition was limited to non-clinical undergraduates and only two major religions were considered without recognition of denominational differences.

Conclusions

These findings indicate that the tendency for highly religious Christians and Muslims to experience greater obsessionality is related to their heightened sense of personal guilt and beliefs that they are responsible for controlling unwanted, threatening intrusive thoughts.     

Performance of compulsive behavior in rats is not a unitary phenomenon – validation of separate functional components in compulsive checking behavior

A previous analysis of the quinpirole sensitisation rat model of obsessive‐compulsive disorder revealed that the behavioral phenotype of compulsive checking consists of three constitutive components – vigor of checking performance, focus on the task of checking, and satiety following a bout of checking. As confirmation of this analysis, the aim of the present study was to reconstitute, without quinpirole treatment, each of the putative components, with the expectation that these would self‐assemble into compulsive checking. To reconstitute vigor and satiety, the employed treatment was a bilateral lesion of the nucleus accumbens core (NAc), as this treatment was shown previously to exaggerate these components. To reconstitute focus, the employed treatment was a low dose of the serotonin‐1A receptor agonist 8‐hydroxy‐2‐(di‐n‐propylamino) tetralin hydrochloride (DPAT) (0.0625 mg/kg), as high doses of this drug induce compulsive behavior and exacerbate focus. Results showed that injection of DPAT to NAc lesion rats did yield compulsive checking. Neither the drug alone nor the NAc lesion by itself produced compulsive checking. The demonstrated synthesis of compulsive checking by the combined treatment of low‐dose DPAT and NAc lesion strengthened the previous fractionation of the model obsessive‐compulsive disorder phenotype into three constitutive components, and suggested a role for serotonin‐1A receptors outside the NAc in enhanced focus on the task of checking.     

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 conditions on depression and worry tendencies were comparable. Individual treatment was more effective than group treatment in decreasing scores on dysfunctional beliefs (responsibility, overestimation of threat, and intolerance to uncertainty) and the use of suppression as a thought control strategy. The post-treatment changes were maintained one year later. The correlations between symptom improvement (OCD severity change) and belief changes were moderate: in the individual treatment the greatest associations were with beliefs about thoughts (importance and control), whereas in the group treatment the greatest associations were with beliefs related to anxiety in general (threat overestimation and intolerance to uncertainty).