The role of magical thinking in Obsessive-Compulsive Disorder symptoms and cognitions in an analogue sample

Background and objectives

In addition to clinical observations exemplifying biased reasoning styles (e.g., overemphasis of thoughts) and particular ritualistic behaviors, it is also empirically supported that magical beliefs are also associated with Obsessive-Compulsive Disorder (OCD) symptoms and some cognitions. It should be noted, however, that most empirical studies have been carried out on the samples from Western cultures, even though these beliefs were culturally determined. Thus, more research is needed in order to understand their roles in the OCD symptoms in different cultural contexts. The present study aimed to examine the impact of magical beliefs in OCD symptoms, cognitions and thought control in a non-Western analogue sample from Turkey.

Method

The measures of paranormal beliefs, fusion of thoughts-actions, obsessive beliefs, strategies of thought control and OCD symptoms were administered to an undergraduate sample.

Result

Consistent with findings in the literature, the analyses of group comparisons, correlation and regression showed that even after controlling general negative affect, magical beliefs were still associated with OCD symptoms, some beliefs and control strategies, namely the symptoms of obsessional thoughts and checking, fusions of thoughts and actions in likelihood, faulty beliefs in perfectionism-certainty and punishment.

Limitations

Some methodological concerns such as cross-sectional nature, inclusion of only non-clinical sample were major restrictions of the present study.

Conclusion

Evidence that magical thinking is a critical factor in the OCD is supported once more in a different cultural context.     

Dementia psychiatric symptoms and immobility: A one-year follow-up

One hundred elderly patients investigated for a cross-sectional relationship between dementia and limited mobility were reviewed a year later. Forty patients had died during this time. While there was a strong relationship between poor mobility and mortality, there was little between psychiatric function or symptoms and mortality. There was also a considerable decline in physical function over the year, but little association between original mental function and this. Finally, there was a decline in cognitive function. There was no increase in the frequency of other psychiatric symptoms, but different patients were affected by particular symptoms initially and one year later.     

Better adherence to treatment recommendations in heart failure predicts improved cognitive function at a one-year follow-up

Introduction: Treatment nonadherence is common in heart failure (HF) and is associated with poor health outcomes in this population. Recent cross-sectional work in heart failure and past work in other medical populations suggest that cognitive function is a key determinant of a patient’s ability to adhere to treatment recommendations. However, it is also possible that treatment adherence is an important modifier and predictor of cognitive function, though no study has examined this possibility, and we sought to do so in a sample of heart failure patients. Method: A total of 115 patients with heart failure self-reported adherence to treatment recommendations. The Modified Mini Mental State Examination (3MS), Trail Making Test Parts A and B, and the California Verbal Learning Test–II (CVLT–II) assessed cognitive function. These procedures were performed at baseline and a 12-month follow-up. Results: Global cognition and memory abilities improved over the 12-month period. Regression analyses controlling for baseline and medical and demographic factors showed that better baseline treatment adherence predicted improved 12-month performances on the 3MS and CVLT–II. Adherence to medication and diet regimens and smoking abstinence emerged as the most important contributors. Conclusions: Better treatment adherence predicted improved cognition one year later in HF. Prospective studies that utilize objective assessments of treatment adherence are needed to confirm our findings and examine whether improved treatment adherence preserves cognitive function in heart failure.     

Evolution of depressive symptoms in Alzheimer disease: one-year follow-up

The current longitudinal study analyzes the natural course of depressive symptoms in patients with Alzheimer disease (AD). The goals were to identify the clinical and sociodemographic variables related to depressive symptoms, to assess the effect of depressive symptoms on the course of cognitive and functional impairment and on associated neuropsychiatric disorders, and to identify which factors are associated with remission, persistence, and emergence of depressive symptoms at 12 months. A sample of 150 patients with mild or moderate severity was assessed at baseline and at 12 months using the neuropsychologic battery Cambridge Cognitive Examination. The Neuropsychiatric Inventory and Rapid Disability Rating Scale were administered to the caregiver. Prevalence, persistence, and emergence of depressive symptoms at baseline were 51%, 55%, and 20%, respectively. Remission of depressive symptoms at 12 months leads to a decreased frequency of other noncognitive disorders and to a slight improvement in the assessment of global function. The presence of depressive symptoms does not affect the course of cognitive impairment at 12 months, and a psychiatric history of the patient and the number of depressive symptoms at baseline are risk factors for the emergence and persistence of depressive symptoms at 12 months.     

