جستجوی مقالات مرتبط با کلیدواژه "اختلال وسواسی - اجباری" در نشریات گروه "پزشکی"

Studies conducted in the field of obsessive-compulsive disorder (OCD) show that various cognitive components play a role in this disorder. Researchers have identified three main levels of cognition in people with OCD: obsessive thoughts, cognitive appraisals, and underlying assumptions. These cognitive levels mutually affect each other and form an integrated system. In other words, primary obsessive thoughts are influenced by the person's cognitive evaluations of these thoughts, and these evaluations are also formed based on the basic assumptions of the person about himself, the world, and the future. Therefore, it can be said that certain cognitive patterns, especially false and extreme beliefs about responsibility, threat, and perfectionism, are characteristic features of people with OCD. Cognitive models of obsessive-compulsive disorder (OCD) believe that people with this disorder have an exaggerated and inaccurate interpretation of their thoughts, images, and impulses. These misinterpretations are rooted in dysfunctional beliefs that a person has about himself, the world, and the future. Beliefs such as feeling too much responsibility, worrying about catastrophic events, needing complete control, and perfectionism are among the common beliefs observed in people with OCD. These beliefs make the person consider obsessive thoughts as a serious threat and try to avoid unpleasant consequences by performing compulsive behaviors. Studies have shown that this process acts as a vicious cycle. At first, the person experiences thoughts that are unpleasant and threatening to him. Then, according to his dysfunctional beliefs, he evaluates these thoughts severely and gives them great importance. Finally, to reduce the anxiety caused by these thoughts, he turns to compulsive behaviors. But instead of reducing anxiety, these behaviors strengthen it and help maintain the disorder. Different researchers have identified different cognitive dimensions in people with OCD. McFall and Wollersheim (1979) have emphasized the role of beliefs such as one's ability, need for certainty, and avoidance of criticism. On the other hand, Warren and Guides (1979) have emphasized the importance of beliefs such as perfectionism, the need for certainty, and not accepting unpleasant thoughts in OCD. People with obsessive-compulsive disorder (OCD) typically experience unwanted and intrusive thoughts that cause them anxiety and distress. To cope with these thoughts, people with OC form dysfunctional beliefs that reinforce these thoughts and help perpetuate the disorder. Studies show that three main beliefs play a role in people with OCD: Overresponsibility and Exaggeration of Threat: People with OCD often feel that they are responsible for preventing bad events from happening and that they are to blame if they do happen. will be Also, they overestimate the probability of these events and consider the consequences to be much more serious than they are. The importance and controllability of thoughts: People with OCD believe that their obsessive thoughts are very important and meaningful and indicate the presence of a serious problem in them. Also, they believe that they can and should control their thoughts. Perfectionism and the need for certainty: People with OCD strongly value perfectionism and certainty. They cannot cope with uncertainty and doubt and therefore, seek to perform compulsive behaviors to achieve reassurance. Obsessive compulsive disorder is a very common and chronic disease associated with significant global disability.While there are many quantitative studies that examine the clinical characteristics and treatment methods of OCD, qualitative research that examines the lived experience of people with OCD is limited. Therefore, the aim of this study was to analyze the cognitive lived experience in people with obsessive-compulsive disorder in the form of a phenomenological study.

The study method was a qualitative and phenomenological research. The statistical population of the research included all people referring to the clinics and counseling centers of Rafsanjan city. By using the purposeful sampling method, the referring people who were diagnosed with obsessive-compulsive disorder based on clinical psychology interview, psychiatrist and DSM-5 diagnostic semi-structured clinical interview, were invited to the research as participants, using the descriptive phenomenological research method. Answer the question of what are the most important cognitive elements and components in their lived experiences. For this purpose, 12 people (6 men and 6 women) diagnosed with OCD disorder and aged 18-50 were interviewed from among the clients referred to the centers until the saturation of information was reached. Data analysis After recording and transcribing the interviews, coding concepts were extracted and reported using the Claysey method of main and secondary themes.

