Robert E. Brady

The Relationship between Obsessive Beliefs and Thought-Control Strategies in a Clinical Sample

Previous research has linked obsessive-compulsive disorder (OCD) to maladaptive strategies of thought control, which in turn may elicit a paradoxical increase in the unwanted thought. One explanation for OCD patients’ use of maladaptive thought control strategies is that they tend to overestimate the importance of their thoughts, or perceive a greater need to control them. The aim of the present study was to examine the relationship between obsessive beliefs and use of maladaptive thought control strategies in a sample of 77 OCD patients and 35 anxious control patients. Patients completed the Obsessive Beliefs Questionnaire-44 (OBQ-44) and the Thought Control Questionnaire (TCQ), as well as measures of trait anxiety and depression. Across the entire sample and for OCD patients only, when controlling for depression and trait anxiety, the TCQ Punishment scale correlated significantly with the OBQ-44 Importance/Control of Thoughts scale. Regression analyses indicated that beliefs about the Importance/Control of Thoughts accounted for the relationship between OCD and the use of Punishment as a thought control strategy. In addition to providing additional construct validation for the OBQ-44, the present data add to a growing body of research suggesting that OCD patients, believing their intrusive thoughts to be particularly important and perceiving a need to control them, overuse maladaptive thought control strategies; these strategies tend to “backfire” and trigger additional intrusive thoughts.

Sustainability Discourse Within a Supply Chain Relationship Mapping Convergence and Divergence

Large organizations involved in supply chain relationships increasingly are creating joint sustainability initiatives. The authors investigated sustainability-related discourse directed to and created by employees representing two organizations engaged in a supply chain relationship. CRAWDAD was used to map the concepts appearing in (a) each company’s sustainability-related training material, and (b) sustainability-focused interviews conducted with employees. Shared terms in the training documents included the following: corporate mission, corporate performance, corporate responsibility, product (healthy, sustainable, design), price, packaging, reduced waste, energy (reduction, use), and carbon emission. Overlaps between training texts and interview comments revolved around key corporate business goals as well as sustainability as the right thing to do. In the interviews, value statements (e.g., sustainability as the right thing to do or a “good way to do business”) were especially strong. Within both text and talk, the buyer-supplier relationship was emphasized. Areas of divergence between talk and text and between organizations were identified.

Unique Affective and Cognitive Processes in Contamination Appraisals: Implications for Contamination Fear

A large body of evidence suggests an important role of disgust in contamination fear (CF). A separate line of research implicates various cognitive mechanisms in contamination fear, including obsessive beliefs, memory biases, and delayed attentional disengagement from threat. This study is an initial attempt to integrate these two lines of research and examines whether disgust and delayed attention disengagement from threat explain unique or overlapping processes within CF. Non-clinical undergraduate students (N = 108) completed a spatial cueing task, which provided measures of delayed disengagement from frightening and disgusting cues, and a self-report measure of disgust propensity (DP). Participants also completed a chain of contagion task, in which they provided contamination appraisals of an object as a function of degrees of removal from an initial contaminant. Results demonstrated that DP predicted greater initial contamination appraisals, but a sharper decline in estimations across further degrees of removal from the contaminant. Delayed disengagement from disgust cues uniquely predicted sustained elevations in contamination estimations across further degrees of removal from the contaminant. These results suggest that DP and delayed disengagement from disgust cues explain unique and complimentary processes in contamination appraisals, which suggests the utility of incorporating the disparate affective and cognitive lines of research on CF.

Disgust in contamination- based obsessive-compulsive disorder: a review and model

Obsessive–compulsive disorder (OCD) is characterized by the presence of unwanted, intrusive thoughts coupled with ritualized behaviors intended to reduce subjective anxiety. Although once considered a homogeneous disorder, recent findings support a view of OCD as consisting of symptom subtypes. Additionally, there has been increased interest in the contribution of disgust to various forms of psychopathology. The present article summarizes the available literature on contamination-based OCD with an emphasis on the role of disgust as it pertains to the etiology and maintenance of this form of OCD. We propose an updated model of contamination-based OCD that accounts for the elevated disgust response observed in individuals with this form of OCD. Treatment implications of a disgust-based model of the disorder are discussed in the context of cognitive–behavioral therapy.

