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The Relationship Between Obsessive-Compulsive Symptoms, Perfectionism, and Anxiety Sensitivity for Not Just Right Experiences

Published online by Cambridge University Press:  22 August 2017

Lauren D. Irwin
Affiliation:
School of Psychology, The University of Sydney, New South Wales, Australia
Mairwen K. Jones*
Affiliation:
Discipline of Behavioural and Social Sciences in Health, The University of Sydney, New South Wales, Australia
*
Address for correspondence: Dr Mairwen Jones, Discipline of Behavioural and Social Sciences in Health, Faculty of Health Sciences, The University of Sydney, PO Box 170, Lidcombe NSW 1825, Australia. Email: Mairwen.Jones@sydney.edu.au
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Abstract

The obsessive-compulsive core dimensions model posits that compulsions are driven by harm avoidance, or to counteract a sense of incompleteness, known as ‘not just right experiences’ (NJREs). Evidence suggests NJREs are associated with obsessive-compulsive disorder (OCD) symptoms and maladaptive perfectionism. However, manipulations of NJREs have focused on the visual system, and have not been examined in the context of arousal fears associated with anxiety sensitivity (AS). This study examined the relationship between OC symptoms, perfectionism, and AS using in vivo manipulations of NJREs across visual, auditory, and tactile sensory modalities. Using a 2 (NJRE vs. JRE) × 2 (AS vs. no AS) between-subjects design, participants (N = 132) completed behavioural tasks designed to elicit NJREs and assess task discomfort and urge to counteract sensory-specific stimuli. Strong relationships were observed between task ratings and self-report measures of NJREs, incompleteness, OCD symptoms, maladaptive perfectionism, and AS. Those in the NJRE conditions gave significantly higher task ratings compared to JRE conditions; however, there was no main effect for AS. While maladaptive perfectionism and AS were significant predictors of task performance, there was no interaction between the two. The results confirm and extend research suggesting a strong association between NJREs and incompleteness motivations, as well as sensory-affective disturbance in OCD.

Type
Standard Papers
Copyright
Copyright © The Author(s) 2017 

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References

Abramowitz, J.S. (2006). In review: The psychological treatment of obsessive-compulsive disorder. Canadian Journal of Psychiatry, 51, 407416.CrossRefGoogle ScholarPubMed
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th edition (DSM-5). Washington, DC: American Psychiatric Association.Google Scholar
Antony, M.M., Purdon, C.L., Huta, V., & Swinson, R.P. (1998). Dimensions of perfectionism across anxiety disorders. Behaviour Research and Therapy, 36, 11431154. doi:10.1016/S0005-7967(98)00083-7 CrossRefGoogle ScholarPubMed
Bouchard, C., Rhéaume, J., & Ladouceur, R. (1999). Responsibility and perfectionism in OCD: An experimental study. Behaviour Research and Therapy, 37, 239248. doi:10.1016/S0005-7967(98)00141-7 CrossRefGoogle ScholarPubMed
Calamari, J.E., Rector, N.A., Woodard, J.L., Cohen, R.J., & Chik, H.M. (2008). Anxiety sensitivity and obsessive-compulsive disorder. Assessment, 15, 351363. doi:10.1177/1073191107312611 CrossRefGoogle ScholarPubMed
Chik, H.M., Whittal, M.L., & O'Neill, M.L. (2008). Perfectionism and treatment outcome in obsessive-compulsive disorder. Cognitive Therapy and Research, 32, 676688. doi:10.1007/s10608-007-9133-2 CrossRefGoogle Scholar
