Guy Doron

The Attachment Paradox How Can So Many of Us (the Insecure Ones) Have No Adaptive Advantages

Bowlby’s (1969/1982) attachment theory has generated an enormous body of research and conceptual elaborations. Although attachment theory and research propose that attachment security provides a person with many adaptive advantages during all phases of the life cycle, numerous studies indicate that almost half of the human species can be classified as insecurely attached or insecure with respect to attachment. It seems odd that evolution left humans in this vulnerable position unless there are some advantages, under at least some conditions, to anxious and avoidant attachment styles. We argue that a social group containing members with different attachment patterns may be more conducive to survival than a homogeneous group of securely attached individuals. In making this argument, we extend the scope of attachment theory and research by considering a broader range of adaptive functions of insecure attachment strategies. We also present preliminary data to support our argument.

The Obsessive Beliefs Questionnaire (OBQ): examination in nonclinical samples and development of a short version

The study aimed to examine the factor structure of the Obsessive Beliefs Questionnaire (OBQ), the most widely used measure of dysfunctional beliefs in obsessive—compulsive disorder (OCD). Multiple exploratory methods (exploratory factor analysis, cluster analysis by variable, multidimensional scaling) were used to examine the questionnaire. Confirmatory factor analyses were also performed in two large nonclinical samples from Australia (N = 1,234) and Israel ( N = 617). Our analyses suggested a four-factor solution with 38 items, where threat and responsibility formed separate dimensions (the “OBQ-TRIP”). This version had superior fit statistics across the two divergent confirmatory samples, when compared with four alternative models suggested by previous authors. Of the OBQ dimensions, the threat scale correlated most strongly with OCD symptom measures, even when controlling for depression. A short, 20-item version of the scale is offered for further study. Implications and limitations are discussed.

The relationship of cognitive confidence to OCD symptoms

The role of meta-memory and meta-cognition in obsessive-compulsive disorder (OCD) symptoms and checking was examined in a student sample, using the memory and cognitive confidence scale (MACCS; Nedeljkovic, M., & Kyrios, M. (2007). Confidence in memory and other cognitive processes in obsessive-compulsive disorder. Behaviour Research and Therapy, 45, 2899-2914). Confirmatory factor analysis supported the MACCSs previously reported structure, and hierarchical regression supported its relationship to OCD symptom severity over-and-above depression and other OCD-related beliefs. Specifically, general confidence in memory was found to be a unique predictor of overall OCD severity. Implications for theory and research are discussed.

Differences in neuropsychological performance between subtypes of obsessive―compulsive disorder

Objective: Neuropsychological studies have suggested that frontal–striatal dysfunction plays a role in obsessive–compulsive disorder (OCD), although findings have been inconsistent, possibly due to heterogeneity within the disorder and methodological issues. The purpose of the present study was therefore to compare the neuropsychological performance of different subtypes of OCD and matched non-clinical controls (NCs) on the Cambridge Automated Neuropsychological Test Battery (CANTAB). Methods: Fifty-nine OCD patients and 59 non-clinical controls completed selected tests from CANTAB examining executive function, visual memory and attentional-set shifting. Depression, anxiety and OCD symptoms were also assessed. Results: From 59 OCD patients, four subtypes were identified: (i) washers; (ii) checkers; (iii) obsessionals; and (iv) mixed symptom profile. Comparisons between washers, checkers, obsessionals and NCs indicated few differences, although checkers were generally found to exhibit poorer performance on spatial working memory, while obsessionals performed poorly on the spatial recognition task. Both checkers and the mixed subgroups showed slowed initial movement on the Stockings of Cambridge planning task and poorer pattern recognition relative to NCs. Conclusion: Overall the results suggested greater impairments in performance on neuropsychological tasks in checkers relative to other subtypes, although the observed effects were small and the conclusions limited by the small subtype samples. Future research will need to account for factors that influence neuropsychological performance in OCD subtypes.

Threats to moral self-perceptions trigger obsessive compulsive contamination-related behavioral tendencies.

BACKGROUND AND OBJECTIVES Obsessive compulsive (OC) phenomena such as contamination fears may lead to significant impairment in daily functioning. In this research, we examined whether threat to moral self-perceptions can trigger contamination-related behavioral tendencies. METHOD Three experiments examined the influence of subtle priming of morality-related information on contamination-related behavioral tendencies. RESULTS Subtle suggestions of incompetence in the morality self-domain led to heightened OC-related behavioral tendencies. These effects were specific to self-relevant (versus other-relevant), negative (versus positive) information about the morality domain (versus a morality-irrelevant domain). Findings were not related to pre-existing variations in self-esteem, stress, anxiety, or depression, and were not explained by mood fluctuations. LIMITATIONS Our studies were conducted with non-clinical samples. CONCLUSIONS Self-sensitivities in the moral domain may be causally linked with contamination-related concerns. Treatments addressing such sensitivities may prove useful when treating obsessive compulsive phenomena.

