New study gives further support to GGRO effectiveness

Throw away and pull towards: A new way to challenge OCD related cognitions using the GGRO mobile application training platform.

Authors: M. Roncero, B. Pascual, S. Arnáez, M. Giraldo-O’Meara, G. García-Soriano, A. Belloch, and G. Doron.

According to cognitive models of OCD, obsessive compulsive symptoms result from catastrophic misinterpretations of commonly occurring intrusive thoughts, images and urges and the use of counterproductive strategies used to manage them. Maladaptive beliefs such as inflated responsibility/threat, importance and control of thoughts, perfectionism and intolerance for uncertainty increase the likelihood of such negative interpretations of intrusive experience. Indeed, traditional cognitive behavioral therapy (CBT) includes a variety of intervention to challenge maladaptive beliefs including behavioral experiments and cognitive reconstruction. Consistent with a growing body of literature supporting the usefulness of mobile based technologies in fostering cognitive behavior change, the present study assessed the effectiveness of a novel cognitive training exercise designed to challenge OCD related cognitive beliefs. This mobile technology (application) based training exercise consists of users having to pull statements challenging OCD-related beliefs towards themselves (downwards) and to throw away (push upwards) contra-productive self-statements Method: 36 third year BA students started the trial. Twenty completed both pre and post measures of OCD symptoms (OCI-R; Foa et al., 2002), ROCD (ROCI & PROCSI; Doron et al., 2012a, 2012b), OCD related beliefs (OBQ; Moulding et al., 2011) and mood (Antony et al., 1998). Participants were instructed to complete two minutes of daily training (3 training levels) for a period of 15 days. Results: No significant differences were found between completers and no-completers on demographic and symptom related measures at Time 1. Repeated-measures ANOVA of the 20 completers showed a significant reductions on all OCD symptoms measures and on OCD-beliefs. No significant reduction was found in depression symptoms. Discussion: This innovative mobile technology based training exercise may be useful in reducing OCD-related beliefs levels and associated symptoms. The use of this and similar mobile training platforms holds promise for low intensity psychological treatments recommended by NICE (2005), and may be effective as prevention tool for those people at risk of suffering OCD. Limitation: This is an open trial with relatively small student sample.

Added to ROCD net: A one year follow up study investigating the reciprocal relationship between partner-focused and relationship-centered ROCD symptoms over time.

 Letting It Linger: : Exploring the Longitudinal Effects of Relationship-Related Obsessive-Compulsive Phenomena [Szepsenwol, Shahar, & Doron, in press]

Associate Prof. Guy Doron and Gur Ilany explain about the new App for ROCD named ‘GG Relationship’

According to Professor Guy Doron and his colleague Gur Ilany, the application developed (named ‘GG Relationship’) was especially designed for dealing with relationship doubts and fears. The application is based on the principles of Cognitive Behavioral Therapy (CBT) – one of the most research-supported psychological therapies.

According to CBT models, negative self-talk – individuals’ ongoing interpretations of the self, others and the world – maintain psychological difficulties such as obsessive preoccupation, low mood, and maladaptive behaviors. In ROCD, for instance, individuals negative self-talk often relates to fear of being in the wrong relationships or/and missing the ‘right’ relationship. Individuals with such fears will continuously say to themselves (in their heads) phrases such as ‘Maybe my partner is not the ONE’, ‘He is not smart enough for me’ or ‘I will regret my decision to stay/leave with my partner forever‘. Such negative self-talk, of course, ultimately increases relationship doubts/fears, intensifies negative mood and often provokes relationship conflict.

Professor Guy Doron says ‘GG Relationship was developed in order to provide an accessible CBT training platform that would allow individuals with relationship fears and doubts to better deal with negative self-talk’. According to Gur Ilany, the application is designed to ‘(1) increase individuals’ awareness of negative self-talk, (2) train individuals’ to better identify and challenge negative self-talk, (3) increase individuals’ access to neutral and positive self-talk, and (4) increase the automaticity of the above processes’.

