A Network Analysis Study to Evaluate Obsessive-Compulsive Beliefs/Dimensions and Personality Beliefs in Patients with Obsessive-Compulsive Disorder (OCD): A Cross-Sectional Study in Two Common OCD Subtypes
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Abstract
Objective: Obsessive-Compulsive Disorder (OCD) has been considered a heterogeneous psychiatric disorder. Identifying this heterogeneity can lead to better diagnosis and treatment. The two most common OCD subtypes include contamination/cleaning and danger/checking. This study aimed to identify the network structure of OCD symptoms, personality, and obsessive beliefs in these OCD subtypes.
Method: 333 patients with OCD were included in the study (156 patients with the danger/check subtype and 177 patients with the contamination/cleaning subtype). In addition, 276 healthy individuals participated in this study. We used a network analysis approach to determine the OCD central symptoms [nodes]. The Personality Beliefs Questionnaire-Short Form [PBQ-SF], Obsessive-Compulsive Inventory-Revised [OCI-R], and Obsessional Beliefs Questionnaire-44 [OBQ-44] were used for network estimation.
Results: The results indicated that the network structure in healthy individuals was different from the network structure in patients with obsessive-compulsive disorder [PwOCD]. In healthy individuals, "obsessive” personality belief and “danger” obsessive belief were the most strength nodes and formed the core of the central communication between symptoms in these subjects. Regarding the contamination/cleaning subtype, the most central symptoms include "washing" obsessive symptom, “danger” obsessive belief, and "wash" obsessive symptom. However, "perfect" obsessive beliefs, "check" obsessive symptoms, and “avoidant” personality beliefs were the most central symptoms in the danger/check subtype. These results demonstrated that each of the studied groups had a unique network structure, which is consistent with the heterogeneous nature of OCD.
Conclusion: Different OCD subtypes have different cognitive-behavioral network structures. According to the results of this study, these symptoms should be given priority in OCD theoretical models and treatment strategies.
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31. Vasileiou E, Fexi P, Spyropoulou A, Mourikis I, Chalimourdas T, Zervas I. Obsessive-compulsive symptoms in pregnancy: Their relationship with obsessive beliefs and obsessive-compulsive personality traits. Psychiatriki. 2022;33(1):39-48.
32. Zhang ZM, Wang MY, Guo X, Miao X, Zhang T, Gao D, et al. Attentional avoidance of threats in obsessive compulsive disorder: An event related potential study. Behav Res Ther. 2017;97:96-104.
33. Abramowitz JS, McKay D, Taylor S. Clinical handbook of obsessive-compulsive disorder and related problems: JHU Press; 2008.
34. Starcevic V, Berle D, Brakoulias V, Sammut P, Moses K, Milicevic D, et al. Obsessive-compulsive personality disorder co-occurring with obsessive-compulsive disorder: Conceptual and clinical implications. Aust N Z J Psychiatry. 2013;47(1):65-73.
35. D'Mello RJ, Kumar A. Experience of Disgust and Symptom Severity in Contamination Subtype of Obsessive-Compulsive Disorder: Role of Experiential Avoidance. Indian J Psychol Med. 2022;44(6):580-5.
36. Oaten M, Stevenson RJ, Case TI. Disgust as a disease-avoidance mechanism. Psychol Bull. 2009;135(2):303-21.
37. Moretz MW, McKay D. The role of perfectionism in obsessive-compulsive symptoms: "not just right" experiences and checking compulsions. J Anxiety Disord. 2009;23(5):640-4.
38. Salkovskis PM, Wroe AL, Gledhill A, Morrison N, Forrester E, Richards C, et al. Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder. Behav Res Ther. 2000;38(4):347-72.
2. Cavallini MC, Di Bella D, Siliprandi F, Malchiodi F, Bellodi L. Exploratory factor analysis of obsessive-compulsive patients and association with 5-HTTLPR polymorphism. Am J Med Genet. 2002;114(3):347-53.
3. Mataix-Cols D, Wooderson S, Lawrence N, Brammer MJ, Speckens A, Phillips ML. Distinct neural correlates of washing, checking, and hoarding symptom dimensions in obsessive-compulsive disorder. Arch Gen Psychiatry. 2004;61(6):564-76.