Coles, M.E., Frost, R.O., Heimberg, R.G., & Rhéaume, J. (2003). ‘Not just right experiences’: Perfectionism, obsessive–compulsive features and general psychopathology. Behaviour Research and Therapy, 41, 681700. doi:10.1016/S0005-7967(02)00044-X CrossRefGoogle ScholarPubMed
Coles, M.E., Heimberg, R.G., Frost, R.O., & Steketee, G. (2005). Not just right experiences and obsessive–compulsive features: Experimental and self-monitoring perspectives. Behaviour Research and Therapy, 43, 153167. doi:10.1016/j.brat.2004.01.002 CrossRefGoogle ScholarPubMed
Cougle, J.R., Fitch, K.E., Jacobson, S., & Lee, H.J. (2013). A multi-method examination of the role of incompleteness in compulsive checking. Journal of Anxiety Disorders, 27, 231239. doi:10.1016/j.janxdis.2013.02.003 CrossRefGoogle ScholarPubMed
Cougle, J.R., Goetz, A.R., Fitch, K.E., & Hawkins, K.A. (2011). Termination of washing compulsions: A problem of internal reference criteria or ‘not just right’ experience? Journal of Anxiety Disorders, 25, 801805. doi:10.1016/j.janxdis.2011.03.019 CrossRefGoogle ScholarPubMed
Ecker, W., & Gönner, S. (2008). Incompleteness and harm avoidance in OCD symptom dimensions. Behaviour Research and Therapy, 46, 895904. doi:10.1016/j.brat.2008.04.002 CrossRefGoogle ScholarPubMed
Fairfax, H. (2008). The use of mindfulness in obsessive-compulsive disorder: Suggestions for its application and integration in existing treatment. Clinical Psychology & Psychotherapy, 15, 5359. doi:10.1002/cpp.557 CrossRefGoogle ScholarPubMed
Fitch, K.E., & Cougle, J.R. (2013). An evaluation of obsessive beliefs as predictors of performance on in vivo assessments of obsessive–compulsive symptoms. Cognitive Therapy and Research, 37, 207220. doi:10.1007/s10608-012-9457-4 CrossRefGoogle Scholar
Foa, E.B., Abramowitz, J.S., Franklin, M.E., & Kozak, M.J. (1999). Feared consequences, fixity of belief, and treatment outcome in patients with obsessive-compulsive disorder. Behavior Therapy, 30, 717724. doi:10.1016/S0005-7894(99)80035-5 CrossRefGoogle Scholar
Foa, E.B., Huppert, J.D., Leiberg, S., Langner, R., Kichic, R., Hajcak, G., & Salkovskis, P.M. (2002). The Obsessive-Compulsive Inventory: Development and validation of a short version. Psychological Assessment, 14, 485496. doi:10.1037/1040-3590.14.4.485 CrossRefGoogle ScholarPubMed
Frost, R.O., & DiBartolo, P.M. (2002). Perfectionism, anxiety, and obsessive-compulsive disorder. In Flett, G.L. & Hewitt, P.L. (Eds.), Perfectionism: Theory, research, and treatment (pp. 341–371). Washington, DC: American Psychological Association.Google Scholar
Frost, R.O., Marten, P.A., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449468. doi:10.1007/BF01172967 CrossRefGoogle Scholar
Ghisi, M., Chiri, L.R., Marchetti, I., Sanavio, E., & Sica, C. (2010). In search of specificity: ‘Not just right experiences’ and obsessive-compulsive symptoms in non-clinical and clinical Italian individuals. Journal of Anxiety Disorders, 24, 879886. doi:10.1016/j.anxdis.2010.06.011 CrossRefGoogle ScholarPubMed
Hajcak, G., Huppert, J.D., Simons, R.F., & Foa, E.B. (2004). Psychometric properties of the OCI-R in a college sample. Behaviour Research and Therapy, 42, 115123. doi:10.1016/j.brat.2003.08.002 CrossRefGoogle Scholar
Henry, J.D., & Crawford, J.R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44, 227239. doi:10.1348/014466505X29657 CrossRefGoogle Scholar
Keough, M.E., & Schmidt, N.B. (2012). Refinement of a brief anxiety sensitivity reduction intervention. Journal of Consulting and Clinical Psychology, 80, 766772. doi:10.1037/a0027961 CrossRefGoogle ScholarPubMed