The core gameplay of the training  is simple: individuals are presented with ‘blocks’ featuring self-talk statements such as “I am proactive”, “I am reliable” or “I am a loser”- and have to respond by pulling the supportive ‘blocks’ towards themselves (i.e., downwards) and throwing away from themselves the negative ‘blocks’ (i.e., rejecting them upwards). A/Prof Doron says ‘to further strengthen learning of supportive self-talk, each level the player completes is followed by a small memory game in which one has to identify a supportive statements that appeared in the previous level’. As the game progresses, the individual passes through thematically relevant issues such as self-esteem, beliefs in change, dealing with relationship doubts, facing uncertainty, overcoming perfectionism, coping with embarrassment, commitment anxiety, etc.,.

Training using this application, Gur says ‘will hopefully allow for gradual, steady learning of more positive self-talk thereby helping to break the vicious thought cycle maintaining relationship doubts and preoccupations’.

We now have the ROCI and the PROCSI translated to Turkish

We now have the Relationship obsessive compulsive inventory (ROCI) and the partner related obsessive compulsive symptom inventory (PROCSI) translated to Turkish (see http://rocd.net/roci-procsi-translated-2/)

We have a new collaborator of ROCD research in Turkey: Dr. Mujgan Inozu

We are happy to have Dr. Mujgan Inozu as one of our collaborators. Dr Inozu is an academic and clinical psychologist at Department of Psychology,Hacettepe University, Ankara, Turkey.

The ROCI and PROCSI are now available in English, Italia, Dutch, Persian, Hebrew

The first symposium entirely dedicated to ROCD [romantic, parent-child, individual-God]

The first symposium entirely dedicated to relationship related obsessions is going to take place at the next Annual EABCT Congress 

CBT: A Road to Hope and Compassion for People in Conflict [August 31- September 3, 2015
Jerusalem, Israel]

Title:  Doubting Love: Investigations into the pathogenesis of relationship obsessions

 

In recent years, a growing body of literature has focused on obsessive-compulsive symptoms centering on close or intimate relationships (Relationship Obsessive Compulsive Disorder; ROCD). ROCD symptoms are characterized by doubts and preoccupations focused on the perceived suitability of the relationship itself (e.g., the strength of one’s feelings towards the relational partner, the “rightness” of the relationship). ROCD symptoms also pertain to disabling preoccupation with perceived deficits in the relationship partner (e.g., not being intelligent enough). Although these ROCD presentations occur in a variety of close relationships (e.g., parent-child and individual-God), are activated by congruent life events (e.g., relationship breakups) and are associated with specific vulnerabilities (e.g. perfectionism), prior research has mainly investigated ROCD symptoms within romantic relationships. Further, most previous studies have been conducted in Israeli, non-religious cohorts. In the present symposium, data collected in four different countries, across various relational and situational contexts are presented with the aim of advancing our understanding of this increasingly recognized form of OCD.

The first presentation examines the link between parental preoccupation with their children’s deficits, mood and parental stress in American parents (US). The second presentation investigates ROCD symptoms following a particularly relevant life stressor — relationship breakups. In this study, associations between ROCD symptoms, relationship stress and intrusive thoughts are explored. In the third presentation, data from Israeli orthodox and ultra-orthodox cohorts is used to examine the unique involvement of obsessive symptoms relating to one’s relationship with God in negative mood, scrupulosity and OCD symptoms. Finally, the contribution of particular aspects of perfectionism to ROCD within romantic relationships is assessed within an Italian cohort. Together this research suggests that ROCD symptoms may have significant impact on personal and interpersonal variables within different relational, situational and cultural contexts.

Title:    I obsess about my child’s flaws: Impact and correlates of parent-child obsessive-         compulsive symptoms

Presenter: Guy Doron, PhD, Baruch Ivcher School of Psychology Interdisciplinary Center (IDC) Herzliya

Co-Presenters:  Ohad Szepsenwol, PhD, Department of Psychology, University of Minnesota,     Minneapolis, MN 55455  and Danny Derby, Cognetica – The Israeli Center for Cognitive Behavioral Therapy, Tel-Aviv

