Maladaptive consequences of mental intrusions with obsessive, dysmorphic, hypochondriac, and eating-disorders related contentscross-cultural differences

  1. Belén Pascual-Vera 1
  2. Burcin Akin 2
  3. Amparo Belloch 3
  4. Gioia Bottesi 4
  5. David A. Clark 5
  6. Guy Doron 6
  7. Héctor Fernández-Alvarez 7
  8. Marta Ghisi 4
  9. Beatriz Gómez 7
  10. Mujgan Inozu 8
  11. Antonia Jiménez-Ros 9
  12. Richard Moulding 10
  13. M. Angeles Ruiz 11
  14. Giti Shams 12
  15. Claudio Sica 13
  1. 1 Universidad Nacional de Educación a Distancia (UNED), España
  2. 2 Başkent University, Ankara
  3. 3 Universitat de València
    info

    Universitat de València

    Valencia, España

    ROR https://ror.org/043nxc105

  4. 4 University of Padova
  5. 5 University of New Brunswick, Canada
  6. 6 Interdisciplinary Center Herzliya, Tel Aviv, Israel
  7. 7 Aiglé Foundation, Buenos Aires, Argentina
  8. 8 Hacettepe University, Ankara
  9. 9 Universidade do Algarve, Faro, Portugal
  10. 10 Deakin University, Melbourne, Australia
  11. 11 Universidad Nacional de Educación a Distancia UNED, Madrid
  12. 12 Tehran University of Medical Science, Roozbeh Hospital, Tehran, Iran
  13. 13 University of Firenze
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Journal:
International journal of clinical and health psychology

ISSN: 1697-2600

Year of publication: 2022

Volume: 22

Issue: 1

Pages: 41-50

Type: Article

DOI: 10.1016/J.IJCHP.2021.100275 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: International journal of clinical and health psychology

Abstract

Background/Objective Unwanted mental intrusions (UMIs) with contents related to Obsessive-Compulsive Disorder (OCD), Body Dysmorphic Disorder (BDD), Illness Anxiety Disorder (IAD), and Eating Disorders (EDs) are highly prevalent, independently of the cultural and/or social context. Cognitive-behavioral explanations for these disorders postulates that the escalation from common UMIs to clinically relevant symptoms depends on the maladaptive consequences (i.e., emotions, appraisals, and control strategies) of experiencing UMIs. This study examines, from a cross-cultural perspective, the cognitive-behavioral postulates of the maladaptive consequences of having UMIs. Method Non-clinical 1,473 participants from Europe, the Middle-East, and South America completed the Questionnaire of Unpleasant Intrusive Thoughts to assess the maladaptive consequences of experiencing highly disturbing OCD, BDD, IAD, and EDs-related UMIs. Results Findings revealed main effects for both the country and the consequences associated with the four UMI contents. Interaction effects between the consequences of each UMI content and the sample location were also observed. Conclusions Cognitive-Behavioral models for OCD, BDD, IAD, and EDs should be implemented along with socio-cultural variables that increase the understanding of the role of these variables in the phenomenology of UMIs and their associated consequences.