Lee, J.C., Prado, H.S., Diniz, J.B., Borcato, S., da Silva, C.B., Hounie, A.G., . . . do Rosário, M.C. (2009). Perfectionism and sensory phenomena: Phenotypic components of obsessive-compulsive disorder. Comprehensive Psychiatry, 50, 431436. doi:10.1016/j.comppsych.2008.11.007 CrossRefGoogle ScholarPubMed
Lovibond, S.H., & Lovibond, P.F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Sydney, Australia: Psychology Foundation Google Scholar
Moretz, M.W., & McKay, D. (2009). The role of perfectionism in obsessive-compulsive symptoms: ‘Not just right’ experiences and checking compulsions. Journal of Anxiety Disorders, 23, 640644. doi:10.1016/j.janxdis.2009.01.015 CrossRefGoogle ScholarPubMed
Myers, S.G., Fisher, P.L., & Wells, A. (2008). Beliefs domains of the Obsessive Beliefs Questionnaire-44 (OBQ-44) and their specific relationship with obsessive-compulsive symptoms. Journal of Anxiety Disorders, 22, 475484. doi:10.1016/j.anxdis.2007.03.012 CrossRefGoogle ScholarPubMed
Olatunji, B.O., & Wolitzky-Taylor, K.B. (2009). Anxiety sensitivity and the anxiety disorders: A meta-analytic review and synthesis. Psychological Bulletin, 135, 974999. doi:10.1037/a0017428 CrossRefGoogle ScholarPubMed
Phillips, J.P., & Giancola, P.R. (2008). Experimentally induced anxiety attenuates alcohol-related aggression in men. Experimental and Clinical Psychopharmacology, 16, 4356. doi:10.1037/1064-1297.16.1.43 CrossRefGoogle ScholarPubMed
Pietrefesa, A.S., & Coles, M.E. (2009). Moving beyond an exclusive focus on harm avoidance in obsessive-compulsive disorder: Behavioural validation for the separability of harm avoidance and incompleteness. Behavior Therapy, 40, 251259. doi:10.1016/j.beth.2008.06.003 CrossRefGoogle ScholarPubMed
Purdon, C. (2008). Unacceptable obsessional thoughts and covert rituals. In Abramowitz, J.S., McKay, D., & Taylor, S. (Eds.), Clinical handbook of obsessive-compulsive disorder and related problems (pp. 61–75). Baltimore, MD: Johns Hopkins University Press.Google Scholar
Radomsky, A.S., & Rachman, S. (2004). Symmetry, ordering and arranging compulsive behaviour. Behaviour Research and Therapy, 42, 893913. doi:10.1016/j.brat.2003.07.001.CrossRefGoogle ScholarPubMed
Raines, A.M., Oglesby, M.E., Capron, D.W., & Schmidt, N.B. (2014). Obsessive-compulsive disorder and anxiety sensitivity: Identification of specific relations among symptom dimensions. Journal of Obsessive-Compulsive and Related Disorders, 3, 7176. doi:10.1016/j.jocrd.2014.01.001 CrossRefGoogle Scholar
Salkovskis, P.M. (1991). The importance of behaviour in the maintenance of anxiety and panic: A cognitive account. Behavioural Psychotherapy, 19, 619. doi:10.1017/S0141347300011472 CrossRefGoogle Scholar
Sica, C., Bottesib, G., Orsuccia, A., Pieraccioli, C., Sighinolfid, C., & Ghisib, M. (2015).’Not just right experiences’ are specific to obsessive–compulsive disorder: Further evidence from Italian clinical samples. Journal of Anxiety Disorders, 31, 7383. doi:10.1016/j.janxdis.2015.02.002 CrossRefGoogle ScholarPubMed
Storch, E.A., Wu, M.S., Small, B.J., Crawford, E.A., Lewin, A.B., Horng, B., & Murphy, T.K. (2014). Mediators and moderators of functional impairment in adults with obsessive-compulsive disorder. Comprehensive Psychiatry, 55, 489496. doi:10.1016/j.comppsych.2013.10.014 CrossRefGoogle ScholarPubMed
Summerfeldt, L.J. (2004). Understanding and treating incompleteness in obsessive-compulsive disorder. Journal of Clinical Psychology, 60, 11151168. doi:10.1002/jclp.20080 CrossRefGoogle ScholarPubMed