4. Ramezani Z, Rahimi C, Mohammadi N. Predicting Obsessive Compulsive Disorder Subtypes Using Cognitive Factors. Iran J Psychiatry. 2016;11(2):75-81.
5. Bhar SS, Beck AT, Butler AC. Beliefs and personality disorders: an overview of the personality beliefs questionnaire. J Clin Psychol. 2012;68(1):88-100.
6. Sadock BJ. Kaplan & Sadock's synopsis of psychiatry: behavioral sciences/clinical psychiatry: Wolters Kluwer Philadelphia, PA; 2015.
7. Thimm JC, Jordan S, Bach B. The Personality Inventory for DSM-5 Short Form (PID-5-SF): psychometric properties and association with big five traits and pathological beliefs in a Norwegian population. BMC Psychol. 2016;4(1):61.
8. Kart A, Yucens B. Personality Beliefs in Obsessive-Compulsive Disorder: How Are They Related to Symptom Severity? Psychiatry Investig. 2020;17(8):822-8.
9. Sookman D, Steketee G. Specialized cognitive behavior therapy for treatment resistant obsessive compulsive disorder. Treatment resistant anxiety disorders Resolving impasses to symptom remission. 2010:31-74.
10. Olatunji BO, Christian C, Brosof L, Tolin DF, Levinson CA. What is at the core of OCD? A network analysis of selected obsessive-compulsive symptoms and beliefs. J Affect Disord. 2019;257:45-54.
11. McNally RJ, Mair P, Mugno BL, Riemann BC. Co-morbid obsessive-compulsive disorder and depression: a Bayesian network approach. Psychol Med. 2017;47(7):1204-14.
12. McNally RJ. Can network analysis transform psychopathology? Behav Res Ther. 2016;86:95-104.
13. Dingemans AE, Volkmer SA, Mulkens S, Vuijk R, van Rood YR. The obsessive-compulsive spectrum: A network analysis. Psychiatry Res. 2022;308:114351.
14. McNally RJ. Network Analysis of Psychopathology: Controversies and Challenges. Annu Rev Clin Psychol. 2021;17:31-53.
15. Kamal M, Abo Omirah M, Hussein A, Saeed H. Assessment and characterisation of post-COVID-19 manifestations. Int J Clin Pract. 2021;75(3):e13746.
16. Ghassemzadeh H, Shams G, Abedi J, Karamghadiri N, Ebrahimkhani N, Rajabloo M. Psychometric properties of a Persian-language version of the obsessive-compulsive inventory-revised: OCI-R-Persian. Psychology. 2011;2(03):210.
17. Shams G, Esmaili Y, Karamghadiri N, Ebrahimhkani N, Yousefi Y, McKay D. Psychometric properties of the Persian language version of Obsessive Beliefs Questionnaire (OBQ-44) in Iranian general population. Acta Med Iran. 2014;52(1):66-75.
18. Esfahani SR, Motaghipour Y, Kamkari K, Zahiredin A, Janbozorgi M. Reliability and Validity of the Persian version of the Yale-Brown Obsessive-Compulsive scale (Y-BOCS). Iran J Psychiatry Clin Psychol. 2012;17(4).
19. Taheri E, Athar ME, Ebrahimi A, Atashipoor HS, Taheri M, Mollaee H. The Persian version of the personality beliefs questionnaire-short-form (PBQ-SF): a psychometric evaluation. J Ration Emot Cogn Behav Ther. 2021:1-15.
20. Van Schalkwyk GI, Bhalla IP, Griepp M, Kelmendi B, Davidson L, Pittenger C. Toward understanding the heterogeneity in obsessive-compulsive disorder: Evidence from narratives in adult patients. Aust N Z J Psychiatry. 2016;50(1):74-81.
21. Epskamp S, Cramer AO, Waldorp LJ, Schmittmann VD, Borsboom D. qgraph: Network visualizations of relationships in psychometric data. J Stat Softw. 2012;48:1-18.
22. Bringmann LF, Elmer T, Epskamp S, Krause RW, Schoch D, Wichers M, et al. What do centrality measures measure in psychological networks? J Abnorm Psychol. 2019;128(8):892-903.
