Hacia la comprensión de factores comunes entre trastornos clínicamente distintos: Las intrusiones mentales en el espectro obsesivo-compulsivo.
DOI:
https://doi.org/10.5944/rppc.30174Palabras clave:
Intrusiones mentales, transdiagnóstico, trastorno obsesivo-compulsivo, espectro obsesivo-compulsivo.Agencias Financiadoras:
Ministerio de Economía y Competitividad (España) (referencia, PSI2013-44733-R)Resumen
Understanding common factors between clinically different disorders: Mental intrusions in the obsessivecompulsive
spectrum
Abstract: This study examines whether the propensity to experience obsessive, dysmorphic, hypochondriac and eating-related unwanted mental intrusions (UMIs) is a common vulnerability factor for these disorders. A total of 149 university students completed the Questionnaire of Unpleasant Intrusive Thoughts (QUIT) that assesses the frequency of and disturbance caused by the four UMI contents as well as self-reports of symptoms. 26.17% of participants experienced the four UMI contents during the past three months. The scores of each UMI were related to their specific self-report of symptoms and predicted the scores on these self-reports. Among those participants who experienced the four UMIs, 61.53% were at risk of obsessive-compulsive disorder (OCD). These subjects, compared to those who also experienced the four UMIs but were at low risk of OCD, reported more negative consequences when they experienced an UMI, regardless of its content. UMIs could be transdiagnostic and common vulnerability factors for different mental disorders.
Keywords: Mental intrusions; transdiagnostic; obsessive-compulsive disorder; obsessive-compulsive spectrum.
Resumen: Este estudio examina si la propensión a experimentar intrusiones mentales no deseadas (IM) con contenidos obsesivos, dismórficos, hipocondríacos y alimentarios es un factor común de vulnerabilidad para esos trastornos. Un total de 149 estudiantes universitarios completaron el Inventario de Pensamientos Intrusos Desagradables (INPIDES), que evalúa la frecuencia y el malestar con que se experimentan los cuatro contenidos de IM, junto con autoinformes de síntomas. El 26.17% había experimentado las cuatro IM en los tres meses previos. Las puntuaciones de cada IM correlacionaron con su autoinforme específico de síntomas y predijeron las puntuaciones en ellos. El 61.53% de quienes tuvieron las cuatro IM, presentó riesgo de trastorno obsesivo-compulsivo (TOC). Estas personas, comparadas con quienes también habían experimentado las cuatro IM pero tenían bajo riesgo de TOC, informaron de más consecuencias negativas cuando tenían una IM, independientemente de su contenido. Las IM podrían ser factores transdiagnósticos y de vulnerabilidad comunes a trastornos mentales distintos.
Palabras clave: intrusiones mentales; transdiagnóstico; trastorno obsesivo-compulsivo; espectro obsesivo-compulsivo.
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Referencias
Abramowitz, J.S., & Jacoby, R.J. (2015). Obsessive-compulsive and related disorders: A critical review of the new diagnostic class. Annual Review of Clinical Psychology, 11, 165-186. http://dx.doi.org/10.1146/annurev-clinpsy-032813-153713
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: Author.
Arnáez, S., García-Soriano, G., & Belloch, A. (2017). Hypochondriasis and illness intrusions: Development and validation of an assessment instrument. Behavioral Psychology/Psicología Conductual, 25, 165-186.
Avia, M.D. (1993). Hipocondría. (Hypochondriasis). Barcelona: Martínez Roca.