What was determined from the extracted codes from the interview was the biocognitive experience in people with obsessive-compulsive disorder, which was based on 6 main themes and 54 sub-themes. The main themes were obtained in the form of individual, social, economic, cultural, emotional and operational consequences. Also, sub-themes extracted from these main themes based on the biological experiences of people, including lack of mental efficiency and extreme work of the mind, extreme responsibility, strict adherence to rules, academic perfectionism, compulsion to do tasks repeatedly, giving additional explanations in all tasks, He was sensitive to heartache and anxiety, the feeling of being annoyed when not doing things, extreme hatred of people, feeling of distrust, feeling of loneliness, control of thoughts, etc.

The results of the present study, while extracting and explaining lived experiences based on cognitive processes in people with OCD disorder, provided additional evidence in defense of the interpretative role of the informational element of cognition in predicting the tendency to this disorder. In such a way that by improving the cognitive processes and components of people with OCD disorder, the cognitive tendency of these people towards all kinds of obsessions can be managed. Therefore, obsessions continue as long as these misinterpretations and cognitive deviations exist. In fact, the cognitive interpretation of people with OCD is such that those thoughts form the basis of the tendency to perform compulsive actions in order to neutralize the anxiety caused by these thoughts and cognitive processes. Therefore, it is necessary for therapists and specialists in this field to pay attention to these lived experiences in cognitive dimensions and to use them to determine their treatment strategies.

Background &

Obsessive-compulsive disorder according to the DSM-5 concept has a separate category that includes repeated and permanent thoughts, desires, or mental images. This disorder forces a person to repeat behaviors or repeated mental actions in response to a session, which causes helplessness and disrupts his daily performance. ObObsessive-compulsive disorder is considered a cognitive processing disorder; In such a way that any type of cognitive belief is significantly and positively related to obsessive-compulsive symptoms. Due to the correlation of cognitive models in obsessive-compulsive disorder, researchers identified three different levels in the cognitive models of obsessive-compulsive disorder and named them under the headings of disturbing thoughts, evaluations, and assumptions. These levels of cognition and meaning-making are in linear interaction with each other and influence each other. InCognitiveimensions, in general, and areas of certain beliefs, in particular, can be considered cognitive characteristics of obsessive-compulsive disorder patients. The cognitive model in this disorder believes that people with OCD interpret their thoughts, images, and impulses as very important and meaningful, and ineffective beliefs are the basis for the formation of these thoughts, images, and impulses. It seems that certain dysfunctional beliefs such as control and importance of thoughts, sense of responsibility and evaluation, sense of danger and threat, perfectionism, and uncertainty play a role in the formation of this disorder. In such a way that the primary ineffective evaluation in connection with the disturbing thoughts and the type of look and analysis of the person's disturbing thoughts leads to the secondary ineffective evaluation or ineffective coping. McFall and Wollersheim (1979) identified the cognitive dimensions of obsession in the area of ​​individual capability and ability, certainty and certainty, and the need to avoid criticism, and on the other hand, Warren and Guides (1979) identified obsessive patients in terms of the intensity of their beliefs in the field of perfectionism. They know certainty and non-acceptance of certain types of thoughts and impulses. All these beliefs are formed in response to and in response to disturbing thoughts and increasing excessive attention to disturbing thoughts; In a way that in a comprehensive review and according to the view of the Obsessive-Compulsive Cognitions Working Group, there are three dysfunctional cognitive aspects in Obsessive-Compulsive Disorder, which include: responsibility/threat overestimation, importance and control of thoughts, and perfectionism/certainty. The cognitive belief of responsibility/threat assessment includes the misunderstanding of the probability and severity of harm or other negative consequences, as well as the individual's sense of responsibility against their occurrence. According to the cognitive belief about the importance and control of thoughts, people suffering from obsessions have the experience that having obsessive thoughts is a sign of their importance and control of these thoughts is possible and necessary. Responsibility is one of the basic components in the cognitive profile of the experiences of obsessive-compulsive people, which of course has been emphasized in the research literature, in a way that Taylor and Purdon proposed in a study that with increasing responsibility The adaptability of the person becomes self-perpetuating. On the other hand, it seems that people suffering from obsessions focus on their sense of certainty and do not have confidence in their memory, so patients with this symptom have an extreme sense of responsibility and suffer from a very disgusting and unbearable doubt. Therefore, they perform ritual behaviors compulsorily to gain certainty and reduce the sense of responsibility for the damage. Obsessive compulsive disorder is a very common and chronic disease associated with significant global disability. While there are many quantitative studies that examine the clinical characteristics and treatment methods of OCD, qualitative research that examines the lived experience of people with OCD is limited. Therefore, the purpose of this study is to study the cognitive experience in people with obsessive-compulsive disorder; It was a qualitative research with an emphasis on gender.

