Differences in clinical intrusive thoughts between obsessive-compulsive disorder, generalized anxiety disorder, and hypochondria.

Differences and similarities between intrusive thoughts typical of obsessive-compulsive disorder, generalized anxiety disorder, and hypochondriasis are relevant for their differential diagnosis, formulation, and psychological treatment. Previous research in non-clinical samples pointed out the relevance of some process variables, such as responsibility, guilt, or neutralization strategies. This research is aimed to investigate the differences and similarities between clinical obsessions, worries, and illness intrusions in some of these process variables. A second aim is to identify models based on these variables that could reliably differentiate between them. Three groups of patients with obsessive-compulsive disorder (n = 35; 60% women, mean age 38.57), generalized anxiety disorder (n = 36; 61.1% women, mean age 41.50), and hypochondriasis (n = 34; 70.6% women, mean age 31.59) were evaluated using the Cognitive Intrusions Questionnaire-Transdiagnostic Version (Romero-Sanchiz, Nogueira-Arjona, Godoy-Ávila, Gavino-Lázaro, & Freeston, ). The results showed that some appraisals (e.g., responsibility or egodystonicity), emotions (e.g., guilt or insecurity), neutralization strategies, and other variables (e.g., verbal content or trigger from body sensation) are relevant for the discrimination between obsessions, worries, and illness intrusions. The results also showed 3 stable models based on these variables for the discrimination between these thoughts. The implication of these results in the diagnosis, formulation, and psychological treatment of obsessive-compulsive disorder, generalized anxiety disorder, and hypochondriasis is discussed.

An experimental analysis of obsessive-compulsive checking as avoidance behaviour / Un análisis experimental de la comprobación obsesivo-compulsiva como conducta de evitación

BACKGROUND: Many explanatory models of obsessive-compulsive disorders (OCD) support the idea that compulsive behaviours are an attempt to avoid an aversive situation. There are few experimental studies carried out on the onset of repetitive behaviours. This study tries to create a repetitive checking behaviour as an analogue explaining similar OCD behaviours. METHOD: An inter-group design with 3 levels of aversion (minimal, progressive and maximum) in a visuo-spatial reasoning task was used. 48 university students without OCD problems (mean= 23 years old) were the participants, randomly distributed in 16 per group. Checking frequency (semi-hidden chronometer) for each task was measured and the questionnaires TONI-2, STAI, MOCI and YBOCS-SR were applied. RESULTS: Participants with a minimal or maximum level difficulty showed a significantly higher level of checking behaviour than those in the progressive difficulty. The differences occurred between the minimal and the progressive group, and between the minimal and maximum difficulty. There were no differences in any other variable. CONCLUSION: In this analogue, the continuous checking of a chronometer was reinforced by the elimination of boring tasks. The momentary escape from an aversive situation explains the checking behaviour. This study could be an experimental analogue of checking behaviour, showing its avoidance function

ANTECEDENTES: múltiples modelos explicativos sobre los trastornos obsesivo compulsivos (TOC) apoyan la idea de que las conductas compulsivas son un intento de eliminar una situación aversiva. Hay pocos estudios experimentales sobre cómo aparecen las conductas repetitivas. Este estudio intenta crear una conducta de comprobación repetitiva como un análogo que podría explicar conductas TOC similares. MÉTODO: se ha utilizado un diseño entregrupos con 3 niveles de aversión (mínimo, progresivo y máximo) en una tarea de razonamiento viso-espacial. Han participado 48 estudiantes universitarios sin problemas TOC (media= 23 años), aleatorizados 16 por grupo. Se ha medido la frecuencia de comprobaciones (cronómetro semioculto) en cada tarea y se aplicaron los cuestionarios TONI-2, STAI, MOCI y YBOCSSR. RESULTADOS: los participantes con dificultad mínima o máxima mostraron significativamente más respuestas de comprobación que el grupo de dificultad progresiva. Las diferencias ocurrieron entre el grupo con tarea de dificultad mínima y progresiva, y mínima frente a máxima. No hubo diferencias en ninguna de las otras variables. CONCLUSIONES: en este análogo la comprobación continua se vería reforzada negativamente al aliviar una tarea monótona, el propio escape momentáneo explicaría la comprobación. Este estudio podría ser un análogo experimental de que las conductas de comprobación tienen una función de evitación

An experimental analysis of obsessive-compulsive checking as avoidance behaviour.