Aldao, A. (2012). Emotion regulation strategies as transdiagnostic processes: A closer look at the invariance of their form and function. Revista de Psicopatología y Psicología Clínica, 17, 261-277. http://dx.doi.org/10.5944/rppc.vol.17.num.3.2012.11843
Belloch, A. (2012). Propuestas para un enfoque transdiagnóstico de los trastornos mentales y del comportamiento: Evidencia, utilidad y limitaciones. Revista de Psicopatología y Psicología Clínica, 17 (3), 295-311. https://doi.org/10.5944/rppc.vol.17.num.3.2012.11845
Belloch, A., Carrió, C., Cabedo, E., & García-Soriano, G. (2015). Discovering what is hidden: The role of non-ritualized covert neutralizing strategies in obsessive-compulsive disorder. Journal of Behavior Therapy and Experimental Psychiatry, 49, 180-187. http://dx.doi.org/10.1016/j.jbtep.2015.02.006
Belloch, A., Roncero, M., García-Soriano, G., Carrió, C., Cabedo, E., & Fernández-Álvarez, H. (2013). The Spanish version of the Obsessive-Compulsive Inventory-Revised (OCI-R): Reliability, validity, diagnostic accuracy, and sensitivity to treatment effects in clinical samples. Journal of Obsessive-Compulsive and Related Disorders, 2, 249-256. https://dx.doi.org/10.1016/j.jocrd.2013.05.001
Belloch, A., Roncero, M., & Perpiñá, C. (2016). Obsessional and eating disorder‐related intrusive thoughts: Differences and similarities within and between individuals vulnerable to OCD or to EDs. European Eating Disorders Review, 24, 446-454. http://dx.doi.org/10.1002/erv.2458
Blackburn, J.F., Thompson, A.R., & May, J. (2012). Feeling good about being hungry: Food-related thoughts in eating disorders. Journal of Experimental Psychopathology, 3, 243-257. http://dx.doi.org/10.5127/jep.018711
Castro, J., Toro, J., Salamero, M., & Guimerá, E. (1991). The Eating Attitudes Test: Validation of the Spanish version. Evaluación Psicológica, 7, 175-189.
Clark, D.A., & Rhyno, S. (2005). Unwanted intrusive thoughts in non-clinical individuals. In: Clark, D.A. (Ed.) (2005). Intrusive thoughts in clinical disorders. Theory, research and treatment (pp.1-29). New York, NY: Guilford Press.
Fang, A., & Wilhelm, S. (2015). Clinical features, cognitive biases, and treatment of body dysmorphic disorder. Annual Review of Clinical Psychology, 11, 187-212. http://dx.doi.org/10.1146/annurev-clinpsy-032814-112849
Foa, E. B., Huppert, J. D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., & Salkovskis, P. M. (2002). The Obsessive-Compulsive Inventory: development and validation of a short version. Psychological Assessment, 14, 485-496 http://dx.doi.org/10.1037/1040-3590.14.4.485
García-Soriano, G., Belloch, A., Morillo, C., & Clark, D.A. (2011). Symptom dimensions in obsessive-compulsive disorder: From normal cognitive intrusions to clinical obsessions. Journal of Anxiety Disorders, 25, 474-482. http://dx.doi.org/10.1016/j.janxdis.2010.11.012
García-Soriano, G., Roncero, M., Perpiñá, C., & Belloch, A. (2014). Intrusive thoughts in obsessive–compulsive disorder and eating disorder patients: A differential analysis. European Eating Disorders Review, 22, 191-199. http://dx.doi.org/10.1002/erv.2285
Garner, D. M., Olmsted, M. P., Bohr, Y., & Garfinkel, P. E. (1982). The eating attitudes test: psychometric features and clinical correlates. Psychological Medicine, 12 (4), 871-878. https://dx.doi.org/10.1017/S0033291700049163
Giraldo O'Meara, M. (2017). Universalidad y dimensionalidad de los pensamientos intrusos relacionados con el aspecto físico y su relación con la habilidad metacognitiva. (Universality and dimensionality of appearance-related defects intrusive thoughts and their relationsiphs with the metacognitive ability.) Tesis Doctoral. Universidad de Valencia, España. http://hdl.handle.net/10550/58521
Giraldo-O’Meara, M., & Belloch, A. (2018). Escalation from normal appearance related intrusive cognitions to clinical preoccupations in Body Dysmorphic Disorder: A cross-sectional study. Psychiatry Research, 265, 137-143. https://doi.org/10.1016/j.psychres.2018.04.047
