Academic journal article Journal of Cognitive Psychotherapy

Access to Information about Harm and Safety in Contamination-Related Obsessive-Compulsive Disorder

Academic journal article Journal of Cognitive Psychotherapy

Access to Information about Harm and Safety in Contamination-Related Obsessive-Compulsive Disorder

Article excerpt

The present study examined the accessibility of harm and safety information regarding threat-relevant and threat-irrelevant stimuli in analogue contamination-related obsessive-compulsive disorder (OCD) participants. High OCD participants (N = 24) and low OCD participants (N = 27) generated lists of reasons why four specific situations (using a public restroom, going cliff diving, reading at the library, going to the museum) might be harmful and why they might be safe. Results revealed that, in comparison to the low OCD participants, high OCD participants were able to generate significantly more items on why using a public restroom might be harmful and significantly fewer items on why using a public restroom might be safe. However, no significant differences were found between the two groups in their ability to generate items regarding harm and safety for other situations. Furthermore, number of safety items predicted contamination group status independent of harm items. Content analysis of the harm items generated for using a public restroom revealed concerns primarily related to contagion and disease. Accordingly, the number of items generated for using a public restroom showed a marginal association with disgust levels. The implications of these findings for understanding cognitive biases underlying contamination-related OCD are discussed.

Keywords: contamination; OCD; harm; safety; disgust; fear

Contamination concerns are the most common theme associated with obsessive-compulsive disorder (OCD; Rachman & Hodgson, 1980; Rasmussen & Eisen, 1992; Rasmussen & Tsuang, 1986). Ritualistic neutralizing behaviors (e.g., washing) associated with contamination concerns in OCD serve a negatively reinforcing function because distress elicited by the obsessions is temporarily alleviated (Rachman, 1994, 2004). As with other anxiety conditions, the clinical presentation of contamination-based OCD would predict differences in the processing of threat-relevant information. Indeed, individuals with contamination-related OCD may avoid situations and stimuli largely because of inflated expectations of disease and infection (Rachman, 1994; Rachman & Shafran, 1998). Avoidance in contamination-based OCD may also reflect heightened vigilance for stimuli in the environment that may facilitate the acquisition of deadly infection and disease. For example, Tata, Leibowitz, Prunty, Cameron, and Pickering (1996) found that OCD patients with contamination concerns displayed significantly more vigilance for contamination-related words (e.g., bacteria) on a modified "dot-probe" task compared to a mood-matched high trait anxious control group.

Cognitive models of psychopathology propose that anxiety disorders are characterized by hypervigilance for threatening information, and a considerable body of literature has supported this notion (Williams, Watts, MacLeod, & Mathews, 1997). This hypervigilance has been interpreted as a tendency to assign information-processing priority to threat-relevant information about feared stimuli in the environment (McNally, 1996). Although similar information processing biases have been reported across the anxiety disorders, this has not been a consistent finding in OCD (e.g., Foa, Amir, Gershuny, Molnar, Kozak, 1997). Studies suggest that the propensity to assign information-processing priority to threat-relevant content may be partially based on expectations that aversive consequences will follow exposure to threat-relevant stimuli (Taylor & Rachman, 1994a). For example, it has been well documented that anxious individuals tend to interpret ambiguous data as threatening (Rapee & Lim, 1992; Stopa & Clark, 1993). These findings highlight the possibility that anxious individuals may have more readily available access to threat-specific interpretations of anxiety-related events.

In addition to the tendency to give greater information-processing priority to threat-relevant stimuli, there is also evidence suggesting that individuals with specific fears give less processing priority to safety resources. …

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