University Medical Center Hamburg-Eppendorf, Germany.
Behav Cogn Psychother. 2013 Oct;41(5):594-609. doi: 10.1017/S1352465812000574. Epub 2012 Sep 13.
The social attitudes and interpersonal relationships of patients with obsessive-compulsive disorder (OCD) are subject to a longstanding controversy. Whereas cognitive-behavioural researchers emphasize exaggerated pro-social attitudes in OCD like inflated responsibility and worry for other people (especially significant others), dynamic theories traditionally focus on anti-social attitudes such as latent aggression and hostility. In two recent studies, we gathered support not only for a co-existence of these seemingly opposing attitudes in OCD, but also for a functional connection: inflated responsibility in part appears to serve as a coping strategy (or “defense”) against negative interpersonal feelings.
In the present study, we tested a shortened version of the Responsibility and Interpersonal Behaviours and Attitudes Questionnaire (RIBAQ-R).
The scale was administered to 34 participants with OCD and 34 healthy controls. The questionnaire concurrently measures pro-social and anti-social interpersonal attitudes across three subscales.
In line with our prior studies, patients displayed higher scores on both exaggerated pro-social attitudes (e.g. “I suffer from a strict conscience concerning my relatives”) as well as latent aggression (e.g. “Sometimes I would like to harm strangers on the street“) and suspiciousness/distrust (e.g. “I cannot even trust my own family”). A total of 59% of the patients but only 12% of the healthy controls showed marked interpersonal ambivalence (defined as scores higher than one standard deviation from the mean of the nonclinical controls on both the prosocial and at least one of the two anti-social subscales).
The study asserts high interpersonal ambivalence in OCD. Further research is required to pinpoint both the dynamic and causal links between opposing interpersonal styles. Normalization and social competence training may prove beneficial to resolve the apparent problems of patients with OCD regarding anger expression and social conflict management.
强迫症（OCD）患者的社会态度和人际关系一直存在争议。认知行为研究人员强调 OCD 患者存在夸大的亲社会态度，例如对他人（尤其是重要他人）过分负责和担忧，而传统的动力理论则侧重于反社会态度，如潜在的攻击性和敌意。在最近的两项研究中，我们不仅为 OCD 中这些看似对立的态度的共存提供了支持，还为它们之间的功能联系提供了支持：过分的责任感部分似乎是一种应对负面人际关系的策略（或“防御”）。
本研究旨在测试简化版责任与人际行为及态度问卷（RIBAQ-R）。
该量表被用于 34 名 OCD 患者和 34 名健康对照组。问卷同时测量了三个子量表中的亲社会和反社会人际态度。
与我们之前的研究一致，患者在夸大的亲社会态度（例如“我对亲戚有强烈的良心谴责”）以及潜在的攻击性（例如“有时我真想在街上伤害陌生人”）和多疑/不信任（例如“我甚至不能信任自己的家人”）方面的得分都较高。共有 59%的患者但只有 12%的健康对照组表现出明显的人际双重性（定义为在亲社会子量表和至少一个反社会子量表上的得分均高于非临床对照组平均值一个标准差以上）。
该研究认为 OCD 患者存在高度的人际双重性。需要进一步研究以确定对立人际风格之间的动态和因果联系。正常化和社交能力训练可能有助于解决 OCD 患者在表达愤怒和处理社交冲突方面的明显问题。
