Highlights of: A novel approach to challenging OCD related beliefs using a mobile-app: An exploratory study
Background and objectives: According to cognitive models, obsessive compulsive symptoms result from catastrophic misinterpretations of commonly occurring intrusive experiences and the use of counterproductive strategies to manage them. Obsessive Compulsive Disorder (OCD) related beliefs such as inflated responsibility, importance of thoughts and perfectionism increases the likelihood of such misinterpretations. Consistent with a growing body of literature supporting the usefulness of mobile delivered technologies in fostering cognitive behavior change, the present study assessed the effectiveness of a novel cognitive training exercise designed to challenge OCD-related beliefs. This mobile app training exercise consists of users having to pull statements challenging OCD beliefs towards themselves (downwards) and to throw away (push upwards) contra-productive self-statements. Methods: 36 third-year BA students started the trial. Twenty completed pre and post measures of OCD-beliefs, mood and OCD symptoms including relationship-obsessions. Participants were instructed to complete 3 min of daily training for a period of 15 days. Results: No significant differences were found between completers and non-completers on demographic and most symptom related measures at Time 1. Repeated-measures MANOVA of the 20 completers showed a significant reduction on all OCD symptoms measures and on OCD-beliefs. No significant reduction was found in depression symptoms. Regression analysis showed change in levels of OCD-beliefs was associated with reduction in OCD symptoms at Time 2 over and above OCD symptoms at Time 1. Limitations: The study is an open trial with non-clinical participants. Conclusions: This mobile delivered training exercise may be useful for the reduction and relapse prevention of OCD-related beliefs and symptoms.
- A novel, mobile delivered, cognitive training exercise is evaluated.
- This training exercise is designed to challenge OCD-related beliefs.
- Training included 2-min daily training for a period of 15 days.
- Training lead to large-effect size reductions in levels of OCD-related beliefs.
- Pre-post changes in OCD-beliefs were associated with reductions in OCD symptoms.
Cite: Roncero, M., Belloch, A., & Doron, G. (2018). A novel approach of challenging OCD related beliefs using a mobile-app: An exploratory study. Journal of Behavior Therapy and Experimental Psychiatry, 59, 157-160.
Highlights of: “I can’t stop thinking about my child’s flaws”: An investigation of parental preoccupation with their children’s perceived flaws [Doron, Derby & Szepsenwol, 2017]
Parent-child obsessive-compulsive (OC) symptoms involve obsessive preoccupation on perceived flaws in one’s child. Such preoccupation is often accompanied by compulsive behaviors aimed at alleviating the resulting distress. Parent-child OC symptoms can be construed as an additional presentation of Relationship Obsessive Compulsive Disorder (ROCD), a presentation of obsessive compulsive disorder (OCD) in which symptoms are centered on a significant other. In this study, a self-report scale for assessing parent-child ROCD symptoms (the PROCSI-PC) was created on the bases of an existing partner-focused ROCD scale. Confirmatory Factor Analysis conducted on a sample of 350 parents supported a five factor solution of the PROCSI-PC corresponding to five perceived-flaw domains: appearance, intelligence, competence, morality, and sociability-stability. The PROCSI-PC total score was associated with parental OCD and mood symptoms, and with parental stress. Moreover, the PROCSI-PC was associated with greater depression above and beyond the effect of parental OCD symptoms, and with greater parental stress above and beyond the effects of OCD symptoms and depression. Finally, the PROCSI-PC was linked to self-reported disability resulting from obsessive preoccupation of parents on their child’s perceived flaws. The results indicate the parent-child OC symptoms may be a prevalent source of unique distress that is especially challenging for parents.
- Parental preoccupation with their children’s perceived flaws are investigated.
- A measure assessing parent-child ROCD symptoms is validated.
- Parent-child ROCD symptoms are associated with increased parental stress, low mood, and OCD symptoms.
- Parental reports indicate parent-child ROCD symptoms cause significant disability.
Cite: Doron, G., Derby, D., & Szepsenwol. O. (2017). “I can’t stop thinking about my child’s flaws”: An investigation of parental preoccupation with their children’s perceived flaws. Journal of Obsessive-Compulsive and Related Disorders, 14, 106-111. doi: 10.1016/j.jocrd.2017.06.007
Highlights of: Assessment and treatment of relationship-related OCD symptoms (ROCD): A modular approach [Doron & Derby, 2017]
Relationship Obsessive Compulsive disorder (ROCD) is a challenging disorder to treat. In this chapter we review theory and findings relating to current research focusing on ROCD, particularly in the context of romantic relationships. We use a case example throughout the chapter to present assessment and treatment interventions based on the proposed development and maintenance model.
