Obsessive-compulsive symptom profiles in individuals exposed to interpersonal versus noninterpersonal trauma.

Obsessive-compulsive (OC) symptoms have been associated with trauma exposure. Although no studies have specified relations between type of trauma and OC symptom presentations, this information may inform personalized care for this complex population. Thus, this study used profile analysis via multidimensional scaling to characterize typical OC symptom profiles in individuals exposed to interpersonal versus noninterpersonal traumas. Profiles were also correlated with self-reported disgust and mental contamination, which have been related to OC symptoms and interpersonal trauma in prior research. The interpersonal trauma group revealed two profiles: (1) Obsessing (high obsessing, low neutralizing), and (2) Ordering (high ordering, low obsessing). The noninterpersonal trauma group showed two profiles: (1) Hoarding/Ordering (high hoarding and ordering, low washing), and (2) Hoarding Only (high hoarding, low ordering). No significant correlations were found between OC profiles and disgust-related constructs. Clinical implications, limitations, and future directions are explored.

The impact of lifetime PTSD on the seven-year course and clinical characteristics of OCD.

Research has suggested that the co-occurrence of PTSD in individuals with OCD is associated with more severe symptoms and less responsivity to empirically supported treatment as compared to individuals with OCD and no history of PTSD. However, much of this work has been limited by non-empirical case report design, cross-sectional and retrospective analyses, or small sample sizes. The current study extended this research by comparing the clinical characteristics of individuals with OCD with and without a lifetime PTSD diagnosis in a large, naturalistic, longitudinal sample over the course of seven years. At baseline, individuals with comorbid lifetime PTSD reported significantly more severe symptoms of OCD (including symptom levels and insight), lower quality of life, and higher rates of comorbid lifetime mood and substance use disorders than participants without lifetime PTSD. Further, individuals with comorbid OCD and lifetime PTSD reported significantly more severe OCD symptoms over the course of seven years than those without lifetime PTSD. These results are largely consistent with the existing literature and support the need to consider PTSD symptoms in the assessment and treatment of OCD.

Impulsivity and test meal intake among women with bulimia nervosa.

Many patients with bulimia nervosa (BN) also meet criteria for a lifetime alcohol use disorder (AUD). In order to understand possible mechanisms contributing to the co-occurrence and perpetuation of these disorders, this study investigated the importance of impulsivity and test meal intake among patients with BN by comparing women with BN only (n = 18), BN and current/past AUDs (n = 13), and healthy controls (n = 12). All participants completed assessments of eating disorder symptoms, frequency of alcohol use, binge eating, and purging via questionnaires and semi-structured interviews over two sessions. Measures of impulsivity consisted of computerized and self-report measures, and laboratory test meals. Significant differences between individuals with BN with/without comorbid AUDs were not found for test meal intake, impulsivity measures, or self-reported psychological symptoms. As hypothesized, compared to healthy controls, individuals with BN had significantly higher scores on two subscales and the total score of the Barratt Impulsiveness Scale, a trait measure of impulsivity, and consumed significantly more calories in the binge instruction meal. Total Barratt Impulsiveness Scale scores were also significantly related to kcal consumed during the laboratory test meal when individuals were instructed to binge eat (BN groups). Data from this study add to the existing literature implicating impulsivity in the psychopathology of disorders of binge eating, including BN, and also support the use of laboratory meals as a symptom-specific measure of this trait in eating disorder populations.

Change in disgust reactions following cognitive-behavioral therapy for childhood anxiety disorders

Disgust, in addition to fear, is a prominent emotional state associated with avoidance of distressing stimuli. While most of the research in disgust has been conducted in relation to Obsessive-Compulsive Disorder (OCD), recent data has also implicated disgust in the etiology of anxiety disorders in general. Studies have shown that decreases in disgust are key to symptom reduction in individuals with OCD. However, there has been little empirical work exploring whether these interventions are efficacious for childhood anxiety disorders that present with prominent disgust components. This study examined how disgust propensity in children with anxiety disorders responds to cognitive-behavioral therapy (CBT) with an emphasis on exposure. Forty-one children, ages 7 to 17, with anxiety disorders were evaluated for disgust propensity and were treated with intensive, weekly, CBT. It was found that disgust levels decreased following treatment across all anxiety disorder diagnoses, where children with primary OCD exhibited significantly greater reductions. Clinical implications and suggestions for further research of the treatment of disgust in relation to childhood anxiety disorders are discussed (AU)

El asco, además del miedo, es un estado emocional prominente asociado con la evitación de estímulos perturbadores. Aunque la mayoría de la investigación se ha llevado a cabo en relación con el trastorno obsesivo-compulsivo (TOC), datos recientes han implicado el asco en la etiología de trastornos de ansiedad en general. Se ha demostrado que la disminución del asco es clave para la reducción de los síntomas en personas con TOC. Sin embargo, son escasos los trabajos que exploren si estas intervenciones son eficaces en trastornos de ansiedad en la infancia con componentes prominentes de asco. Este estudio examinó cómo la propensión al asco en niños con trastornos de ansiedad responde a la terapia cognitivo-conductual (TCC) con énfasis en la exposición. Cuarenta y un niños de 7 a 17 años, con trastornos de ansiedad, fueron evaluados en la propensión al asco y tratados semanalmente con TCC intensiva. Se encontró que los niveles de asco disminuyeron tras el tratamiento en todos los diagnósticos de trastorno de ansiedad, siendo los niños con TOC primario los que mostraron reducciones significativamente mayores. Se discuten las implicaciones clínicas y sugerencias para futuras investigaciones sobre el tratamiento de la asco en relación con los trastornos de ansiedad infantil (AU)

Change in disgust reactions following cognitive-behavioral therapy for childhood anxiety disorders.

