School of Psychological Sciences, Tel Aviv University, Israel.
School of Psychological Sciences, Tel Aviv University, Israel.
Behav Res Ther. 2021 Dec;147:103987. doi: 10.1016/j.brat.2021.103987. Epub 2021 Oct 8.
The Seeking Proxies for Internal States (SPIS) model of obsessive-compulsive disorder (OCD) proposes an account of OCD symptoms in terms of two core components: attenuation of access to internal states and seeking proxies for internal states. Specifically, the SPIS model posits that OCD is associated with difficulty in accessing various internal states, including feelings, preferences, memories, and even physiological states. This difficulty drives obsessive-compulsive individuals seek and rely on compensatory proxies, or substitutes, for their internal states. These proxies are perceived by the individual with OCD to be more easily discernible or less ambiguous compared to the internal states for which they substitute, and can take the form of fixed rules, rituals, or reliance on external sources of information. In the present article we first provide a detailed explanation of the SPIS model, and then review empirical studies that examined the model in a variety of domains, including bodily states, emotions, and decision-making. Next, we elaborate on the SPIS model's novel account of compulsive rituals, obsessions and doubt and relate them to extant theoretical accounts of OCD. To conclude, we highlight open questions that can guide future research and discuss the model's clinical implications.
寻求内部状态代理（SPIS）模型的强迫症（OCD）提出了一种用两个核心成分来解释 OCD 症状的方法：内部状态获取的衰减和寻求内部状态代理。具体来说，SPIS 模型假设 OCD 与各种内部状态的获取困难有关，包括感觉、偏好、记忆，甚至生理状态。这种困难促使强迫症患者寻求和依赖内部状态的补偿代理或替代品。与他们替代的内部状态相比，强迫症患者认为这些代理更容易辨别或不那么模糊，并且可以采取固定规则、仪式或依赖外部信息来源的形式。在本文中，我们首先详细解释了 SPIS 模型，然后回顾了在身体状态、情绪和决策等各种领域检验该模型的实证研究。接下来，我们详细阐述了 SPIS 模型对强迫性仪式、强迫观念和疑虑的新颖解释，并将其与 OCD 的现有理论解释联系起来。最后，我们强调了可以指导未来研究的开放性问题，并讨论了该模型的临床意义。
