Comparison of thought-action fusion and self-compassion in individuals with different patterns of obsessive-compulsive disorder and normal individuals

Document Type : Original Article

Authors

1 Master of Clinical Psychology, Faculty of Educational Sciences and Psychology, Shiraz University, Shiraz, Iran

2 Professor, Department of Psychology, Faculty of Educational Sciences and Psychology, Shiraz University, Shiraz, Iran

Abstract

Abstract
Introduction: Identifying the factors involved in Obsessive-compulsive disorder (OCD), especially compared to non-clinical groups, is of utmost importance. The aim of this  study is to compare thought-action fusion and self-compassion in individuals with different patterns of obsessive-compulsive disorder and normal individuals.
Method: To perform the study, 45 participants with OCD symptoms, ie, checking obsession (n=15), washing obsession(n=15), and scrupulosity(n=15) who referred to  consultation and psychotherapy centers in Behbahan City and 45 healthy and normal individuals were selected using convenient sampling. The participants completed the Maudsley Obsessional Compulsive Inventory (MOCI), the Penn Inventory of Scrupulosity (PIOS), the Thought-Fusion Instrument (TFI) developed by Wells, Gwilliam, and Cartwright-Hatton (2001), and the Self-Compassion Scale developed by Reese et al. (SCS). Afterward, the collected data were analyzed using multivariate analysis of variance (MANOVA).
Results: The results indicated a significant difference between normal individuals and individuals suffering from various patterns of OCD  via thought-action fusion (p<0.001) and self-compassion (p<0.001).
Conclusion: It seems that people suffering from OCD have a higher level of thought-action fusion and a lower level of self-compassion compared to normal healthy individuals.
 