Specific and differential prediction of health anxiety by disgust sensitivity and propensity

Current models of health anxiety suggest that fear resulting from false alarms to perceived threats to ones health results in the development of hypochondriasis and related disorders. Disgust has been proposed as an affective response that may function as an etiological and maintenance mechanism in health anxiety. Moreover, the way in which an individual perceives the disgust response (disgust sensitivity) may affect health anxiety, separately from their likelihood of experiencing disgust (disgust propensity). The present study utilized multiple hierarchical regression analysis to investigate the degree to which self-reported disgust sensitivity and disgust propensity differentially predict elevated health anxiety in a sample of 620 non-treatment-seeking undergraduates. Further, this effect is tested in comparison to that of anxiety sensitivity, a construct demonstrated to be strongly related to health anxiety. Analyses indicate that disgust sensitivity, rather than disgust propensity, is primarily responsible for this relation. An additional analysis tested the specificity of disgust sensitivity relative to anxiety sensitivity. Disgust sensitivity was no longer significant after including anxiety sensitivity in the model. Suggestions for further evaluation of this relation are provided. These results suggest that although disgust sensitivity may appear related to health anxiety, this relation may be confounded by anxiety sensitivity.

Examining the effects of alexithymia on the relation between posttraumatic stress disorder and over-reporting.

Objective: Empirical examinations of the relation between posttraumatic stress disorder (PTSD) and objective measures of symptom over-reporting may be useful for identification of mechanisms of this previously observed relation. The present study examined the moderating effect of alexithymia, defined as a deficit in the ability to identify and describe emotions, on the relation between PTSD and over-reporting. Method: Seventy-five veterans diagnosed with PTSD were recruited from an outpatient Veterans Affairs facility and the community. Participants were administered the Miller Forensic Assessment of Symptoms Test, along with the Toronto Alexithymia Scale and PTSD Checklist within a larger study of behavioral and physiological correlates of PTSD. Results: Hierarchical linear regression analyses showed a significant moderating effect of alexithymia, such that the relation between PTSD symptom severity and over-reporting was only significant in the presence of elevated alexithymia. Evaluation of the subscales of the Toronto Alexithymia Scale showed that the effect was greatest for the Difficulty Describing Emotions subscale. Conclusions: Alexithymia should be considered as a potential mechanism contributing to the over-reporting phenomena observed in the assessment and treatment of PTSD, and warrants further study. Brief interventions to improve understanding and description of emotional experiences may help to improve accuracy of symptom report.

A behavioral test of contamination fear in excessive health anxiety.

BACKGROUND AND OBJECTIVES Health anxiety is characterized by a preoccupation with the possibility of having a serious health condition or disease. Contemporary conceptualizations of health anxiety have improved in recent years to incorporate a fear of acquiring an illness; however, there is limited experimental data demonstrating the presence of fear of contamination among health anxious individuals. METHOD The present study utilized behavior approach tasks (BATs) to examine the degree to which contamination fear is present in elevated health anxiety. Participants were 60 undergraduate students who reported elevated health anxiety, contamination fear, or no anxiety about either health or contamination. Participants completed four BATS from which avoidance, anxiety, and disgust ratings were derived. RESULTS Health anxious and contamination fearful individuals exhibited a similar degree of avoidance during the BATs. Contamination fearful participants reported significantly more anxiety and disgust relative to the non-anxious controls, but not the health anxious participants. Health anxious participants did not report more anxiety or disgust than the non-anxious participants. LIMITATIONS The use of an analogue sample may limit the extension of these findings to clinical populations. Additionally, the role of general negative affect could not be reliably determined in the absence of an anxious control group. CONCLUSIONS These findings suggest that contamination fear may be a source of conceptual overlap between health anxiety and other disorders characterized by contamination fear. This highlights the importance of considering contamination fear in excessive health anxiety.

Effect of Symptom Over-Reporting on Heart Rate Variability in Veterans With Posttraumatic Stress Disorder.

Physiological assessment of posttraumatic stress disorder (PTSD) presents an additional avenue for evaluating the severity of PTSD symptoms. We investigated whether the presence of a high number of uncommon symptoms attenuated the relation between self-reported PTSD symptoms and heart rate variability (HRV). Participants were 115 veterans from Operation Iraqi Freedom and Operation Enduring Freedom with or without PTSD. Symptom over-report was assessed using the Miller Forensic Assessment of Symptoms Test (M-FAST). Participants completed the Clinician-Administered PTSD Scale and M-FAST and underwent physiological assessment to determine HRV. These data were then entered into a hierarchical linear regression equation to test the moderating effect of over-reporting on the relation between PTSD symptom severity and HRV. The result of this analysis failed to demonstrate a significant moderating effect of over-reporting on the PTSD and HRV relation. HRV was a significant predictor of PTSD symptom severity, and this relation did not differ across levels of over-reporting. These findings did not support the hypothesis that over-reporting would attenuate the relation between PTSD and HRV. Clinical and research implications and directions for future investigation are discussed.