Adam S. Radomsky

Memory bias in obsessive-compulsive disorder (OCD).

There is a memory bias associated with depression, and good reason to expect a memory bias associated with anxiety. However, the results of studies reported to date have been ambiguous. Accordingly, an experiment was conducted to assess memory for contamination in people with different types of anxiety. Memory for contaminated stimuli among participants who met DSM-IV criteria for obsessive-compulsive disorder (OCD) and indicated a fear of contamination (n = 10) was compared to memory in a group of anxious controls (n = 10), and in undergraduate students (n = 20). Participants were shown 50 objects, 25 of which were contaminated by the experimenter and 25 which were touched but not contaminated. They then completed a neuropsychological memory assessment, after which the participants were asked to recall all of the objects touched by the experimenter. They were then asked to approach each object and to rate their anxiety about touching it. Finally, participants were asked about their perceptions of the cleanliness of each object. The OCD group had better memory for contaminated objects than for clean ones. Neither control group showed such a bias. Neuropsychological test scores indicated that this bias is not the result of differences in general memory ability. The results are discussed in terms of the memory-deficit theory of OCD and of behavioural and cognitive approaches to understanding the role of information processing in fear and anxiety.

Safety behaviour: a reconsideration.

There is ample evidence that the use of safety behaviour can interfere with the progress of therapy, particularly if exposure is involved. As a result, it is widely asserted that safety behaviour is anti-therapeutic. However, an unqualified rejection of safety behaviour should be reconsidered because we now have theoretical justification, experimental evidence and clinical observations showing that the judicious use of safety behaviour, especially in the early stages of treatment, can be facilitative. Experiments in which escape behaviour facilitated fear reduction, and others in which the use of safety gear facilitated fear reduction, are reviewed. It also appears that safety behaviour does not necessarily prevent disconfirmatory experiences. We propose that additional investigations of the judicious use of safety behaviour will help to elucidate therapeutic uses of safety behaviour in the treatment of anxious and related types of psychopathology.

Connections among symptoms of obsessive–compulsive disorder and posttraumatic stress disorder: a case series

Theoretical, clinical, and empirical implications of the functional connections between symptoms of obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are abundant. As such, four cases are presented here of men and women who met criteria for comorbid OCD and PTSD. All had been diagnosed with treatment-resistant OCD and were seeking treatment from an OCD specialty clinic or institute, all reported a history of traumatic experiences prior to the onset of OCD, and all appeared to demonstrate negative treatment outcomes. Upon examination, it appeared that symptoms of OCD and PTSD were connected such that decreases in OCD-specific symptoms related to increases in PTSD-specific symptoms, and increases in OCD-specific symptoms related to decreases in PTSD-specific symptoms. Speculations about the function of OCD symptoms in relation to post-traumatic psychopathology are put forth; and theoretical, research, and treatment implications are discussed.

The Claustrophobia Questionnaire.

The content and psychometric properties of the Claustrophobia Questionnaire (CLQ) are described. An earlier version of the CLQ was developed to test the hypothesis that claustrophobia is comprised of two distinct but related fears--the fear of suffocation and the fear of restriction [J. Anxiety Disord. 7 (1993) 281.]. The scale was used to assess patients undergoing the magnetic resonance imaging (MRI) procedure [J. Behav. Med. 21 (1998) 255.] and in participants with panic disorder [J. Abnorm. Psychol. 105 (1996) 146; Taylor, S., Rachman, S., & Radomsky, A. S. (1996). The prediction of panic: a comparison of suffocation false alarm and cognitive theories. Unpublished data.]. On the basis of these studies, we decided to revise and shorten the CLQ, collect normative data, and provide information on the scales predictive and discriminant validity as well as its internal consistency and test-retest reliability. This was done through a set of four interconnected studies that included psychometric analyses of undergraduate and community adult questionnaire responses and behavioural testing. Results indicate that the CLQ has good predictive and discriminant validity as well as good internal consistency and test-retest reliability. The CLQ appears to be a reliable and sensitive measure of claustrophobia and its component fears. We encourage the use of the CLQ in a variety of clinical and research applications. The scale is provided in this paper for public use.

Psychometric Properties of the French and English Versions of the Vancouver Obsessional‐Compulsive Inventory and the Symmetry Ordering and Arranging Questionnaire

The Vancouver Obsessional‐Compulsive Inventory (VOCI) and the Symmetry Ordering and Arranging Questionnaire (SOAQ) are self‐report measures that assess a wide variety of symptoms and features of obsessive‐compulsive disorder (OCD) including checking, contamination, obsessions, hoarding, “just right”, indecisiveness, and symmetry, ordering and arranging obsessions and compulsions. The original English versions of the VOCI and SOAQ have been shown to demonstrate excellent psychometric properties. The present study examined the reliability and validity of French translations of these measures in a non‐clinical sample, and also involved the collection of supplementary psychometric information about the English versions of the scales from a new sample. Volunteer undergraduate students completed questionnaire packages including the VOCI and SOAQ, as well as measures of obsessive‐compulsive, phobic and depressive symptomatology in their native language of either French or English. Results indicate that the French versions of the VOCI and SOAQ demonstrate similar and excellent psychometric properties to the English versions and that these measures are highly valid and reliable assessment tools for use in clinical and research applications in both languages.

