Investigation of Theory of Mind, Disgust Sensitivity, and Mental Contamination in Patients with Obsessive-Compulsive Disorder

Year 2024, Volume: 16 Issue: Supplement 1, 239 - 248

Cansu Ünsal , Esra Yalım , Çiçek Hocaoğlu

https://doi.org/10.18863/pgy.1528785

Abstract

Objective: The aim of this study is to examine the relationships between theory of mind (ToM), disgust sensitivity, and mental contamination patients with obsessive-compulsive disorder (OCD).
Methods: In this cross-sectional study, 37 patients with OCD and 45 healthy volunteers with similar socio-demographic characteristics were enrolled at the Silifke State Hospital Department of Psychiatry between October 2023 and March 2024. We utilized the Padua Inventory - Washington State University Revision, the Dokuz Eylül Theory of Mind Index, the Disgust Scale — Revised, and the Vancouver Obsessive-Compulsive Inventory — Mental Contamination Scale.
Results: Patients with OCD exhibited significantly higher sensitivity to disgust (mean ± standard deviation 68.19±12.28) and mental contamination (mean ± standard deviation= 25.54± 7.64) compared to healthy controls. Although the differences in ToM abilities approached significance, they did not reach statistical significance. A significant correlation was identified between the subscale of "disgust related to contamination" and "checking compulsions" (r = 0.433), as well as with "obsessive thoughts about harming oneself/others" (r = 0.515). No significant correlation was found between mental contamination and the other variables (r = 0.240).
Conclusion: The findings highlight impairments in certain ToM skills among patients with OCD, alongside elevated disgust sensitivity and mental contamination, relative to controls. The significant correlations between disgust sensitivity and specific OCD symptoms emphasize the influence of disgust in exacerbating certain compulsive behaviors. These insights contribute to our understanding of the interactions between OCD symptoms, ToM abilities, and disgust sensitivity.

Keywords

obsessive-compulsive disorder, theory of mind, disgust sensitivity, mental contamination

Supporting Institution

Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Thanks

Acknowledgements: Not applicable

Obsesif-Kompulsif Bozukluğu Olan Hastalarda Zihin Kuramı, Tiksinme Duyarlılığı ve Mental Kontaminasyonun İncelenmesi

Abstract

Amaç: Bu çalışmada Obsesif-kompulsif bozukluk (OKB) hastalarında zihin kuramı (ZK), tiksinme duyarlılığı ve mental kontaminasyon arasındaki ilişkilerinin incelenmesi amaçlanmıştır.
Yöntem: Mevcut kesitsel çalışmaya Ekim 2023-Mart 2024 tarihleri arasında Silifke Devlet Hastanesi Psikiyatri kliniğine başvuran 37 OKB hastası ve sosyodemografik açıdan benzer özellikteki 45 sağlıklı gönüllü dahil edilmiştir. Çalışmada Padua Envanteri - Washington Eyalet Üniversitesi Revizyonu, Dokuz Eylül Zihin Kuramı İndeksi, Tiksinme Ölçeği - Gözden Geçirilmiş ve Vancouver Obsesif - Kompulsif Envanteri - Mental Kontaminasyon Ölçeği kullanılmıştır,
Bulgular: OKB hastalarında sağlıklı kontrollere kıyasla anlamlı düzeyde daha yüksek tiksinme duyarlılığı (ort±SS: 68,19±12,28) ve mental kontaminasyon düzeyleri (ort±SS: 25,54 ±7,64) saptandı. Zihin kuramı becerilerindeki farklılıklar anlamlılığa yakın olmakla birlikte, istatistiksel anlamlılığa ulaşmamıştır. “Kontaminasyon ile ilişkili tiksinme” alt ölçeğinin “Kontrol etme kompulsiyonları” ile (r=0,433) ve “Kendine/başkalarına zarar verme ile ilgili obsesyonel düşünceler” ile (r=0.515) arasında anlamlı bir korelasyon belirlenmiştir. Mental kontaminasyon ile diğer değişkenler arasında anlamlı bir korelasyon saptanmamıştır (r=0.240).
Sonuç: Bulgularımız, OKB hastalarında belirli ZK becerilerinde bozuklukların yanı sıra, kontrol grubuna göre daha yüksek tiksinme duyarlılığı ile mental kontaminasyon olduğunu vurgulamaktadır. Tiksinme duyarlılığı ile spesifik OKB semptomları arasındaki anlamlı korelasyonlar, tiksinmenin bazı kompulsif davranışları şiddetlendirmedeki etkisini öne çıkarmaktadır.

