Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-29T18:59:13.820Z Has data issue: false hasContentIssue false

Emotional and Cognitive Variables Associated with Contamination-Related Obsessive-Compulsive Symptoms

Published online by Cambridge University Press:  23 May 2016

Gemma García-Soriano*
Affiliation:
Universidad de Valencia (Spain)
Vicent Rosell-Clari
Affiliation:
Universidad de Valencia (Spain)
Miguel Ángel Serrano
Affiliation:
Universidad de Valencia (Spain)
*
*Correspondence concerning this article should be addressed to Gemma García-Soriano. Universidad de Valencia. Personalidad, Evaluación y Tratamientos Psicológicos. Valencia (Spain). E-mail: [email protected]

Abstract

Different variables have been associated with the development/ maintenance of contamination-related obsessive-compulsive disorder (OCD), although the relevance of these factors has not been clearly established. The present study aimed to analyze the relevance and specificity of these variables. Forty-five women with high scores on obsessive-compulsive contamination symptoms (n = 16) or checking symptoms (n = 15), or non-clinical scores (n = 14) participated in a behavioral approach/avoidance task (BAT) with a contamination-OCD stimulus. Vulnerability variables and participants’ emotional, cognitive, physiological and behavioral responses to the BAT were appraised. Results show that fear of illness was a relevant vulnerability variable specific to contamination participants (p = .001; η2p = .291). Contamination participants responded with significantly higher subjective disgust (p =.001; η2p = .269), anxiety (p = .001; η2p = .297), urge to wash (p < .001; η2p = 370), threat from emotion (p < .001; η2p = .338) and contamination severity (p = .002; η2p = .260) appraisals, and with lower behavioral approach (p = .008; η2p = .208) than the other two groups. Moreover, contamination participants showed lower heart rate acceleration (p = .046; η2p = .170) and higher contamination likelihood appraisals (p < .001; η2p = .342) than the non-clinical group. Urge to wash was predicted by state disgust (R2 change = .346) and threat from emotion (R2 change = .088). These responses were predicted by general anxiety sensitivity (R2 change = .161), disgust propensity (R2 change = .255) and fear of illness (R2 change = .116), but not by other vulnerability variables such as dysfunctional beliefs about thoughts (Responsibility and Overestimation of threat) or disgust sensitivity. State disgust, threat from disgust, anxiety sensitivity and fear of illness were found to be the most relevant variables in contamination symptoms.