The study method was a qualitative and phenomenological research. The statistical population of the research included all people referring to the clinics and counseling centers of Rafsanjan city. By using the purposeful sampling method, the referring people who were diagnosed with obsessive-compulsive disorder based on clinical psychology interview, psychiatrist and DSM-5 diagnostic semi-structured clinical interview, were invited to the research as participants, using the descriptive phenomenological research method. Answer the question of what are the most important cognitive elements and components in their lived experiences. For this purpose, 12 people (6 men and 6 women) diagnosed with OCD disorder and aged 18-50 were interviewed from among the clients referred to the centers until the saturation of information was reached. Data analysis After recording and transcribing the interviews, coding concepts were extracted and reported using the Claysey method of main and secondary themes.

What was determined from the extracted codes from the interview was the biocognitive experience in people with obsessive-compulsive disorder, which was based on 6 main themes and 54 sub-themes. The main themes were obtained in the form of individual, social, economic, cultural, emotional and operational consequences. Also, sub-themes extracted from these main themes based on the biological experiences of people, including lack of mental efficiency and extreme work of the mind, extreme responsibility, strict adherence to rules, academic perfectionism, compulsion to do tasks repeatedly, giving additional explanations in all tasks, He was sensitive to heartache and anxiety, the feeling of being annoyed when not doing things, extreme hatred of people, feeling of distrust, feeling of loneliness, control of thoughts, etc. On the one hand, according to gender segregation in the presented lived experiences, it was found that women had more frequency and intensity than men in the main and secondary themes presented.

The results of the present study, while extracting and explaining lived experiences based on cognitive processes in people with OCD disorder, provided additional evidence in defense of the interpretative role of the informational element of cognition in predicting the tendency to this disorder. In such a way that by improving the cognitive processes and components of people with OCD disorder, the cognitive tendency of these people towards all kinds of obsessions can be managed. Therefore, obsessions continue as long as these misinterpretations and cognitive deviations exist. In fact, the cognitive interpretation of people with OCD is such that those thoughts form the basis of the tendency to perform compulsive actions in order to neutralize the anxiety caused by these thoughts and cognitive processes. Therefore, it is necessary for therapists and specialists in this field to pay attention to these lived experiences in cognitive dimensions and to determine their treatment strategies, especially for women with this disorder.

Obsessive-Compulsive Disorder (OCD) is the fourth most common psychiatric disorder. It consists of symptoms, including intrusive thoughts, rituals, behaviors, preoccupations, and compulsions. This study aimed to evaluate the effectiveness of attention bias modification and selective serotonin reuptake inhibitors in reducing the symptoms of OCD.

 study population comprised patients with OCD referring to the outpatient clinic of Amir Kabir Hospital in Arak City, Iran. Of them, 80 patients were randomly assigned to the two groups. The first group received the selective serotonin reuptake inhibitors, and the other group received the treatment modality to determine the effectiveness of the Yale-Brown OCD scale and dot-probe task tests.

 The Research Ethics Committee of Arak University of Medical Sciences approved this study (Research Ethics Code: IR.ARAKMU.REC.1396.284). 

 Treatment of attention bias modification in comparison with selective serotonin reuptake inhibitors did not show a significant difference in the reduction of attention bias (P=0.377). Also, a significant difference between the two groups in reducing the symptoms of OCD (P=0.007), indicates that selective serotonin reuptake inhibitors are more effective in diminishing the symptoms of OCD. Besides the attention bias modification decreased the symptoms of OCD, but these results were not significant (P=0.228)

 Attention bias modification is a significant improvement in reducing attention bias and can be used with other interventions. However, it appears that the reduction in the severity of OCD symptoms, as against this intervention, continues to be the preferred treatment for pharmacotherapy.

