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David A. Clark - One of the best experts on this subject based on the ideXlab platform.
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part 1 you can run but you can t hide Intrusive Thoughts on six continents
Journal of Obsessive-Compulsive and Related Disorders, 2014Co-Authors: Adam S. Radomsky, David A. Clark, Amparo Belloch, Meredith E. Coles, Jonathan S. Abramowitz, Gillian M. Alcolado, Pino Alonso, Martine Bouvard, Guy Doron, Hector FernandezalvarezAbstract:Abstract Most cognitive approaches for understanding and treating obsessive-compulsive disorder (OCD) rest on the assumption that nearly everyone experiences unwanted Intrusive Thoughts, images and impulses from time to time. These theories argue that the intrusions themselves are not problematic, unless they are misinterpreted and/or attempts are made to control them in maladaptive and/or unrealistic ways. Early research has shown unwanted intrusions to be present in the overwhelming majority of participants assessed, although this work was limited in that it took place largely in the US, the UK and other ‘westernised’ or ‘developed’ locations. We employed the International Intrusive Thoughts Interview Schedule (IITIS) to assess the nature and prevalence of intrusions in nonclinical populations, and used it to assess ( n =777) university students at 15 sites in 13 countries across 6 continents. Results demonstrated that nearly all participants (93.6%) reported experiencing at least one intrusion during the previous three months. Doubting intrusions were the most commonly reported category of Intrusive Thoughts; whereas, repugnant intrusions (e.g., sexual, blasphemous, etc.) were the least commonly reported by participants. These and other results are discussed in terms of an international perspective on understanding and treating OCD.
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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, 2014Co-Authors: David A. Clark, Amparo Belloch, Meredith E. Coles, Jonathan S. Abramowitz, Gillian M. Alcolado, Pino Alonso, Martine Bouvard, Richard Moulding, Guy DoronAbstract:Abstract Cognitive models of Obsessive Compulsive Disorder (OCD) purport that obsessions are normal Intrusive Thoughts that are misappraised as significant, leading to negative emotional responses and maladaptive attempts to control the Thoughts and related emotions. This paper utilised a large multi-national dataset of interview data regarding Intrusive Thoughts, to investigate three questions related to the cognitive model of OCD and to its stability across cultures. First, the paper aimed to investigate the implicit yet-hitherto-untested assumption of cognitive models that misappraisals and control strategies for Intrusive Thoughts relate similarly across cultures. Second, this study aimed to build upon recent studies categorising Intrusive Thoughts into repugnant and non-repugnant categories, by investigating whether the content of Intrusive thought moderates the relationship between the Thoughts and appraisals and control strategies. Finally, this study aimed to provide further evidence regarding whether general beliefs implicated in cognitive models of OCD (e.g., responsibility, importance of Thoughts) influence the occurrence of intrusions via maladaptive appraisals and control strategies. Overall, it was found that while overall Intrusive thought frequency, distress, ease and importance of dismissal all varied significantly by site, their relationship with appraisals and control strategies did not. Generally, appraisals and action taken to confront the thought were the more consistent predictors, with the notably caveat that the relationship between thought frequency and appraisals was not strong. Second, repugnant vs. non-repugnant thought-content differed only with respect to thought frequency, but thought-content did not moderate the relationship between Intrusive Thoughts and control strategies and appraisals. Finally, appraisals and control strategies generally partially mediated the relationship between general OCD-related beliefs and the occurrence of, and distress associated with, Intrusive Thoughts. The results are taken to add credence to cognitive models of OCD and their validity across cultures.
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unwanted Intrusive Thoughts cultural contextual covariational and characterological determinants of diversity
Journal of Obsessive-Compulsive and Related Disorders, 2014Co-Authors: David A. Clark, Mujgan InozuAbstract:Abstract Cognitive behavioral theories trace the origins of clinical obsessions to common unwanted Intrusive Thoughts, images or impulses that are universally experienced in the general population. It is the erroneous interpretation of the intrusion as a personally significant threat that must be diminished or neutralized that result in the vicious escalation into a clinical obsession. This paper reviews four critical determinants of individuals׳ diverse experience of unwanted Intrusive Thoughts (UITs). First we consider the role that culture may play in the types of Thoughts that become Intrusive, repetitive and persistent. Next the role of context is considered and the differences found between UITs and obsessions that are externally precipitated versus those that are more autonomous. A third section considers the role of current clinical state and whether there is a specific relation between certain types of intrusions and obsessional states in particular. The final section examines the role of personality, enduring dysfunctional beliefs and self-view discrepancies as potential vulnerability factors for UITs and obsessions. The paper concludes with a summary of current status and future directions for research on UITs.
