Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-22T02:37:16.522Z Has data issue: false hasContentIssue false
  • English
  • Français

‘I was treated like dirt’: evaluating links between betrayal and mental contamination in clinical samples

Published online by Cambridge University Press:  28 August 2020

Rowena Pagdin ,
Paul M. Salkovskis ,
Falguni Nathwani ,
Megan Wilkinson-Tough  and
Emma Warnock-Parkes
Rowena Pagdin*
Affiliation:
Avon and Wiltshire Mental Health Partnership NHS Trust, UK
Paul M. Salkovskis
Affiliation:
Oxford Institute of Clinical Psychology Training, Oxford, UK Oxford Cognitive Therapy Centre, Oxford, UK University of Bath, Bath, UK
Falguni Nathwani
Affiliation:
Avon and Wiltshire Mental Health Partnership NHS Trust, UK University of Bath, Bath, UK
Megan Wilkinson-Tough
Affiliation:
Avon and Wiltshire Mental Health Partnership NHS Trust, UK University of Bath, Bath, UK
Emma Warnock-Parkes
Affiliation:
Department of Experimental Psychology, University of Oxford, Oxford, UK
*
*Corresponding author. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Little is known about the impact of interpersonal betrayal experiences on mental health. Research suggests a link between betrayal and mental contamination (MC) within some forms of obsessive compulsive disorder (OCD). This study represents an initial exploration of that link in clinical samples.

Aims:

A measure for assessing perceptions of betrayal was developed and evaluated (Study 1) in order to assess the extent of specificity of any association between the impact of betrayal and MC, and to estimate the extent of the impact of betrayal across common psychological disorders (Study 2).

Method:

In Study 1, the Perception of Betrayal Scale (POBS) was completed by 217 community participants; an exploratory principal components analysis identified the dimensional structure of the POBS. Study 2 was based on a cross-sectional, between-groups design, with three clinical groups [OCD (n = 23), other anxiety disorders (n = 21) and depression (n = 18)] and a non-clinical control group (n = 21). Three clinical groups (OCD, other anxiety disorders, and depression) and a community group completed a selection of measures via questionnaire.

Results:

In Study 1, the POBS was found to have an internal consistency of α = .95, and four factors were identified: preoccupation with betrayal events, belief that betrayal had caused major life change, lack of trust due to betrayal and betrayal leading to traumatic responses. In Study 2, the OCD group scored more highly in terms of maladaptive perceptions of betrayal than the other groups. Regression analysis showed betrayal scores to be a moderate predictor of the experience of MC; the POBS subscales lack of trust due to betrayal and betrayal leading to traumatic responses were found to be significantly associated with MC. Although there was some overlap with bitterness, betrayal better predicted MC.

Conclusion:

Findings support the hypothesis of a specific relationship between the construct of betrayal and MC.

