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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]

Objective: Disgust is a basic emotion evolved to safeguard our omnivorous species from contagion. Although the factors eliciting disgust typically involve concerns related to physical contamination, physical disgust responses are also prompted by moral transgressions, (i.e. cannibalism, pedophilia, betrayal). The link between the general propensity to experience disgust (i.e. "Disgust Sensitivity") and morality, in particular in the deontological domain, is supported by an increasing amount of data on clinical and non-clinical sample. Evolutionistic explanations of this link posit that disgust evolved to indicate the presence of a threat to the integrity of the individual not only in the physical domain but also in the social and moral domain. In addition to the evolutionary point of view, this link could also be better investigated in terms of individual development. To the best of our knowledge, literature is scarce regarding which early experiences are associated to high DS. Therefore, this study aims to explore the content of early memories associated with disgust. Based on the strict link between disgust and morality, we hypothesized an association between DS and early memories of moral criticism. Method: 60 non-clinical participants filled in measures of DS. They were then presented with an auditory disgust induction, after which they recalled early memories through the technique of the "affect bridge". 10 independent raters assessed the emotional content of the memories on visual-analogical scales. Results: Results showed a positive association between disgust sensitivity and the propensity to experience deontological guilt. There was also a significant positive association between disgust sensitivity and moral memories, in particular relating to early experiences of being the object of contempt, moral criticism, anger, and of being held responsible. Conclusions: These data directly support the centrality of early morally-loaded interpersonal experiences in the development of DS, confirming the link between disgust and morality also at the level of individual historical development. [ABSTRACT FROM AUTHOR]

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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]

The present work is the second of a corpus of two papers, aimed at proposing an original and more structured translation of the Standard Cognitive Behavioral Therapy (CBT) model of the Obsessive Compulsive Disorder (OCD), in the framework proposed by Mancini, into the language of Schema Therapy, in terms of Mode work. In the first of the two works, we illustrated OCD dynamics, the process of functioning of OCD and we suggested a proposal for the therapeutic rationale for the Mode work, characterizing the obsessive experience. In this work, a clinical example will be proposed also through a graphic representation of the translation of the CBT model of OCD into the Schema Therapy language. The main techniques of of CBT, adapted by the authors to the Schema Therapy framework will be presented. [ABSTRACT FROM AUTHOR]

Copyright of Cognitivismo Clinico is the property of Giovanni Fioriti Editore and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The close link between obsessive symptomatology, guilt and inflated responsibility is well documented, although one might suppose that guilt sensitiveness and dysfunctional beliefs about responsibility are rooted further in time. Imagery with rescripting (IWR) is an emotion-focused technique that binds actual stressful emotions to past memories where similar feelings were activated. It is used to change the meaning of emotionally distressing memories, turning aversive mental images into positive ones, and achieving a healthier prospective on the event. the aim of this study was to compare the content of IWR exercises, collected during an on-going cognitive-behavioral psychotherapy, in OCD and non-OCD patients, in order to explore eventual differences in their early negative childhood memories. We expected guilt and blame-related childhood episodes to be more frequent in OCD, compared against non-OCD patients. Method: forty-one imagery exercises were collected and categorized according to their content, emotions, needs, type of re-scripting, and final cognitive re-attribution. Results: OCD patients reported significantly more blame/reproach memories, expressing more guilt emotion and needs for acceptance. Within the re-scripting phase, all patients, regardless of their diagnosis, concluded the exercise protecting, reassuring and fostering emotional and needs expression, with no specific difference between groups. Conclusions: this work has several limitations, including the subjective nature of the study, the small sample size and unbalanced gender distribution across samples. However, our findings are in line with cognitive models on OCD, supporting the role of guilt-related early experiences that seem to be specific to this disorder. [ABSTRACT FROM AUTHOR]

Objective: Schema Therapy (ST) places particular emphasis on affective experiences, therapeutic relationship and early life experiences. Ad hoc ST conceptualizations for specific psychological conditions, mainly focusing on personality disorders, have been suggested in the last decade. The aim of this study was to explore schemas, modes and coping styles in outpatients with Obsessive-Compulsive Disorder (OCD). Method: thirty-four patients with OCD [DSM5 criteria, mean age(SD)=33(8.38) years; 12 females] were recruited. Schemas, modes and coping styles were measured. Indexes of OCD symptoms', guilt and disgust levels were also collected. Descriptive, correlation and multiple regression analyses were performed. Results: OCD symptoms' severity was significantly associated with social isolation, failure, subjugation and punishment schemas, and with the punitive parent mode. A positive relationship was also detected between OCD severity, and avoidance and intra-psychic coping styles and disgust intensity. Regression analyses revealed that the social isolation and punitiveness schemas, the punitive parent mode and behavioral avoidance coping style predicted OCD severity, with behavioral avoidance playing a significant mediation role between dysfunctional schemas and symptoms. Conclusions: Our data confirm previous findings on Schema model applied to OCD. An important limitation of the study is represented by the lack of an Italian control group. [ABSTRACT FROM AUTHOR]