Parents often report that their children’s happiness and success is one of their most important life endeavor. For some individuals, however, this endeavor may be associated with increased fears and preoccupation relating to perceived deficits in their children’s behaviors, personality, and appearance. Such preoccupations may become increasingly time consuming, distressing, and a cause of significant parental distress. Following recent research of relationship-related OC phenomena, in this study we investigated OC symptoms focusing relating to parental preoccupation with their children’s perceived flaws and deficits. Four hundred and three (187 mothers) completed the Parent-Child Related Obsessive Compulsive Inventory (P-CROCI), an adapted version of the partner related obsessive-compulsive inventory (PROCSI, Doron et la., 2012).  We examined links between parent-child OC phenomena, parental OCD symptoms and pre-existing parental mood symptoms. We also examined the incremental contribution of the P-CROCI to the prediction of parental stress beyond the contribution of pre-existing mood and OCD symptoms. We found significant positive correlations between parent child OC symptoms and measures of parental OCD and mood. In addition, the P-CROCI significantly predicted parental stress over and above parental mood and other OC symptoms. Our preliminary investigation of parent-child OC phenomena has the potential to increase research and clinical awareness of patients with such clinical presentations. Interventions for such phenomena may draw on OCD and relationship OCD treatment literature.

 

Title:  Obsessing About Love: How Relationship OC Tendencies Affects Romantic Breakup in Young Canadian Adults

Presenter:        David A. Clark, University of New Brunswick, CANADA

Co-Presenters:  Lucia O’Sullivan and Rice Fuller, University of New Brunswick  CANADA

Relationship obsessive compulsive disorder (ROCD) is characterized by preoccupations and doubts about one’s love and commitment towards a romantic partner, the partner’s love and commitment toward the individual, and the person’s sense of “rightness” about the relationship (Doron, Derby & Szepsenwol, 2014).  Recent studies indicate that ROCD may be a distinct form of OCD, which is detrimental to intimate relationships and personal well-being (Doron, Derby, Szepsenwol & Talmor, 2012).  However no studies have investigated the effects of ROCD in the context of romantic breakup, which might be an important stressor for individuals struggling with doubts about love and acceptance.  In the present study 101 Canadian undergraduates who experienced a significant romantic breakup in the last three months completed an online battery of measures that assessed past relationship characteristics, self-esteem, depressive symptoms, breakup distress, coping strategies and unwanted intrusive thoughts.  In addition all participants completed the 12 item Relationship Obsessive Compulsive Inventory (ROCI; Doron et al., 2012).  A series of standard regression analyses revealed that obsessive doubts about whether the ex-partner loved him or her was a significant unique predictor of breakup distress, unwanted intrusive thoughts about the ex-partner and depressive symptoms.  Further analyses will be conducted to determine whether the greater difficulty with a breakup by individuals with excessive doubts about the ex-partner’s love and commitment is mediated by pre-existing self-esteem, pessimism or coping strategies.  At the very least, this study indicates that in addition to relationship quality and personal well-being, ROCD may also be detrimental to coping with romantic breakup in young adults.

 

Title: Relationship obsession within the individual-God context: Exploring obsessive tendencies about one’s relationship with God

Presenter:        Yaniv Efrati, 1School of Psychology, Interdisciplinary Center (IDC), Herzliya , ISRAEL

Co-Presenters:  Guy Doron, PhD, School of Psychology, Interdisciplinary Center (IDC) and

Ohad Szepsenwol, Department of Psychology, University of Minnesota,      Minneapolis, MN 55455

Research of relationship-centered obsessive compulsive symptoms has mainly focused on romantic relationships.  Theoretically, however, relationship obsession may occur within a variety of relationships perceived as significant to the individual. In fact, clinical experience suggests relationship obsessions may also occur within the individual-God context.  Indeed, one’s personal relationship with God is considered a core element of monotheistic religions such as Christianity and Judaism. Research of religious obsessive-compulsive (OC), however, has mainly focused on scrupulosity — persistent doubts about sin, intrusive mental images of a sacrilegious or blasphemous nature, and fears that one will be punished by God.  Following recent research of relationship-related OC phenomena, the present study reports on the development and evaluation of the Relationship with God Obsessive Compulsive Inventory (R-GOCI). Two hundred and fifty religious Jews and one hundred and fifty ultra-religious Jews completed the R-GOCI, a 10-item measure assessing the severity of OC symptoms centering on the individual’s feelings towards his or her God and the “rightness” of the relationship experience as well as obsessions relating to religious observance. Factor analysis supports a 2-factor structure of the R-GOCI above alternative measurement models. The R-GOCI (Study 1) was found to be internally consistent and showed the expected associations with OCD related symptoms and cognitions, mood and relationship variables (Study 2). Our preliminary investigation of relationship-with-God OC phenomena has the potential to increase research and clinical awareness of patients with such clinical presentations thereby reducing misdiagnosis of this disabling phenomena. Interventions for such phenomena may draw on OCD and relationship OCD treatment literature.

