Objective. The potential causal and maintaining role of vulnerable self-themes and beliefs about the self in obsessive-compulsive disorder (OCD) have received increasing attention from cognitive-behavioural theorists. This interest was translated into the development of a self-report measurement of the feared self (the fear of who one might be or become), a construct theoretically and empirically pertinent to unwanted thoughts and impulses in OCD (i.e., repugnant obsessions).Method. The current study aimed to provide converging evidence on the relevance of the feared self in OCD, by examining whether improvements in symptoms associated with repugnant obsessions (measured on the Vancouver Obsessional Compulsive Inventory [VOCI] obsessions subscale) would be predicted by reduced feared selfperceptions (measured on the Fear-of-Self Questionnaire [FSQ]) in a sample of 93 patients receiving psychotherapy for OCD.Results. Using a series of hierarchical linear regression models, we found that treatment-related reductions on the FSQ significantly and uniquely predicted reductions on the VOCI obsessions subscale and the contamination subscale.Conclusions. The current study thus replicated previous research suggesting the relevance of the feared possible self in psychological disorders such as OCD, where negative self-perception is a dominant theme.
Practitioner pointsCurrent results suggest that changes in feared self-perceptions may be the mechanism through which OCD symptoms improve via therapy.
The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and different versions of the Padua Inventory (PI) are frequently used instruments to measure symptoms of obsessive-compulsive disorder (OCD). However, little is known of how these different versions of the PI compare to each other in their sensitivity to measuring treatment outcome, and there is currently no adequate explanation to account for the weak relationships between self-report measures and the Y-BOCS. This study aimed to investigate the sensitivity of these measures to treatment outcome, and to examine whether differences in how they measure symptom severity can explain the weak relationships. Hypotheses were: (1) the Y-BOCS would be significantly more sensitive to measuring treatment outcome than the PI versions; (2) correlations between the measures would be significantly stronger for change scores as compared to relations measured at a single point in time; (3) weak relationships can be explained by the PI measuring symptom severity based on content and the Y-BOCS measuring symptoms, independent of content. Results showed that the Y-BOCS was significantly more sensitive to measuring treatment outcome than the PI versions, while differences between the questionnaires in which severity is measured can provide a partial account for why weak relations are observed between these measures.
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