Browsing by Subject "Obsessive compulsive disorder"

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A phenomenological study of OCD : formative experiences and the dialectic of shame and obsession
(2020-05-08) Kouttab, Amal Christine; Ainslie, Ricardo C.; Damer, Diana; Suizzo, Marie-Anne P; Sanchez, Delida
This qualitative study used a modified Giorgian (Giorgi, 1985, 2009) approach to descriptive phenomenology to explore four primary areas of inquiry: 1) how individuals conceptualize or make meaning of their experience living with OCD, 2) common core fears that may underlie obsessions, 3) formative experiences shared by people with OCD, and 4) internal self-representations, which included how self-concept effects and is affected by OCD. Various dynamic processes potentially implicated in the development and maintenance of OCD were examined through a series of 9 in-depth interviews, including whether individuals with OCD share qualitatively similar formative experiences, self-perceptions, and core fears. It also interrogated the role of shame in OCD; specifically, whether certain obsessions are accompanied by feelings of shame and if these feelings ultimately reinforce the condition. Analysis of interview data revealed seven primary themes: 1) lack of understanding, 2) meanings, manifestations & metaphors, 3) duality of mind, 4) formative and traumatic experiences, 5) impact of OCD on self, 6) impact of OCD on relationships, and 7) coping strategies. One primary theme, formative and traumatic experiences, included five subordinate themes: impaired familial communication, experiences of being an outsider, traumatic experiences, family instability, and parental expectations and overcontrol. All participants described phenomena consistent with of OCD symptomology and universally reported experiencing obsessions and compulsions. Obsessions were consistent with widely recognized subtypes (i.e., aggressive/harm obsessions, contamination, sexual obsessions, hypermorality and scrupulosity), and the most commonly reported were contamination obsessions, followed by hypermorality/scrupulosity and aggressive obsessions. Similarly, compulsions were easily identified within existing categories (i.e., overt and covert checking behavior, symmetry/counting and repetitive movement, washing/cleaning, and anxious avoidance). The most commonly described compulsion was checking/reassurance-seeking, followed by anxious avoidance and symmetry/counting & repetitive movement. The majority recalled experiencing anxiety and obsessive tendencies beginning at an early age, while several identified precipitating factors leading up to symptom onset, most notably stressful events and increasing levels of anxiety. More than half described a sudden onset of symptoms. Symptom course was described as lifelong, pervasive, and waxing-and-waning. Narratives generally revealed that obsessions tended to change over time and that symptoms, and the ability to manage them, gradually improved.
Mindfulness training for intrusive thoughts
(2010-05) Kissen, Debra Anne; McCarthy, Christopher J.; Rude, Stephanie; Drum, David; Rude, Stephanie; Stark, Kevin
The cognitive model of obsessions (Rachman, 1997, 1998) proposes the escalation from normal intrusive thought into clinical obsession begins with the appraisal of thoughts as being significant or dangerous. The cognitive theory of obsessions also posits through targeting and dismantling maladaptive thought related beliefs and thought control strategies, one can reduce the frequency of and discomfort associated with obsessive thoughts. The current study first set out to obtain additional empirical support for the proposed relationship between maladaptive thought related beliefs, thought management strategies, and obsessive thinking. Next, this study explored the potential impact of targeting and altering maladaptive thought related beliefs and thought management strategies, through mindfulness-based training (thought acceptance), in comparison to relaxation-based training (thought control). Finally, this study assessed which, if any, participant characteristics were associated with positively responding to mindfulness training. Results highlighted the strong relationship between maladaptive thought related beliefs, thought management strategies and obsessive thinking, with mindfulness mediating the relationship between maladaptive thought related beliefs and obsessive thinking. Research results also lend support for the potential efficacy of both mindfulness as well as relaxation based training, for the treatment of obsessive thinking. Participants assigned to both conditions exhibited decreased obsessive thinking as well increased positive mood state and decreased maladaptive thought related beliefs. Process related analysis uncovered a significant relationship between decreased maladaptive thought related beliefs and decreased obsessive thinking for the mindfulness condition, providing initial evidence for changes in meta-cognitive beliefs as an active ingredient in mindfulness training. In contrast, a significant relationship between decreased maladaptive thought related beliefs and decreased obsessive thinking was not found for the relaxation condition. Finally, when assessing participant characteristics associated with positively responding to mindfulness training, level of obsessive thinking predicted self reporting to have obtained a significant benefit from engaging in mindfulness training, with study participants experiencing higher levels of obsessive thinking interpreting the mindfulness intervention as more beneficial than study participants who experienced lower levels of obsessive thinking. These findings offer initial evidence that mindfulness training may be a useful treatment approach, in targeting and altering maladaptive thought related beliefs, for the treatment of obsessive thinking.