¿Qué papel juegan la evitación del daño y la sensación de inacabado en los síntomas obsesivos de orden y comprobación?

María Roncero, Gertrudis Fornés-Romero

Resumen


Numerosas investigaciones han intentado determinar las variables implicadas en la génesis y mantenimiento del Trastorno Obsesivo-Compulsivo (TOC). Recientemente, se han propuesto la evitación del daño y la sensación de inacabado como dos dimensiones nucleares motivadoras de la sintomatología obsesivo-compulsiva. El objetivo de este estudio fue analizar el papel de la evitación del daño y la sensación de inacabado en su relación con los síntomas obsesivo-compulsivos. Para ello, se realizó un Path analysis en una muestra de 267 personas de la población general (74.5% eran mujeres). Los resultados mostraron que la asociación entre evitación del daño y los síntomas de orden y comprobación estaba mediada, en gran medida, por la sensación de inacabado, apoyando una mayor especificidad de esta última en la fenomenología TOC. Futuros estudios deberán corroborar este resultado en muestras clínicas.

Palabras clave


Trastorno obsesivo-compulsivo; sensación de inacabado; evitación del daño; orden; comprobación

Texto completo:

PDF           Cómo citar un elemento

Referencias


Abramowitz, J. S. (1996). Variants of exposure and response prevention in the treatment of obsessive-compulsive disorder: A meta-analysis. Behavior Therapy, 27(4), 583-600.

Abramowitz, J. S., Fabricant, L. E., Taylor, S., Deacon, B. J., McKay, D., y Storch, E. A. (2014). The relevance of analogue studies for understanding obsessions and compulsions. Clinical Psychology Review, 34(3), 206-217.

Abrams, K. Y., Yune, S. K., Kim, S. J., Jeon, H. J., Han, S. J., Hwang, J., ... y Lyoo, I. K. (2004). Trait and state aspects of harm avoidance and its implication for treatment in major depressive disorder, dysthymic disorder, and depressive personality disorder. Psychiatry and Clinical Neurosciences, 58(3), 240-248.

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th Edition). Washington, DC: Author.

Belloch, A., Fornés, G., Carrasco, A., López-Solá, C., Alonso, P., y Menchón, J. M. (2016). Incompleteness and not just right experiences in the explanation of obsessive-compulsive disorder. Psychiatry Research, 236, 1-8.

Belloch, A., Roncero, M., García-Soriano, G., Carrió, C., Cabedo, E., y Fernández- Álvarez, H. (2013). The Spanish version of the Obsessive–Compulsive Inventory- Revised OCI-R: reliability, validity, diagnostic accuracy, and sensitivity to treatment effects in clinical samples. Journal of Obsessive–Compulsive and Related Disorder, 2(3), 249–256.

Bentler, P. M. (2006). EQS 6.1 Structural Equations Program Manual. Multivariate

Software, Inc, Encino, CA.

Bentler, P. M., Bonnet, D. G. (1980). Significance tests and goodness of fit in the

analysis of covariance structures. Psychological Bulletin, 88, 588–606.

Calamari, J. E., Cohen, R. J., Rector, N. A., Szacun-Shimizu, K., Riemann, B. C., y Norberg, M. N. (2006). Dysfunctional belief-based obsessive–compulsive disorder subgroups. Behaviour Research and Therapy, 44(9), 1347–1360.

Carrasco, A., y Belloch, A. (2013). Algo no está bien: una nueva lectura de la duda obsesiva. Psicología Conductual, 21(2), 341–361.

Cloninger, C. R., Svrakic, D. M., y Przybeck, T. R. (1993). A psychobiological model of temperament and character. Archives of General Psychiatry, 50(12), 975-990.

Coles, M. E., Frost, R. O., Heimberg, R. G., y Rhéaume, J. (2003). “Not just right experiences”: perfectionism, obsessive–compulsive features and general psychopathology. Behaviour Research and Therapy, 41(6), 681-700.

Coles, M. E., Heimberg, R. G., Frost, R. O., y Steketee, G. (2005). Not just right experiences and obsessive–compulsive features: Experimental and self-monitoring perspectives. Behaviour Research and Therapy, 43(2), 153-167.

Cougle, J. R., Fitch, K. E., Jacobson, S., y Lee, H. J. (2013). A multi-method examination of the role of incompleteness in compulsive checking. Journal of Anxiety Disorders, 27(2), 231-239.

Cougle, J. R., y Lee, H. J. (2014). Pathological and non-pathological features of obsessive-compulsive disorder: Revisiting basic assumptions of cognitive models. Journal of Obsessive-Compulsive and Related Disorders, 3(1), 12-20.

Ecker, W., y Gönner, S. (2008). Incompleteness and harm avoidance in OCD symptom dimensions. Behaviour Research and Therapy, 46(8), 895-904.

Ecker, W., Kupfer, J., y Gönner, S. (2014). Incompleteness as a link between obsessive–compulsive personality traits and specific symptom dimensions of obsessive–compulsive disorder. Clinical Psychology and Psychotherapy, 21(5), 394-402.

Ferrão, Y. A., Shavitt, R. G., Prado, H., Fontenelle, L. F., Malavazzi, D. M., de Mathis, M. A., ... y do Rosario, M. C. (2012). Sensory phenomena associated with repetitive behaviors in obsessive-compulsive disorder: an exploratory study of 1001 patients. Psychiatry Research, 197(3), 253-258.

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 (4) 485-96.

Foa, E. B., Liebowitz, M. R., Kozak, M. J., Davies, S., Campeas, R., Franklin, M. E., ... y Simpson, H. B. (2005). Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder. American Journal of Psychiatry, 162(1), 151-161.

