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Objective: Obsessive compulsive disorder (OCD) is a clinical condition, which is formed by cognitive, emotional and behavioral components. According to cognitive model of OCD, development of OCD is associated with misinterpretation of normal intrusive thoughts, overinşated responsibility, thought suppression and thought action fusion. According to metacognitive therapy approach, ruminative thinking style plays an important role in the development and maintenance of OCD. This paper demonstrates the results of a study aimed to determine associations of OCD and emotional processing and cognitive processes.
Method: Forty-five Obsessive compulsive disorder (OCD) patients from a specialized outpatient clinic of Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery were enrolled into the study. Sociodemographic data form, Yale Brown Obsessive-compulsive Scale (Y-BOCS), Ruminative Thinking Style Scale (RTSS), Thought Action Fusion Scale (TAFS) and Leahy Emotional Schema Scale were used for assessment of cognitive and emotional processes of patients.
Results: Forty-six point eight percent of OCD patients had the clinical features of reactive subtype and 53.2% had autogenous features. In Y-BOCS total test score and sub-test scores did not differ in reactive and autogenous groups (p=0.370, p=0.607, p=0.374). The difference between RTSS scores of the two groups was not significant statistically (p=0.176). LESS-control, LESS-acceptance of emotions, LESS-expression subscale scores were higher in autogenous group (p=0.018, p=0.003, p=0.003) and LESS- comprehensibility subscale score was higher in reactive group (p=0.039). TAFS total score, TAFS-morality and TAFS-Likelihood subscale scores did not differ significantly between OCD subgroups (p=0.088, p=0.162, p=0.235). According to Spearmen Correlation Analysis; RTSS was positively correlated with Y-BOCS and LESS (p<0.001, p=0.034). Additionally, Y-BOCS and LESS were positively correlated with TAFS (p=0.031, p=0.011).
Conclusion: Consistent with the findings of the previous studies, severity of rumination was found to be correlated with obsessive-compulsive symptom severity. However, there were no differences in ruminative thinking style in between the reactive and autogenous subgroups. Our study also showed that thought-action fusion is associated with obsessive-compulsive symptom severity. Similar to the relationship of emotional schemas in all types of anxiety disorders, present study also showed that emotional schemas are highly related with OCD symptoms in both subgroups. Different high scores of sub-scales in OCD subgroups are coherent with the suggestion that OCD is a highly heterogeneous condition, which is composed of two distinct subtypes. These findings are expected to provide a basis for classifying and explaining the heterogeneous phenomena of obsessive–compulsive disorder, and application of tailored therapy approaches.