Rowa Karen, Purdon Christine, Summerfeldt Laura J, Antony Martin M
Anxiety Treatment and Research Centre, St. Joseph's Healthcare, Hamilton, Ont., and Department of Psychiatry and Behavioural Neurosciences, McMaster University, Canada.
Behav Res Ther. 2005 Nov;43(11):1453-65. doi: 10.1016/j.brat.2004.11.003. Epub 2005 Jan 28.
Little is known about why certain obsessional thoughts are more upsetting than others for people with obsessive compulsive disorder (OCD). Obsessional thought content often seems arbitrary to sufferers. The current study examined three possible reasons why particular thoughts would be especially upsetting for individuals, based on suggestions put forth by cognitive theories of obsessional thoughts. Twenty-eight individuals with a principal diagnosis of OCD completed questionnaires and interviews at two different periods of time on (1) their most upsetting current obsession and (2) their least upsetting current obsession. Results suggested that more upsetting obsessions were evaluated as more meaningful or significant than less upsetting obsessions, and more upsetting obsessions contradicted valued aspects of the self to a greater degree. All examples of current obsessions, both most and least upsetting, arose in the context of life concerns or issues. Results support cognitive theories in that the strength and nature of appraisal appears to be linked with the distress associated with a thought, and more upsetting thoughts are those that have implications for a person's sense of self.
对于患有强迫症（OCD）的人来说，为何某些强迫观念比其他观念更令人苦恼，目前所知甚少。强迫观念的内容对患者而言往往显得随意。基于强迫观念的认知理论所提出的建议，本研究考察了特定观念对个体格外令人苦恼的三个可能原因。28名主要诊断为强迫症的个体在两个不同时间段完成了问卷和访谈，内容涉及（1）他们当前最令人苦恼的强迫观念，以及（2）他们当前最不令人苦恼的强迫观念。结果表明，与不太令人苦恼的强迫观念相比，更令人苦恼的强迫观念被评估为更有意义或更重要，并且更令人苦恼的强迫观念在更大程度上与自我的重要方面相矛盾。当前所有强迫观念的例子，无论是最令人苦恼的还是最不令人苦恼的，都出现在生活关切或问题的背景中。结果支持认知理论，因为评估的强度和性质似乎与与一种观念相关的痛苦有关，而更令人苦恼的观念是那些对一个人的自我感有影响的观念。
