Third ROCD symposium at the WCBCT Berlin

Below are the abstracts of the talks presented:

Pathological narcissism and relationship obsessive compulsive disorder (ROCD) symptoms

Laura Caccico, Gabriele Melli, Francesco Bulli, Simona Gelli, Elena Micheli, Guy Doron

Introduction: One impairing symptom dimension of obsessive-compulsive disorder (OCD) that has been receiving increasing research and clinical interest is Relationship OCD (ROCD). This OCD dimension includes two main presentations. Relationship-centered ROCD symptoms focusing on the suitability of the relationship itself and partner-focused ROCD symptoms centering on the relational partner perceived suitability. Partner-focused ROCD symptoms include obsessive doubts and concerns about perceived partners’ flaws in a wide variety of domains, such as morality, sociability, appearance. Clinical experience suggests that clients presenting with partner-focused ROCD symptoms may also show increased levels of narcissistic traits. For instance, like increased narcissistic traits, partner-focused ROCD symptoms have been associated with over-reliance on partner’s perceived value for one’s self-esteem, increased attentiveness to alternative romantic partners, and infidelity. This study aimed to explore the association between partner-focused ROCD symptoms and pathological narcissism, particularly the vulnerable narcissism. More specifically, we evaluated a model whereby narcissistic traits increase vulnerability to partner-focused ROCD symptoms via partner value contingent self-worth.

Methods: 310 participants with a self-referred diagnosis of ROCD were recruited online. They were administered the Pathological Narcissism Inventory (PNI)the Partner-Related Obsessive-Compulsive Symptoms Inventory (PROCSI), the Partner Value Contingent Self-Worth (PVCSW), the Relationship Catastrophization Scale (RECATS), and the maladaptive relationship belief and the Obsessive Beliefs Questionnaire-20 (OBQ-20).

Results: As expected, the correlation between vulnerable narcissism and partner-focused ROCD symptoms was large (.51). Vulnerable narcissism was a significant predictor of partner-focused ROCD symptoms, together with maladaptive beliefs about the catastrophic consequences of remaining in a wrong relationship and partner value contingent self-worth. The latter was a partial mediator in the relationship between vulnerable narcissism and partner-focused ROCD symptoms.

Conclusion: As expected, vulnerable narcissism seems to have an important role in the development of partner-focused ROCD symptoms via partner value contingent self-worth.

Reducing Relationship Obsessive-Compulsive Disorder symptoms and related psychological features: preliminary evidence form a brief mobile-app intervention

Silvia Cerea1, Gioia Bottesi1, Guy Doron2, Denise Broggio1, & Marta Ghisi1

1Department of General Psychology, University of Padua, Italy; 2Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel

Introduction: Relationship Obsessive-Compulsive Disorder (ROCD) is characterized by obsessive and compulsive symptoms pertaining intimate relationships (Doron et al., 2014). ROCD have been associated with dyadic distress, depression, and anxiety (Doron et al., 2012; Doron et al., 2014). A recent study (Roncero et al., 2019) found a reduction in ROCD symptoms after 15 consecutive days of training with a mobile-app intervention called GGRO. GGRO was developed by Doron to challenge maladaptive beliefs that underline ROCD following Cognitive Behavioral Therapy principles. Based on previous evidence, the aim of the current study was to evaluate the efficacy of GGRO in reducing ROCD symptoms and its associated psychological features in the Italian context.

Method: Thirty-three participants (72.73% females) who scored above the cut-off on self-report questionnaires assessing ROCD beliefs and symptoms were randomized to groups undertaking immediate-use (iApp, n = 17) or delayed use (dApp, n = 16) of GGRO. All participants completed online self-report questionnaires assessing ROCD (Relationships Obsessive Compulsive Inventory, ROCI; Partner-Related Obsessive Compulsive Symptoms Inventory, PROCSI) and OCD (Obsessive Compulsive Inventory-Revised, OCI-R) symptoms, and related psychological features such as self-esteem (Rosenberg Self-Esteem Scale, RSES), social anxiety (Social Interaction Anxiety Scale, SIAS), general distress (Depression Anxiety Stress Scale-21, DASS-21), and intolerance of uncertainty (Intolerance of Uncertainty Scale-12, IUS-12). Questionnaires were completed at baseline (T0), 15 days from baseline (T1), and 30 days from baseline (T2). Participants in the iApp group started to use the app at baseline and continued for 15 days. Participants in the dApp group were requested to wait for 15 days before starting to use the app for 15 consecutive days (T1 to T2).