Type
Research Article
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2016 

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

Abramowitz, J. S., Fabricant, L. E., Taylor, S., Deacon, B. J., McKay, D., & Storch, E. A. (2014). The utility of analogue studies for understanding obsessions and compulsions. Clinical Psychology Review, 34, 206217. http://dx.doi.org/10.1016/j.cpr.2014.01.004 Google Scholar
Adams, T. G., Cisler, J. M., Brady, R. E., Lohr, J. M., & Olatunji, B. O. (2013). Preliminary psychometric evidence for distinct affective and cognitive mechanisms mediating contamination aversion. Journal of Psychopathology and Behavioral Assessment, 35, 375388. http://dx.doi.org/10.1007/s10862-013-9343-8 Google Scholar
Arnáez, S., García-Soriano, G., & Belloch, A. (2015). Contenidos obsesivos, miedo a la enfermedad y asco [Obsessional contents, fear of illness and disgust]. Revista Española de Psicología Clínica y Psicopatología, 20, 3340. http://dx.doi.org/10.5944/rppc.vol.1.num.1.2015.14406 Google Scholar
Beck, A. T., & Steer, R. A. (1993). Manual for the Beck Anxiety Inventory. San Antonio, TX: The Psychological Corporation.Google Scholar
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual of the Beck Depression Inventory (2a Ed.), San Antonio, TX: The Psychological Corporation.Google Scholar
Belloch, A., Fernández-Álvarez, H., & Castañeiras, C. (2004). Presentación de un instrumento para la detección y valoración de las preocupaciones hipocondriacas en la población general: El Inventario de Preocupaciones Hipocondriacas Aiglé (IPHA). [Presentation of an instrument for the detection and assessment of hypochondriacal concerns in the general population: The Aiglé Inventory of Hypochondriac Concerns (IPHA)]. Revista Argentina de Clínica Psicológica, 13, 183195.Google Scholar
Belloch, A., Morillo, C., Luciano, J. V., García-Soriano, G., Cabedo, E., & Carrió, C. (2010). Dysfunctional belief domains related to obsessive-compulsive disorder: A further examination of their dimensionality and specificity. The Spanish Journal of Psychology, 13(1), 376388. http://dx.doi.org/10.1017/S1138741600003930 Google Scholar
Belloch, A., Roncero, M., García-Soriano, G., Carrió, C., Cabedo, E., & Fernández-Álvarez, H. (2013). The Spanish version of the Obsessive-Compulsive Inventory-Revised (OCI-R): Reliability, validity, diagnostic accuracy, and sensitivity to treatment effects in clinical samples. Journal of Obsessive-Compulsive and Related Disorders, 2, 249256. http://dx.doi.org/10.1016/j.jocrd.2013.05.001 Google Scholar
Cassirame, J., Tordi, N., Mourot, L., Rakobowchuk, M., & Regnard, J. (2007). L’utilisation d’un nouveau système d’enregistrement de fréquence cardiaque battement à battement pour l’analyse traditionnelle de variabilité de fréquence cardiaque [Using of new beat to beat recorder system for traditional analysis of heart rate variability]. Science & Sports, 22, 238242. http://dx.doi.org/10.1016/j.scispo.2007.07.006 Google Scholar
Cisler, J. M., Brady, R. E., Olatunji, B. O., & Lohr, J. M. (2010). Disgust and obsessive beliefs in contamination-related OCD. Cognitive Therapy and Research, 34, 439448. http://dx.doi.org/10.1007/s10608-009-9253-y Google Scholar
Cisler, J. M., Olatunji, B. O., & Lohr, J. M. (2009). Disgust, fear, and the anxiety disorders: A critical review. Clinical Psychology Review, 29(1), 3446. http://dx.doi.org/10.1016/j.cpr.2008.09.007 Google Scholar
Cougle, J. R., Lee, H.-J., Horowitz, J. D., Wolitzky-Taylor, K. B., & Telch, M. J. (2008). An exploration of the relationship between mental pollution and OCD symptoms. Journal of Behavior Therapy and Experimental Psychiatry, 39, 340353. http://dx.doi.org/10.1016/j.jbtep.2007.08.007 CrossRefGoogle ScholarPubMed
Cougle, J. R., Wolitzky-Taylor, K. B., Lee, H.-J., & Telch, M. J. (2007). Mechanisms of change in ERP treatment of compulsive hand washing: Does primary threat make a difference? Behaviour Research and Therapy, 45, 14491459. http://dx.doi.org/10.1016/j.brat.2006.12.001 CrossRefGoogle Scholar
Dorfan, N. M., & Woody, S. R. (2011). Danger appraisals as prospective predictors of disgust and avoidance of contaminants. Journal of Social and Clinical Psychology, 30, 105132. http://dx.doi.org/10.1521/jscp.2011.30.2.105 Google Scholar
Feinstein, S. B., Fallon, B. A., Petkova, E., & Liebowitz, M. R. (2003). Item-by-item factor analysis of the Yale-Symptom Checklist. Journal of Neuropsychiatry and Clinical Neurosciences, 15, 187193.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, 485496. http://dx.doi.org/10.1037/1040-3590.14.4.485 Google Scholar
