Ricks Warren

Psychometric validation of the Obsessive Beliefs Questionnaire and the Interpretation of Intrusions Inventory: Part I

This article reports on the validation of the Obsessive Beliefs Questionnaire (OBQ) and Interpretations of Intrusions Inventory (III) developed by the Obsessive Compulsive Cognitions Working Group (OCCWG) to assess the primary beliefs and appraisals considered critical to the pathogenesis of obsessions. A battery of questionnaires that assessed symptoms of anxiety, depression, obsessive-compulsive symptoms and worry was administered to 248 outpatients with a DSM-IV diagnosis of Obsessive-Compulsive Disorder (OCD), 105 non-obsessional anxious patients, 87 non-clinical adults from the community, and 291 undergraduate students. Tests of internal consistency and test-retest reliability indicated that the OBQ and III assessed stable aspects of OC-related thinking. Between-group differences and correlations with existing measures of OC symptoms indicated that the OBQ and III assess core cognitive features of obsessionality. However, the various subscales of the OBQ and III are highly correlated, and both measures evidenced low discriminant validity. The findings are discussed in terms of the relevance and specificity of cognitive constructs like responsibility, control and importance of thoughts, overestimated threat, tolerance of uncertainty and perfectionism for OCD.

Mood, personality disorder symptoms and disability in obsessive compulsive hoarders : a comparison with clinical and nonclinical controls

Hoarding is a symptom of obsessive compulsive disorder (OCD), as well as a diagnostic criterion for obsessive compulsive personality disorder (OCPD). One recent study suggests that people who suffer from compulsive hoarding report more general psychopathology than people who do not [Frost, R.O., Krause, M.S., & Steketee, G. (1996). Hoarding and obsessive compulsive symptoms. Behavior Modification, 20, 116-132]. The present study addressed whether persons with OCD hoarding exhibit more depression, anxiety, OCD and personality disorders symptoms than community controls, OCD nonhoarders, or other anxiety disorder patients. Disability was also examined. Hoarding subjects were older than the other three groups, but age did not account for any of the differences observed among the groups. Compared to controls, OCD hoarding, nonhoarding OCD and anxiety disorder patients showed elevated YBOCS scores, as well as higher scores on depression, anxiety, family and social disability. Compared to nonhoarding OCD and anxiety disorder patients, OCD hoarding patients scored higher on anxiety, depression, family and social disability. Hoarding subjects had greater personality disorder symptoms than controls. However, OCD hoarding subjects differed from OCD nonhoarding and anxiety disorder subjects only on dependent and schizotypal personality disorder symptoms. The findings suggest that hoarding is associated with significant comorbidity and impairment compared to nonhoarding OCD and other anxiety disorders.

Cognitive–behavior therapy of obsessive–compulsive disorder in private practice: An effectiveness study

A controversy exists over whether or not the results of randomized controlled trials (RCTs) are generalizable to routine clinical practice. The present study examines the effectiveness of cognitive-behavior therapy (CBT) for obsessive-compulsive disorder (OCD) in a private practice setting. Twenty-six consecutive clients referred to a private anxiety disorders specialty clinic began treatment for OCD. Of the 19 (73%) clients who completed treatment, 84% were treatment responders. Clients, treatment, and outcome of the present study are compared with those of representative RCTs, and it is concluded that there are more similarities than differences. It is concluded that CBT can be effectively delivered in routine clinical practice.

Cognitive bias and irrational belief as predictors of avoidance

Cognitive bias, i.e. overestimates of subjective probability and cost of catastrophic events, and irrational belief were explored as predictors of avoidance. Three groups-anxiety disordered clients, a mixed group of clinic outpatients, and normals--were administered several self-report inventories. Multiple regression analyses were used to investigate a modified version of the Agoraphobic Cognitions Questionnaire, the Belief Scale, and the Body Sensations Questionnaire as predictors of avoidance, as measured by the Mobility Inventory. It was hypothesized that frequency x probability x cost of catastrophic cognitions (and the occurrence of the events they represent) would be a better predictor of avoidance than frequency alone. It was also hypothesized that irrational thinking would be a significant predictor of avoidance. The results generally supported the hypotheses, with subjective probability emerging as a particularly potent predictor of avoidance. Theoretical and clinical implications are discussed.