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Bibliographic References

  • Arnaez, S., García-Soriano, G., & Belloch, A. (2017). Hypochondria- sis and illness intrusions: Development and validation of an assessment instrument. Behavioral Psychology, 25, 165–186.
  • Arnaez, S., García-Soriano, G., Lopez-Santiago, J., & Belloch, A. (2020). Dysfunctional beliefs as mediators between illness-related intrusive thoughts and health anxiety symptoms Behavioural and Cognitive Psychotherapy, 48, 315–326. https://doi.org/10.1111/papt.12267.
  • Arna ez, S., García-Soriano, G., Lopez-Santiago, J., & Belloch, A. (2021). Illness-related intrusive thoughts and Illness Anxiety Disorder. Psychology and Psychotherapy: Theory, Research and Practice, 94, 63–80. https://doi.org/10.1111/papt.12267.
  • Belloch, A., Roncero, M., & Perpin~a, C. (2016). Obsessional and eating disorder-related intrusive thoughts: Differences and similarities within and between individuals vulnerable to OCD or to EDs. European Eating Disorders Review, 24, 446–454. https://doi.org/10.1002/erv.2458.
  • Clark, D. A., Abramowitz, J., Alcolado, G. S., Alonso, P., Belloch, A., Bouvard, M., Coles, M. E., Doron, G., Fernandez- Alvarez, H., García-Soriano, G., Ghisi, M., Gomez, B., Inozu, M., Moulding, R., Radomsky, A., Shams, G., Sica, C., Simos, G., & Wong, W. (2014). Part 3 - A question of perspective: The association between intrusive thoughts and obsessionality in 11 countries. Journal of Obsessive-Compulsive and Related Disorders, 3, 292–299. https://doi.org/10.1016/j.jocrd.2013.12.006.
  • Doron, G., Derby, D. S., & Szepsenwol, O. (2014). Relationship obsessive compulsive disorder (ROCD): A conceptual framework. Journal of Obsessive-Compulsive and Related Disorders, 3, 169– 180. https://doi.org/10.1016/j.jocrd.2013.12.005.
  • Eli, K. (2018). Striving for liminality: Eating disorders and social suffering. Transcultural Psychiatry, 55, 475–494. https://doi.org/10.1177/363461518757799.
  • Fang, A., & Wilhelm, S. (2015). Clinical features, cognitive biases, and treatment of body dysmorphic disorder. Annual Review of Clinical Psychology, 11, 187–212. https://doi.org/10.1146/annurev-clinpsy-032814-112849.
  • Fergus, T. A. (2013). Repetitive thought and health anxiety: Tests of specificity. Journal of Psychopathology and Behavioral Assessment, 35, 366–374. https://doi.org/10.1007/s10862-013-9340-y.
  • García-Soriano, G., Belloch, A., Morillo, C., & Clark, D. A. (2011). Symptom dimensions in obsessive-compulsive disorder: From normal cognitive intrusions to clinical obsessions. Journal of Anxiety Disorders, 25, 474–482. https://doi.org/10.1016/j.janxdis.2010.11.012.
  • Giraldo-O'Meara, M., & Belloch, A. (2017). The Appearance Intrusions Questionnaire: A self-report questionnaire to assess the universality and intrusiveness of preoccupations about appearance defects. European Journal of Psychological Assessment, 35, 423–435. https://doi.org/10.1027/1015-5759/a000406.
  • Giraldo-O'Meara, M., & Belloch, A. (2018). Escalation from normal appearance related intrusive cognitions to clinical preoccupations in body dysmorphic disorder: A cross-sectional study. Psychiatry Research, 265, 137–143. https://doi.org/10.1016/j.psychres.2018.04.047.
  • Hesse-Biber, S., Leavy, P., Quinn, C. E., & Zoino, J. (2006). The mass marketing of disordered eating and eating disorders: The social psychology of women, thinness and culture. Women's Studies International Forum, 29, 208–224. https://doi.org/10.1016/j.wsif.2006.03.007.
  • Inozu, M., Haciomeroglu, € A. B., Keser, E., Akin-Sari, B., & Ozmenler, K. N. (2021). What does differentiate unwanted men- € tal intrusions in OCD? A phenomenological study of the mental intrusions in OCD, anxiety disorders, and non-clinical groups using the interview technique. Journal of Obsessive-Compulsive and Related Disorders, 29, 100640. https://doi.org/10.1016/j.jocrd.2021.100640 Article 100640.
  • Inozu, M., Karanci, A. N., & Clark, D. A. (2012). Why are religious individuals more obsessional? The role of mental control beliefs and guilt in Muslims and Christians. Journal of Behavior Therapy and Experimental Psychiatry, 43, 959–966. https://doi.org/10.1016/j.jbtep.2012.02.004.
  • Koc¸, V., & Kafa, G. (2019). Cross-cultural research on psychotherapy: The need for a change. Journal of Cross-Cultural Psychology, 50, 100–115. https://doi.org/10.1177/0022022/8806577. Marsella, A. J., & Yamada, A. M. (2010). Culture and psychopathology: Foundations, issues, directions. Journal of Pacific Rim Psychology, 4, 103–115. https://doi.org/10.1375/prp.4.2.103.
  • Miller, M. N., & Pumariega, A. J. (2001). Culture and Eating Disorders: A historical and cross-cultural review. Psychiatry: Interpersonal and Biological Processes, 64, 93–110. https://doi.org/10.1521/psyc.64.2.93.18621.
  • Moulding, R., Coles, M. E., Abramowitz, J. S., Alcolado, G. M., Alonso, P., Belloch, A., Bouvard, M., Clark, D. A., Doron, G., Fernandez- Alvarez, H., García-Soriano, G., Ghisi, M., Gomez, B., Inozu, M., Radomsky, A., Shams, G., Sica, C., Simos, G., & Wong, W. (2014). Part 2. They scare because we care: The relationship between obsessive intrusive thoughts and appraisals and control strategies across 15 cities. Journal of Obsessive-Compulsive and Related Disorders, 3, 280–291. https://doi.org/10.1016/j.jocrd.2014.02.006.