Obsessive-compulsive disorder is a heterogeneous disorder and has different therapeutic approaches. Over the past few decades, we have witnessed tremendous advances in the role of cognitive systems in the formation, continuity, and treatment of the obsessive-compulsive disorder (OCD). Certain beliefs have been identified as a significant contributor to the creation and continuation of this disorder, Cognitive models of OCD also indicating that responsibility assessment is involved in the etiology and preservation of OCD symptoms. According to Salkovskis (1985), the Inflated Sense of responsibility in OCD has a central role. Intolerance of uncertainty (IU), which means the tendency to avoid ambiguous situations and the inability to deal with uncertainty, is considered significant damage to OCD. ERP as a standard golden treatment, including the gradual inclusion of anxiety due to obsessive-compulsive disorder, and the prevention or limitation of obsessive-compulsive procedures and reduction of anxiety. Aim of this study was the efficacy of Exposure and Response Prevention Therapy (ERP) in Inflated Sensory Responsibility and Intolerance of Uncertainty in Patients with OCD.

The research design was a semi-experimental study with pretest, post-test, and follow-up. The statistical population consisted of all the people of Mahallat city, which is located in Markazi province in Iran in 2018. Sixteen patients with OCD were selected through the available sampling method and randomly within two groups: ERP and control group. (8 patients in each group). Each person in the treatment group received 12 treatment sessions by the Salkovskis exposure and Response prevention therapy method for OCD. Subjects were measured both before and at the end of interventions as well as three months later in the follow-up phase by the Yale-Brown Obsessive-Compulsive Scale (Yale-BOCS; Goodman, 1989), the Salkovskis Responsibility Attitude Scale; (RAS; Salkovskis, Wroe, Morrison, Richards, Reynolds & Thorpe, 2000) and The Intolerance of Uncertainty Scale; (IUS; Freeston et al, 1994) . The Yale-Brown Obsessive-Compulsive Scale is a reliable instrument; with internal stability of 0.89 by Goodman and in Iran with internal stability for the sign index (SC) and severity scale (SS) were 0.97 and 0. 95 for the Persian version by Rajazi Esfahani et al. Responsibility Attitude Scale is a 26-item scale, consistency (α=0.91), excellent test-retest reliability over a five-week period (r=0.78), and Intolerance of Uncertainty Scalexcellent internal consistency (α=0.89), and satisfactory test-retest reliability (r=0.74). Post-extraction research data analyzed by repeated measurements analysis using SPSS-23 software.

To test the hypothesis of the research, about the existence of the pre-test variables and the possibility of the primary difference between the two intervention and control groups, as well as reducing the initial difference and comparing the groups, the multivariate analysis of variance, and used repeated measure design. In the semi-experimental design, before analyzing the hypothesis of the research, Levin's findings showed that the homogeneous assumption of covariance of data and regression slope established. The results of Mocheli's test also showed that there is no spheroidal assumption (p<0.050). The findings showed that there is a significant difference between the mean variables of the inflated sense of responsibility and uncertainty of intolerance in the experimental group with the control group. Therefore, the effectiveness of treatment on the reduction of the inflated sense of responsibility and uncertainty of intolerance can be verified (p<0.001), and this effect was lasting after three months (p<0.001).

The results of this study have shown the effectiveness of exposure and Response prevention therapy in improving an inflated sense of responsibility and uncertainty of intolerance in patients with OCD.

