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强迫观念能否区分无抽动的强迫症患者与伴有抽动及妥瑞氏综合征的强迫症患者?

Do obsessional beliefs discriminate OCD without tic patients from OCD with tic and Tourette's syndrome patients?

作者信息

Anholt Gideon E, Cath Danielle C, Emmelkamp Paul M G, van Oppen Patricia, Smit Johannes H, van Balkom Anton J L M

机构信息

Department of Clinical Psychology, University of Amsterdam, The Netherlands.

出版信息

Behav Res Ther. 2006 Nov;44(11):1537-43. doi: 10.1016/j.brat.2005.11.007. Epub 2006 Feb 14.

Abstract

UNLABELLED

There is considerable overlap in symptomatology between Tourette's syndrome (TS) and obsessive-compulsive disorder (OCD). Increased rates of tics are found in OCD and up to 60% obsessive-compulsive symptoms in TS. However, in OCD obsessive-compulsive symptoms are more often anxiety-related and, as a consequence, aimed at anxiety-reduction, whereas in TS these symptoms are more stimulus-bound. Therefore, it is of clinical interest to study whether these phenomenological differences are reflected in differences between dysfunctional cognitions accompanying OC symptoms in OCD with or without tics and TS. Current cognitive theory of OCD ascertains that specific dysfunctional beliefs are important in the etiology and maintenance of OCD. To assess these beliefs, the obsessive-compulsive beliefs questionnaire-87 (OBQ-87) has been developed. In the present study, OBQ-87 scores of OCD patients without tics, OCD with tics, and TS (without OCD) patients were compared to those of normal controls.

RESULTS

OCD without tic patients exhibited higher OBQ-87 scores than TS patients. No differences were found between OCD with or without tic patients on any of the OBQ-87 subscales. These results suggest that: (1) dysfunctional beliefs have no discriminative power with respect to OCD with or without tic patients; (2) the direct relationship between types of OC symptoms and specific dysfunctional beliefs is questionable. Therefore, one can doubt the specificity of cognitive theory of OCD to explain specific OC behavior.

摘要

未标注

抽动秽语综合征(TS)和强迫症(OCD)在症状学上有相当大的重叠。在强迫症患者中发现抽动发生率增加,而在抽动秽语综合征患者中高达60%有强迫症状。然而,在强迫症中,强迫症状更常与焦虑相关,因此旨在减轻焦虑,而在抽动秽语综合征中,这些症状更多地受刺激约束。因此,研究这些现象学差异是否反映在伴有或不伴有抽动的强迫症以及抽动秽语综合征中强迫症状所伴随的功能失调认知差异上具有临床意义。当前的强迫症认知理论确定特定的功能失调信念在强迫症的病因和维持中很重要。为了评估这些信念,已经开发了强迫信念问卷-87(OBQ-87)。在本研究中,将无抽动的强迫症患者、有抽动的强迫症患者和抽动秽语综合征(无强迫症)患者的OBQ-87得分与正常对照组进行了比较。

结果

无抽动的强迫症患者的OBQ-87得分高于抽动秽语综合征患者。在OBQ-87的任何子量表上,有或无抽动的强迫症患者之间均未发现差异。这些结果表明:(1)功能失调信念对有或无抽动的强迫症患者没有鉴别能力;(2)强迫症状类型与特定功能失调信念之间的直接关系值得怀疑。因此,人们可能会怀疑强迫症认知理论解释特定强迫行为的特异性。

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