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Introduction: A global perspective on unwanted Intrusive Thoughts
Journal of Obsessive-Compulsive and Related Disorders, 2014Co-Authors: David A. Clark, Adam S. RadomskyAbstract:Abstract Because of Rachman and de Silva׳s (1978) influential research on normal and abnormal obsessions, it is now a basic tenet of cognitive behavioral theories (CBT) that clinical obsessions have their origins in the normal Intrusive thought phenomena that characterizes the stream of consciousness. However much of the empirical research on unwanted Intrusive Thoughts has utilized retrospective self-report questionnaires that have weak construct validity and the samples have been drawn primarily from Western European and North American populations. To enhance the measurement precision and investigate the universality of unwanted intrusions, a structured Intrusive Thoughts interview was developed and administered to 777 nonclinical individuals drawn from 13 countries. The three papers in this special issue present findings based on this large data set. Together it was found that unwanted Intrusive Thoughts are reported by the majority of individuals in all countries, that significant cross-cultural differences are apparent in primary Intrusive thought content, that faulty appraisals and confrontational control strategies are related to the distress of intrusions, and that the frequency of dirt/contamination, doubt, and miscellaneous intrusions are specifically related to obsessive compulsive symptom distress. The authors discuss these findings in terms of their consistency with predictions derived from the CBT perspective on obsessions. The special issue concludes with a discussion paper by Professor Jack Rachman, originator of the obessional intrusions concept.
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Part 3: A question of perspective: The association between Intrusive Thoughts and obsessionality in 11 countries
Journal of Obsessive-Compulsive and Related Disorders, 2014Co-Authors: David A. Clark, Amparo Belloch, Meredith E. Coles, Jonathan S. Abramowitz, Gillian M. Alcolado, Pino Alonso, Martine Bouvard, Guy Doron, Héctor Fernández-Álvarez, Gemma García-sorianoAbstract:Abstract A key assumption of contemporary cognitive-behavioral models of obsessive–compulsive disorder (OCD) is that obsessional Thoughts exist on a continuum with “normal” unwanted Intrusive Thoughts. Recently, however, some authors have challenged this notion. The present study aimed to clarify (a) the extent that different types of Intrusive Thoughts in nonclinical individuals are associated with obsessionality, (b) the relative contribution of frequency, distress and control ratings to obsessionality, and (c) the extent that existing findings (primarily from North American or European samples) generalize to other countries in the world. Five hundred and fifty-four non clinical individuals from 11 different countries were administered an interview assessing the presence, frequency, distress, and perceived control of different types of Intrusive Thoughts. Participants also completed measures of obsessional beliefs, obsessive–compulsive (OC) symptoms, and depression. Results from data analyses supported the universality of unwanted Intrusive Thoughts, the continuity of normal and abnormal obsessions, and the specificity of dirt/contamination, doubt and miscellaneous intrusions to OC symptoms. Implications for Intrusive Thoughts as a potential vulnerability factor for OCD are discussed.
Stephen J. Lepore - One of the best experts on this subject based on the ideXlab platform.
