Graham C L Davey Frances Meeten Georgina Barnes amp Suzanne R Dash University of Sussex UK What are Clinical Constructs Inferred states or processes derived most often from the clinical experiences of researchers or clinicians in their interactions with patients Davey 2003 ID: 218766
Download Presentation The PPT/PDF document "Aversive intrusive thoughts as contribut..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Aversive intrusive thoughts as contributors to inflated responsibility, intolerance of uncertainty, and thought-action fusion
Graham C L Davey, Frances
Meeten
, Georgina Barnes & Suzanne R Dash
University of Sussex, UKSlide2
What are Clinical Constructs?
“Inferred states or processes derived most often from the clinical experiences of researchers or clinicians in their interactions with patients” (Davey, 2003)
Clinical Constructs have various functions:
To help understand psychopathology symptoms
To provide a basis for developing interventions
To link thoughts, beliefs and cognitive processes to subsequent symptoms (often in an implied causal manner)Slide3
Examples of Clinical Constructs in OCD Research
Inflated Responsibility (
Salkovskis
, 1985)
Intolerance of Uncertainty (
Dugas
et al., 1998)
Thought-Action Fusion (
Shafran
&
Rachman
, 2002)Slide4
Inflated Responsibility
“The
belief that one has the power to bring about or prevent subjectively crucial negative
outcomes” (
Rachman
, 1998;
Salkovskis
, 1985)
Slide5
Intolerance of Uncertainty (IU)
A
“dispositional characteristic that arises from a set of negative beliefs about uncertainty and its connotations and consequences” (
Birrell
et al., 2011, p1200) and is underpinned by beliefs such as ‘uncertainty is dangerous/intolerable’ (
Koerner
&
Dugas
, 2006)
Slide6
Thought-Action Fusion (TAF)
A
set of cognitive distortions involving erroneous and maladaptive beliefs about the relationship between mental events and overt behavior, and specifically that
thinking unacceptable thoughts (e.g. having sex with a parent; thinking about one’s house burning down) are either moral equivalents of performing unacceptable behaviour
or will increase the probability of that event happening (
Berle
&
Starcevic
, 2005;
Shafran
et al., 1996)
Slide7
The Present Studies
Previous research has demonstrated a causal effect of Constructs such as RESP, IU and TAF on OCD symptoms
Present studies reversed this experimental procedure
Investigated the effect of “symptoms” (thinking forced aversive thoughts) on measures of Constructs such as IR, IU and TAFSlide8
Experiment 1
Exposure to Obsessive Aversive Thoughts (28 obsessive statements
vs
4 obsessive/24 neutral statements
)in a nonclinical population
Effects
on measures
of:
Inflated
Responsibility (Responsibility Attitude
Scale)
Intolerance
of Uncertainty (Intolerance of Uncertainty Scale
)
Thought
-Action Fusion (Thought Fusion Instrument, TFI
)
Constructs measured (1) on composite VAS scales, and (2) on full validated questionnairesSlide9
Statements
Aversive Statements
“I will harm someone I love”
“I will push someone under a train or bus”
Neutral Statements
“I will have my usual breakfast”
“I will meet someone I know”
Rachman
&
DeSilva
(1978); Berry &
Laskey
(2012)Slide10
Results – Experiment 1
Mean composite ratings of
RESP (p<.05),
IU
(ns) and
TAF
(p<.05) by
high and low obsessive thought groups Slide11
Results – Experiment 1
Mean full questionnaire scores for
RAS (p<.05),
IUS
(ns) and
TFI
(p<.05) for
high and low obsessions groupsSlide12
Experiment 2
Exposure to Obsessive Aversive Thoughts (28 obsessive statements
vs
4 obsessive/24 neutral statements
)in a nonclinical population
Self-relevant
vs
Non-self-relevant
Effects on measures of:
Inflated Responsibility (Responsibility Attitude Scale)
Intolerance of Uncertainty (Intolerance of Uncertainty Scale)
Thought-Action Fusion (Thought Fusion Instrument, TFI)
Constructs measured (1) on composite VAS scales, and (2) on full validated questionnairesSlide13
Results – Experiment 2
Mean composite ratings of
RESP (
ns
),
IU
(sig effect of Obsessions + interaction) and
TAF
(sig effect of Obsessions) by
high and low obsessive thought groups Slide14
Results – Experiment 2
Mean full questionnaire scores for
RAS (sig interaction, p<.05),
IUS
(sig Main effect of obsessions, p<.05) and
TFI
(sig interaction, p=.05) for
high and low obsessions groupsSlide15
High Obsessions/Self-Referent Groups
RAS scores were
comparable to obsessional and anxious clinical samples
TFI scores
were higher than control
norms
but not as high as clinical population norms
Scores on the IUS were higher that student population norms, but not as high as clinical normsSlide16
Mediating Factors
No clear mediation models were observed
In some cases negative mood (sadness and anxiety) significantly mediated Responsibility measures (e.g. Experiment 1)
In other cases, construct measures (e.g. TAF and IU) mediated the relationship between obsession group and sadness/anxietySlide17
Conclusions
Experiencing aversive uncontrollable thoughts may facilitate appraisal processes directly implicated in OCD
Appraisals such as RESP, IU and TAF would not necessarily have to be etiological precursors of OCD symptoms
Bidirectionality would be expected if symptoms, constructs and negative moods are all part of a functional ‘threat management’ network
The development of clinical constructs may need more care to prevent adaptive processes being confused with dysfunctional symptoms in the construct’s definition