Rational-emotive therapy vs general cognitive-behavior therapy in the treatment of low self-esteem and related emotional disturbances

The present study compared the relative effectiveness of “preferential” rational-emotive therapy (RET) and general cognitive-behavior therapy (CBT) in the treatment of low self-esteem and related emotional disturbances. Thirty-three subjects were randomly assigned to RET, CBT, and waiting-list control (WLC) groups. Therapy consisted of 8 weekly 1 1/2hour group sessions. At posttest, both the RET and CBT groups changed significantly more than the WLC group on all measures: self-esteem, depression, general and social-evaluative anxiety, anger, and rational thinking. On the self-esteem and self-efficacy measures, the CBT group changed significantly more than the RET group. At a six-month follow-up, both the RET and CBT groups maintained their gains, and there were no significant differences between groups on any measure.

Relationships between catastrophic cognitions and body sensations in anxiety disordered, mixed diagnosis, and normal subjects

Clarks (Behaviour Research and Therapy, 24, 461-470, 1986) cognitive model proposes that panic attacks result from the catastrophic misinterpretation of certain body sensations. The present study examined correlations between feared body sensations and catastrophic cognitions. It was hypothesized that regardless of diagnostic status meaningful correlations between sensations and cognitions would be obtained. Three groups--anxiety disordered patients (n = 33), nonanxiety disordered patients (n = 57), and normals (n = 60)--completed the Agoraphobic Cognitions Questionnaire and the Body Sensations Questionnaire. Results generally supported the hypothesis and the cognitive model of panic and anxiety. Limitations of the correlational methodology are discussed, and treatment implications are noted.

What do RET therapists think they are doing? An international survey

This article presents the results of an international survey of rational-emotive therapists who had completed either the Fellow or Associate Fellow program of the Institute for Rational-Emotive Therapy. Two hundred and twenty eight questionnaires were mailed out, 144 (63%) were returned. The survey investigated theoretical opinions, treatment strategies, assessment procedures, in-session therapy techniques, homework assignments, therapist personality characteristics and preferences, as well as descriptive data on both therapists and clients. Results suggest that most RET therapists follow the philosophies and practices of RET as espoused and advocated by Albert Ellis. A significant number of therapists, however, disagree with Ellis in some of his philosophical views and appeared to adapt the practice of RET to their own preferred style.

Self-Report Versions of the Yale-Brown Obsessive-Compulsive Scale: An Assessment of a Sample of Normals

The Yale-Brown Obsessive-Compulsive Scale was administered to 180 undergraduates and 50 medical clinic patients to obtain normative data for this widely used instrument. These data should prove useful to clinicians who assess obsessive-compulsive symptomatology.

Propranolol treatment of paruresis (psychogenic urinary retention): a brief case report.

Propranolol, a nonselective beta-blocker, was administered to a client with paruresis (psychogenic urinary retention) following a novel in vivo exposure treatment. The client did not report a significant increase in his ability to urinate in public facilities during subsequent exposures. Rationale for including propranolol as an adjunct to exposure therapy of paruresis is discussed.

Further validity and normative data for the Malouff and Schutte belief scale

The present study provides further validity and normative data for the Malouff and Schutte (1986) Belief Scale. Belief Scale, Eysenck Personality Questionnaire-Neuroticism Scale, and Beck Depression Inventory scores of a sample of 197 adults were correlated, and evidence for both construct and discriminant validities and support for the RET model were obtained. The Belief Scale appears to be a promising instrument for clinical research and the assessment of irrational beliefs.