Somatic symptoms for predicting depression: one-year follow-up study in annual health examinations

It has recently been noted that screening for depression can improve clinical outcomes. The purpose of the present study was to examine whether somatic symptoms reported at health examinations predicted depression in the following year. Subjects were 1066 Japanese workers (732 men, mean age 35 years) attending annual health examinations at an institute in two successive years. A self-administered questionnaire including items of 12 major somatic symptoms was given to all the subjects. Then clinical interviews of the DSM-IV were used to diagnose major depression and minor depression in both years. In addition, the 17-item Hamilton Depression Scale (HDS-17) was measured as one of the outcomes of depression in the following year. The prevalence of major (minor) depression was 3.7 (7.8)% at baseline and 3.4 (5.9)% for the following year, respectively. The following year's HDS-17 scores were higher (all P < 0.05) in those who had complained of each somatic symptom at baseline than in those who had not. Three somatic symptoms (low back pain, dizziness, and abdominal pain) at baseline were significant risk factors of major depression for the following year. Dizziness at baseline significantly predicted major and minor depression for the following year as well. Somatic symptoms may be good predictors to screen for depression at health examination.     

Intensive group cognitive therapy and individual cognitive therapy for social phobia: Sustained improvement at 5-year follow-up

Little is known about the long-term outcome of treatments for social phobia. At 5 years post-treatment we contacted the 67 patients who had been treated with intensive group cognitive therapy (IGCT) or individual cognitive therapy (ICT) in a randomized controlled trial (Mörtberg, Clark, Sundin, & Åberg Wistedt, 2007) that originally compared IGCT, ICT, and treatment as usual (n = 100 for the full trial). Seventy-two percent (48 patients) who received IGCT or ICT agreed to participate in the follow-up assessment. All re-completed the original self-report measures of symptoms and disability and a quality of life measure. A subset was also interviewed. Seventy-five percent (36 patients) had sought no further treatment for social phobia. Comparisons between post-treatment and 5-year follow-up indicated that patients who had received either treatment showed further improvement in social phobia symptoms and disability during the follow-up period. These improvements were present in patients who had no additional treatment, as well as in the total sample. In conclusion, it appears that the effects of IGCT and ICT are maintained and improved upon at 5 years post-treatment.     

Age and impaired subjective support. Predictors of depressive symptoms at one-year follow-up.

We followed a cohort of subjects (predominantly inpatients) suffering a major depressive episode in midlife and late-life for 1 year (N = 118). In this follow-up study, we examined three hypotheses. a) Elder subjects suffering major depression, compared with middle-aged subjects, will more likely report endogenous symptoms and less likely report decreased life satisfaction symptoms at 1-year follow-up. b) Impaired social support during the index episode will predict poor life satisfaction, but not endogenous symptoms at 1-year follow-up, regardless of age. c) Impaired social support during the index episode will be more predictive of decreased life satisfaction symptoms in midlife, compared with late life, at 12-month follow-up. The first two hypotheses were not supported, but the third hypothesis was. Both decreased life satisfaction and endogenous symptoms at outcome were significantly predicted by impaired social support during the index episode. Impaired social support predicted a poor outcome from an episode of major depression in both middle life and late life in controlled analyses. However, the effect of impaired subjective social support was conditional on age. Subjective social support appears to have a decreasing influence on the report of both endogenous and decreased life satisfaction symptoms for older individuals.     