23. van Borkulo C, Boschloo L, Borsboom D, Penninx BW, Waldorp LJ, Schoevers RA. Association of Symptom Network Structure With the Course of [corrected] Depression. JAMA Psychiatry. 2015;72(12):1219-26.
24. Cha EJ, Moon Y, Ryu S-H, Jeon HJ. Central features in health-related quality of life in older adults: network analysis using nationwide survey data. BJPsych Open. 2023;9(5):e145.
25. Isvoranu A-M, Epskamp S, Waldorp L, Borsboom D. Network psychometrics with R: A guide for behavioral and social scientists: Routledge; 2022.
26. Hofmann SG, Dozois DJ, Rief WE, Smits JA. The Wiley handbook of cognitive behavioral therapy, Vols. 1-3: Wiley Blackwell; 2014.
27. Trak E, İnözü M. Obsessive beliefs prospectively predict adherence to safety behaviours related to COVID-19 through obsessive-compulsive symptoms and COVID-19 distress: A serial multiple mediator analysis. Int J Psychol. 2022;57(5):559-66.
28. Mindel C, Salhi L, Oppong C, Lockwood J. Alienated and unsafe: Experiences of the first national UK COVID-19 lockdown for vulnerable young people (aged 11-24 years) as revealed in Web-based therapeutic sessions with mental health professionals. Couns Psychother Res. 2022;22(3):708-24.
29. Ren SY, Gao RD, Chen YL. Fear can be more harmful than the severe acute respiratory syndrome coronavirus 2 in controlling the corona virus disease 2019 epidemic. World J Clin Cases. 2020;8(4):652-7.
30. Darawad MW, Othman EH, Saleh A, Rezk-Hanna M. Preventive and Avoidant Behaviors Followed by Jordanians During COVID-19 Pandemic. Disaster Med Public Health Prep. 2022;17:e222.
31. Vasileiou E, Fexi P, Spyropoulou A, Mourikis I, Chalimourdas T, Zervas I. Obsessive-compulsive symptoms in pregnancy: Their relationship with obsessive beliefs and obsessive-compulsive personality traits. Psychiatriki. 2022;33(1):39-48.
32. Zhang ZM, Wang MY, Guo X, Miao X, Zhang T, Gao D, et al. Attentional avoidance of threats in obsessive compulsive disorder: An event related potential study. Behav Res Ther. 2017;97:96-104.
33. Abramowitz JS, McKay D, Taylor S. Clinical handbook of obsessive-compulsive disorder and related problems: JHU Press; 2008.
34. Starcevic V, Berle D, Brakoulias V, Sammut P, Moses K, Milicevic D, et al. Obsessive-compulsive personality disorder co-occurring with obsessive-compulsive disorder: Conceptual and clinical implications. Aust N Z J Psychiatry. 2013;47(1):65-73.
35. D'Mello RJ, Kumar A. Experience of Disgust and Symptom Severity in Contamination Subtype of Obsessive-Compulsive Disorder: Role of Experiential Avoidance. Indian J Psychol Med. 2022;44(6):580-5.
36. Oaten M, Stevenson RJ, Case TI. Disgust as a disease-avoidance mechanism. Psychol Bull. 2009;135(2):303-21.
37. Moretz MW, McKay D. The role of perfectionism in obsessive-compulsive symptoms: "not just right" experiences and checking compulsions. J Anxiety Disord. 2009;23(5):640-4.
38. Salkovskis PM, Wroe AL, Gledhill A, Morrison N, Forrester E, Richards C, et al. Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder. Behav Res Ther. 2000;38(4):347-72.
| Files | ||
| Issue | Vol 19 No 1 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v19i1.14337 | |
| Keywords | ||
| Cognitive Therapy Network Analysis Obsessive Behavior Personality Assessment | ||
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How to Cite
1.
Davoudi M, Pourshahbaz A, Dolatshahi B, Nazeri Astaneh A. A Network Analysis Study to Evaluate Obsessive-Compulsive Beliefs/Dimensions and Personality Beliefs in Patients with Obsessive-Compulsive Disorder (OCD): A Cross-Sectional Study in Two Common OCD Subtypes. Iran J Psychiatry. 2023;19(1):30-44.
