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Objective: Fear of moral guilt and conseque:nt increased attention to personal actions and intentions are the main ingredients of the self-criticism in patients suffering from obsessive-compulsive disorder (OCD). This pathogenic attitude takes shape in a typical guilt-inducing self-talk. The purpose of this work is to describe in detail a novel cognitive therapeutic procedure for OCD called "Dramatized Socratic Dialogue" (DSD). Method: DSD is a theory-oriented intervention that combine elements of Socratic dialogue, chairwork, and cognitive acceptance strategies derived from Mancini's model, which posits that obsessive-compulsive (OC) symptoms stem from a fear of deontological guilt. Results: DSD appears to have many strengths, being a theory-oriented treatment and focusing, as a therapeutic target, on the cognitive structures that determine pathogenic processes and OC symptoms. Furthermore, it is a short, flexible and tailormade intervention. Conclusions: Detailed description of the intervention could foster future research perspectives and thus be used in evidence-based effectiveness studies to establish whether DSD reduces OC symptoms and to investigate its mechanism of action. [ABSTRACT FROM AUTHOR]

This article describes the clinical case of a patient with Pathological Affective Dependence (PAD). The interest in reporting this case is related to some specific aspects of PAD: (a) the overinvestment in avoiding loneliness, meant as loss of nurture, unworthiness and sufferance, due to the cross-scope of not losing relationships; (b) the role of the intrapsychic conflict in explaining the psychological suffering, and (c) the intergenerational transmission of PAD. Giving the lack of an effective treatment for PAD, guideline to treat Dependent Personality Disorder (DDP) were considered adequate in this case. However, even if DDP shares some common traits with PAD, it does not totally overlap with it. From a clinical point of view, this treatment overlap between PAD and DDP, shows some limitations such as objectives and behavioural patterns not shared between the two disorders. As such, there is the need of creating a specific treatment protocol for PAD that takes into account objectives, believes, and maladaptive behaviours to prevent longlasting difficulties and pathological relapses. Such protocol in currently under validation with the authors of the PAD cognitive model. [ABSTRACT FROM AUTHOR]

Guilt plays a role in various forms of psychopathology. However, different types of guilt might be involved in different mental disorders. Obsessive-compulsive (OC) patients are prone to a type of guilt in which the violation of an internalized moral norm is necessary and sufficient, whereas data suggest that depression might be linked to more interpersonal types of guilt. However, the extent to which a specific guilt phenomenology is involved in each condition is yet to be determined. Here we assessed the association between different types of guilt and different diagnostic groups. Two clinical samples (33 OCD and 35 non-OCD) filled in the Moral Orientation Guilt Scale (MOGS) along with other OCD and depression measures. Regression was employed to test group differences in the MOGS subscales and to test the influence of MOGS subscales on OCD and depression levels. Results confirm that different types of guilt might be implicated in different psychopathological conditions. Specifically, moral norm violation guilt is more present in OC patients than in other disorders. Depression seems to be associated with different guilt feelings depending on the psychopathological condition, specifically in non-OC patients, with types of guilt involving a "victim", supporting the accounts viewing interpersonal guilt as involved in the emergence of depressive symptomatology and hyper-altruistic behavior as a vulnerability factor for depression. [ABSTRACT FROM AUTHOR]

Cognitive–behavioral therapy is a well-established treatment for obsessive–compulsive disorder (OCD). There are a variety of cognitive and behavioral strategies, and it is necessary to analyze the outcomes of the treatments. The aim of the present study is to verify the effectiveness of a treatment that combines evidence-based procedures and specific cognitive interventions highlighting the issue of acceptance. Forty patients with OCD were recruited and underwent a specific treatment procedure. All patients had a psychodiagnostic assessment for OCD using the Y–BOCS (Yale–Brown obsessive–compulsive scale) performed twice: before treatment (t0) and after nine months (t1). Data analysis showed a decrease in the scores between t0 and t1 according to the Y–BOCS in terms of the interference, severity, and impairment of obsessive–compulsive symptoms. A repeated-measures ANOVA showed a significant reduction in symptoms after treatment, with values of F (1, 39) = 137.56, p < 0.001, and η2 = 0.78. The ANOVA results were corroborated by a Wilcoxon signed-rank test. A reliable change index analysis indicated that 33 participants reported improvements in symptoms, of which 23 were clinically significant. The results showed clinical relevance for OCD treatment and highlighted how this cognitive procedure favored positive outcomes. [ABSTRACT FROM AUTHOR]

Guilt emerges as the emotional result of a conflict between our behavior and internalized morality. Since morality is best conceptualized as a multidimensional construct, guilt results in different phenomena depending on the moral values internalized by the "guilty". Indeed, mounting evidence supports the distinction between guilt feelings emerging from deontological morality and guilt feelings emerging from altruistic morality. Most measures fail to consider moral orientation when assessing guilt. Our aim was to develop a reliable and valid tool, able to independently measure different types of guilt feelings. We presented the 17-items Moral Orientation Guilt Scale (MOGS) to a large subclinical sample, along with other questionnaires. Analyses included measures of classical test theory and innovative techniques of network analysis. This cross-validation approach pointed at four factors: "Moral Norm Violation", "Moral Dirtiness", "Empathy" and "Harm". Results suggested MOGS good reliability and a strong construct and convergent validity. Importantly, "Moral Norm Violation" and "Moral Dirtiness" scores were positively correlated with disgust sensitivity, supporting the link between disgust and deontological guilt. Differently, "Harm" scores were negatively correlated with disgust sensitivity scores, in line with the notion that altruism and disgust possibly evolved as part of contrasting motivational systems. • MOGS measures different types of guilt considering individual moral orientation. • Deontological guilt shows a positive association with disgust sensitivity. • Altruistic guilt shows a negative association with disgust sensitivity. [ABSTRACT FROM AUTHOR]