Group cognitive behavioural therapy as a treatment for negative symptoms in first-episode psychosis

Aim: We aimed to test the idea that there is an early critical time period during a psychotic illness when patients may be more responsive to psychological treatment attention. Methods: We tested this hypothesis by comparing the treatment responsiveness to group cognitive behavioural therapy (CBT) of 25 first‐episode psychosis participants (FEP) and 15 patients with currently stable psychosis (n = 40). Results: Following 12 sessions of outpatient‐based group CBT, there were significant decreases in positive, depressive and anxiety symptoms, and an improvement in quality of life for both groups. However, negative symptoms only improved in the FEP group. Conclusion: Considering the pernicious nature of negative symptoms as well as the difficulties in treating them, this study provides some support for the concept of early intervention with CBT.     

Group Cognitive-Behavior Therapy with Family Involvement for Middle-School-Age Children with Obsessive-Compulsive Disorder: A Pilot Study

Objective. Middle-school-aged children with obsessive-compulsive disorder (OCD) are poised in development between the dependency of elementary-school-aged children and growing independence of adolescence. OCD patients of this age group may differ from older ones in the quality of symptoms and level of insight. We report the results of a naturalistic, pilot study of group Cognitive-behavior Therapy (CBT) for school-aged children with OCD with parents involved. The authors predicted symptom improvement and format acceptability. Method: Over a 1.5 year period, 14 children with OCD aged 8–14 years and their parents received 14-week group CBT based on March and Mulle’s OCD in Children and Adolescents: A Cognitive-Behavioral Treatment Manual in three consecutive sessions of four to six families. Age of onset averaged 8.7 years, 36% had undergone at least one medication trial, and 36% had previous CBT experience. Results: OCD symptoms measured by the Children’s Yale-Brown Obsessive Compulsive Scale improved significantly, both statistically and clinically (25%) from moderate-severe to mild-moderate. Mean Clinical Global Impression of Impairment (NIMH-CGI) Impairment ratings fell from clinical to sub-clinical and CGI Improvement ratings were “much improved”. Children’s self-reported depression decreased significantly from pre- to post-group. Parent ratings of the negative impact of OCD symptoms on the Children’s OCD Impact Scale and of behavior problems on the Child Behavior Checklist each improved significantly. Conclusions: This pilot study, which included a non-selected clinical sample, demonstrates that a manual-based treatment protocol may be effectively adapted for group treatment of different developmental levels and be exported for clinical use. Clinical improvement justifies further investigation in a controlled study.     

Virtual Reality for Obsessive-Compulsive Disorder: Past and the Future

The use of computers, especially for virtual reality (VR), to understand, assess, and treat various mental health problems has been developed for the last decade, including application for phobia, post-traumatic stress disorder, attention deficits, and schizophrenia. However, the number of VR tools addressing obsessive-compulsive disorder (OCD) is still lacking due to the heterogeneous symptoms of OCD and poor understanding of the relationship between VR and OCD. This article reviews the empirical literatures for VR tools in the future, which involve applications for both clinical work and experimental research in this area, including examining symptoms using VR according to OCD patients'' individual symptoms, extending OCD research in the VR setting to also study behavioral and physiological correlations of the symptoms, and expanding the use of VR for OCD to cognitive-behavioral intervention.     

A longitudinal study of cerebrospinal fluid beta-endorphin-like immunoreactivity in delirium: changes at the acute stage and at one-year follow-up

Cerebrospinal fluid beta-endorphin-like immunoreactivity (CSF BLI) was determined on 3 occasions for elderly delirious patients and the BLI levels were compared with age-equivalent controls. Delirious patients showed a significant reduction in the BLI values in the first sample and a declining trend was seen in the follow-up. The results suggest a role for beta-endorphinergic dysfunction in the genesis of some symptoms of delirium, and this dysfunction may be a common phenomenon in various forms of delirium and dementia.     