BACKGROUND: Many explanatory models of obsessive-compulsive disorders (OCD) support the idea that compulsive behaviours are an attempt to avoid an aversive situation. There are few experimental studies carried out on the onset of repetitive behaviours. This study tries to create a repetitive checking behaviour as an analogue explaining similar OCD behaviours. METHOD: An inter-group design with 3 levels of aversion (minimal, progressive and maximum) in a visuo-spatial reasoning task was used. 48 university students without OCD problems (mean= 23 years old) were the participants, randomly distributed in 16 per group. Checking frequency (semi-hidden chronometer) for each task was measured and the questionnaires TONI-2, STAI, MOCI and YBOCS-SR were applied. RESULTS: Participants with a minimal or maximum level difficulty showed a significantly higher level of checking behaviour than those in the progressive difficulty. The differences occurred between the minimal and the progressive group, and between the minimal and maximum difficulty. There were no differences in any other variable. CONCLUSION: In this analogue, the continuous checking of a chronometer was reinforced by the elimination of boring tasks. The momentary escape from an aversive situation explains the checking behaviour. This study could be an experimental analogue of checking behaviour, showing its avoidance function.

Propiedades psicométricas de la versión española del Obsessive Belief Questionnaire-Children Version (OBQ-CV) en una muestra no clínica / Psychometric properties of the Spanish version of the Obsessive Belief Questionnaire-Children’s Version in a non-clinical sample

En este estudio se realiza la adaptación y validación del Obsessive Belief Questionnaire-Children Version (OBQ-CV) en una muestra no clínica de niños y adolescentes españoles. Los análisis factoriales confirmatorios revelaron que el modelo que mejor se ajusta a los datos es el de tres factores de primer orden (Responsabilidad/Estimación de la amenaza, Perfeccionismo/Incertidumbre, Importancia/Control del pensamiento) que, a su vez, constituyen un factor de segundo orden. Los resultados mostraron que las puntuaciones del OBQ-CV presentan una alta fiabilidad, así como adecuada validez de criterio con medidas de síntomas obsesivo-compulsivos y de creencias obsesivas, y una buena validez discriminante con medidas de depresión y ansiedad (AU)

The aim of this study was the adaptation to Spanish of the Obsessive Belief Questionnaire-Children’s Version (OBQ-CV) in a non-clinical sample. Confirmatory factor analyses revealed the best fit for a model of three factors (Perfectionism/Certainty, Importance/Control of Thoughts, and Responsibility/Threat Estimation) and one higher-order factor. Moreover, results showed that the Spanish OBQ-CV is a reliable measure. This version also showed good criterion validity with obsessive-compulsive symptom measures and with scores of beliefs relevant to obsessive compulsive disorder. Lastly, this version showed good divergent validity with depression and anxiety measures (AU)

[Psychometric properties of the Spanish version of the Obsessive Belief Questionnaire-Children's Version in a non-clinical sample]. / Propiedades psicométricas de la versión española del Obsessive Belief Questionnaire-Children Version (OBQ-CV) en una muestra no clínica.

The aim of this study was the adaptation to Spanish of the Obsessive Belief Questionnaire-Children's Version (OBQ-CV) in a non-clinical sample. Confirmatory factor analyses revealed the best fit for a model of three factors (Perfectionism/Certainty, Importance/Control of Thoughts, and Responsibility/Threat Estimation) and one higher-order factor. Moreover, results showed that the Spanish OBQ-CV is a reliable measure. This version also showed good criterion validity with obsessive-compulsive symptom measures and with scores of beliefs relevant to obsessive-compulsive disorder. Lastly, this version showed good divergent validity with depression and anxiety measures.

