Academic journal article Iranian Journal of Psychiatry

Comparing Attentional Control and Intrusive Thoughts in Obsessive-Compulsive Disorder, Generalized Anxiety Disorder and Non Clinical Population

Academic journal article Iranian Journal of Psychiatry

Comparing Attentional Control and Intrusive Thoughts in Obsessive-Compulsive Disorder, Generalized Anxiety Disorder and Non Clinical Population

Article excerpt

In recent years, researchers have been interested in studying the role of attention in anxiety and mood disorders such as post traumatic stress disorder (1), obsessive- compulsive disorder (2-5), generalized anxiety disorder (2), major depressive disorder (6), dysphoric mood (7) and neuroticism (8) .

Attention is a core factor in information processing and has an important role in learning. Attention arises from several interacting systems, one of which is anterior attentional system that serves as an executive function over other attentional processes (9). Attentional control has three factors: focusing, shifting and ability to control attention (9). These constructs are defined as "attentional focusing which is the capacity to intentionally hold the attentional focus on desired channels and thereby resist unintentional shifting to irrelevant or distracting channels. attentional shifting is the capacity to intentionally shift the attentional focus to desired channels, thereby avoiding unintentional focusing on particular channels", and "ability to control attention" is the flexibility to control thoughts (9-10, p 225).

Recent conceptualizations of GAD and OCD suggest that these two disorders may be fundamentally more similar in functionality and content of worry and obsession (11). Obsession is a main feature of OCD and worry is the core feature of GAD (12). Worry is a chain of thoughts and images which negatively affect-laden and is relatively uncontrollable. It represents an attempt to engage in mental problem-solving on an issue whose outcome is uncertain but contains the possibility of one or more negative outcomes. Therefore, worry relates closely to the fear process (13). According to the Diagnostic and Statistical Manual of Mental Disorders (12), obsessions are defined as "intrusive thoughts, ideas, images, impulses, or doubts that the person experiences in some ways as senseless and that evoke affective distress". Generally, both worry and obsessions are intrusive and uncontrollable thoughts produce negative affect. They often share similar themes (e.g., fears of getting sick, making mistakes or losing someone important) (Schut, Castonguay, & Borkovec, 2001as cited in (14)).

Turner, Beidel, and Stanley (1992, p 265, as cited in (15)) reviewed the literature on obsession and worry and outlined five main similarities concluding that obsession and worry (1) both occur in non-clinical and clinical populations (2), have a similar form and content in nonclinical and clinical populations, (3) occur in greater frequency and with greater perceptions of uncontrollability in clinical compared to non-clinical samples, (4) are both associated with adverse mood and (5) appear to have some shared vulnerability. Finally, although they are distinct experiences, pathological worry and obsession may share notable similarities in their underlying vulnerability and maintenance (14), and researches reported significant correlations between measures of obsessions and worry (16, 17) .

Rumination is another intrusive thought that is defined as "repetitive and passive thinking about one's symptoms of depression and the possible causes and consequences of these symptoms" (18). Rumination has been implicated in OCD and GAD (2). The associations between obsessional thoughts, worry and rumination that are related to both disorders may suggest that these cognitive symptoms derive from a common underlying mechanism. Therefore, while obsessional thoughts, preservative worry and rumination are all distinct in terms of content and form, they might be exacerbated by a common cognitive vulnerability (2). One such cognitive vulnerability might be a deficit in attentional control (9).

In the current study, it was hypothesized that if an attentional control deficit is playing a role in appearing worry, obsession and rumination, it can be targeted in the treatment of OCD and GAD due to the nature of plasticity of attentional control (2). …

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