Analyses of mental contamination: Part I, experimental manipulations of morality.

The fear of contamination is thought to be comprised of two separate but related fears: those pertaining to physical and mental contamination. Previous research on mental contamination involved studies in which more than one independent variable was manipulated simultaneously. In particular, an immoral act (e.g., a non-consensual kiss) had been coupled with an immoral man (e.g., the person who forces the kiss) in each manipulation. The purpose of this study was to separate manipulations of the immorality of the man from the immorality of the act. Female undergraduate students (n=148) listened to an audio recording and imagined that they were experiencing either sharing a consensual kiss with a man described as moral or immoral, or receiving a forced, non-consensual kiss from a man described as moral or immoral. Participants indicated the presence and degree of mental contamination and then completed a behavioural task for which spontaneous washing was recorded. Results indicated that a non-consensual kiss evoked greater feelings of mental contamination than a consensual kiss. In particular, participants who imagined a non-consensual kiss from a man described as either moral or immoral reported the greatest feelings of mental contamination, whereas participants who imagined a consensual kiss from a man described as moral reported the least. Results are discussed in terms of cognitive-behavioural conceptualizations of and treatments for contamination fears.

Why do people seek reassurance and check repeatedly? An investigation of factors involved in compulsive behavior in OCD and depression.

Excessive reassurance-seeking (ERS) is a common problem among both obsessive-compulsive and depressed populations. However, the content and cognitive processes involved in ERS may differ in these populations according to the unique cognitive and behavioral characteristics demonstrated by each group. To assess factors involved in the onset, maintenance and termination of ERS and repeated checking, the current investigation employed a semi-structured interview with non-depressed obsessive-compulsive disorder (OCD) respondents (n=15), clinically depressed individuals without OCD (n=15), and healthy control participants (n=20). Results showed that whereas individuals with OCD reported seeking reassurance primarily about perceived general threats (e.g., fire, theft), the depressed group reported seeking reassurance primarily about perceived social threats (e.g., abandonment, loss of support). Clinical participants reported greater anxiety, sadness and perceived threat in association with ERS and repeated checking than healthy control participants. These findings are discussed in terms of cognitive-behavioral models of OCD and depression.

Mental contamination: the perpetrator effect

In order to test the proposition that imagining carrying out an unacceptable non-consensual act can evoke contamination-related feelings in the perpetrator, 4 connected experiments were carried out involving male students. The effects of the experimental procedure were enhanced by the introduction of a theme of betrayal which boosted the feelings of contamination and urges to wash. The non-consensual scenarios were followed by substantial increases in negative emotions, notably shame, disgust and guilt, and these increases were boosted over successive enhancements of the procedure. Overall the results show that perpetrators of (imagined) unacceptable acts report a range of negative emotions and feelings of dirtiness. The main conclusion of this research is that imagining an unacceptable, non-consensual act can produce feelings of contamination. It is an experimental illustration of mental contamination, that is, contamination which is evoked by a mental event without any contact with a tangible contaminant.

Don’t even think about checking: Mental checking causes memory distrust

Compulsive checking occurs in both physical and mental forms and is a common symptom of obsessive-compulsive disorder (OCD). Though there has been much recent attention devoted to research on physical checking, mental checking has been largely neglected. Previous research has reliably found that repeated physical checking reduces memory confidence, vividness and detail, while memory accuracy remains relatively unaffected. The current study examined memory accuracy and meta-memory in (n=62) undergraduate students for both physical and mental checks after repeated physical or mental checking of a stove. We hypothesized that repeated physical checking would lead to reductions in meta-memory for previous physical checks and that repeated mental checking would lead to reductions in meta-memory for previous mental checks. Results were consistent with hypotheses, in that checking in each modality led to significant decreases in all meta-memory variables for that modality but not the other. Results also showed that checking in each modality led to slight but significant declines in memory accuracy for that modality. Findings are discussed in terms of cognitive-behavioural models of and treatments for compulsive checking in OCD.

Believe in yourself: Manipulating beliefs about memory causes checking.

One of the most common compulsions in obsessive-compulsive disorder (OCD) is repeated checking. Although individuals often report that they check to become more certain, checking has been shown to have the opposite effect - increased checking causes increased uncertainty. However, checking may also be thought of as beginning because of memory uncertainty. Beliefs about responsibility, over-estimation of threat, intolerance of uncertainty, perfectionism, and importance of and control of thoughts are already known to affect different aspects of OCD symptomatology. Beliefs about memory, however, are not currently considered to influence compulsive behaviour. In the current study, beliefs about memory were manipulated to test whether or not they affected urges to check. Ninety-one undergraduate participants received (positive or negative) false feedback about their performance on aspects of a standardized memory test, and then completed two additional memory tasks. Their urges to check following these tasks were assessed. Consistent with our hypotheses, individuals in the low memory confidence condition had greater urges to check following the memory tasks than those in the high memory confidence condition, demonstrating that manipulations of beliefs about memory can influence checking. Results and implications are discussed in terms of cognitive-behavioural models of and treatments for OCD.