Keywords

Main Subjects


  1. Abdollahzadeh Davan, S., Imani M. Investigating the relationship between feeling guilty and thought-action fusion by mediating obsessive-compulsive disorder and scrupulosity. 0 J Adv Pharm Educ Res. 2020;10(4):150–4.
  2. American Psychiatric Publishing.. American Psychiatric Association Diagnostic and statistical manual of mental disorders, fifth edition [DSM-5®]. Am Psychiatr Publ. 2016;51(13).
  3. Krzanowska E, Kuleta M. From anxiety to compulsivity – A review of changes to OCD classification in DSM-5 and ICD-11. Arch Psychiatry Psychother. 2017;19(3).
  4. Krzyszkowiak W, Kuleta-Krzyszkowiak M, Krzanowska E. Treatment of obsessive-compulsive disorders (OCD) and obsessive-compulsive-related disorders (OCRD). Psychiatr Pol. 2019;53(4).
  5. American Psychological Association (APA). Diagnostic and Statistical Manual of Mental Disorders: Depressive Disorders. Diagnostic and Statistical Manual of Mental Disorders,. 2013.
  6. Hezel DM, Stewart SE, Riemann BC, McNally RJ. Clarifying the thought-action fusion bias in obsessive-compulsive disorder. J Obsessive Compuls Relat Disord. 2019;20.
  7. Salkovskis PM. Obsessional-compulsive problems: A cognitive-behavioural analysis. Behav Res Ther. 1985;23(5).
  8. Rachman S. A cognitive theory of obsessions. Behav Res Ther. 1997;35(9).
  9. Rachman S. Obsessions, responsibility and guilt. Behav Res Ther. 1993;31(2).
  10. Rachman S, Shafran R. Cognitive Distortions: Thought-Action Fusion. Clin Psychol Psychother. 1999;6(2).
  11. Evans DW, Hersperger C, Capaldi PA. Thought-action fusion in childhood: Measurement, development, and association with anxiety, rituals and other compulsive-like behaviors. Child Psychiatry Hum Dev. 2011;42(1).
  12. Shafran R, Rachman S. Thought-action fusion: A review. Vol. 35, Journal of Behavior Therapy and Experimental Psychiatry. 2004.
  13. Reuman L, Buchholz J, Blakey S, Abramowitz JS. Uncertain and fused: Cognitive fusion, thought-action fusion, and the intolerance of uncertainty as predictors of obsessive-compulsive symptom dimensions. J Cogn Psychother. 2017;31(3).
  14. Malehmir, B., Mikaeeli, N. Narimani M. Comparison of family functioning and thought-action fusion in patients with obsessive-compulsive disorder, bipolar disorder and normal people. Med J od mashhad Univ Med Sci. 2021;64(6):147–59.
  15. Abramowitz JS, Lackey GR, Wheaton MG. Obsessive-compulsive symptoms: The contribution of obsessional beliefs and experiential avoidance. J Anxiety Disord. 2009;23(2).
  16. Wheaton MG, Abramowitz JS, Berman NC, Riemann BC, Hale LR. The relationship between obsessive beliefs and symptom dimensions in obsessive-compulsive disorder. Behav Res Ther. 2010;48(10).
  17. Leeuwerik T, Cavanagh K, Strauss C. The Association of Trait Mindfulness and Self-compassion with Obsessive-Compulsive Disorder Symptoms: Results from a Large Survey with Treatment-Seeking Adults. Cognit Ther Res. 2020;44(1).
  18. Neff KD. The Development and Validation of a Scale to Measure Self-Compassion. Self Identity. 2003;2(3).
  19. Eichholz A, Schwartz C, Meule A, Heese J, Neumüller J, Voderholzer U. Self-compassion and emotion regulation difficulties in obsessive–compulsive disorder. Clin Psychol Psychother. 2020;27(5).
  20. Belloch A, Morillo C, Garcia-Soriano G. Strategies to control unwanted intrusive thoughts: Which are relevant and specific in obsessive-compulsive disorder? Cognit Ther Res. 2009;33(1).
  21. Barnard LK, Curry JF. Self-Compassion: Conceptualizations, Correlates, & Interventions. Rev Gen Psychol. 2011;15(4).
  22. Marshall EJ, Brockman RN. The relationships between psychological flexibility, self-compassion, and emotional well-being. J Cogn Psychother. 2016;30(1).
  23. Johnson EA, O’Brien KA. Self-compassion soothes the savage ego-threat system: Effects on negative affect, shame, rumination, and depressive symptoms. J Soc Clin Psychol. 2013;32(9).
  24. Krieger T, Altenstein D, Baettig I, Doerig N, Holtforth MG. Self-Compassion in Depression: Associations With Depressive Symptoms, Rumination, and Avoidance in Depressed Outpatients. Behav Ther. 2013;44(3).
  25. Smeets E, Neff K, Alberts H, Peters M. Meeting suffering with kindness: Effects of a brief self-compassion intervention for female college students. J Clin Psychol. 2014;70(9).
  26. Landmann S, Cludius B, Tuschen-Caffier B, Moritz S, Külz AK. Mindfulness predicts insight in obsessive-compulsive disorder over and above OC symptoms: An experience-sampling study. Behav Res Ther. 2019;121.
  27. Wetterneck CT, Lee EB, Smith AH, Hart JM. Courage, self-compassion, and values in Obsessive-Compulsive Disorder. J Context Behav Sci. 2013;2(3–4).
