همبسته های شناختی اختلال وسواسی - جبری: سهم پیش بین سبک ناسازگارانه بزرگ نمایی تهدید، کارکرد اجرایی، آمیختگی فکر و عمل و فراشناخت (مقاله علمی وزارت علوم)
درجه علمی: نشریه علمی (وزارت علوم)
آرشیو
چکیده
اختلال وسواسی جبری یکی از شایع ترین اختلال های روانی است که بر تمام جنبه های زندگی انسان اثرگذار است. 300 نفر از دانشجویان دانشگاه شهید مدنی آذربایجان به صورت نمونه گیری خوشه ای در پژوهش شرکت داده شدند. آزمودنی ها به پرسشنامه های خودگزارشی سبک ناسازگارانه بزرگ نمایی تهدید، پرسشنامه نقص کارکردهای اجرایی: بارکلی، پرسشنامه ارزیابی فراشناخت - 30سؤالی، پرسشنامه همجوشی فکر و پرسشنامه مقیاس وسواس فکری عملی ییل براون پاسخ دادند. یافته های به دست آمده از تحلیل پژوهش نشان داد میان مؤلفه باور مثبت درباره نگرانی (p≤0.05) و مؤلفه های کنترل ناپذیری، اطمینان شناختی، خودمدیریتی، خودسازمان دهی، خودکنترلی و خودانگیزشی (p≤0.01) همبستگی مثبت و معناداری با علائم اختلال وسواسی وجود دارد. همچنین، میان مؤلفه های باور مثبت درباره نگرانی، کنترل ناپذیری، نیاز به کنترل، سبک ناسازگارانه بزرگ نمایی تهدید فیزیکی، خودسازمان دهی (p≤0.05) و مؤلفه اطمینان شناختی (p≤0.01) همبستگی مثبت و معناداری با علائم اختلال جبری وجود داشت. نتایج تحلیل رگرسیون نشان داد متغیرهای پیش بین باور مثبت درباره نگرانی، کنترل ناپذیری، خودمدیریتی و خودانگیزشی سهمی معنادار در پیش بینی مؤلفه اختلال وسواسی دارند. همچنین، نتایج تحلیل رگرسیون آشکار کرد متغیرهای پیش بین باور مثبت درباره نگرانی، اطمینان شناختی، سبک ناسازگارانه بزرگ نمایی تهدید اجتماعی، خودسازمان دهی و خودکنترلی در پیش بینی مؤلفه اختلال جبری در آسیب شناسی علائم وسواسی جبری سهم معنا دار داشته اند. با توجه به اهمیت نقش باورهای فراشناختی و راهبردهای کنترل فکر که آن هم متأثر از باورهای فراشناختی است، در پیش بینی و تبیین علائم وسواسی، درمان فراشناختی پرفایده به نظر می رسد.The Cognitive Correlates of Obsessive-Compulsive Disorder: The Predictive Role of Looming Maladaptive Style, Executive Function, Thought-Action Fusion and Metacognition
Obsessive-compulsive disorder (OCD) is one of the most common mental disorders, affecting all aspects of human life. In this study, 300 students from Azarbaijan Shahid Madani University participated through cluster sampling. The participants completed the Threat Magnification Maladaptive Style Questionnaire, the Barkley Deficits in Executive Functioning Scale, the Metacognition Assessment Questionnaire (30 items), the Thought-Action Fusion Questionnaire, and the Yale-Brown Obsessive-Compulsive Scale. The analysis revealed a significant positive correlation between positive beliefs about anxiety and components such as uncontrollability, confidence, self-management, self-control, and self-motivation, with statistical significance at the 1% level. Additionally, a positive and significant correlation was found between positive beliefs about anxiety, uncontrollability, the need for control, maladaptive style of physical threat magnification, and self-organization at the 5% level, and the cognitive component at the 1% level, with symptoms of obsessive-compulsive disorder. Regression analysis indicated that positive beliefs about anxiety, uncontrollability, self-management, and self-motivation significantly predicted the obsessive-compulsive disorder component. Moreover, the predictors of positive belief about anxiety, cognition, maladaptive style of social threat magnification, self-organization, and self-control significantly contributed to predicting obsessive-compulsive disorder component. Given importance of metacognitive beliefs and thought control strategies, influenced by metacognitive beliefs, metacognitive therapy may be useful in predicting and addressing obsessive-compulsive symptoms.
Introduction
Obsessive-compulsive disorder (OCD) is characterized by obsessions, compulsions, or both. Obsessions are intrusive and distressing thoughts that persistently recur, often leading individuals to engage in compulsive actions to alleviate the distress (Jalal et al., 2023). Research shows that individuals with OCD, as well as non-clinical individuals with high OCD-related scores, exhibit significant cognitive biases. Cognitive models of OCD suggest that exaggerated evaluations of intrusive thoughts and a strong commitment to suppress them play a crucial role in distress and the urge to engage in behaviors such as compulsions, neutralizing actions, thought suppression, reassurance-seeking, and avoidance. When a heightened sense of vulnerability is triggered, it acts as a cognitive threat factor, making individuals more sensitive to danger cues and influencing their cognitive processes with a bias toward threat perception. Similar to other anxiety disorders, maladaptive threat magnification may heighten vulnerability to OCD by imposing a cognitive burden that undermines mental control abilities. Cognitive theory posits that cognitive processes are central to OCD (Jennings, 2022).