Keywords

betrayalobsessive compulsive disordermental contamination
Type
Main
Information
Behavioural and Cognitive Psychotherapy , Volume 49 , Issue 1 , January 2021 , pp. 21 - 34
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alonso, P., Menchón, J. M., Jiménez, S., Segalàs, J., Mataix-Cols, D., Jaurrieta, N., & Pujol, J. (2008). Personality dimensions in obsessive-compulsive disorder: relation to clinical variables. Psychiatry Research, 157, 159–168.CrossRefGoogle ScholarPubMed
Altenberg, K. (2015). Top 10 books about betrayal. The Guardian, 22 April 2015; https://www.theguardian.com/books/2015/apr/22/top-10-books-about-betrayal Google Scholar
American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Publishing.Google Scholar
Bartlett, M. S. (1954). A note on the multiplying factors for various χ2 approximations. Journal of the Royal Statistical Society. Series B (Methodological), 16, 296–298.CrossRefGoogle Scholar
Bjelland, I., Krokstad, S., Mykletun, A., Dahl, A. A., Tell, G. S., & Tambs, K. (2008). Does a higher educational level protect against anxiety and depression? The HUNT study. Social Science & Medicine, 66, 1334–1345.CrossRefGoogle ScholarPubMed
Breslau, J., Lane, M., Sampson, N., & Kessler, R. C. (2008). Mental disorders and subsequent educational attainment in a US national sample. Journal of Psychiatric Research, 42, 708–716.CrossRefGoogle Scholar
Coughtrey, A. E., Shafran, R., Knibbs, D., & Rachman, S. J. (2012a). Mental contamination in obsessive–compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 1, 244–250.CrossRefGoogle Scholar
Coughtrey, A. E., Shafran, R., Lee, M., & Rachman, S. J. (2012b). It’s the feeling inside my head: a qualitative analysis of mental contamination in obsessive-compulsive disorder. Behavioural and Cognitive Psychotherapy, 40, 163–173.CrossRefGoogle ScholarPubMed
Coughtrey, A. E., Shafran, R., Lee, M., & Rachman, S. (2013). The treatment of mental contamination: a case series. Cognitive and Behavioral Practice, 20, 221–231.CrossRefGoogle Scholar
Coughtrey, A., Shafran, R., Bennett, S., Kothari, R., & Wade, T. (2018). Mental contamination: relationship with psychopathology and transdiagnostic processes. Journal of Obsessive-Compulsive and Related Disorders, 17, 39–45.CrossRefGoogle Scholar
Creamer, M., Bell, R., & Failla, S. (2003). Psychometric properties of the impact of event scale – revised. Behaviour Research and Therapy, 41, 1489–1496.CrossRefGoogle ScholarPubMed
De Berardis, D., Campanella, D., Gambi, F., Sepede, G., Salini, G., Carano, A., … Cotellessa, C. (2005). Insight and alexithymia in adult outpatients with obsessive-compulsive disorder. European Archives of Psychiatry and Clinical Neuroscience, 255, 350–358.CrossRefGoogle ScholarPubMed
Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319–345.CrossRefGoogle ScholarPubMed
Elliott, C. M., & Radomsky, A. S. (2013). Meaning and mental contamination: focus on appraisals. Clinical Psychologist, 17, 17–25.CrossRefGoogle Scholar
Fairbrother, N., Newth, S. J., & Rachman, S. (2005). Mental pollution: feelings of dirtiness without physical contact. Behaviour Research and Therapy, 43, 121–130.CrossRefGoogle ScholarPubMed
Fairbrother, N., & Rachman, S. (2004). Feelings of mental pollution subsequent to sexual assault. Behaviour Research and Therapy, 42, 173–189.CrossRefGoogle ScholarPubMed
Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., & Salkovskis, P. M. (2002). The Obsessive-Compulsive Inventory: development and validation of a short version. Psychological Assessment, 14, 485.CrossRefGoogle ScholarPubMed
Hajcak, G., Huppert, J. D., Simons, R. F., & Foa, E. B. (2004). Psychometric properties of the OCI-R in a college sample. Behavior Research and Therapy, 42, 115–123.CrossRefGoogle Scholar
Herba, J. K., & Rachman, S. (2007). Vulnerability to mental contamination. Behaviour Research and Therapy, 45, 2804–2812.CrossRefGoogle ScholarPubMed
Ishikawa, R., Kobori, O., & Shimizu, E. (2015). Unwanted sexual experiences and cognitive appraisals that evoke mental contamination. Behavioural and Cognitive Psychotherapy, 43, 74–88.CrossRefGoogle ScholarPubMed
Kaiser, H. F. (1974). An index of factorial simplicity. Psychometrika, 39, 31–36.10.1007/BF02291575CrossRefGoogle Scholar
Kroenke, K. Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9. Journal of General Internal Medicine, 16, 606–613.CrossRefGoogle ScholarPubMed
Linden, M. (2003). Posttraumatic embitterment disorder. Psychotherapy and Psychosomatics, 72, 195–202.CrossRefGoogle ScholarPubMed
Linden, M., Baumann, K., Rotter, M., & Schippan, B. (2007). The psychopathology of posttraumatic embitterment disorders. Psychopathology, 40, 159–165.CrossRefGoogle ScholarPubMed