Keywords

obsesif-kompulsif bozukluk, zihin kuramı, tiksinme duyarlılığı, mental kontaminasyon

References

• Abu-Akel A (2003) The neurochemical hypothesis of ‘theory of mind.’ Med Hypotheses, 60:382–386.
• Ayribas B, Ayhan G, Topcuoglu V, Kose S, Sayar K (2020) Theory of mind abilities and insight dimension in patients with obsessive-compulsive disorder and schizophrenia. Psychiatry and Clinic Psychopharmacology, 30:434-442.
• Badour CL, Feldner MT, Blumenthal H, Bujarski SJ (2013) Examination of increased mental contamination as a potential mechanism in the association between disgust sensitivity and sexual assault-related posttraumatic stress. Cognit Ther Res, 37:697–703.
• Berle D, Phillips ES (2006) Disgust and obsessive–compulsive disorder: an update. Psychiatry, 69:228–238.
• Bora E (2022) Social cognition and empathy in adults with obsessive compulsive disorder: a meta-analysis. Psychiatry Res, 316:114752.
• Bozikas VP, Kosmidis MH, Giannakou M, Saitis M, Fokas K, Garyfallos G (2009) Emotion perception in obsessive–compulsive disorder. J Int Neuropsychol Soc, 15:148–153.
• Broderick J, Grisham JR, Weidemann G (2013) Disgust and fear responding in contamination-based obsessive-compulsive disorder during pictorial exposure. Behav Ther, 44:27–38.
• Burns GL, Keortge SG, Formea GM, Sternberger LG (1996) Revision of the Padua Inventory of obsessive compulsive disorder symptoms: distinctions between worry, obsessions, and compulsions. Behav Res Ther, 34:163–173.
• Carraresi C, Bulli F, Melli G, Stopani E (2013) Mental contamination in OCD: its role in the relationship between disgust propensity and fear of contamination. Clin Neuropsychiatry, 10:13-19.
• Ching THW, Rouleau TM, Turner E, Williams MT (2021) Disgust sensitivity mediates the link between homophobia and sexual orientation obsessive-compulsive symptoms. Cogn Behav Ther, 50:452–465.
• Coughtrey AE, Shafran R, Knibbs D, Rachman SJ (2012) Mental contamination in obsessive–compulsive disorder. J Obsessive Compuls Relat Disord, 1:244–250.
• Coughtrey AE, Shafran R, Lee M, Rachman SJ (2012) It’s the feeling inside my head: a qualitative analysis of mental contamination in obsessive-compulsive disorder. Behav Cogn Psychother, 40:163–173.
• Değirmencioğlu B (2008) İlk kez geliştirilecek olan Dokuz Eylül Zihin Teorisi Ölçeğinin (DEZTÖ) geçerlik ve güvenirlik çalışması. (Yüksek lisans tezi). İzmir, Dokuz Eylül Üniversitesi.
• Fairbrother N, Rachman S (2004) Feelings of mental pollution subsequent to sexual assault. Behav Res Ther, 42:173–189.
• Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods, 39:175-191
• Fontenelle LF, Soares ID, Miele F, Borges MC, Prazeres AM, Rangé BP et al. (2009) Empathy and symptoms dimensions of patients with obsessive–compulsive disorder. J Psychiatr Res, 43:455–463.
• Georgiadis C, Schreck M, Gervasio M, Kemp J, Freeman J, Garcia A et al. (2020) Disgust propensity and sensitivity in childhood anxiety and obsessive-compulsive disorder: two constructs differentially related to obsessional content. J Anxiety Disord, 76:102294.
• Hair JF, Black WC, Babin BJ, Anderson RE (2010) Multivariate Data Analysis, 7th ed. New York, Pearson.
• Haidt J, McCauley C, Rozin P (1994) Individual differences in sensitivity to disgust: a scale sampling seven domains of disgust elicitors. Pers Individ Dif, 16:701–713.
• İnözü M, Eremsoy CE (2013) Tiksinme ölçeği ile bulaşma/kirlenme bilişleri ölçeği’nin Türkçe versiyonlarının psikometrik özellikleri. Türk Psikoloji Yazıları, 16:1–10.
• Inchausti Gómez F, Delgado González AR, Prieto Adánez G (2015) Obsessive-compulsive disorder and its relationship with disgust vulnerability and conscientiousness. Psicothema, 27:254–260.