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Social Constraints, Intrusive Thoughts, and Mental Health after Prostate Cancer
Journal of Social and Clinical Psychology, 1998Co-Authors: Stephen J. Lepore, Vicki S. HelgesonAbstract:We examined how the social environment influences men's ability to cognitively process and recover psychologically from the trauma associated with prostate cancer. We hypothesized that men who judge others to be unreceptive to their attempts to talk about their cancer-related concerns would have poorer mental health than men with more receptive social networks. In a survey with 1 78 prostate cancer survivors, we measured Intrusive Thoughts about cancer, social constraints in talking about cancer, avoidance in thinking and talking about cancer, and mental health. There were significant interactive effects of Family/Friend Social Constraints × Intrusive Thoughts and Wife Social Constraints × Intrusive Thoughts on mental health. Plots of the interactions showed a stronger negative relation between Intrusive Thoughts and mental health among men who felt socially constrained in talking about their cancer than among men who felt unconstrained. In addition, level of constraints from family and friends was positively associated with level of avoidance in thinking and talking about cancer which, in turn, was associated with poorer mental health. These results suggest that supportive social networks may promote psychological adjustment by facilitating cognitive processing of the cancer experience.
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Expressive Writing Moderates the Relation Between Intrusive Thoughts and Depressive Symptoms
Journal of personality and social psychology, 1997Co-Authors: Stephen J. LeporeAbstract:The author investigated whether expressive writing enhances emotional adaptation to a stressful event (graduate entrance exams) by reducing event-related Intrusive Thoughts or by desensitizing people to such Thoughts. Participants in the experimental group, who were instructed to write their deepest Thoughts and feelings about the exam, exhibited a significant decline in depressive symptoms from 1 month (Time 1) to 3 days (Time 2) before the exam. Participants in the control group, who wrote about a trivial topic, maintained a relatively high level of depressive symptoms over this same period. Expressive writing did not affect the frequency of Intrusive Thoughts, but it moderated the impact of Intrusive Thoughts on depressive symptoms. Specifically, Intrusive Thoughts at Time 1 were positively related to depressive symptoms at Time 2 in the control group and were unrelated to symptoms in the expressive writing group.
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Social constraints, Intrusive Thoughts, and depressive symptoms among bereaved mothers.
Journal of personality and social psychology, 1996Co-Authors: Stephen J. Lepore, Roxane Cohen Silver, Camille B. Wortman, Heidi A. WaymentAbstract:The study examined how social constraints on discussion of a traumatic experience can interfere with cognitive processing of and recovery from loss. Bereaved mothers were interviewed at 3 weeks (T1), 3 months (T2), and 18 months (T3) after their infants' death. Intrusive Thoughts at T1, conceptualized as a marker of cognitive processing, were negatively associated with talking about infant's death at T2 and T3 among socially constrained mothers. The reverse associations were found among unconstrained mothers. Controlling for initial level of distress, there was a positive relation between T1 Intrusive Thoughts and depressive symptoms over time among socially constrained mothers. However, higher levels of T1 Intrusive Thoughts were associated with a decrease in T3 depressive symptoms among mothers with unconstrained social relationships.
Christine Purdon - One of the best experts on this subject based on the ideXlab platform.
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Attention Training in the Reduction and Reappraisal of Intrusive Thoughts
Behavioural and Cognitive Psychotherapy, 2007Co-Authors: Chris Watson, Christine PurdonAbstract:Attention Training (ATT) is an auditory attention-focusing technique that attempts to reduce the perseverative self-focused processing characteristic of anxiety and mood disorders. The present study investigated the effects of one session of ATT in the reduction and reappraisal of Intrusive Thoughts in a university sample reporting high levels of obsessive-compulsive symptoms. One-hundred and eight participants identified their most distressing Intrusive thought and spent 7 minutes monitoring their stream of consciousness while recording occurrences of the identified thought. They then rated the unpleasantness of the Intrusive thought, their attempts to dismiss the thought from consciousness, and their perceived success in reducing the frequency of the thought. Participants were then randomly assigned to receive one session of ATT, thought replacement instructions (TR), distraction instructions (DI), or no intervention (CONT). Participants then repeated the thought monitoring interval and ratings. ATT was expected to be the most effective in decreasing the frequency and unpleasantness of Intrusive Thoughts. However, contrary to hypotheses, all groups reported similar decreases across intervals. Implications of these findings are discussed.