Objectives This study aimed to investigate the effect of emotion-focused therapy on emotional regulation styles and severity of obsessive-compulsive symptoms in women with Obsessive-Compulsive Disorder (OCD).
Methods The present study has a quasi-experimental design with pre-test-post-test and control group with follow-up. The statistical population included all women with OCD referring to clinics and counseling centers of Ahvaz City, Iran. In order to select the eligible samples, 30 women were recruited from the patients referred to the treatment centers by convenience sampling method, but some of them were excluded due to discontinuation of treatment sessions. Finally, a sample of 24 patients were evaluated in experimental group (12 subjects) and control group (12 subjects). To collect data, we used the Yale-Brown obsessive-compulsive scale and affective styles questionnaire. The obtained data were analyzed using covariance analysis in SPSS V. 22.
Results Multivariate ANOVA test results showed that there was significant difference between test and study groups in terms of concealing style (10.0≥P, 07.7=F) and severity of obsessive-compulsive symptoms (100.0≥P, 84.02=F) after intervention. Moreover, between female patients in both group, a significant difference was found with respect to concealing style (50.0≥P, 06.2=F) and severity of obsessive-compulsive symptoms (100.0≥P, 99.92=F) during follow-up period.
Conclusion Based on the results, emotion-focused therapy is an effective treatment to reduce the symptoms of obsessive-compulsive symptoms in patients with OCD

The aim of the current study was investigation the effectiveness of Acceptance and Commitment Therapy (ACT) on career development of students with obsessive compulsive disorder. This is a quasi-experimental study with pretest-posttest-follow up design with control group. Thirty students were selected using convenience sampling and randomly divided to two experiment and control groups. Data was gathered by Career Development Questionnaire (CDI) and was analyzed using Repeated Measure ANOVA. Students in one experimental group received ACT in eight weekly sessions and the control group were in wait list. The results showed that there was significant difference between two groups in path career development (p<0.05). ACT can improve path career development of students with obsessive compulsive disorder.

Objectives The aim of this study was to evaluate the structural relationships between behavioral brain systems, disgust sensitivity, and obsessive-compulsive disorder using structural equation modeling. It is assumed that the behavioral brain systems and disgust sensitivity in interaction with each other will lead to obsessive-compulsive disorder. Despite the prominence of this model, not enough research has been done to assess its experimental.
Methods In a descriptive-correlation study, a sample of 340 students from Tabriz University was selected using cluster sampling method. Participants responded to Inventory system activation / inhibition of behavior (Carver and White, 1994), The Disgust Sensitivity Scale, Obsessive Compulsive Inventory- Revised (OCI-R). Data were analyzed using Structural Equation Modeling (SEM).
Results The evaluation of hypothetical model with fit indexes demonstrated that the hypothetical model fits the measurement model (CFI=0.96, NFI=0.94, and RMSEA=0.076). BIS and BAS with standardized coefficients of 0.264 and -0.241, respectively, have a significant effect on obsessive-compulsive disorder by the mediation of disgust sensitivity at the P˂0.05 level.
Conclusion The result, supporting the theoretical model for obsessive-compulsive disorder, proposes a suitable framework for the etiology of the disorder. Accordingly, high sensitivity of BIS and low sensitivity of BAS by the mediation of disgust sensitivity due to an increase in the symptoms of OCD.

Obsessive-compulsive disorder (OCD) is one of the most challenging clinical issues. Due to considerable expenses associated with OCD, revisiting the related literature to take up a useful therapeutic option seems necessary. The present study aimed to compare the schema of the primary defense mechanisms incompatible with religious attitude among women with OCD and healthy women.
All women with OCD in Hamadan formed the participants of this causal-comparative study. Using simple random sampling, 100 women with OCD and 100 healthy women were selected based on clinical interviews, diagnostic criteria for DSM-V, and questionnaires. Research instruments were maladaptive schemas (YSQ-SF), defense mechanisms (DSQ-40) and religious attitude (RAQ). The data were analyzed using descriptive statistics and multivariate analysis of variance (MANOVA). It is worth noting that all ethical issues required were carefully observed and the authors declare no conflict of interest.
The results showed a significant difference between clinical and normal groups in terms of five areas of early maladaptive schemas, namely disconnection and rejection, dysfunction, impaired limits, otherdirectedness, subjugation, and inhibition), (P The results highlight the importance of preventive interventions in psychological symptoms among neurotic patients and broaden the horizons of clinical interventions when it comes to religion.