Giraldo-O'Meara, M., & Belloch, A. (2019). The Appearance Intrusions Questionnaire: A self-report questionnaire to assess the universality and intrusiveness of preoccupations about appearance defects. European Journal of Psychological Assessment, 35, 423-435. doi:10.1027/1015-5759/a000406
Kogan, C.S., Stein, D.J., Maj, M., First, M.B., Emmelkamp, P.M., & Reed, G.M. (2016). The classification of anxiety and fear-related disorders in the ICD-11. Depression and Anxiety, 33, 1141-1154. http://dx.doi.org/10.1002/da.22530
Kollei, I., Schieber, K., de Zwaan, M., Svitak, M., & Martin, A. (2013). Body dysmorphic disorder and nonweight-related body image concerns in individuals with eating disorders. International Journal of Eating Disorders, 46, 52-59. http://dx.doi.org/10.1002/eat.22067
Muse, K., McManus, F., Hackmann, A., Williams, M., & Williams, M. (2010). Intrusive imagery in severe health anxiety: Prevalence, nature and links with memories and maintenance cycles. Behaviour Research and Therapy, 48, 792-798. http://dx.doi.org/10.1016/j.brat.2010.05.008
Nolen-Hoeksema, S., & Watkins, E.R. (2011). A heuristic for developing transdiagnostic models of psychopathology: Explaining multifinality and divergent trajectories. Perspectives on Psychological Science 6, 589–609. http://dx.doi.org/10.1177/1745691611419672
Obsessive Compulsive Cognitions Working Group (2003). Psychometric validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory: Part I. Behaviour Research and Therapy, 41, 863-878. http://dx.doi.org/10.1016/S0005-7967(02)00099-2
Osman, S., Cooper, M., Hackmann, A., & Veale, D. (2004). Spontaneously occurring images and early memories in people with body dysmorphic disorder. Memory, 12, 428-436. http://dx.doi.org/10.1080/09658210444000043
Pascual-Vera, B., Akin, B., Belloch, A., Bottesi, G., Clark, D.A., Doron, G., et al. (2019). The cross-cultural expression and transdiagnostic nature of unwanted mental intrusions. International Journal of Clinical and Health Psychology, 19, 85-96. https://doi.org/10.1016/j.ijchp.2019.02.005
Pascual Vera, B., & Belloch, A. (2018a). El carácter transdiagnóstico de las intrusiones mentales: una revisión y una propuesta basada en datos. Revista de Psicopatología y Psicología Clínica, 23 (2), 135-147. https://doi.org/10.5944/rppc.vol.23.num.2.2018.20738
Pascual-Vera, B., & Belloch, A. (2018b). Functional links of obsessive, dysmorphic, hypochondriac, and eating-disorders related mental intrusions. International Journal of Clinical and Health Psychology, 18, 43-51. http://dx.doi.org/10.1016/j.ijchp.2017.09.001
Pascual-Vera, B., Roncero, M., & Belloch (2017). Are unwanted mental intrusions a transdiagnostic variable? Psicothema, 29, 166-171. http://dx.doi.org/10.7334/psicothema2016.199
Pilowsky, I., Spence, N., Cobb, J., & Katsikitis, M. (1984). The Illness Behavior Questionnaire as an aid to clinical assessment. General Hospital Psychiatry, 6, 123-130. https://dx.doi.org/10.1016/0163-8343(84)90070-7
Phillips, K.A., Atala, K.D., & Pope, H.G. (1995). Diagnostic instruments for body dysmorphic disorder. In American Psychiatric Association (Ed.). New research program and abstracts. 148th meeting of the American Psychiatric Association. Miami:American Psychiatric Association.
Phillips, K.A., Wilhelm, S., Koran, L.M., Didie, E.R., Fallon, B.A., Feusner, J., & Stein, D.J. (2010). Body dysmorphic disorder: Some key issues for DSM‐V. Depression and Anxiety, 27, 573-591. http://dx.doi.org/10.1002/da.20709
Purdon, C., Gifford, S., McCabe, R., & Antony, M. M. (2011). Thought dismissability in obsessive-compulsive disorder versus panic disorder. Behaviour Research and Therapy, 49, 646-653. https://dx. doi.org/10.1016/j.brat.2011.07.001
Rachman, S. (1981). Part 1. Unwanted intrusive cognitions. Advances in Behaviour Research and Therapy, 3, 89-99. http://dx.doi.org/10.1016/0146-6402(81)90007-2
Steketee, G (Ed.). (2012). The Oxford Handbook of Obsessive-Compulsive and Spectrum Disorders. New York, NY: Oxford Univ. Press.
Stein, D.J., Kogan, C.S., Atmaca, M., Fineberg, N.A., Fontenelle, L.F.,
Grant, J.E.,… Reed, G.M. (2016).The classification of obsessive-compulsive and related disorders in the ICD-11. Journal of Affective Disorders, 190, 663-674. http://dx.doi.org/10.1016/j.jad.2015.10.061