Disgust, in addition to fear, is a prominent emotional state associated with avoidance of distressing stimuli. While most of the research in disgust has been conducted in relation to Obsessive-Compulsive Disorder (OCD), recent data has also implicated disgust in the etiology of anxiety disorders in general. Studies have shown that decreases in disgust are key to symptom reduction in individuals with OCD. However, there has been little empirical work exploring whether these interventions are efficacious for childhood anxiety disorders that present with prominent disgust components. This study examined how disgust propensity in children with anxiety disorders responds to cognitive-behavioral therapy (CBT) with an emphasis on exposure. Forty-one children, ages 7 to 17, with anxiety disorders were evaluated for disgust propensity and were treated with intensive, weekly, CBT. It was found that disgust levels decreased following treatment across all anxiety disorder diagnoses, where children with primary OCD exhibited significantly greater reductions. Clinical implications and suggestions for further research of the treatment of disgust in relation to childhood anxiety disorders are discussed.

La asco, además del miedo, es un estado emocional prominente asociado con la evitación de estímulos perturbadores. Aunque la mayoría de la investigación se ha llevado a cabo en relación con el trastorno obsesivo-compulsivo (TOC), datos recientes han implicado la asco en la etiología de trastornos de ansiedad en general. Se ha demostrado que la disminución de la asco es clave para la reducción de los síntomas en personas con TOC. Sin embargo, son escasos los trabajos que exploren si estas intervenciones son eficaces en trastornos de ansiedad en la infancia con componentes prominentes de asco. Este estudio examinó cómo la propensión a la asco en niños con trastornos de ansiedad responde a la terapia cognitivo-conductual (TCC) con énfasis en la exposición. Cuarenta y un niños de 7 a 17 años, con trastornos de ansiedad, fueron evaluados en la propensión a la asco y tratados semanalmente con TCC intensiva. Se encontró que los niveles de asco disminuyeron tras el tratamiento en todos los diagnósticos de trastorno de ansiedad, siendo los niños con TOC primario los que mostraron reducciones significativamente mayores. Se discuten las implicaciones clínicas y sugerencias para futuras investigaciones sobre el tratamiento de la asco en relación con los trastornos de ansiedad infantil.

Disgust as a unique affective predictor of mental contamination following sexual trauma.

Mental contamination has been described as an internal experience of dirtiness that can arise and persist in the absence of contact with observable physical contaminants. Recent research has examined mental contamination specifically related to unwanted physical contact and sexual trauma. This study evaluated the degree to which disgust propensity and both self-focused and perpetrator-focused peritraumatic disgust were associated with mental contamination in a sample of women who experienced sexual trauma (n=72). Results showed that peritraumatic self-focused disgust, but not peritraumatic perpetrator-focused disgust or fear, was significantly associated with mental contamination. Additionally, disgust propensity contributed significantly to the incremental validity of the model. These findings support the nascent literature showing that disgust plays a significant role in mental contamination, particularly following sexual trauma. Future research directions, and clinical/theoretical implications of these results are discussed.

Alleviation of moral disgust, shame, and guilt in posttraumatic stress reactions: an evaluation of comprehensive distancing.

Research suggests that moral disgust, shame, and guilt are present in posttraumatic psychopathology. However, it is unclear that these emotional states are responsive to empirically supported interventions for posttraumatic stress symptoms (PTSS). This study explored the relations among moral disgust, shame, guilt, and PTSS, and examined comprehensive distancing (CD) as a novel intervention for these emotional states in undergraduates with elevated PTSS. Participants were randomly assigned to use a CD or a cognitive challenge task in response to personalized scripts of a traumatic event. Both interventions were associated with decreases in disgust, moral disgust, shame, and guilt. Contrary to predictions, there were no significant differences between the exercises in the reduction of negative emotions. In addition, PTSS severity was correlated with trauma-related guilt as well as state guilt and shame, but not trait or state measures of disgust or moral disgust. This proof of concept project sets the stage for further research examining CD as an alternative or adjunctive intervention for posttraumatic stress reactions with strong features of moral disgust, shame, and guilt.

Does the overvaluation of shape and weight predict initial symptom severity or treatment outcome among patients with binge eating disorder?

OBJECTIVE: To examine whether overvaluation of shape and weight is associated with initial symptom severity or treatment outcome among patients with binge eating disorder (BED). METHOD: Patients with BED (n = 116) completed assessments at baseline and treatment termination, including the Eating Disorder Examination (EDE) and self-report measures of eating-related cognitions and behaviors, depression, and self-esteem. Clinical overvaluation was determined by EDE. RESULTS: The clinical overvaluation group demonstrated significantly higher pre-treatment scores on measures of depression, behavioral and cognitive aspects of binge eating, and eating-related psychopathology, and lower self-esteem scores than individuals without overvaluation. At treatment termination, patients with overvaluation continued to display elevated scores on measures of binge eating severity at a trend level. DISCUSSION: Overvaluation of shape and weight was associated with symptom severity in patients with BED, but additional research is needed to determine whether this construct holds clinically useful predictive validity for treatment outcome.