Mental Contamination in Obsessive-Compulsive Disorder: Associations With Contamination Symptoms and Treatment Response

Mathes, Brittany M.; McDermott, Katherine A.; Okey, Sarah A.; Vázquez, Ana María Martín; Harvey, Ashleigh M.; Cougle, Jesse R.

doi:10.1016/j.beth.2018.03.005

Cited by 24 publications

(15 citation statements)

References 23 publications

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“…Compulsive washing can be motivated by harm avoidance (wanting to decontaminate), incompleteness (wanting to feel “just right”), or “mental contamination” (Coughtrey, Shafran, Knibbs, & Rachman, ; Rachman, ) transmitted and spread in the absence of physical contact with a contaminant (Coughtrey et al, ; Ishikawa, Kobori, & Shimizu, ; Mathes, McDermott, Okey, Vasquez, Harvey, Cougle, 2019). Feelings of mental contamination can be prompted by thinking about dirt or remembering immoral events, undesirable people, or unpleasant things or events (Coughtrey, Shafran, & Rachman, ; Mathes et al, ). If the person does nothing, the feeling of being mentally contaminated decreases over time.…”

Section: Introductionmentioning

confidence: 99%

A study of the Repeated Actions Diary in patients suffering from obsessive compulsive disorder

Bouvard

Fournet

Denis

et al. 2020

Clin Psychology and Psychoth

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The structured Repeated Action Diary (RAD) collects in vivo data on compulsions and their various characteristics. Certain compulsions (i.e., those ending because the patient feels certain that it is safe to stop) are then compared with uncertain compulsions. The compulsion profile in patients with obsessive compulsive disorder (OCD) was assessed by using the RAD. Thirty‐two patients from two sources participated in the study. Before pooling the two subgroups, we checked that they did not differ significantly with regard to demographic and clinical variables. Patients reported several categories of compulsion. The most frequently reported compulsions were washing and checking. In a given person, checking compulsions (in contrast to washing compulsions) were often produced by several different obsessions. Almost all the patients reported repeating the compulsions because of a need to feel sure. There were far more “certain” compulsions than “uncertain” compulsions. The number of repetitions was significantly lower for certain compulsions than for uncertain compulsions. The person felt greater relief from guilt and responsibility and a greater decrease in discomfort at the end of a compulsive episode for certain compulsions than for uncertain compulsions. In conclusion, the need to ritualize (prompted by uncertainty, i.e., potential danger) might explain the maintenance (or posttreatment recurrence) of OCD in many patients. The need for certainty in the completion of a compulsion may be worth considering as a therapeutic tool. The development of an approach based on the need for certainty might help to improve treatment outcomes.

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Section: Introductionmentioning

confidence: 99%

A study of the Repeated Actions Diary in patients suffering from obsessive compulsive disorder

Bouvard

Fournet

Denis

et al. 2020

Clin Psychology and Psychoth

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“…To determine if the AR stimuli provoked different levels of anxiety for the clinical and control groups, and if these interacted with the different stimuli presented, we conducted a robust heteroscedastic mixed analysis of variance (ANOVA) based on 20% trimmed means (Mair and Wilcox, 2020). For the mixed ANOVA, the between-subjects factor was the group variable (clinical or control), and the within-subjects factor was the stimuli (bag, bread, shoes, and meat).…”

Section: Statistical Analysesmentioning

confidence: 99%

“…For the mixed ANOVA, the between-subjects factor was the group variable (clinical or control), and the within-subjects factor was the stimuli (bag, bread, shoes, and meat). Additionally, to compare the mean scores in virtual presence between the clinical and control groups, we employed Yuen's two-sample robust heteroscedastic test based on 20% trimmed means (Mair and Wilcox, 2020). Additionally, as a robust measure of standardized effect size, we used the Xi explanatory measure (ξ), which is analogous to a correlation coefficient and can be interpreted using Cohen's guidelines of 10, 0.30, and 0.50, for small, medium, and large effects, respectively.…”

Section: Statistical Analysesmentioning

confidence: 99%

Design and Validation of Augmented Reality Stimuli for the Treatment of Cleaning Obsessive-Compulsive Disorder

et al. 2021

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Fear to contamination is an easy-to-provoke, intense, hard-to-control, and extraordinarily persistent fear. A worsening of preexisting psychiatric disorders was observed during the COVID-19 (coronavirus disease 2019) outbreak, and several studies suggest that those with obsessive–compulsive disorder (OCD) may be more affected than any other group of people. In the face of worsening OCD symptoms, there is a need for mental health professionals to provide the support needed not only to treat patients who still report symptoms, but also to improve relapse prevention. In this line, it is recommended to improve alternative strategies such as online consultations and digital psychiatry. The aim of this study is to develop augmented reality (AR) stimuli that are clinically relevant for patients with cleaning OCD and assess their efficiency to obtain emotionally significant responses. Four AR stimuli were developed: a plastic bag full of garbage, a piece of bread with mold, a dirty sports shoe, and a piece of rotten meat. All stimuli were shown to a clinical group (17 patients with cleaning OCD) and a control group (11 patients without OCD). Relevant results were the design of the AR stimuli. These stimuli were validated with the statistical difference in perceived anxiety in the meat stimuli between the clinical and control groups. Nevertheless, when looking at effect sizes, all stimuli present effect sizes from small (plastic bag) to large (meat), with both shoe and bread between small and medium effect sizes. These results are a valuable support for the clinical use of these AR stimuli in the treatment of cleaning OCD.

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“…As well as physical contamination from direct contact with dirt or perceived contaminants, a person may experience mental contamination – feelings and fears that arise without physical contact. 29 The source of contamination is human rather than inanimate, and the feelings of dirtiness may come from the individual with OCD. Mental contamination is often associated with another person having abused, betrayed or humiliated the patient.…”

Section: Assessment Of Obsessions and Compulsionsmentioning

confidence: 99%

When self-harm is about preventing harm: emergency management of obsessive–compulsive disorder and associated self-harm

Palombini

Richardson

McAllister³

et al. 2020

BJPsych Bull

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Summary Mental health staff may have limited exposure to emergencies associated with obsessive–compulsive disorder (OCD) during postgraduate training. The first time they encounter a person in the midst of severe obsessions, or one who has compulsively self-harmed in response to such obsessions, might be when working on call covering the emergency department. This educational article presents the lived experience of one of the authors as a clinical scenario. The scenario is then used to illustrate the severity of disability and the rates of self-harm and suicide-related mortality caused by OCD. The recognition and assessment of OCD is described, along with what helps in emergency situations. Written informed consent was obtained for the publication of clinical details.

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Mental Contamination in Obsessive-Compulsive Disorder: Associations With Contamination Symptoms and Treatment Response

Cited by 24 publications

References 23 publications

A study of the Repeated Actions Diary in patients suffering from obsessive compulsive disorder

A study of the Repeated Actions Diary in patients suffering from obsessive compulsive disorder

Design and Validation of Augmented Reality Stimuli for the Treatment of Cleaning Obsessive-Compulsive Disorder

When self-harm is about preventing harm: emergency management of obsessive–compulsive disorder and associated self-harm

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