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WHY ARE CERTAIN Intrusive Thoughts MORE UPSETTING THAN OTHERS
Behavioural and Cognitive Psychotherapy, 2003Co-Authors: Karen Rowa, Christine PurdonAbstract:Recent cognitive behavioural models of obsessive compulsive disorder (OCD) suggest that the misinterpretation of the meaning of Intrusive Thoughts plays a pivotal role in the escalation of these Thoughts to clinical obsessions, but less attention has been paid to why only certain Intrusive Thoughts become the focus of these misappraisals. Theoretical speculation suggests that Thoughts that have relevance for an individual's value system or sense of self may be particularly salient and upsetting for people. The role of thought appraisal and contradiction of valued aspects of self were examined in a nonclinical population. It was hypothesized that participants reporting on upsetting Intrusive Thoughts would appraise these Thoughts negatively and would report that these Thoughts contradict important aspects of self to a greater degree than participants reporting on less upsetting Intrusive Thoughts. Participants ( N = 64) were randomly assigned to report on either the most or least upsetting Intrusive thought they had experienced. They completed questionnaires on appraisals of these Thoughts, valued aspects of self, and contradiction of self. Consistent with predictions, participants reporting on more upsetting Thoughts appraised these Thoughts in a more negative manner and reported that these Thoughts contradicted valued aspects of self to a greater degree than participants in the least upsetting thought group. These results support Salkovskis' (1985) and Rachman's (1997, 1998) cognitive behavioural models of OCD, and suggest that the degree of contradiction of self may help us understand why some obsessional Thoughts are much more upsetting than others.
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Appraisal and control of sexual and non-sexual Intrusive Thoughts in university students.
Behaviour research and therapy, 2000Co-Authors: David A. Clark, Christine Purdon, E. Sandra ByersAbstract:This study examined differences in the appraisal and thought control strategies associated with the perceived control of unwanted sexual and non-sexual Intrusive Thoughts. Eleven appraisal dimensions, subjective physiological arousal and 10 thought control strategies were measured in 171 university students who were administered the Revised Obsessive Intrusions Inventory-Sex Version, a self-report measure of unwanted Intrusive Thoughts. Thought-action fusion (TAF) likelihood was a significant unique predictor of the perceived controllability of respondents' most upsetting sexual and non-sexual Intrusive thought. Moreover greater subjective physiological arousal was a significant predictor of reduced control over sexual intrusions, whereas worry that one might act on an Intrusive thought and greater effort to control the intrusion were significant unique predictors of the control of non-sexual Intrusive Thoughts. Various thought control strategies were more often used in response to non-sexual than sexual cognitions. The results are discussed in terms of the differential role of various appraisal processes in the control of unwanted sexual and non-sexual Thoughts.
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Sexual Intrusive Thoughts of college students.
Journal of Sex Research, 1998Co-Authors: E. Sandra Byers, Christine Purdon, David A. ClarkAbstract:Despite the fact that a substantial minority of individuals describe sexual Thoughts that are perceived as unwanted and unacceptable, for the most part sexuality researchers have not differentiated sexual Thoughts and fantasies that are perceived as positive by the respondent from those which are perceived as negative. At the same time, cognitive‐behavioral researchers investigating Intrusive Thoughts—that is, unwanted, sudden, and involuntary ego‐dystonic Thoughts and obsessions—have not distinguished those reflecting sexual themes from those reflecting other themes. The purpose of this study was to examine sexual Intrusive Thoughts in a nonclinical population. One hundred seventy‐one college students participated in the study and were administered measures assessing Intrusive Thoughts, psychological distress, and disposition towards sexuality. Sexual Intrusive Thoughts were reported by 84% of participants. Compared to the women, the men reported a greater number of different sexual Intrusive Thoughts, a...
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The assessment of unwanted Intrusive Thoughts: A review and critique of the literature
Behaviour research and therapy, 1995Co-Authors: David A. Clark, Christine PurdonAbstract:In this paper we review the assessment and measurement of normal unwanted Intrusive Thoughts, images, and impulses that are considered the basis of clinical obsessions. After highlighting some difficulties with how the definition of cognitive intrusion has been applied to the development of assessment measures, we evaluate the construct validity of a number of retrospective self-report instruments such as the Intrusive Thoughts Questionnaire, Cognitive Intrusions Questionnaire, and Obsessional Intrusions Inventory, as well as interview and diary procedures. Measures of personal responsibility and meta-cognitive beliefs, which are still in the developmental phase, are also discussed. We conclude with a number of recommendations and areas of further research which would strengthen the construct validity of measures of Intrusive Thoughts and related constructs.