García-Soriano, G., & Belloch, A. (2012). Exploring the role of obsessive-compulsive relevant self-worth contingencies in obsessive-compulsive disorder patients. Psychiatry Research, 198(1), 9499. http://dx.doi.org/10.1016/j.psychres.2011.11.011 Google Scholar
García-Soriano, G., & Belloch, A. (2013). Symptom dimensions in obsessive-compulsive disorder: Differences in distress, interference, appraisals and neutralizing strategies. Journal of Behavior Therapy and Experimental Psychiatry, 44, 441448. http://dx.doi.org/10.1016/j.jbtep.2013.05.005 Google Scholar
Goetz, A. R., Lee, H.-J., Cougle, J. R., & Turkel, J. E. (2013). Disgust propensity and sensitivity: Differential relationships with obsessive-compulsive symptoms and behavioral approach task performance. Journal of Obsessive-Compulsive and Related Disorders, 2, 412419. http://dx.doi.org/10.1016/j.jocrd.2013.07.006 Google Scholar
Jones, M. K., & Menzies, R. G. (1997). The cognitive mediation of obsessive-compulsive hand-washing. Behaviour Research and Therapy, 35, 843850.Google Scholar
Kreibig, S. D. (2010). Autonomic nervous system activity in emotion: A review. Biological Psychology, 84, 394421. http://dx.doi.org/10.1016/j.biopsycho.2010.03.010 Google Scholar
Mancini, F., Gragnani, A., & D’Olimpio, F. (2001). The connection between disgust and obsessions and compulsions in a non-clinical sample. Personality and Individual Differences, 31, 11731180. http://dx.doi.org/10.1016/S0191-8869(00)00215-4 Google Scholar
McCubbin, R. A., & Sampson, M. J. (2006). The relationship between obsessive-compulsive symptoms and appraisals of emotional states. Journal of Anxiety Disorders, 20(1), 4257. http://dx.doi.org/10.1016/j.janxdis.2004.11.008 Google Scholar
McKay, D. (2006). Treating disgust reactions in contamination-based obsessive-compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 37(1), 5359. http://dx.doi.org/10.1016/j.jbtep.2005.09.005 Google Scholar
Mitte, K. (2008). Trait-disgust vs. fear of contamination and the judgmental bias of contamination concerns. Journal of Behavior Therapy and Experimental Psychiatry, 39, 577586. http://dx.doi.org/10.1016/j.jbtep.2008.01.005 Google Scholar
Nicholson, E., & Barnes-Holmes, D. (2012). Developing an implicit measure of disgust propensity and disgust sensitivity: Examining the role of implicit disgust propensity and sensitivity in obsessive-compulsive tendencies. Journal of Behavior Therapy and Experimental Psychiatry, 43, 922930. http://dx.doi.org/10.1016/j.jbtep.2012.02.001 Google Scholar
Obsessive Compulsive Cognitions Working Group. (1997). Cognitive assessment of obsessive-compulsive disorder. Obsessive Compulsive Cognitions Working Group. Behaviour Research and Therapy, 35, 667681.Google Scholar
Obsessive Compulsive Cognitions Working Group. (2005). Psychometric validation of the Obsessive Belief Questionnaire and Interpretation of Intrusions Inventory—Part 2: Factor analyses and testing of a brief version. Behaviour Research and Therapy, 43, 15271542. http://dx.doi.org/10.1016/j.brat.2004.07.010 Google Scholar
Olatunji, B. O. (2010). Changes in disgust correspond with changes in symptoms of contamination-based OCD: A prospective examination of specificity. Journal of Anxiety Disorders, 24, 313317. http://dx.doi.org/10.1016/j.janxdis.2010.01.003 Google Scholar
Olatunji, B. O., Cisler, J. M., Deacon, B. J., Connolly, K., & Lohr, J. M. (2007). The Disgust Propensity and Sensitivity Scale-Revised: Psychometric properties and specificity in relation to anxiety disorder symptoms. Journal of Anxiety Disorders, 21, 918930. http://dx.doi.org/10.1016/j.janxdis.2006.12.005 Google Scholar
Olatunji, B. O., Cisler, J., McKay, D., & Phillips, M. L. (2010). Is disgust associated with psychopathology? Emerging research in the anxiety disorders. Psychiatry Research, 175, 110. http://dx.doi.org/10.1016/j.psychres.2009.04.007 Google Scholar
Olatunji, B. O., Lohr, J. M., Sawchuk, C. N., & Tolin, D. F. (2007). Multimodal assessment of disgust in contamination-related obsessive-compulsive disorder. Behaviour Research and Therapy, 45, 263276. http://dx.doi.org/10.1016/j.brat.2006.03.004 Google Scholar
Olatunji, B. O., Sawchuk, C. N., Arrindell, W. A., & Lohr, J. M. (2005). Disgust sensitivity as a mediator of the sex differences in contamination fears. Personality and Individual Differences, 38, 713722. http://dx.doi.org/10.1016/j.paid.2004.05.025 Google Scholar
Rachman, S. (2004). Fear of contamination. Behaviour Research and Therapy, 42, 12271255. http://dx.doi.org/10.1016/j.brat.2003.10.009 Google Scholar
Rasmussen, S. A., & Eisen, J. L. (1992). The epidemiology and clinical features of obsessive compulsive disorder. Psychiatric Clinics of North America, 15, 743758.Google Scholar