 

Title: The role of perfectionism in relationship obsessive-compulsive disorder (ROCD)

Presenter:        Gabriele Melli, Institute of Behavioral and Cognitive Psychology and Psychotherapy, IPSICO, Florence, Italy

Co-Presenters:  Claudia Carraresi, Institute of Behavioral and Cognitive Psychology and

Psychotherapy, IPSICO, Florence, Italy  and Guy Doron School of Psychology, Interdisciplinary Center (IDC)

Recently, research has begun to investigate relationship obsessive-compulsive disorder (ROCD). ROCD symptoms involve obsessive-compulsive disorder (OCD) symptoms including doubts, preoccupations and reassurance seeking centering on one’s feelings towards the partner and the ‘rightness’ of the relationships. ROCD symptoms involve cognitive beliefs and biases similar to those underlying other OCD phenomena. Some dysfunctional OCD related processes, however, may be more pertinent to the relational OCD theme. In particular, perfectionism has been suggested to have an important role in ROCD symptoms that needs further investigation. The present study aimed to explore the unique role of perfectionist beliefs in ROCD. The Multidimensional Perfectionism Scale (MPS) was administered to 187 Italian non-clinical participants together with a series of self-report measures assessing OCD, ROCD, and general distress. Correlation analysis showed that perfectionism, in particular the Concern over Mistakes (CM) subscale of the MPS, was strongly associated with ROCD symptoms. Hierarchical regression analyses revealed that CM was a significant predictor of relational OCD symptoms, also controlling for general distress and OCD symptoms. Limitations as well as theoretical and clinical implications of these findings will be discussed.

 

Online draft: ROCD conceputal framework

see this link

Coming soon: Relationship Obsessive Compulsive Disorder (ROCD): A conceptual framework

We are currently working on the above paper. We hope to publish a draft in the next couple of weeks.

Relationship obsessive compulsive disorder (ROCD): A conceptual framework

1.      Relationship Obsessive Compulsive Disorder (ROCD): Phenomenology

2.      Measures of Relationship Obsessive-Compulsive Symptoms

3.      Development and Maintenance Mechanisms in ROCD

3.1.   ROCD and cognitive models of OCD related disorders

3.1.1.      ROCD symptoms and OCD related beliefs:

3.1.2.      ROCD symptoms and increased monitoring of internal states

3.1.3.      ROCD symptoms and relationship-related dysfunctional beliefs

3.2.   ROCD and self-related processes 

3.3.   ROCD and attachment representations

3.4.   ROCD and other personality and societal factors

3.5.   ROCD, parenting and family environment

4.      Relationship-Centered and Partner-Focused OC Symptoms

4.1.   The personal and dyadic consequences of ROCD symptoms

4.2.   ROCD and relationship satisfaction

4.3.   ROCD and well-being

4.4.   Within-person bidirectional infiltration of ROCD symptoms.

4.5.   Between-person infiltration of ROCD symptoms

5.      ROCD symptoms and related constructs

5.1.   Relationship-centered OC symptoms and worries

5.2.   Relationship-centered OC symptoms and Social anxiety

5.3.   Partner-focused OC symptoms and BDD

6.      Assessment and treatment

6.1.   Assessment

7.      Treatment 

7.1.   Pharmacotherapy

7.2.   Psychosocial treatments


A new paper about relationship-centered OC symptoms was added

Our paper entitled: “Obsessing About Intimate-Relationship: Testing the Double Relationship-Vulnerability Hypothesis” was accepted to the Journal of Behavior Therapy and Experimental Psychiatry (see Our ROCD Papers).