Cite: Doron, G., & Derby, D. (2017). Assessment and treatment of relationship-related OCD symptoms (ROCD): A modular approach. In J. S. Abramowitz, D. McKay, & E. A. Storch (Eds.), The Wiley Handbook of Obsessive Compulsive Disorders, 547.
Highlights of: Letting It Linger: : Exploring the Longitudinal Effects of Relationship-Related Obsessive-Compulsive Phenomena [Szepsenwol, Shahar, & Doron, 2016]
Background. Relationship obsessive-compulsive disorder (ROCD) symptoms are characterized by obsessive doubts and preoccupation centered on the relationship (i.e., relationship-centered) or the relationship partner (i.e. partner-focused). Such obsessions often lead to significant distress and are associated with compulsive behaviors (e.g., compulsive checking and reassurance seeking) aimed at mitigating this distress. The current study examined the reciprocal relationship between partner-focused and relationship-centered obsessive-compulsive (OC) symptoms over time. Method. Participants (N = 141) completed measures of partner-focused and relationship-centered OC symptoms at two time points one year apart. Results. Partner-focused symptoms were associated with a relative increase in relationship-centered symptoms one year later. Relationship-centered symptoms were associated with the persistence of partner-focused symptoms one year later, but only among individuals in long-lasting relationships. The potentially detrimental effects of ROCD symptoms within romantic relationships are discussed.
- One year longitudinal links between two ROCD presentations were assessed.
- Partner-focused symptoms were linked with increased relationship-centered symptoms.
- Relationship-centered symptoms were linked with increased partner-focused symptoms.
- The latter links were found only among individuals in long-lasting relationships
- ROCD phenomena may self-perpetuate over time
Cite: Szepsenwol. O., Shahar, B., & Doron, G. (2016). Letting it Linger: Exploring the Longitudinal Effects of Relationship-Related Obsessive-Compulsive Phenomena. Journal of Obsessive-Compulsive and Related Disorders, 11, 101-104. doi: 10.1016/j.jocrd.2016.10.001
Highlights of: Relationship obsessive compulsive disorder (ROCD): Interference, symptoms and maladaptive beliefs [Doron, Derby, Szepsenwol, Nahaloni., & Moulding, 2016]
Background. Obsessive preoccupation, doubts, and compulsive behaviors focusing on one’s romantic relationship and partner are receiving increasing clinical, theoretical and empirical attention. Commonly referred to as relationship obsessive-compulsive disorder (ROCD), such symptoms have been linked with decreased relational and sexual functioning and lower mood, even after controlling for other obsessive-compulsive disorder (OCD) symptoms. To date, however, these symptoms have been studied in community sample alone. In the present study, we compared levels of interference, OCD and mood symptom between clinical participants with ROCD, OCD and community controls. We also examined group differences in maladaptive beliefs previously linked with OCD and ROCD.
Method. Participants included 22 ROCD clients, 22 OCD clients, and 28 community controls. The Mini International Neuropsychiatric Interview was used to attain clinical diagnoses of OCD and ROCD. The Yale Brown Obsessive-Compulsive Scale was used to evaluate primary-symptoms severity. All participants completed measures of symptoms and dysfunctional beliefs.
Results. ROCD clients reported more severe ROCD symptoms than the OCD and control groups. ROCD and OCD clients did not differ in severity of their primary-symptoms. ROCD clients scored higher than the other groups on maladaptive OCD-related and relationship-related beliefs. Finally, ROCD clients showed more severe depression symptoms than community controls.
Conclusions. ROCD is a disabling presentation of OCD that warrants research attention. Maladaptive OCD-related and relationship-related beliefs may be implicated in the development and maintenance of ROCD.
Cite: Doron, G., Derby, Szepsenwol. O., Nahaloni, E., & Moulding, R. (2016). Relationship obsessive compulsive disorder (ROCD): Interference, symptoms and maladaptive beliefs. Frontiers Psychiatry. doi: 10.3389/fpsyt.2016.00058.