Summerfeldt, L.J., Gilbert, S.J., & Reynolds, M. (2015). Incompleteness, aesthetic sensitivity and the obsessive-compulsive need for symmetry. Journal of Behaviour Therapy and Experimental Psychiatry, in press. doi:10.1016/j.jbtep.2015.03.006 CrossRefGoogle ScholarPubMed
Summerfeldt, L.J., Kloosterman, P.H., Antony, M.M., & Swinson, R.P. (2014). Examining an obsessive-compulsive core dimensions model: Structural validity of harm avoidance and incompleteness. Journal of Obsessive-Compulsive and Related Disorders, 3, 8394. doi:10.1016/j.jocrd.2014.01.003.CrossRefGoogle Scholar
Summers, B.J., Fitch, K.E., & Cougle, J.R. (2014). Visual, tactile, and auditory ‘not just right’ experiences: Associations with obsessive-compulsive symptoms and perfectionism. Behavior Therapy, 45, 678689. doi:10.1016/j.beth.2014.03.008 CrossRefGoogle ScholarPubMed
Tallis, F. (1996). Compulsive washing in the absence of phobic and illness anxiety. Behaviour Research and Therapy, 34, 361362. doi:10.1016/0005-7967(95)00079-8 CrossRefGoogle ScholarPubMed
Taylor, S., McKay, D., Crowe, K.B., Abramowitz, J.S., Conelea, C.A., Calamari, J.E., & Sica, C. (2014). The sense of incompleteness as a motivator of obsessive-compulsive symptoms: An empirical analysis of concepts and correlates. Behavior Therapy, 45, 254262. doi:10.1016/j.beth.2013.11.004 CrossRefGoogle ScholarPubMed
Taylor, S., Zvolensky, M.J., Cox, B.J., Deacon, B., Heimberg, R.G., Ledley, D.R., . . . Cardenas, S.J. (2007). Robust dimensions of anxiety sensitivity: Development and initial validation of the Anxiety Sensitivity Index-3. Psychological Assessment, 19, 176188. doi:10.1037/1040-3590.19.2.176 CrossRefGoogle ScholarPubMed
Tolin, D.F., Brady, R.E., & Hannan, S. (2008). Obsessional beliefs and symptoms of obsessive-compulsive disorder in a clinical sample. Journal of Psychopathology and Behavioural Assessment, 30, 3142. doi:10.1007/s10862-007-9076-7 CrossRefGoogle Scholar
Viar, M.A., Bilsky, S.A., Armstrong, T., & Olatunji, B.O. (2011). Obsessive beliefs and dimensions of obsessive-compulsive disorder: An examination of specific associations. Cognitive Therapy and Research, 35, 108117. doi:10.1007/s10608-011-9360-4 CrossRefGoogle Scholar
Wahl, K., Salkovskis, P.M., & Cotter, I. (2008). ‘I wash until it feels right’: The phenomenology of stopping criteria in obsessive-compulsive washing. Journal of Anxiety Disorders, 22, 143161. doi:10.1016/j.janxdis.2007.02.009 CrossRefGoogle ScholarPubMed
Wheaton, M.G., Deacon, B.J., McGrath, P.B., Berman, N.C., & Abramowitz, J.S. (2012). Dimensions of anxiety sensitivity in the anxiety disorders: Evaluation of the ASI-3. Journal of Anxiety Disorders, 26, 401408. doi:10.1016/j.janxdis.2012.01.002 CrossRefGoogle ScholarPubMed
Wilson, A., & Chatterjee, A. (2005). The assessment of preference for balance: Introducing a new test. Empirical Studies of the Arts, 23, 165180. doi:10.2190/B1LR-MVF3-F36X-XR64 CrossRefGoogle Scholar
Wu, K.D., & Cortesi, G.T. (2009). Relations between perfectionism and obsessive–compulsive symptoms: Examination of specificity among the dimensions. Journal of Anxiety Disorders, 23, 393400. doi:10.1016/j.anxdis.2008.11.006 CrossRefGoogle ScholarPubMed
Zor, R., Szechtman, H., Hermesh, H., Fineberg, N.A., & Eilam, D. (2011). Manifestation of incompleteness in obsessive-compulsive disorder (OCD) as reduced functionality and extended activity beyond task completion. PLoS ONE, 6, e25217. doi:10.1371/journal.pone.0025217 CrossRefGoogle ScholarPubMed