The Nature and Management of Obsessive-Compulsive Checking
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Type
ThesisThesis type
Doctor of PhilosophyAuthor/s
Vaccaro, Lisa DanielaAbstract
Obsessive Compulsive Disorder (OCD) is a common and disabling condition with an approximate lifetime prevalence of 2%. While OCD is a heterogeneous condition, factor analyses have consistently identified obsessional doubts about harm and checking compulsions as one of the major ...
See moreObsessive Compulsive Disorder (OCD) is a common and disabling condition with an approximate lifetime prevalence of 2%. While OCD is a heterogeneous condition, factor analyses have consistently identified obsessional doubts about harm and checking compulsions as one of the major symptom dimensions. However, to date few studies have examined this OCD checking (OC-Ch) subtype. This thesis aimed to further research in this area by first examining the phenomenology of checking compulsions in a sample of 50 individuals with OC-Ch. The most commonly experienced harm-related obsessions were fears about harm to self (82%) and being responsible for something terrible happening (82%). The most common checking compulsion was checking locks/stove/appliances (96%). The findings also demonstrated the prominence of avoidance, obsessional slowness, doubting and indecision in this group, with consequential impairment and interference experienced across family, relationship, social, and work roles. Secondly, this thesis described the development of the new cognitive treatment package Danger Ideation Reduction Therapy for OCD Checkers (DIRT-C). Two studies investigated the effectiveness of this treatment. The first trial was a preliminary investigation in three people with OC-Ch. Substantial reductions in OCD symptomatology were experienced by all participants and improvements were maintained. The second trial involved 50 people with OC-Ch randomly allocated to either DIRT-C or Exposure Response Prevention (ERP). Clinically significant changes were obtained after both treatments. However, greater symptom reduction from post-treatment to follow-up was observed in the DIRT-C group compared to the ERP condition. Additionally, an examination of a variety of maladaptive beliefs, including danger expectancy and responsibility, found that change in checking symptoms following treatment was significantly and positively associated with change in dysfunctional beliefs about danger.
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See moreObsessive Compulsive Disorder (OCD) is a common and disabling condition with an approximate lifetime prevalence of 2%. While OCD is a heterogeneous condition, factor analyses have consistently identified obsessional doubts about harm and checking compulsions as one of the major symptom dimensions. However, to date few studies have examined this OCD checking (OC-Ch) subtype. This thesis aimed to further research in this area by first examining the phenomenology of checking compulsions in a sample of 50 individuals with OC-Ch. The most commonly experienced harm-related obsessions were fears about harm to self (82%) and being responsible for something terrible happening (82%). The most common checking compulsion was checking locks/stove/appliances (96%). The findings also demonstrated the prominence of avoidance, obsessional slowness, doubting and indecision in this group, with consequential impairment and interference experienced across family, relationship, social, and work roles. Secondly, this thesis described the development of the new cognitive treatment package Danger Ideation Reduction Therapy for OCD Checkers (DIRT-C). Two studies investigated the effectiveness of this treatment. The first trial was a preliminary investigation in three people with OC-Ch. Substantial reductions in OCD symptomatology were experienced by all participants and improvements were maintained. The second trial involved 50 people with OC-Ch randomly allocated to either DIRT-C or Exposure Response Prevention (ERP). Clinically significant changes were obtained after both treatments. However, greater symptom reduction from post-treatment to follow-up was observed in the DIRT-C group compared to the ERP condition. Additionally, an examination of a variety of maladaptive beliefs, including danger expectancy and responsibility, found that change in checking symptoms following treatment was significantly and positively associated with change in dysfunctional beliefs about danger.
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Date
2013-02-13Licence
The author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.Faculty/School
Faculty of Health SciencesAwarding institution
The University of SydneyShare