  • Muse, K., McManus, F., Hackmann, A., Williams, M., & Williams, M. (2010). Intrusive imagery in severe health anxiety: Prevalence, nature and links with memories and maintenance cycles. Behaviour Research and Therapy, 48, 792–798. https://doi.org/10.1016/j.brat.2010.05.008.
  • Nicolini, H., Salin-Pascual, R., Cabrera, B., & Lanzagorta, N. (2017). Influence of Culture in Obsessive-compulsive Disorder and Its Treatment. Current Psychiatry Reviews, 13, 285–292. https://doi.org/10.2174/2211556007666180115105935.
  • Onden-Lim, M., & Grisham, J. R. (2014). Intrusive imagery experiences in a high dysmorphic concern population. Journal of Psychopathology and Behavioral Assessment, 35, 99–105. https://doi.org/10.1007/s10862-012-9318-1.
  • Osman, S., Cooper, M., Hackmann, A., & Veale, D. (2004). Spontaneously occurring images and early memories in people with body dysmorphic disorder. Memory, 12, 428–436. https://doi.org/10.1080/09658210444000043.
  • Pascual-Vera, B., Akin, B., Belloch, A., Bottesi, G., Clark, D. A., Doron, G., Fernandez- Alvarez, H., Ghisi, M., Gomez, B., Inozu, M., Jimenez-Ros, A., Moulding, R., Ruiz, M. A., Shams, G., & Sica, C. (2019). The cross-cultural expression and transdiagnostic nature of unwanted mental intrusions. International Journal of Clinical and Health Psychology, 19, 85–96. https://doi.org/10.1016/j.ijchp.2019.02.005.
  • Pascual-Vera, B., & Belloch, A. (2018a). El caracter transdiagnostico de las intrusiones mentales: Una revision y una propuesta basada en datos (The transdiagnostic nature of mental intrusions: A review and a data-based proposal). Revista de Psicopatología y Psicología Clínica, 23, 135–148. https://doi.org/10.5944/rppc. vol.23.num.1.2018.18494.
  • Pascual-Vera, B., & Belloch, A. (2018b). Functional links of obsessive, dysmorphic, hypochondriac, and eating-disorders related mental intrusions. International Journal of Clinical and Health Psychology, 18, 43–51. https://doi.org/10.1016/j.ijchp.2017.09.001.
  • Pascual-Vera, B., Roncero, M., & Belloch (2017). Are unwanted mental intrusions a transdiagnostic variable? Psicothema, 29, 166–171. https://doi.org/10.7334/psicothema2016.199.
  • Pascual-Vera, B., & Belloch, A. (2021). Dysmorphic and illness-anxiety related unwanted intrusive thoughts in individuals with obsessive-compulsive disorder. Clinical Psychology and Psychotherapy. https://doi.org/10.1002/cpp.2636.
  • Pascual-Vera, B., Ruiz, M.A., & Belloch, A. (in press). Understanding common factors between clinically different disorders: mental intrusions in the obsessive-compulsive spectrum. Journal of Psychopathology and Clinical Psychology
  • Rachman, S., & De Silva, P (1978). Abnormal and normal obsessions. Behaviour Research and Therapy, 16, 233–248. https://doi.org/10.1016/0005-7967(78)90022-0.
  • Radomsky, A. S., Alcolado, G. M., Abramowitz, J. S., Alonso, P., Belloch, A., Bouvard, M., Clark, D. A., Coles, M. E., Doron, G., Fernandez- Alvarez, H., García-Soriano, G., Ghisi, M., Gomez, B., Inozu, M., Moulding, R., Shams, G., Sica, C., Simos, G., & Wong, W. (2014). Part 1-You can run but you can't hide: Intrusive thoughts on six continents. . Journal of Obsessive-Compulsive and Related Disorders, 3, 269–279. https://doi.org/10.1016/j.jocrd.2013.09.002.
  • Senín-Calderon, C., Perona-Garcelan, S., & Rodríguez- Testal, J. F. (2020). The dark side of Instagram: Predictor model of dysmorphic concerns. International Journal of Clinical and Health Psychology, 20, 253–261. https://doi.org/10.1016/j.ijchp.2020.06.005.
  • Sergi, J. F. (1983). Historia de los Italianos en la Argentina. ItaloArgentina.
  • Sica, C., Novara, C., Sanavio, E., Coradeschi, D., & Dorz, S. (2002). OCD cognitions across cultures. In R. O. Frost, & G. Steketee (Eds.), Cognitive approaches to obsessions and compulsions: Theory, assessment, and treatment (pp. 371 384). Elsevier.
  • Sica, C., Taylor, S., Arrindell, W. A., & Sanavio, E. (2006). A crosscultural test of the cognitive theory of obsessions and compulsions: A cmparison of Greek, Italian, and American Individuals. A preliminary study. Cognitive Therapy and Research, 30, 585–597. https://doi.org/10.1007/s10608-006-9078-x.
  • Thaiposri, N., & Reece, J. (2020). Gender differences in eating disorder-related intrusive thoughts. Eating Disorders, 1–25. https://doi.org/10.1080/10640266.2020.1789830.
  • Williams, M. T., Chapman, L. K., Simms, J. V., & Tellawi, G. (2017). Cross-Cultural Phenomenology of Obsessive-Compulsive Disorder. In J. S. Abramowitz, D. McKay, E. A. Storch (Eds.), The Wiley Handbook of Obsessive-Compulsive Disorder (pp. 56 74). Wiley Blackwell.
  • Yorulmaz, O., Genc¸ o€z, T., & Woody, S. R. (2010). Vulnerability factors in OCD symptoms: Cross-cultural comparisons between Turkish and Canadian Samples. Clinical Psychology and Psychotherapy, 17, 110–121. https://doi.org/10.1002/cpp.642.
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