University of Miami, Coral Gables, Florida, USA.
Bowdoin College, Brunswick, Maine, USA.
Br J Clin Psychol. 2021 Sep;60(3):293-311. doi: 10.1111/bjc.12290. Epub 2021 Apr 9.
Obsessive-compulsive disorder (OCD) is a condition marked by recurrent and distressing thoughts, images, and urges accompanied by repetitive physical or mental rituals. An emerging line of work suggests that emotion may be an important consideration when looking at the role of impulsivity across the spectrum of psychopathology, including OCD. The current study examined the relationship between obsessive-compulsive symptomatology (OCS) and impulsive cognitive and behavioural reactions to emotion using a multi-study, multi-method approach.
Data were collected cross-sectionally online (Study 1) or via an in-person laboratory visit (Study 2).
In Study 1, self-report measures of impulsivity and OCS were administered to a large, non-selected community sample (N = 386). Study 2 extended these findings with a young adult sample (N = 107) with clinically elevated OCS using self-report measures, clinical interview, and two behavioural symptom provocation tasks.
Emotion-related impulsivity, but not non-emotion-related impulsivity, was associated with greater severity of OCS across symptom domains and across all modes of assessment. Impulsive cognitive responses to emotion were associated with greater obsession severity, while impulsive behavioural reactions to emotion were associated with greater compulsions. Emotion-related impulsivity also acted synergistically with a belief in the importance and control of thoughts, such that this established risk factor for OCD was associated with greater OCS severity only when behavioural reactivity to emotion was also present.
Results highlight the importance of considering emotional context when studying impulsivity in OCD, and point to the potentially differential relationship between OCS and behavioural versus cognitive impulsive reactions to emotion.
Emotion-related impulsivity (ERI) reflects a tendency to act impulsively in the context of strong emotions. ERI was associated with greater OCS across symptom domains and type of symptom assessment (self-report, interview, or symptom provocation). ERI also interacted with an established OCS risk factor, a belief in the importance and control of thoughts, to predict symptom severity, suggesting that it may be important to evaluate and address ERI alongside unhelpful beliefs in patients with OCS. Given the present study's cross-sectional nature, we cannot draw conclusions about the directionality of the ERI - OCS relationship, and while our study included individuals with clinically elevated OCS, results should be replicated in a fully clinical sample.
强迫症（OCD）是一种以反复出现的痛苦思想、意象和冲动为特征的疾病，并伴有重复的躯体或精神仪式。越来越多的研究表明，在观察包括 OCD 在内的精神病理学谱系中的冲动性时，情绪可能是一个重要的考虑因素。本研究采用多研究、多方法的方法，考察了强迫症状（OCS）与对情绪的冲动认知和行为反应之间的关系。
数据通过在线（研究 1）或面对面实验室访问（研究 2）进行横断面收集。
在研究 1 中，对一个大型、非选择性的社区样本（N=386）进行了冲动性和 OCS 的自我报告测量。研究 2 使用自我报告测量、临床访谈和两项行为症状激发任务，对具有临床显著 OCS 的年轻成年样本（N=107）扩展了这些发现。
情绪相关的冲动性，而不是非情绪相关的冲动性，与所有症状领域和所有评估模式的 OCS 严重程度相关。对情绪的冲动认知反应与更严重的强迫症状有关，而对情绪的冲动行为反应与更严重的强迫症状有关。情绪相关的冲动性也与对思维的重要性和控制力的信念协同作用，即这种 OCD 的既定风险因素仅在情绪反应行为也存在时才与更严重的 OCS 严重程度相关。
结果强调了在 OCD 中研究冲动性时考虑情绪背景的重要性，并指出 OCS 与情绪冲动反应的行为与认知之间可能存在差异。
情绪相关的冲动性（ERI）反映了在强烈情绪背景下冲动行事的倾向。ERI 与所有症状领域和症状评估类型（自我报告、访谈或症状激发）的 OCS 严重程度相关。ERI 还与 OCD 的一个既定风险因素，即对思维的重要性和控制力的信念相互作用，以预测症状严重程度，这表明在 OCD 患者中，评估和解决 ERI 以及无益的信念可能很重要。鉴于本研究的横断面性质，我们不能得出 ERI-OCS 关系的方向性结论，而且虽然我们的研究包括临床 OCS 水平较高的个体，但结果应在完全临床样本中得到复制。