  28. Berman NC, Shaw AM, Wilhelm S. Emotion Regulation in Patients with Obsessive Compulsive Disorder: Unique Effects for Those with “Taboo Thoughts.” Cognit Ther Res. 2018;42(5).
  29. Spitzer RL, Gibbon M, Williams JB. User’s guide for the Structured clinical interview for DSM-IV axis I disorders SCID-I: clinician version. Washington, DC Am Psychiatr Assoc. 1997;
  30. Golshani F, Mazaheri MA, Borjali A, Ahadi H. The Effect of Dialectical Behavioral Therapy in the treatment of borderline personality disorder. Psychol Res. 2009;2(5):1–25.
  31. Hodgson RJ, Rachman S. Obsessional-compulsive complaints. Behav Res Ther. 1977;15(5):389–95.
  32. Mohammadkhani S. The role of fusion beliefs and metacognitions in obsessive–compulsive symptoms in general population. Pract Clin Psychol. 2013;1(2):97–104.
  33. Abramowitz JS, Huppert JD, Cohen AB, Tolin DF, Cahill SP. Religious obsessions and compulsions in a non-clinical sample: The Penn Inventory of Scrupulosity (PIOS). Behav Res Ther. 2002;40(7):825–38.
  34. Kaviani S, Eskandari H, EBRAHIMI GS. The relationship between scrupulosity, obsessive-compulsive disorder and its related cognitive styles. 2015;
  35. Wells A, Gwilliam P, Cartwright-Hatton S. The Thought Fusion Instrument (unpublished self-report scale). UK Univ Manchester. 2001;
  36. Gwilliam P, Wells A, Cartwright‐Hatton S. Dose meta‐cognition or responsibility predict obsessive–compulsive symptoms: a test of the metacognitive model. Clin Psychol Psychother An Int J Theory Pract. 2004;11(2):137–44.
  37. Khoramdel K, Rabiee M, Molavi H, Neshatdoost HT. Psychometric properties of thought fusion instrument (TFI) in Students. Iran J psychiatry Clin Psychol. 2010;16(1):74–8.
  38. Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the self‐compassion scale. Clin Psychol Psychother. 2011;18(3):250–5.
  39. Khanjani S, Foroughi AA, Sadghi K, Bahrainian SA. Psychometric properties of Iranian version of self-compassion scale (short form). Pajoohandeh J. 2016;21(5):282–9.
  40. Wells A. Emotional Disorders and Metacognition: Innovative Cognitive Therapy. Emotional Disorders and Metacognition: Innovative Cognitive Therapy. 2008.
  41. Lee EB, Barney JL, Twohig MP, Lensegrav-Benson T, Quakenbush B. Obsessive compulsive disorder and thought action fusion: Relationships with eating disorder outcomes. Eat Behav. 2020;37.
  42. Key BL, Rowa K, Bieling P, McCabe R, Pawluk EJ. Mindfulness-based cognitive therapy as an augmentation treatment for obsessive–compulsive disorder. Clin Psychol Psychother. 2017;24(5).
  43. Selchen S, Hawley LL, Regev R, Richter P, Rector NA. Mindfulness-Based Cognitive Therapy for OCD: Stand-Alone and Post-CBT Augmentation Approaches. Int J Cogn Ther. 2018;11(1).
  44. Külz AK, Landmann S, Cludius B, Rose N, Heidenreich T, Jelinek L, et al. Mindfulness-based cognitive therapy (MBCT) in patients with obsessive–compulsive disorder (OCD) and residual symptoms after cognitive behavioral therapy (CBT): a randomized controlled trial. Eur Arch Psychiatry Clin Neurosci. 2019;269(2).
  45. Strauss C, Lea L, Hayward M, Forrester E, Leeuwerik T, Jones AM, et al. Mindfulness-based exposure and response prevention for obsessive compulsive disorder: Findings from a pilot randomised controlled trial. J Anxiety Disord. 2018;57.
  46. Öst LG, Havnen A, Hansen B, Kvale G. Cognitive behavioral treatments of obsessive-compulsive disorder. A systematic review and meta-analysis of studies published 1993-2014. Vol. 40, Clinical Psychology Review. 2015.
  47. Weingarden H, Renshaw KD. Shame in the obsessive compulsive related disorders: A conceptual review. Vol. 171, Journal of Affective Disorders. 2015.
  48. Stein MB, Forde DR, Anderson G, Walker JR. Obsessive-compulsive disorder in the community: An epidemiologic survey with clinical reappraisal. Am J Psychiatry. 1997;154(8).
  49. Ouellet-Courtois C, Wilson S, O’Connor K. Cognitive confidence in obsessive-compulsive disorder: A systematic review and meta-analysis. Vol. 19, Journal of Obsessive-Compulsive and Related Disorders. 2018.
  50. De Silva P. Obsessive-compulsive disorder. In Adult Psychological Problems ‏. In Taylor & Francis; 2014. p. 143–62.
  51. Pourfaraj M. Study of relationship between Thought-Action Fusion, Responsibility and Guilt with OCD symptoms in Shiraz university students. ‏. Clin Psychol Personal. 2009;37(16):69–82.
  52. Goldberg SB, Tucker RP, Greene PA, Davidson RJ, Wampold BE, Kearney DJ, et al. Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Vol. 59, Clinical Psychology Review. 2018.