Highlights of: Partner-focused obsessions and self-esteem: An experimental investigation [Doron & Szepsenwol, 2015]
Background: Relationship-related obsessive-compulsive phenomena (ROCD) are encountered frequently in the clinic, and involve severe consequences to personal and relational well-being. One common presentation of ROCD involves disabling preoccupation and doubts focusing on intimate partner’s flaws (partner-focused obsessions). It was previously suggested that individuals perceiving their partner’s failures or flaws as reflecting on their own self-worth may be more sensitive to intrusive thoughts pertaining to their partner’s qualities and characteristics. In the current studies, we assessed the link between partner-focused OC symptoms and self-esteem contingent on partner-value. Methods: In two studies we assessed the impact of experimentally induced partner-focused intrusions on self-esteem. In Study 1, we assessed individuals’ self-esteem after one of three primes: (a) intrusion about one’s partner comparing unfavorably with others of the same sex (i.e., alternative partners), (b) intrusion about one’s partner comparing unfavorably to oneself, (c) and a neutral prime. In study 2, we tried to replicate Study 1 and also examine whether favorable intrusions of one’s partner would have an opposite effect on self-esteem than unfavorable intrusions. Results: Compared with the other groups, participants who were primed with intrusions of their partner being unfavorably compared to others reported lower self-esteem, but only if they had high levels of partner-focused symptoms. Favorable intrusions of partner to others did not have a positive effect on self-esteem among individuals with high levels of partner-focused symptoms. Conclusions: Partner-value self-sensitivity may be one of the perpetuating mechanisms involved in partner-focused OC phenomena.
- Partner-focused OC symptoms are associated with self-esteem (SE) sensitivity to negative partner-related intrusive thoughts.
- Exposure to unfavorable intrusions of one’s partner to alternative partners decreases SE in individuals with high partner-focused symptoms.
- SE of individuals with high partner-focused symptoms does not benefit from favorable intrusions of the same kind.
- Treatments addressing such sensitivities may prove useful when treating Partner focused OC phenomena.
Cite: Doron, G., & Szepsenwol. O. (2015). Partner-focused obsessions and self-esteem: An experimental investigation. Journal of Behavior Therapy and Experimental Psychiatry, 49, 173-179.
Relationship Obsessive Compulsive Disorder (ROCD) is marked by the presence of obsessions and compulsions focusing on romantic relationships. ROCD symptoms were previously linked with decreased relationship quality and might interfere with sexual functioning. In this study, we examined the association between ROCD symptoms and sexual satisfaction. Participants completed an online survey assessing ROCD symptoms, relationship and sexual satisfaction levels. Depression, general worry, obsessive compulsive disorder (OCD) symptoms and attachment orientation were also measured. Findings suggest that ROCD symptoms were associated with decreased sexual satisfaction over and above symptoms of depression, general worry, OCD and attachment orientation. The link between ROCD symptoms and sexual satisfaction was mediated by relationship satisfaction. Identifying and addressing ROCD symptoms may be important for treatment of sexual functioning.
Cite: Doron, G., Mizrahi, M., Szepsenwol, O., & Derby, D. (2014). Right or Flawed: Relationships Obsessions and Sexual Satisfaction. Journal of Sexual Medicine, 11, 2218-2224.
Obsessive compulsive disorder (OCD) is a disabling and prevalent disorder with a variety of clinical presentations and obsessional themes. Recently, research has begun to investigate relationship-related obsessive-compulsive (OC) symptoms including relationship-centered and partner-focused OC symptoms. In this paper, we present relationship obsessive compulsive disorder (ROCD), delineate its main features, and describe its phenomenology. Drawing on recent cognitive-behavioral models of OCD, social psychology and attachment research, we present a model of the development and maintenance of ROCD. The role of personality factors, societal influences, parenting, and family environments in the etiology and preservation of ROCD symptoms is also evaluated. Finally, the conceptual and empirical links between ROCD symptoms and related constructs are explored and theoretically driven assessment and intervention procedures are suggested.
- The phenomenology of relationship obsessive compulsive disorder (ROCD) is described
- A conceptual framework for ROCD is offered
- Development and maintenance mechanisms are proposed
- Links between ROCD and related constructs are discussed
- Suggestions for assessment and treatment are made
Cite: Doron, G., Derby, D. S., & Szepsenwol, O. (in press). Relationship obsessive compulsive disorder (ROCD): A conceptual framework. Journal of Obsessive-Compulsive and Related Disorders, 3, 169-180. http://dx.doi.org/10.1016/j.jocrd.2013.12.005
Highlights of:Obsessing about intimate-relationships: Testing the Double Relationship-Vulnerability Hypothesis [Doron et al., 2013]
Background and Objectives: Obsessive preoccupation and doubts centering on one’s intimate relationship may have a negative impact on the romantic dyad and lead to significant distress. In this research we investigated whether the co-occurrence of attachment anxiety and overreliance on intimate relationships for self-worth—what we call double relationship-vulnerability—is linked with relationship-centered obsessions and obsessive-compulsive tendencies. Method: Study 1 employed a correlational design to examine the link between double relationship-vulnerability and relationship-centered obsessions. Study 2 employed an experimental design to assess response to subtle threats to the relationship self-domain among individuals with double relationship-vulnerability. Results: Study 1 supported the link between double relationship-vulnerability and relationship-centered obsessions. Study 2 showed that when confronted with subtle threats to the relationship self-domain, individuals with double relationship-vulnerability are more likely to experience distress and engage in mitigating behavior in response to relationship doubts and fears. Limitations: Our studies were conducted with non-clinical samples. Conclusions: These findings suggest that double relationship-vulnerability may make individuals more susceptible to the development and maintenance of relationship-centered obsessions and compulsions.