Foa, E. B., Steketee, G., y Milby, J. B. (1980). Differential effects of exposure and response prevention in obsessive-compulsive washers. Journal of Consulting and Clinical Psychology, 48(1), 71.

Fornés-Romero, G., Ruiz, M. A., Belloch, A. (2016). Sensación de inacabado y experiencias “no del todo correctas” como motivadoras de los síntomas obsesivo–compulsivos. Revista de Psicopatología y Psicología Clínica, 21, 105-118.

García-Soriano, G., Belloch, A., y Morillo Prats, C. (2008). Sobre la heterogeneidad del trastorno obsesivo-compulsivo: una revisión. Revista de Psicopatología y Psicología Clínica, 13(2), 65-84.

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(8), 879-886.

Gibbs, N. A. (1996). Non-clinical populations in research on obsessive–compulsive disorder: A critical review. Clinical Psychology Review, 16(8), 729–773.

Hu, L. T., y Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1–55.

Leckman, J. F., Walker, D. E., Goodman, W. K., Pauls, D. L., y Cohen, D. J. (1994). "Just right" perceptions associated with compulsive behavior in Tourette's syndrome. American Journal of Psychiatry, 151(5), 675-680.

Lindsay, M., Crino, R., y Andrews, G. (1997). Controlled trial of exposure and response prevention in obsessive-compulsive disorder. The British Journal of Psychiatry, 171(2), 135-139.

Lochner, C., y Stein, D. J. (2003). Heterogeneity of obsessive-compulsive disorder: a literature review. Harvard Review of Psychiatry, 11(3), 113-132.

Miettunen, J., y Raevuori, A. (2012). A meta-analysis of temperament in axis I psychiatric disorders. Comprehensive Psychiatry, 53(2), 152-166.

Miguel, E. C., do Rosário-Campos, M. C., da Silva Prado, H., do Valle, R., Rauch, S. L., Coffey, B. J., ... y Leckman, J. F. (2000). Sensory phenomena in obsessive-compulsive disorder and Tourette's disorder. The Journal of Clinical Psychiatry, 61(2), 1-478.

Pietrefesa, A. S., y Coles, M. E. (2008). Moving beyond an exclusive focus on harm avoidance in obsessive compulsive disorder: Considering the role of incompleteness. Behavior Therapy, 39(3), 224-231.

Pietrefesa, A. S., y Coles, M. E. (2009). Moving beyond an exclusive focus on harm avoidance in obsessive-compulsive disorder: behavioral validation for the separability of harm avoidance and incompleteness. Behavior Therapy, 40(3), 251-259.

Rachman, S. J. (2002). A cognitive theory of compulsive checking. Behaviour Research and Therapy, 40(6), 625-639.

Radomsky, A. S., y Rachman, S. (2004). Symmetry, ordering and arranging compulsive behaviour. Behaviour Research and Therapy, 42(8), 893-913.

Rapoport, J. L. (1991). Basal ganglia dysfunction as a proposed cause of obsessive-compulsive disorder. Psychopathology and The Brain, 77-95.

Rasmussen, S.A., y Eisen, J.L. (1992). The epidemiology and clinical features of obsessive compulsive disorder. The Psychiatric Clinics of North America, 15, 743–758.

Salkovskis, P. M. (1999). Understanding and treating obsessive-compulsive disorder. Behaviour Research and Therapy, 37(Suppl. 1), S29-S52.

Smith, D. J., Duffy, L., Stewart, M. E., Muir, W. J., y Blackwood, D. H. (2005). High harm avoidance and low self-directedness in euthymic young adults with recurrent, early-onset depression. Journal of Affective Disorders, 87(1), 83-89.

Summerfeldt, L. J. (2004). Understanding and treating incompleteness in obsessive?compulsive disorder. Journal of Clinical Psychology, 60(11), 1155-1168.

Summerfeldt, L. J. (2007). Treating incompleteness, ordering, and arranging concerns. In: M. M. Antony, C. Purdon, & L. J. Summerfeldt (Eds.), Psychological treatment of obsessive-compulsive disorder (pp. 187–207). Washington, DC: American Psychological Association.

Summerfeldt, L. J., Kloosterman, P. H., Antony, M. M., y 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(2), 83-94.

Summers, B. J., Fitch, K. E., y Cougle, J. R. (2014). Visual, tactile, and auditory “not just right” experiences: associations with obsessive-compulsive symptoms and perfectionism. Behavior Therapy, 45(5), 678-689.

Tallis, F. (1996). Compulsive washing in the absence of phobic and illness anxiety. Behaviour Research and Therapy, 34(4), 361-362.

Taylor, S., McKay, D., Crowe, K. B., Abramowitz, J. S., Conelea, C. A., Calamari, J. E., y Sica, C. (2014). The sense of incompleteness as a motivator of obsessive-compulsive symptoms: An empirical analysis of concepts and correlates. Behavior therapy, 45(2), 254-262.

Tolin, D. F., Abramowitz, J. S., Kozak, M. J., y Foa, E. B. (2001). Fixity of belief, perceptual aberration, and magical ideation in obsessive–compulsive disorder. Journal of Anxiety Disorders, 15(6), 501-510.

Whittal, M. L., Robichaud, M., Thordarson, D. S., y McLean, P. D. (2008). Group and individual treatment of obsessive-compulsive disorder using cognitive therapy and exposure plus response prevention: A 2-year follow-up of two randomized trials. Journal of Consulting and Clinical Psychology, 76(6), 1003.




DOI: http://dx.doi.org/10.33776/amc.v46i173-4.3186 ';



------------------------------------------------------------------

e-ISSN: 2173-6855   -   ISSN: 0211-7339

Entidad editora: Universidad de Huelva. Servicio de Publicaciones.

Licencia de uso: Creative Commons 4.0