[Psychometric properties of the Vancouver Obsessional Compulsive Inventory (VOCI) in two non-clinical Spanish samples]. / Propiedades psicométricas del Vancouver Obsessional Compulsive Inventory (VOCI) en dos muestras no clínicas de población española.

In this study, the factorial structure and psychometric properties of the Vancouver Obsessional Compulsive Inventory (VOCI) were examined in two non-clinical Spanish samples. An exploratory factor analysis replicated the original six-factor structure. Moreover, results showed that the Spanish VOCI is a reliable measure. Also, this version had good convergent validity with other obsessive-compulsive symptom measures and with an instrument that assess beliefs that are relevant to the obsessive-compulsive disorder. Lastly, this version showed good divergent validity with measures of depression, anxiety and worries.

Cuestionario de diagnóstico del trastorno obsesivo compulsivo (CUDIATOC): descripción y propiedades psicométricas / Questionnaire for Obsessive Compulsive Disorder Diagnosis (Q-OCDD): description and psychometric properties

Se describe el “Cuestionario de diagnóstico del trastorno obsesivo-compulsivo” (CUDIATOC) que operativiza los criterios diagnósticos del DSM-IV. Se describen las reglas de decisión que permiten asignar una persona a una categoría (tOC, Sintomático, Asintomático) y se presentan dos estudios de algunas de sus propiedades psicométricas en grupos no clínico y clínico, respectivamente. El estudio 1, en un grupo no clínico formado por 48 hombres y 190 mujeres, muestra la: (a) concordancia (k= 1) entre dos evaluadores, (b) validez convergente/ discriminante entre CUDIATOC y las escalas de Y-BOCS y MOCI. Con Y-BOCS hay homogeneidad en las puntuaciones entre los grupos Asintomático y Sintomático, existiendo diferencias significativas a partir del grupo TOC. Con MOCI hay diferencias entre el grupo Asintomático y los otros dos en todas las escalas excepto Lentitud. El estudio 2, en un grupo clínico formado por 11 hombres y 6 mujeres, muestra la: (a) fiabilidad (k= 0,87), (b) validez convergente/discriminante entre CUDIATOC e Y-BOCS, habiendo diferencias estadísticamente significativas en las medias de obsesiones, compulsiones y total entre personas con y sin TOC, (c) validez de criterio de CUDIATOC con una entrevista clínica, siendo sensibilidad 78,6%, especificidad 100,0% y eficiencia diagnóstica 82,35% (AU)

This paper describes the Questionnaire for Obsessive-Compulsive Disorder Diagnosis (Q-OCDD)’ based on diagnostic criteria of DSM-IV. Decision criteria to classify a subject into one of three categories (OCD, Symptomatic, Asymptomatic) are described and two studies of some of its psychometric properties are shown in the non clinical and clinical group. Study 1 (non clinical group: 48 males and 190 females) determines: (a) agreement (k= 1) between two OCD inter-scorers, (b) convergent validity between Q-OCDD and Y-BOCS and MOCI. Convergent/divergent validity of Q-OCDD with Y-BOCS shows homogeneity in the Y-BOCS scores in the Asymptomatic and Symptomatic groups, there being a higher number of significant differences from the OCD group. Convergent validity of Q-OCDD with MOCI shows differences between the Asymptomatic and any one of the other two groups in all scales except in Slowness. Study 2 (clinical group: 11 males and 6 females) shows: (a) inter-scorer reliability (k= 0.87), (b) convergent/divergent validity between Q-OCDD (with or without OCD) and Y-BOCS. There are statistically significant differences in the means of obsessions, compulsions and total between subjects with or without OCD, (c) the following values: sensitivity 78.6%, specificity 100.0%, and diagnostic efficiency 82.35% (From diagnoses established by clinical interview and Q-OCDD)

