School of Psychology, Ridley Building 1, Newcastle University, Queen Victoria Road, Newcastle upon Tyne NE1 7RU, UK.
School of Psychology, Ridley Building 1, Newcastle University, Queen Victoria Road, Newcastle upon Tyne NE1 7RU, UK; Northumberland Tyne and Wear NHS Foundation Trust, UK.
Clin Psychol Rev. 2014 Apr;34(3):256-71. doi: 10.1016/j.cpr.2014.03.003. Epub 2014 Mar 15.
Increasing attention has focused on the role of emotion and internal experience in Obsessive Compulsive Disorder (OCD). This review examines three key constructs that capture different aspects of understanding, appraisal and tolerance of internal states in OCD - alexithymia, anxiety sensitivity (AS) and distress tolerance (DT). The review examines the evidence for the role each of these constructs plays in OCD and considers whether conclusions can be drawn about the implications for our understanding and treatment of OCD. There is evidence that all three are elevated in clinical cases compared to controls, but there is no evidence that any of the three shows specificity for OCD over other anxiety disorders. However, the review has highlighted significant methodological heterogeneity and consequent variation in findings that currently limits broader conclusions from being drawn. There is an indication that this is a valuable area to explore and future studies should focus on deriving greater conceptual clarity around these constructs, independently replicating findings, and establishing a common methodology to enhance the comparability of studies. Studies exploring the ways in which internal experience, cognitions and symptoms may relate to one another would be of significant value in developing models that then lead to improved treatment approaches.
越来越多的人关注情绪和内在体验在强迫症（OCD）中的作用。本综述探讨了三个关键结构，它们分别捕获了 OCD 中理解、评估和容忍内在状态的不同方面：述情障碍、焦虑敏感性（AS）和痛苦耐受力（DT）。本综述考察了这些结构中的每一个在 OCD 中所扮演的角色，并考虑了这些结论对我们理解和治疗 OCD 的意义。有证据表明，与对照组相比，所有这三个结构在临床病例中都升高，但没有证据表明这三个结构中的任何一个比其他焦虑障碍更具有 OCD 的特异性。然而，综述强调了方法学上的显著异质性，以及目前限制得出更广泛结论的发现的变化。有迹象表明，这是一个值得探索的有价值领域，未来的研究应集中在这些结构上获得更大的概念清晰度，独立复制发现，并建立共同的方法，以提高研究的可比性。探索内在体验、认知和症状之间可能相互关联的方式的研究将对开发能够改善治疗方法的模型具有重要价值。