Lindley, J., & Machin, S. (2013). The Postgraduate Premium: Revisiting Trends in Social Mobility and Educational Inequalities in Britain and America. London, UK: Sutton Trust.Google Scholar
Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008). Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Medical Care, 46, 266–274.CrossRefGoogle Scholar
Mataix-Cols, D., Cowley, A. J., Hankins, M., Schneider, A., Bachofen, M., Kenwright, M., & Marks, I. M. (2005). Reliability and validity of the Work and Social Adjustment Scale in phobic disorders. Comprehensive Psychiatry, 46, 223–228.CrossRefGoogle ScholarPubMed
McPherson, M., Smith-Lovin, L., & Cook, J. M. (2001). Birds of a feather: homophily in social networks. Annual Review of Sociology, 27, 415–444.CrossRefGoogle Scholar
Millar, J. F. A., Salkovskis, P. M., & Brown, C. (2016). Mental contamination in the ‘dirty kiss’: imaginal betrayal or bodily fluids? Journal of Obsessive-Compulsive and Related Disorders, 8, 70–74.CrossRefGoogle Scholar
Mills, S., Salkovskis, P., & Gillmore, C. (2014). An exploration of the construct of bitterness. Unpublished doctoral dissertation, University of Bath, UK.Google Scholar
Mundt, J. C., Marks, I. M., Shear, M. K., & Greist, J. M. (2002). The Work and Social Adjustment Scale: a simple measure of impairment in functioning. The British Journal of Psychiatry, 180, 461–464.CrossRefGoogle ScholarPubMed
Pagdin, R., Warnock-Parkes, E., Nathwani, F., & Salkovskis, P.M., (2015). Evaluating links between betrayal and mental contamination. Unpublished doctoral dissertation, University of Bath, UK.Google Scholar
Rachman, S. (2004). Fear of contamination. Behaviour Research and Therapy, 42, 1227–1255.CrossRefGoogle ScholarPubMed
Rachman, S. (2005). Vancouver Obsessional Compulsive Inventory (VOCI-MC). Rachman Laboratory, University of British Columbia, Canada.Google Scholar
Rachman, S. (2006). The fear of contamination: assessment and treatment. In Cognitive Behaviour Therapy: Science & Practice. Oxford, UK: Oxford University Press.Google Scholar
Rachman, S. (2010). Betrayal: a psychological analysis. Behaviour Research and Therapy, 48, 304–311.CrossRefGoogle ScholarPubMed
Rachman, S., Radomsky, A. S., Elliott, C. M., & Zysk, E. (2012). Mental contamination: the perpetrator effect. Journal of Behavior Therapy and Experimental Psychiatry, 43, 587–593.CrossRefGoogle ScholarPubMed
Radomsky, A. S., & Elliott, C. M. (2009). Analyses of mental contamination: Part II, individual differences. Behaviour Research and Therapy, 47, 1004–1011.CrossRefGoogle ScholarPubMed
Salkovskis, P. M. (1985). Obsessional-compulsive problems: a cognitive-behavioural analysis. Behaviour Research and Therapy, 23, 571–583.CrossRefGoogle ScholarPubMed
Solem, S., Haaland, A. T., Hagen, K., Launes, G., Hansen, B., Vogel, P. A., & Himle, J. A. (2015). Interpersonal style in obsessive compulsive disorder. The Cognitive Behaviour Therapist, 8, e29.CrossRefGoogle Scholar
Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 1092–1097.CrossRefGoogle ScholarPubMed
Tinsley, H. E., & Kass, R. A. (1979). The latent structure of the need satisfying properties of leisure activities. Journal of Leisure Research, 11, 278–291.CrossRefGoogle Scholar
Waller, K., & Boschen, M. J. (2014). Evoking and reducing mental contamination in female perpetrators of an imagined non-consensual kiss. Journal of Behavior Therapy and Experimental Psychiatry, 49, 195–202.CrossRefGoogle ScholarPubMed
Warnock-Parkes, E., Salkovskis, P. M., & Rachman, S. (2012). When the problem is beneath the surface in OCD: the cognitive treatment of a case of pure mental contamination. Behavioural and Cognitive Psychotherapy, 40, 383–399.CrossRefGoogle ScholarPubMed
Weiss, D. S., & Marmar, C. R. (1997). The Impact of Events Scale-Revised. In Wilson, J. P. & Keane, T. M. (eds), Assessing Psychological Trauma and PTSD (pp. 399–411). Guilford Press.Google Scholar
Williams, M., Davis, D. M., Thibodeau, M. A., & Bach, N. (2013). Psychometric properties of the obsessive-compulsive inventory revised in African Americans with and without obsessive-compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 2, 399–405.CrossRefGoogle Scholar
Znoj, H. (2011). Features of embitterment. In Linden, M. & Maercker, A. (eds), Embitterment: Societal, Psychological, and Clinical Perspectives (pp. 5–16). Springer Science & Business Media.CrossRefGoogle Scholar
Supplementary material: File

Pagdin et al. supplementary material

Pagdin et al. supplementary material

Download Pagdin et al. supplementary material(File)
File 533.5 KB
Submit a response

Comments

No Comments have been published for this article.