• Inözü M, Bilekli I, Özcanli FU (2016) Zihinsel Kirlenmenin (ZK) obsesif-kompulsif bozukluk ile ilişkisi: Vancouver obsesif-kompulsif envanteri-ZK ve düşünce-eylem kaynaşması-kirlenme ölçeklerinin psikometrik özellikleri. Dusunen Adam, 29:335–348.
• Liu W, Fan J, Gan J, Lei H, Niu C, Chan, RCK et al. (2017) Disassociation of cognitive and affective aspects of theory of mind in obsessive-compulsive disorder. Psychiatry Res, 255:367–372.
• Mavrogiorgou, P, Bethge M, Luksnat S, Nalato F, Juckel G, Brüne M (2016) Social cognition and metacognition in obsessive–compulsive disorder: an explorative pilot study. Eur Arch Psychiatry Clin Neurosci, 266:209–216.
• Melli G, Bulli F, Carraresi C, Stopani E (2014) Disgust propensity and contamination-related OCD symptoms: the mediating role of mental contamination. J Obsessive Compuls Relat Disord, 3:77–82.
• Mentser S, Nussinson R (2020) We’re not of the same feather: disgust sensitivity and reduced perceived similarity to unknown others. Pers Individ Dif, 163:110039.
• Mısır E, Bora E, Akdede BB (2018) Relationship between social-cognitive and social-perceptual aspects of theory of mind and neurocognitive deficits, insight level and schizotypal traits in obsessive-compulsive disorder. Compr Psychiatry, 83:1–6.
• Oaten M, Stevenson RJ, Case TI (2009) Disgust as a disease-avoidance mechanism. Psychol Bull, 135:303–321.
• Olatunji BO, Haidt J, McKay D, David B (2008) Core, animal reminder, and contamination disgust: three kinds of disgust with distinct personality, behavioral, physiological, and clinical correlates. J Res Pers, 42:1243–1259.
• Olatunji BO, Sawchuk CN, Lohr JM, De Jong PJ (2004) Disgust domains in the prediction of contamination fear. Behav Res Ther, 42:93–104.
• Pino MC, De Berardis D, Mariano M, Vellante F, Serroni N, Valchera A et al. (2016) Two systems for empathy in obsessive-compulsive disorder: mentalizing and experience sharing. Braz J Psychiatry, 38:307–313.
• Rachman S (1994) Pollution of the mind. Behav Res Ther, 32:311–314.
• Rachman S (2005) Vancouver Obsessional Compulsive Inventory (VOCI-MC). Rachman Lab, University of British Columbia.
• Şahin B, Bozkurt A, Usta MB, Aydın M, Çobanoğlu C, Karabekiroğlu, K (2019) Theory of mind: development, neurobiology, related areas and neurodevelopmental disorders. Psikiyatride Güncel Yaklaşımlar, 11:24-41.
• Salazar Kämpf M, Kanske P, Kleiman A, Haberkamp A, Glombiewski J, Exner C (2022) Empathy, compassion, and theory of mind in obsessive‐compulsive disorder. Psychol Psychother, 95:1–17.
• Sayın A, Oral N, Utku C, Baysak E, Candansayar S (2010) Theory of mind in obsessive-compulsive disorder: comparison with healthy controls. Eur Psychiatry, 25:116–122.
• The jamovi project (2.5). (2024). https://www.jamovi.org
• Thorpe SJ, Patel SP, Simonds LM (2003) The relationship between disgust sensitivity, anxiety and obsessions. Behav Res Ther, 41:1397–1409.
• Tolin DF, Woods CM, Abramowitz JS (2006). Disgust sensitivity and obsessive–compulsive symptoms in a non-clinical sample. J Behav Ther Exp Psychiatry, 37:30–40.
• Van Overveld WJM, De Jong PJ, Peters ML, Cavanagh K, Davey GCL (2006) Disgust propensity and disgust sensitivity: separate constructs that are differentially related to specific fears. Pers Individ Dif, 41:1241–1252.
• Yılmaz B, Bahtiyar B (2019) Obsesif kompulsif bozukluk belirtileri, tiksinme duyarlılığı ve zihinsel kirlenmenin cinsel doyumla ilişkisi. Klinik Psikoloji Dergisi, 3:92–103.
• Yorulmaz O, Karancı AN, Dirik G, Baştuğ B, Kısa C, Göka E et al. (2007) Padua envanteri-Washington Eyalet Üniversitesi revizyonu: Türkçe versiyonunun psikometrik özellikleri. Türk Psikoloji Yazıları, 10:75–85.