- Links between relationship OC phenomena, attachment and self-vulnerabilities were assessed.
- Both correlational and experimental designs were used.
- Double relationship-vulnerability was linked with relationship-centered OC Phenomena.
- Findings were not related to pre-existing variations in relevant variables.
- Treatments addressing such vulnerabilities in relationship-OC phenomena may prove useful.
Cite: Doron, G., Szepsenwol. O., Karp. E., & Gal. N. (2013) Obsessing About Intimate-Relationships: Testing the Double Relationship-Vulnerability Hypothesis.Journal of Behavior Therapy and Experimental Psychiatry.44, 433-440.
Obsessive-compulsive disorder (OCD) is a disabling anxiety disorder with a wide range of clinical presentations. Previous research has examined a variety of obsessional themes within OCD including contamination fears, sexual or aggressive obsessions and scrupulosity. Absent from current literature of OCD, however, is an investigation of obsessive-compulsive (OC) symptoms centering on intimate relationships. The present investigation reports on the development and evaluation of the Relationship Obsessive Compulsive Inventory (ROCI), a 12-item measure assessing the severity of OC symptoms centering on three relationship dimensions: the individual’s feelings towards his or her partner, the partner’s feelings towards the individual, and the ‘‘rightness’’ of the relationship experience. Factor analysis supports a 3-factor structure of the ROCI above two alternative measurement models (Study 1). The ROCI was found to be internally consistent and showed the expected associations with OCD related symptoms and cognitions, mood and relationship variables (Study 2). Moreover, the ROCI significantly predicted depression and relationship related distress, over-and-above common OCD symptoms, and other mental health and relationship insecurity measures. Relationship-centered OC symptoms may be an important theme for further OCD research.
- We investigated obsessive compulsive symptoms centering on intimate relationships.
- The Relationship Obsessive Compulsive Inventory (ROCI) was developed and validated.
- The ROCI significantly predicted depression and relationship related distress.
- Effects remained after controlling for OCD, mood and relationship variables.
- Relationship centered OC symptoms are an important theme for further research.
Cite: Doron, G., Derby, D., Szepsenwol. O., & Talmor. D. (2012). Tainted Love: exploring relationship-centered obsessive compulsive symptoms in two non-clinical cohorts. Journal of Obsessive-Compulsive and Related Disorders, 1, 16-24.
Obsessive-compulsive disorder (OCD) is a disabling disorder with a variety of clinical presentations. Recently, research has begun to explore relationship-centered obsessive-compulsive (OC) symptoms, which include obsessions, checking, and reassurance seeking behaviors centered on an individual’s feelings towards his or her partner and the ‘‘rightness’’ of their relationship. The present investigation extends previous research by examining OC symptoms focused on one’s partner’s perceived flaws. We report on the development and validation of the Partner-Related Obsessive-Compulsive Symptoms Inventory (PROCSI), a 24-item self-report scale assessing the severity of partner-focused OC symptoms in six domains: physical appearance, sociability, morality, emotional stability, intelligence and competence. The PROCSI was found to be internally consistent, and its factorial structure was supported by confirmatory factor analysis. Moreover, the PROCSI showed the expected associations with measures of OCD symptoms and cognitions, negative affect and relationship functioning, and significantly predicted depression and relationship-related distress over and above other symptom and relationship measures (Study 1). In addition, longitudinal analyses suggested reciprocal links between relationship-centered OC symptoms and partner-focused OC symptoms. Links between body dysmorphic concerns and partner-focused OC symptoms were also found (Study 2). Implications for theory and treatment are discussed.
- We investigated obsessive-compulsive (OC) symptoms focusing on one’s partner’s flaws.