Anna María Nápoles - One of the best experts on this subject based on the ideXlab platform.
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Social support as a moderator in the relationship between Intrusive Thoughts and anxiety among Spanish-speaking Latinas with breast cancer.
Psycho-oncology, 2019Co-Authors: Cristian Escalera, Jasmine Santoyo-olsson, Anita L. Stewart, Carmen Ortiz, Anna María NápolesAbstract:Author(s): Escalera, Cristian; Santoyo-Olsson, Jasmine; Stewart, Anita L; Ortiz, Carmen; Napoles, Anna Maria | Abstract: ObjectiveIntrusive Thoughts, defined as unwanted and recurrent Thoughts about a stressful experience, are associated with psychological distress in women with breast cancer. This study assessed moderating effects of various social support dimensions on associations between Intrusive Thoughts and psychological distress among Latina breast cancer survivors.MethodsWe used baseline data from a randomized controlled trial of a stress management intervention delivered to 151 Spanish-speaking Latinas with nonmetastatic breast cancer within 1 year of diagnosis. Intrusive Thoughts, four dimensions of social support (emotional/informational, tangible, affectionate, and positive social interaction), and symptoms of anxiety and depression were assessed through in-person interviews. Information on age, time since diagnosis, breast cancer variables, history of depression, and marital status served as covariates. Generalized linear models were used to investigate bivariate and multivariate associations and to explore moderation effects of the four dimensions of social support.ResultsIn bivariate models, Intrusive Thoughts were associated positively with depression (β = .024, .001) and anxiety (β = .047, P l .001) symptoms. Adjusting for other factors, Intrusive Thoughts remained associated with depression symptoms (β = .022, .008), regardless of level of social support (for all support dimensions). For anxiety, there were significant interactions of tangible (β = -.013, .034) and affectionate (β = -.022, .005) support with Intrusive Thoughts. Intrusive Thoughts were associated more strongly with anxiety symptoms among women reporting less tangible and affectionate support than those with higher levels of these types of support.ConclusionsTangible and affectionate support have protective effects on anxiety symptoms among Spanish-speaking Latina breast cancer survivors experiencing Intrusive Thoughts, but not depression symptoms.
Lorenzo Cohen - One of the best experts on this subject based on the ideXlab platform.
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The association between social support, Intrusive Thoughts, avoidance, and adjustment following an experimental cancer treatment.
Psycho-oncology, 2003Co-Authors: Danielle Devine, Patricia A. Parker, Rachel T. Fouladi, Lorenzo CohenAbstract:A social-cognitive processing model was used to examine the association of social support with Intrusive Thoughts and avoidance in predicting adjustment in 53 patients receiving an experimental vaccine for the treatment of either metastatic melanoma (n=24) or metastatic renal cell cancer (n=29). Social support, Intrusive Thoughts/avoidance, psychological distress and quality of life were assessed on the day of the first treatment, on the day of the final treatment, and 1 month after the end of treatment during a routine follow-up visit. Social support at the beginning of treatment was negatively associated with psychological distress and positively associated with mental health quality of life (QOL) 1 month after treatment, and these associations were mediated by Intrusive Thoughts/avoidance at the end of treatment. There was also an interaction between social support and Intrusive Thoughts/avoidance at the beginning of treatment in predicting both psychological distress and mental health QOL 1 month after treatment. Specifically, for patients with lower levels of support, greater Intrusive Thoughts/avoidance was associated with greater psychological distress and poorer mental health QOL 1 month after treatment. However, there was no association between Intrusive Thoughts/avoidance and adjustment in patients with high levels of social support. These results suggest that social support buffers the negative association between Intrusive Thoughts/avoidance and psychological adjustment. Overall, the results are consistent with a social-cognitive processing model of post-trauma reactions among cancer patients. Our results highlight the need to assess patients' perceived support and to further develop and assess the benefits of interventions to increase patients' supportive networks and to facilitate cognitive processing of the cancer experience.