The intolerance of uncertainty model was initially developed as an explanation for worry within the context of generalized anxiety disorder. However، recent research has identified intolerance of uncertainty (IU) as a transdiagnostic maintaining factor across the anxiety disorders. The aim of the present study was to compare the intolerance of uncertainty in patients with generalized anxiety disorder (GAD)، obsessive compulsive disorder (OCD)، panic disorder (PD) and control group. The present study was a cross-sectional and ex-post facto investigation (causal comparative method). Statistical universe constituted all patients had been referred the first to the Bozorgmehr clinic in Tabriz in the 1389_1390. In this study، 30 client with Generalized anxiety disorder (GAD)، 30 client with Obsessive-Compulsive disorder (OCD)، panic disorder (PD) and 30 control group were selected accessibility. The groups were matched in demographic characteristics with other. Data were collected through a structured clinical interview and the Intolerance of Uncertainty Scale (IUS). The gathered data is analyzed by SPSS-17 and descriptive statistic indexs and Multivariate Analysis of Variance (MANOVA). The present study has found that people with GAD، OCD، and PD disorders compared with controls، according to the f=89/6 significance levels of /0001 had higher intolerance of uncertainty، but people with GAD، OCD، and PD disorders were not significantly different in the intolerance of uncertainty. The results showe differences between the (GAD، OCD، and PD) disorders and control groups in the (F=1/7)، significance level0/0001، F=23/5، and significance level 0/002،in the two factors the intolerance of uncertainty questionnaire. In tolerance of uncertainty is not just for generalized anxiety disorder، It construct seen in the obsessive compulsive disorder and panic disorder. It seems cognitive factor of intolerance of uncertainty plays a pivotal role in causing in this disorders. A potential application of these results for the treatment of anxiety disorders are treatable.

The aim of the present study was to comparing attentional biases among the Patients with panic disorder، obsessive-compulsive disorder and normal individuals. For this purpose، 32 patient with panic disorder and obsessive-compulsive disorder and 32 normal individuals were selected accessibility. The groups were matched in their demographic characteristics with other. The subjects completed modified stroop task. The collected data was analyzed by descriptive statistic method of Multivariate Analysis of Variance (MANOVA). The results showed differences between panic disorder patients and normal individuals and also between Obsessive-Compulsive Disorder and normal individuals. Also results showed that attentional bias in patients is with specific stimulus the disorder. Attentional bias toward the stimulus that are associated with panic disorders and obsessive compulsive disorder play a vital role in onset and maintenance of these disorders.

The relationship between family context and environment with mental illness has been of interest for years. The obsessive compulsive disorder (OCD) can impair family functioning and quality of life. The aim of this study was to investigate family function in patients with OCD according to the theory of McMaster model and compare it with normal subjects. This descriptive-analytical study included all OCD patients referring to psychiatric and psychological clinics of Tabriz. Among them 50 OCDs were selected by available sampling method. The control group was selected from students and employees of Tabriz University. All patients were asked to complete the Moudsley Obsessive Compulsive Inventory (MOCI) and Family Assessment Device (FAD). The data were analyzed by descriptive statistics and t-test. OCD patients act poorly in many aspects of family functioning compared to normal people. OCD people had poor performance in general functioning (p<0.001), communication (p<0.001), and affective involvement (p<0.001), but there was no significant difference between the patients and control group in problem solving, affective responsibility, control of behavior, and roles. According to the results, OCD patients have dysfunction in most aspects of their family functioning.

This study plans to determine diagnostic features and the best cut-off point in Maudsley Obsessive-Compulsive Inventory for patients with schizophrenia. In a cross-sectional study, 96 inpatients (56 men and 40 women) with schizophrenia (based on DSM-IV diagnostic criteria) were selected from Iran Psychiatry Hospital (in Tehran) by convenient sampling and screened for Obsessive-Compulsive Disorder using standard clinical interview (SCID) and Maudsley Inventory. Based on the clinical interview, 47 patients (49%) were diagnosed to have obsessive-compulsive symptoms. In the Maudsley Inventory, 38 patients (40%) scored above the given cut-off point (score of 9). The sensitivity and specificity of the Maudsley Inventory were 74.5% and 93.9% respectively. Despite the high specificity of Maudsley Inventory, the clinical interview is preferred over it because of higher sensitivity and the number of true-positive diagnoses