- The Partner Related Obsessive-Compulsive Symptom Inventory (PROCSI) was developed.
- Cross-sectional and longitudinal analyses were undertaken.
- The expected links between the PROCSI and relevant variables were found.
- Partner-focused OC symptoms constitute an important theme for further research.
Cite: Doron, G., Derby, D., Szepsenwol. O., & Talmor. D. (2012). Flaws and All: Exploring Partner-Focused Obsessive-Compulsive Symptoms. Journal of Obsessive-Compulsive and Related Disorders, 1, 234-243
Obsessive-compulsive disorder (OCD) is a disabling and prevalent anxiety disorder comprised of multiple symptoms and a variety of clinical presentations. Research had examined obsessional themes and compulsive behaviors such as contamination fears, pathological doubt, a need for symmetry or order, and sexual or aggressive obsessions. However, absent from current literature of OCD is the investigation of obsessive-compulsive symptoms relating to romantic relationships. In this paper, we introduce and discuss the theoretical construct of relationship-centered obsessive-compulsive phenomena. We then present preliminary data supporting the validity and structure of this construct. Consistent with recent models of OCD, we then propose a model integrating OCD related cognitive beliefs, catastrophic relationship biases, self-vulnerability and attachment insecurities in the maintenance and development of relationship-centered obsessive-compulsive symptoms. Finally, we discuss the possible theoretical and clinical implications of the proposed model and suggest future research directions.
- We introduce obsessive-compulsive symptoms centering on intimate relationships.
- We present data supporting the validity and structure of this construct.
- We propose a model integrating OCD cognitive beliefs, catastrophic relationship biases, self vulnerability and attachment insecurities.
- We discuss possible theoretical and clinical implications of the proposed model and suggest future research directions.
Cite: Doron, G., Talmor, D., Szepsenwol, O., & Derby, S. D. (2012). Relationship-centered obsessive compulsive symptoms, Psicoterapia Cognitiva e Comportamentale, 18, 79-90.
Highlights of Relationship related OC phenomena: The case of relationship-centered and partner-focused OC symptoms [Doron et al., 2012]
Obsessive-compulsive disorder (OCD) is a disabling and prevalent anxiety disorder comprised of multiple symptoms and a variety of clinical presentations. Recently, research has begun to explore relationship-related obsessive-compulsive (OC) symptoms including relationship-centred and partner-focused OC symptoms. In this paper, we introduce and discuss the theoretical construct of relationship-related obsessive-compulsive phenomena. We then present data supporting the validity of the two types of relationship-related OC symptoms and show findings pertaining to their associations with theoretically related constructs. We then discuss similarities and differences in the underlying processes that may be involved in the maintenance and development of these two types of relationship-related obsessional themes. Finally, we discuss the possible theoretical and clinical implications of the proposed model and suggest future research directions.
- We introduce the two types of obsessive-compulsive symptoms relating to intimate relationships.
- We discuss similarities and differences in the underlying processes that may be involved in the maintenance and development of these two types of relationship-related obsessional themes.
- We discuss possible theoretical and clinical implications.
Cite: Doron, G., Szepsenwol, O., Derby, S. D., & Nahaloni. E. (2012). Relationship-related obsessive-compulsive phenomena: The case of relationship-centred and partner-focused obsessive compulsive symptoms, Psicoterapia Cognitiva e Comportamentale, 18, Monograph Supplement, 71-82.
Highlights of Integrating psychodynamic and cognitive approaches to obsessive compulsive disorder – Attachment insecurities and self-related sensitivities in morality and relational domains (Doron et al., 2015).
- We present a model suggesting sensitivity in specific self-domains may increase preoccupations relating to these domains.
- Dysfunctions of the attachment system can disrupt adaptive coping with intrusive experience.
- We look at the morality and relationship self-domains in OCD.
- For people with high attachment anxiety, experiences challenging an important self-domain can increase the accessibility of maladaptive cognitions and activate dysfunctional cognitive processes.
- This can lead to the development of obsessional preoccupations and disabling compulsive behaviors.
Cite: Doron, G., Mikuincer, M., Sar-El, D., & Kyrios, M. (2015). Integrating psychodynamic and cognitive approaches to Obsessive Compulsive Disorder – attachment insecurities and self-related sensitivities in the morality and relational domains in: Handbook of Contemporary Psychodynamic Approaches to Psychopathology, edited by P. Luyten, L. Mayes, P. Fonagy, M. Target, & S. J. Blatt; NY: Guilford Press.