Propiedades psicométricas del Vancouver Obsessional Compulsive Inventory (VOCI) en dos muestras no clínicas de población española / Psychometric properties of the Vancouver Obsessional Compulsive Inventory (VOCI) in two nonclinical Spanish samples

En este estudio se han examinado las propiedades psicométricas de la versión española del Vancouver Obsessional Compulsive Inventory (VOCI) en dos muestras españolas de población no clínica. El análisis factorial exploratorio replicó la estructura de seis factores del cuestionario original. Los resultados también mostraron que se trata de una medida fiable. Por otra parte, este instrumento mostró una adecuada validez convergente con otra medida de síntomas obsesivo-compulsivos y con un instrumento que evalúa creencias relevantes en el trastorno obsesivo-compulsivo (TOC) y una buena validez discriminante con medidas de depresión, ansiedad y preocupaciones (AU)

In this study, the factorial structure and psychometric properties of the Vancouver Obsessional Compulsive Inventory (VOCI) were examined in two non-clinical Spanish samples. An exploratory factor analysis replicated the original six-factor structure. Moreover, results showed that the Spanish VOCI is a reliable measure. Also, this version had good convergent validity with other obsessive-compulsive symptom measures and with an instrument that assess beliefs that are relevant to the obsessive-compulsive disorder. Lastly, this version showed good divergent validity with measures of depression, anxiety and worries (AU)

[Strategies of clinical hypothesis testing]. / Estrategias de comprobación de hipótesis clínicas.

This research examines whether Psychology students, when they test clinical hypotheses, follow either confirmatory or disconfirmatory reasoning strategies. Two hundred and six psychology students, divided in four groups, participated. One group received information about the probability that the hypothesis was correct by means of verbal labels, and another group, by means of numerical expressions. An additional group received the information that getting a precise diagnosis was clinically important. In a last group, diagnostic tests allowed them to increase certainty about the hypothesis. Results show a partial use of confirmatory strategies because, although participants did not seek confirming information, they indeed avoided collecting disconfirming information. When the information increased certainty about the hypothesis, confirmatory strategies became more likely. Neither the increase in the task importance nor the numerical expression of the likelihood that the hypothesis was correct seemed to affect the testing strategy used.

Estrategias de comprobación de hipótesis clínicas / Strategies of clinical hypothesis testing

Esta investigación pretende comprobar si los estudiantes de Psicología, cuando comprueban hipótesis clínicas, siguen estrategias de razonamiento confirmatorias o refutadoras. Participaron 206 estudiantes de Psicología divididos en cuatro grupos. Un grupo recibió la información sobre la probabilidad de que la hipótesis fuera correcta expresada mediante etiquetas verbales, y otro mediante expresiones numéricas. Un grupo adicional recibió información de que afinar en el diagnóstico era clínicamente importante. En un último grupo las pruebas diagnósticas permitían aumentar la seguridad en la hipótesis. Los resultados han mostrado una utilización parcial de estrategias confirmatorias, ya que no se recogió información confirmatoria pero sí se evitó recoger información refutadora. Cuando la información aumenta la seguridad en la hipótesis, es más probable que se utilicen estrategias confirmatorias. Ni el aumento de la importancia de la tarea ni la expresión numérica de la probabilidad de que la hipótesis sea correcta parecen afectar la estrategia seguida (AU)

This research examines whether Psychology students, when they test clinical hypotheses, follow either confirmatory or disconfirmatory reasoning strategies. Two hundred and six psychology students, divided in four groups, participated. One group received information about the probability that the hypothesis was correct by means of verbal labels, and another group, by means of numerical expressions. An additional group received the information that getting a precise diagnosis was clinically important. In a last group, diagnostic tests allowed them to increase certainty about the hypothesis. Results show a partial use of confirmatory strategies because, although participants did not seek confirming information, they indeed avoided collecting disconfirming information. When the information increased certainty about the hypothesis, confirmatory strategies became more likely. Neither the increase in the task importance nor the numerical expression of the likelihood that the hypothesis was correct seemed to affect the testing strategy used (AU)