Attention and basic literacy and numeracy in children with Autism Spectrum Disorder: A one-year follow-up study

Little is known about the link between Executive Functioning (EF) and academic performance in children with Autism Spectrum Disorder (ASD) and how such links develop over time. This study examined word reading, basic mathematics, attention switching, sustained attention and their development. Two age, gender and perceptual IQ matched groups of cognitively able 7–12 year olds (ASD N = 40; typical developing [TYP] N = 40) were assessed at baseline and one year later, completing Word Reading and Numerical Operations tests and computerized tasks tapping attention switching and sustained attention. Children with ASD had similar word reading and numerical operations performance and similar development of these skills relative to TYP children. A delay in attention switching but similar development was found in children with ASD relative to TYP children. The EF tasks were correlated with reading and mathematics in ASD children only, however, in regression analyses these factors were not significant predictors of Time 2 reading and mathematics after accounting for Time 1 reading and mathematics scores. These findings indicate similar word reading and mathematics development but atypical attention profiles in cognitively able children with ASD. Implications for educators are discussed.     

Clinical efficacy of individual cognitive therapy in reducing psychiatric symptoms in people at ultra-high risk for psychosis

Aim: Recently, cognitive therapy in people at ultra‐high risk (UHR) for psychosis has been reported to show modest treatment benefits. The aim of this study was to assess the feasibility and efficacy of cognitive therapy in reducing psychiatric symptoms in UHR people in Korea. Methods: We developed cognitive therapy for people at UHR for psychosis inspired by Morrison in 2004. Twenty‐two UHR subjects were assigned to cognitive therapy, and 18 subjects completed the 10‐session therapy. Psychopathology scores were assessed at baseline and post‐treatment. Results: Cognitive therapy significantly reduced the severity of psychopathology including positive, negative and depressive symptoms. The within‐group effect sizes indicated large treatment benefits for these psychopathologies. Conclusion: These findings suggest that cognitive therapy can be administered to people at UHR for psychosis in non‐western culture.     

Social cognitive bias and neurocognitive deficit in paranoid symptoms: evidence for an interaction effect and changes during treatment

Persistent paranoid symptoms are best understood as having multiple causal mechanisms. An enhanced multidimensional understanding of paranoia may result from the convergence of two distinct measurement paradigms, experimental psychopathology and social cognitive research. This study investigated the role of neurocognitive deficits and emotion misperception bias as they relate to paranoid symptoms at two different time points in a sample of individuals with severe mental illness (primarily schizophrenia spectrum disorders [N=91]) undergoing intensive psychosocial rehabilitation. Before intensive rehabilitation (but after initial stabilization), paranoid symptoms were related to a tendency to misperceive emotion as disgust. The impact of this social cognitive bias was amplified by perseveration (as measured by the COGLAB Card Sorting Task). Perseverative errors were associated with paranoid symptoms at both time points. After 6 months of treatment, there were significant reductions in paranoid symptoms and perseverative errors but no significant changes in emotion misperception biases. This study is one of few to date to evaluate the contribution of both neurocognitive deficits and social cognitive biases to paranoid symptoms. The results demonstrate how social cognitive biases can interact with neurocognitive deficits in expression of paranoid symptoms, and how these relationships change during treatment.     

Two-year follow-up of bibliotherapy and individual cognitive therapy for depressed older adults

This study examined the stability of treatment gains after receiving either cognitive bibliotherapy or individual cognitive psychotherapy for depression in older adults. A 2-year follow-up of 23 participants from Floyd, Scogin, McKendree-Smith, Floyd, and Rokke (2004) was conducted by comparing pre-and posttreatment scores with follow-up scores on the Hamilton Rating Scale for Depression (HRSD) and the Geriatric Depression Scale (GDS). Results indicated that treatment gains from baseline to the 2-year follow-up period were maintained on the HRSD and GDS, and there was not a significant decline from posttreatment to follow-up. There were no significant differences between the treatments on the GDS or HRSD at the 2-year follow-up; however, bibliotherapy participants had significantly more recurrences of depression during the follow-up period.