دانلود رایگان مقاله ارائه بالینی تجربه نه فقط درست (NJREs) در افراد مبتلا به وسواس

Abstract

There is increasing recognition that instead of being motivated by a desire to prevent harm and reduce anxiety, some obsessive-compulsive symptoms may be driven by a desire to get things ‘just right’ or ‘complete’ and to reduce a sense of discomfort. However, existing data is largely from non-clinical samples. Therefore, in the current paper we examine the clinical presentation of not just right experiences (NJREs) in patients diagnosed with OCD and compare their experiences to both anxious and unselected controls. Then, we provide preliminary data on NJREs before and after cognitive behavioral therapy (exposure and response prevention). First, individuals with OCD were found to report experiencing significantly more NJREs and being more distressed by them compared to anxious controls and unselected controls. Next, there was some support for the specificity of NJREs to feelings of incompleteness. Finally, we found that after completing treatment, patients reported experiencing significantly less NJREs and experienced less distress associated with the NJREs. In conclusion we believe that more work on the role of NJREs is warranted and that characterizing OCD symptoms as either based on harm avoidance or incompleteness/NJREs may be a useful framework for classifying OCD symptoms.

3. Discussion

These findings add to a growing body of work suggesting the utility of studying NJREs in individuals with OCD. These experiences have been observed clinically for many years but empirical work on their correlates and consequences has lagged behind. Findings from the current study are the first that we are aware of that directly tested whether CBT was associated with reductions in NJREs. Given that CBT for OCD was developed focusing on addressing anxiety, it could not be assumed that the intervention would also reduce NJREs or sensations of incompleteness. However, in our sample we found that CBT was associated with significant reductions in NJRE scores and that the amount of change in NJREs was significantly correlated with the amount of OCD symptom reduction. These findings support the continued examination of NJREs in OCD and the potential benefits of addressing them in treatment.