Results: Concerning the iApp group,  1×3 (Time; T0 vs. T1 vs. T2) Repeated Measure ANOVAs were performed and a significant reduction from T0 to T1 and from T0 to T2 (but not from T1 to T2) emerged in the ROCI (p <.001), PROCSI (p <.001), OCI-R (p =.03), and IUS-12 (p <.001); the same pattern emerged with an increasing of the RSES (p <.001). Regarding the SIAS and the DASS-21, a significant reduction only from T0 to T1 (respectively, p =.02 and p =.03) was observed. Moreover, a series of 2 (Group) x2 (Time; T0 vs. T1) Repeated Measure ANOVAs were conducted to compare the iApp and the dApp groups across time. Analyses revealed significant Group x Time interactions in RSES (p =.01), SIAS (p =.01), ROCI (p =.01), PROCSI (p <.001), and IUS-12 (p =.03); specifically, the iApp group showed decreased scores (increased with respect to RSES) than the dApp group at T1.

Discussion and Conclusion: Present results show that 15 consecutive days of GGRO may lead to significant reduction in ROCD symptoms and in its associated psychological features. To note, most of those reductions were maintained after 2 weeks (follow-up). These findings, in accordance with previous studies (Roncero et al., 2018; Roncero et al., 2019), provide further evidence for the efficacy of GGRO in reducing ROCD beliefs and symptoms and its associated psychological features also in an Italian non-clinical sample.

Differential Cognitive Predictors of Relationship, Sexual-Orientation and general Obsessive Compulsive Symptoms

Richard Moulding, Stephanie Fernandez. Deakin University, Geelong, Australia.

Background and Objectives: Two previously understudied symptom themes of Obsessive Compulsive Disorder (OCD)  have recently received greater consideration in the literature: Relationship-related OCD (ROCD) and Sexual-Orientation OCD (SO-OCD). Cognitive appraisal models of OCD suggest that symptoms are maintained by maladaptive beliefs that drive unhelpful interpretations of normal intrusive thoughts. The present study aimed to examine the contribution of general, specific, and self-related beliefs to obsessive-compulsive (OC) symptoms of both ROCD and SO-OCD.

Method: The sample comprised 264 non-clinical participants (135 males) with a mean age of 34.65 years (SD = 12.01). Participants completed an online questionnaire, which comprised a battery of self-report items.

Results: Using Structural Equation Modeling (SEM), the study found that different cognitions related to different OCD symptoms dimensions. It was found that general maladaptive beliefs were predictive of most forms of general OCD symptoms. Specific sexual-orientation beliefs were predictive of SO-OCD, over-and-above the more general beliefs noted in the cognitive appraisal model of OCD, but specific relationship-related beliefs did not strongly predict ROCD symptoms. Self-themes, particularly the “feared self”, were found to contribute significantly to OC symptoms in ROCD and SO-OCD, as well as to general OCD (particularly symptoms involving repugnant thoughts).

Conclusions: Self-themes and their contribution to specific OCD symptoms suggest that beliefs centred on feared self-perceptions and inner-self concerns may also be important in understanding symptom presentations. These findings, if replicated in clinical samples, may provide a basis for the development of specific cognitive-behavioural interventions that target such beliefs relevant to OCD, and potentially other related disorders. 

“My Partner is Unreliable”: Exploring Obsessive Distrust as an Additional Dimension of Partner-Focused ROCD Symptoms

Guy Doron, Or Brandes & Avital Stern 

Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel

Relationship Obsessive–compulsive disorder (ROCD) is a dimension of Obsessive–compulsive disorder (OCD) focusing on close and intimate relationships. ROCD may focus on the relationship itself (i.e., relationship-centered) or the perceived flaws of the relationship partner (i.e., partner-focused). Obsessive preoccupations with the perceived flaws of the relationship partner has been shown to center on domains such as intelligence, appearance, sociality, emotional regulation, competence and morality. Clinical experience suggests, however, that obsessive doubts and preoccupation with the perceived untrustworthiness or unreliability of the partner (i.e., obsessive distrust) may be an additional domain of partner-focused ROCD symptoms. The present investigation reports on the development and evaluation of the Obsessive Distrust Inventory (ODIS), an 11-item measure assessing the severity of obsessive distrust phenomena. Factor analysis supported a one internally consistent factor. The ODIS also showed the expected associations with OCD symptoms, ROCD symptoms and other mental health and relationship measures. Moreover, the ODIS significantly predicted depression, anxiety and relationship violence, over-and-above common mental health and relationship measures. Theoretical and clinical implications of these results will be discussed.

A paper published using our GGRO mobile application for ROCD

The paper is entitled: A novel approach to challenging OCD related beliefs using a mobile-app: An exploratory study .

To see a pre-printed version of the paper see this link