Literature indicates that individuals with high cognitive threat magnification are more susceptible to anxiety in stressful life events compared to those without this predisposition. However, a notable exception is the strong correlation between social and physical components of threat magnification in women compared to men (Gonzales Diez et al., 2014).
Thought-action fusion, a cognitive distortion, can be categorized into probability thought-action fusion and moral distortion (Einstein & Menzies, 2004). Studies on probability and general thought-action fusion in clinical populations reveal high reliability in the general measure. Furthermore, strong links between general thought-action fusion and the probability subscales with OCD characteristics—relative to symptoms of depression and worry—have been confirmed (Myers & Wells, 2013). Recent research has implicated neurological dysfunctions in OCD, including deficits in working memory and executive functions, which may play critical roles in the disorder's assessment and treatment (Bukhari, 2013). Individuals with OCD often exhibit impairments in cognitive control, cognitive flexibility, and inhibitory control.
Wells proposed a metacognitive theory of obsession that merges schema theory and information processing theory, highlighting beliefs individuals hold about their cognitive processes (McNicol & Wells, 2012). A study found significant differences in metacognitive beliefs, thought control strategies, and anxiety-inducing thoughts among individuals with generalized anxiety disorder, OCD, dysthymia, and non-clinical individuals (Moin Al-Ghorabaiee et al., 2017).
The objective of this study was to address the question:
What role do cognitive correlates (specifically, predictors of maladaptive threat magnification style, executive functions, thought-action fusion, and metacognition) play in obsessive-compulsive disorder?
Methodology
This study has a theoretical aim and employs a descriptive-correlational approach for data collection. The statistical population includes all students from Azarbaijan Shahid Madani University during the 2019-2020 academic year. A total of 300 participants were selected through cluster sampling. The following self-report questionnaires assessed maladaptive threat magnification style, executive functions, thought-action fusion, and metacognition in obsessive-compulsive disorder (OCD): the Threat Magnification Self-Report Questionnaire, Barkley Deficits in Executive Functioning Scale, 30-item Metacognition Assessment Questionnaire, Thought-Action Fusion Questionnaire, and Yale-Brown Obsessive-Compulsive Scale. Data were analyzed using SPSS software at a significance level of (P<0.05), and divided into descriptive and inferential sections. Descriptive measures of dispersion were used to characterize the research variables, while Pearson’s correlation coefficient and multiple regression analysis were utilized for inferential statistics.
Findings
The sample comprised 193 females and 107 males, with 21 participants married and 279 single. Regarding education, 215 participants held bachelor's degrees, 70 ones had master's degrees, and 15 ones had doctoral degrees. Age distribution indicated that 68% were between 20-25 years and 32% between 30-35 years. Results showed that the skewness and kurtosis values for predictor and criterion variables suggested a normal distribution. Pearson correlation analysis revealed significant positive correlations between the positive belief component and components like uncontrollability, cognitive confidence, self-management, self-organization, self-control, and self-motivation. Furthermore, significant correlations existed between cognitive correlates (maladaptive threat magnification style, executive functions, thought-action fusion, and metacognition) and OCD symptoms, particularly in components of positive belief, uncontrollability, need for control, maladaptive physical threat magnification style, and self-organization with cognitive confidence. Regression analysis indicated that the predictor variables of positive belief about anxiety, uncontrollability, self-management, and self-motivation significantly contributed to predicting the OCD component. Additionally, positive belief about anxiety, cognitive confidence, maladaptive social threat magnification style, self-organization, and self-control were significant predictors of the compulsive disorder component.
Discussion and Conclusion
This study examined obsessive-compulsive disorder (OCD) from a cognitive perspective, focusing on cognitive correlates such as maladaptive threat magnification style, executive functions, thought-action fusion, and metacognition. The results showed a positive and significant correlation at the 5% level between the positive belief component and uncontrollability, cognitive confidence, self-management, self-organization, self-control, and self-motivation at the 1% level. Higher levels of these cognitive components in the studied population were associated with a greater likelihood of experiencing OCD symptoms.
Furthermore, Pearson correlation analysis revealed significant positive correlations at the 5% level among cognitive correlates—maladaptive threat magnification style, executive functions, thought-action fusion, and metacognition—and OCD symptoms. Notably, positive belief, uncontrollability, need for control, maladaptive physical threat magnification style and self-organization showed significant correlations at both the 5% and 1% levels with cognitive confidence. Thus, the studied population is likely to exhibit symptoms of compulsive disorder.
These findings align with previous research (Mirza, Fisher, & Wells, 2009; Irah & Toussaint, 2008; Mohammadi, 2013). This study highlights the mediating role of predictor variables—positive belief, cognitive confidence, maladaptive social threat magnification style, self-organization, and self-control—in predicting the compulsive disorder component of obsessive-compulsive symptoms. These variables, thus, clarify the symptoms of OCD. Given their significant role, it is essential for university health authorities to implement training programs and mental health promotion strategies for students. Additionally, metacognitive beliefs and thought control strategies are crucial in predicting obsessive-compulsive symptoms, suggesting that metacognitive therapy and its techniques could be beneficial.
While the instruments used have scientific validity, they may have limitations in measuring certain variables. Due to restrictions, the cognitive assessment tool (Beshra test) was not administered; however, such tools could be valuable in future research. Diagnostic interviews, particularly for clinical groups, are also recommended.
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