Nicholls, Andrew James
Description
Cognitive appraisal models propose that obsessive-compulsive
disorder (OCD) develops as a consequence of dysfunctional beliefs
which give rise to distress-provoking, negative appraisals of
intrusive thoughts (ITs), subsequently promoting compulsive
neutralising behaviour. Increased awareness of the processes,
conditions and contexts under which OCD-relevant beliefs and
appraisals may operate differentially is important in moving
forward our understanding of...[Show more] the disorder and its treatment.
Teasdale’s (1983) associative networks model of cognition
implies that mood may represent a condition under which different
types of dysfunctional beliefs and negative appraisals of
intrusive thoughts vary in their salience and function. The
current research comprised two empirical studies and one clinical
case series analysis designed to investigate the impact of
mood-state and emotion regulation skills on negative appraisal
and neutralising activity in obsessive-compulsive disorder.
Study 1 examined the impact of induced anxious, dysphoric and
neutral mood-states on negative appraisals and neutralising
motivations in response to an induced obsession-like thought.
This analogue study utilised a non-clinical sample (N=120) and
employed an obsession-like thought provocation protocol to
generate an obsession-like experience. Results revealed
mood-state-dependent patterns in participants’ appraisals of
the obsession-like thought and their neutralising motivations.
These findings suggest that the prominence of particular types of
dysfunctional appraisals is differentially affected by specific
mood-states, and that mood-state-dependent appraisal patterns
appear to subsequently exert unique influences on individuals’
motivations for engaging in neutralising behaviour. The primary
implication of these findings is that enhanced capacity to manage
or regulate negative affect may attenuate the impact of
mood-state on negative appraisal and neutralising activity in
obsessive-compulsive disorder.
Study 2 was a replication and extension of Study 1. Study 2
investigated the impact of emotion regulation skills training
(ERST) on mood-state-dependent patterns in 198 adult
participants' negative appraisals and neutralising motivations in
response to an induced obsession-like thought. Results
replicated Study 1 findings of mood-state-dependent patterns in
participants’ appraisals of an obsession-like thought and their
subsequent motivations for neutralising. Study 2 additionally
found that enhanced emotion regulation skills translated to an
attenuation of mood-state-dependent patterns in negative
appraisal and neutralising motivations. These findings identify
mood-state as an important pathogenic process which appears to
intersect with cognitive processes in the development and
maintenance of OCD. A key implication of these findings is that
OCD sufferers may benefit from an incorporation of emotion
regulation skills training within traditional
cognitive-behavioural therapy.
Study 3 was a case series analysis assessing the impact of the
addition of a 6-session emotion regulation skills training (ERST)
program into a traditional course of CBT for OCD for four OCD
patients. ERST was inserted between different phases of therapy
creating a multiple baseline design. Visual analyses revealed
that ERST was associated with obsessive-compulsive symptom
reduction and reductions in negative appraisals for three of the
four participants, suggesting that ERST may represent a valuable
augmentation to CBT for some OCD sufferers. There was evidence
of covariation in participants’ negative mood-states and
negative appraisals, however, relationships appeared more
generalised in the clinical study compared with the specific
relationships observed in the analogue studies.
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