Sandin, B., Chorot, P., Olmedo, M., & Valiente, R. M. (2008). Escala de propensión y sensibilidad al asco-revisada (DPSS-R): Propiedades psicométricas y relación del asco con los miedos y los síntomas obsesivo-compulsivos [Revised Propensity and sensitivity scale: Psychometric properties and disgust association with fears and obsessive-compulsive symptoms]. Análisis y Modificación de Conducta, 34, 127168.Google Scholar
Sandin, B., Valiente, R. M., Chorot, P., & Santed, M. A. (2007). ASI-3: Nueva escala para la evaluación de la sensibilidad a la ansiedad. [ASI-3: A new scale for the assessment of anxiety sensitivity]. Revista de Psicopatología y Psicología Clínica, 12, 91104.Google Scholar
Schmidt, N. B., & Koselka, M. (2000). Gender differences in patients with panic disorder: Evaluating cognitive mediation of phobic avoidance. Cognitive Therapy and Research, 24, 533550.CrossRefGoogle Scholar
Shkolnikova, M., Baturova, M., Medvedev, M., Veleslavova, O., Shubik, Y., Jdanov, D., & Shkolnikov, V. (2011). Using portable recorder of R-R intervals (heart monitor “Wrist Watch”) in the epidemiologic study for the estimation of heart rate variability. Journal of Electrocardiology, 44, e55. http://dx.doi.org/10.1016/j.jelectrocard.2010.12.133 Google Scholar
Smith, A. H., Wetterneck, C. T., Hart, J. M., Short, M. B., & Björgvinsson, T. (2012). Differences in obsessional beliefs and emotion appraisal in obsessive compulsive symptom presentation. Journal of Obsessive-Compulsive and Related Disorders, 1(1), 5461. http://dx.doi.org/10.1016/j.jocrd.2011.11.003 Google Scholar
Tabachnick, B., & Fidell, L. S. (2007). Using multivariate statistics (5 th Ed.). Boston, MA: Allyn and Bacon.Google Scholar
Taylor, S., Zvolensky, M. J., Cox, B. J., Deacon, B., Heimberg, R. G., Ledley, D. R., … Cardenas, S. J. (2007). Robust dimensions of anxiety sensitivity: Development and initial validation of the Anxiety Sensitivity Index-3. Psychological Assessment, 19, 176188. http://dx.doi.org/10.1037/1040-3590.19.2.176 Google Scholar
Thorpe, S. J., Barnett, J., Friend, K., & Nottingham, K. (2011). The mediating roles of disgust sensitivity and danger expectancy in relation to hand washing behaviour. Behavioural and Cognitive Psychotherapy, 39, 175190. http://dx.doi.org/10.1017/S1352465810000676 CrossRefGoogle ScholarPubMed
Thorpe, S. J., Patel, S. P., & Simonds, L. M. (2003). The relationship between disgust sensitivity, anxiety and obsessions. Behaviour Research and Therapy, 41, 13971409. http://dx.doi.org/10.1016/S0005-7967(03)00058-5 Google Scholar
Thorpe, S. J., & Salkovskis, P. M. (1995). Phobic beliefs: Do cognitive factors play a role in specific phobias? Behaviour Research and Therapy, 33, 805816. http://dx.doi.org/10.1016/0005-7967(95)00022-P Google Scholar
Tolin, D. F., Brady, R. E., & Hannan, S. (2008). Obsessional beliefs and symptoms of obsessive-compulsive disorder in a clinical sample. Journal of Psychopathology and Behavioral Assessment, 30, 3142. http://dx.doi.org/10.1007/s10862-007-9076-7 Google Scholar
Tolin, D. F., Woods, C. M., & Abramowitz, J. S. (2006). Disgust sensitivity and obsessive-compulsive symptoms in a non-clinical sample. Journal of Behavior Therapy and Experimental Psychiatry, 37(1), 3040. http://dx.doi.org/10.1016/j.jbtep.2005.09.003 Google Scholar
Torresan, R. C., Ramos-Cerqueira, A. T., Shavitt, R. G., do Rosário, M. C., de Mathis, M. A., Miguel, E. C., & Torres, A. R. (2013). Symptom dimensions, clinical course and comorbidity in men and women with obsessive-compulsive disorder. Psychiatry Research. 209, 186195. http://dx.doi.org/10.1016/j.psychres.2012.12.006 Google Scholar
Wheaton, M. G., Abramowitz, J. S., Berman, N. C., Riemann, B. C., & Hale, L. R. (2010). The relationship between obsessive beliefs and symptom dimensions in obsessive-compulsive disorder. Behaviour Research and Therapy, 48, 949954. http://dx.doi.org/10.1016/j.brat.2010.05.027 Google Scholar
Wheaton, M. G., Mahaffey, B., Timpano, K. R., Berman, N. C., & Abramowitz, J. S. (2012). The relationship between anxiety sensitivity and obsessive-compulsive symptom dimensions. Journal of Behavior Therapy and Experimental Psychiatry, 43, 891896. http://dx.doi.org/10.1016/j.jbtep.2012.01.001 Google Scholar
Woody, S. R., & Teachman, B. A. (2000). Intersection of disgust and fear: Normative and pathological views. Clinical Psychology: Science and Practice, 7, 291311. http://dx.doi.org/10.1093/clipsy.7.3.291 Google Scholar
Woody, S. R., & Tolin, D. F. (2002). The relationship between disgust sensitivity and avoidant behavior: Studies of clinical and nonclinical samples. Journal of Anxiety Disorders, 16, 543559.Google Scholar