Universal biases in self-perception : better and more human than average

There is a well-established tendency for people to see themselves as better than average (self-enhancement), although the universality of this phenomenon is contested. Much less well-known is the tendency for people to see themselves as more human than average (self-humanizing). We examined these biases in six diverse nations: Australia, Germany, Israel, Japan, Singapore, and the USA. Both biases were found in all nations. The self-humanizing effect was obtained independent of self-enhancement, and was stronger than self-enhancement in two nations (Germany and Japan). Self-humanizing was not specific to Western or English-speaking cultures and its magnitude was less cross-culturally variable than self-enhancement. Implications of these findings for research on the self and its biases are discussed.

Adult attachment insecurities are associated with obsessive compulsive disorder

OBJECTIVES Obsessive compulsive disorder (OCD) is one of the most disabling and highly prevalent anxiety disorders (ADs). Current cognitive models of OCD implicate views about the self and world in the maintenance of the disorder. However, little research has focused on issues that may lead to vulnerability to such views. In particular, a persons attachment insecurities (attachment anxiety, avoidance) may be important risk factors increasing the likelihood of such non-adaptive perceptions (Doron & Kyrios, 2005). DESIGN Participants meeting criteria for OCD were compared with cohorts meeting criteria for other ADs and healthy controls on a range of measures including adult attachment, OC symptoms, cognitions, and mood. METHODS Diagnosis of the clinical groups was established using the Anxiety Disorders Interview Schedule for DSM-IV (Brown, Di Nardo, & Barlow, 1994). The clinical relevance of attachment insecurities was ascertained by comparing their prevalence in an OCD sample (N = 30), an ADs sample (N = 20), and a community sample (N = 32). RESULTS Attachment anxiety was significantly higher in individuals with OCD, even when controlling for depression. CONCLUSIONS Addressing attachment anxiety in individuals presenting with OCD may be important for enhancing therapeutic outcomes. However, findings are based on cross-sectional data that preclude conclusions relating to causal influence.

Obsessing about intimate-relationships: Testing the double relationship-vulnerability hypothesis

BACKGROUND AND OBJECTIVES Obsessive preoccupation and doubts centering on ones intimate relationship may have a negative impact on the romantic dyad and lead to significant distress. In this research we investigated whether the co-occurrence of attachment anxiety and overreliance on intimate relationships for self-worth-what we call double relationship-vulnerability-is linked with relationship-centered obsessions and obsessive-compulsive tendencies. METHODS Study 1 employed a correlational design to examine the link between double relationship-vulnerability and relationship-centered obsessions. Study 2 employed an experimental design to assess response to subtle threats to the relationship self-domain among individuals with double relationship-vulnerability. RESULTS Study 1 supported the link between double relationship-vulnerability and relationship-centered obsessions. Study 2 showed that when confronted with subtle threats to the relationship self-domain, individuals with double relationship-vulnerability are more likely to experience distress and engage in mitigating behavior in response to relationship doubts and fears. LIMITATIONS Our studies were conducted with non-clinical samples. CONCLUSIONS These findings suggest that double relationship-vulnerability may make individuals more susceptible to the development and maintenance of relationship-centered obsessions and compulsions.

Desire for control, sense of control and obsessive-compulsive checking: An extension to clinical samples

Research in non-clinical samples has suggested that control beliefs, specifically desire for control and sense of control, may play a role in Obsessive--Compulsive Disorder. The present study extends a previous research design to clinical participants [Moulding, R., Kyrios, M., & Doron, G. (2007). Obsessive-compulsive behaviours in specific situations: The relative influence of appraisals of control, responsibility and threat. Behaviour Research and Therapy, 45, 1693-1702]. In this study, clinical participants with OCD-checking symptoms (n=16), anxiety disorders (n=17) and community controls (n=27) were presented with four hypothetical scenarios. Using a manipulation paradigm, the relationship between control appraisals and other OCD-relevant constructs (threat, responsibility) was examined. As in the non-clinical study, desire for control was moderately affected by responsibility and threat manipulations, while sense of control was not affected by these manipulations. Individuals with OCD recorded higher desire for control and lower sense of control relative to community controls, and a higher desire for control than the anxiety group, suggesting some specificity to OCD. A possible interactive model of control, threat and responsibility is discussed.

We Do Not See Things as They Are, We See Them as We Are: A Multidimensional Worldview Model of Obsessive- Compulsive Disorder

Cognitive-behavioral models of obsessive-compulsive disorder (OCD) assign a central role to specific beliefs and coping strategies in the development, maintenance and exacerbation of obsessive-compulsive (OC) symptoms. These models also implicate perceptions of self and the world in the development and maintenance of OC phenomena (e.g., overestimation of threat, sociotropy, ambivalent or sensitive sense of self, looming vulnerability), although such self and world domains have not always been emphasized in recent research. Following recent recommendations (Doron & Kyrios, 2005), the present study undertook a multifaceted investigation of self and world perceptions in a nonclinical sample, using a coherent worldview framework (Janoff-Bulman, 1989, 1991). Beliefs regarding the self and the world were found to predict OC symptom severity over and above beliefs outlined in traditional cognitive-behavioral models of OCD. Self and world beliefs were also related to other OC-relevant beliefs. Implications of these findings for theory and treatment of OCD are discussed.