The role of disgust propensity and sensitivity on sexual excitation and inhibition in obsessive-compulsive disorder

Sexuality is understudied in Obsessive-Compulsive Disorder (OCD). According to the Dual Control Model, low sexual excitation (SE) and high sexual inhibition (SI) are indicative of a higher probability of experiencing a sexual dysfunction. The present study investigated SE and SI in OCD patients compared with controls. It was hypothesized that OCD patients report lower SE and higher SI than controls. Given their potential role as inhibitors of sexual response, it was hypothesized that in the OCD group higher disgust propensity/sensitivity, contamination/washing symptoms, unacceptable thoughts, and obsessive beliefs predicted lower SE, higher SI due to Threat of Performance Failure, and higher SI due to Threat of Performance Consequences. Seventy-two OCD patients and 72 controls matched on gender/age completed the Disgust Propensity and Sensitivity Scale-Revised, Obsessive Beliefs Questionnaire-46, Obsessive Compulsive Inventory-Revised, and Sexual Inhibition/Sexual Excitation Scales. OCD patients had higher SE, SI due to Threat of Performance Failure, and SI due to Threat of Performance Consequences than controls. In the OCD group, higher disgust sensitivity, SI due to Threat of Performance Consequences, and perfectionism predicted higher SI due to Threat of Performance Failure. Higher SI due to Threat of Performance Failure and contamination/washing symptoms predicted higher SI due to Threat of Performance Consequences. These findings highlight the presence of sexual difficulties in OCD patients, particularly a higher SE and SI. The latter is especially relevant in those patients with higher disgust sensitivity, contamination/washing symptoms and perfectionism. Psychotherapists should assess and target sexuality during clinicalpractice with OCD patients.

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Sexual response in obsessive–compulsive disorder: the role of obsessive beliefs

CNS Spectrums ◽

10.1017/s1092852920001649 ◽

2020 ◽

pp. 1-10

Author(s):

Andrea Pozza ◽

Donatella Marazziti ◽

Federico Mucci ◽

Nicole L. Angelo ◽

Davide Prestia ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Matched Control ◽

Control Model ◽

Sexual Response ◽

Dual Control ◽

Obsessive Beliefs ◽

Obsessive Compulsive ◽

Sexual Excitation ◽

Compulsive Disorder ◽

Dual Control Model

Abstract Background. Sexual response in obsessive–compulsive disorder (OCD) research and practice is overlooked. According to the Dual Control Model, satisfactory sexual response is based upon a balance of sexual excitation and inhibition. The assessment of sexual response in OCD may have clinical implications, such as the integration of sex therapy in psychotherapeutic intervention. The present study was aimed at comparing sexual excitation and inhibition levels between OCD patients and matched control subjects, and investigating whether obsessive beliefs might predict sexual excitation/inhibition. Methods. Seventy-two OCD patients (mean age ± standard deviation [SD]: 34.50 ± 10.39 years) and 72 matched control subjects (mean age ± SD: 34.25 ± 10.18) were included (62.50% men and 37.50% women in both groups). The Obsessive Compulsive Inventory-Revised (OCI-R), the Obsessive Beliefs Questionnaire-46 (OBQ-46), and the Sexual Inhibition/Sexual Excitation Scales (SIS/SES) were administered. Results. Patients with OCD showed significantly higher levels of sexual excitation, inhibition due to threat of performance failure, and inhibition due to threat of performance consequences than the controls. In addition, the patients with more severe symptoms showed lower excitation than those with less severe symptoms, and those with higher perfectionism had stronger inhibition due to threat of performance failure than those with lower perfectionism. Conclusions. This is the first study exploring sexual response in OCD according to the Dual Control Model. Sexual response is an impaired quality of life outcome in OCD that should be assessed in routine clinical practice. These findings support the importance of addressing specific obsessive beliefs to improve sexuality in OCD patients.

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A Pilot Study of Gender Differences in Sexual Arousal of Patients With OCD: The Moderator Roles of Attachment and Contamination Symptoms

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.609989 ◽

2021 ◽

Vol 11 ◽

Author(s):

Davide Dèttore ◽

Nicole Loren Angelo ◽

Donatella Marazziti ◽

Federico Mucci ◽

Davide Prestia ◽

...

Keyword(s):

Sexual Arousal ◽

Attachment Styles ◽

Attachment Anxiety ◽

Sexual Inhibition ◽

Attachment Avoidance ◽

Obsessive Compulsive ◽

Sexual Excitation ◽

Compulsive Disorder ◽

Performance Consequences ◽

Gender Based

Sexual arousal is often impaired in patients with obsessive–compulsive disorder (OCD). However, little is known about the factors related to this impairment: no study focused on the role of gender-based effects of attachment styles and contamination symptoms. The Dual Control Model assumes three processes driving sexual arousal: sexual excitation (SE), sexual inhibition (SI) due to threat of performance failure, and SI due to threat of performance consequences (e.g., getting contaminated with sexually transmitted diseases). In a group of OCD patients, we hypothesized that (a) women report lower SE and higher SI than men; (b) patients with insecure (both anxious and avoidant) attachment styles show lower SE and higher SI; (c) attachment styles moderate the relation between gender and sexual arousal (respectively, for women, higher attachment anxiety, and for men higher attachment avoidance were related to impaired sexual arousal (higher SE and SI) controlling for OCD severity); and (d) contamination symptoms moderate the relation between gender and sexual impairment (women with contamination symptoms show impaired sexual arousal). Seventy-two OCD patients (37.50% women) completed the Obsessive–Compulsive Inventory-Revised, Attachment Styles Questionnaire and Sexual Inhibition/Sexual Excitation Scales. In contrast with our hypotheses, women reported higher SE and lower SI due to threat of performance consequences than men. Patients with higher attachment avoidance (discomfort with intimacy) but also confidence in self and others had higher SE. Women with attachment avoidance (i.e., discomfort with intimacy) had lower SE, while women with attachment anxiety (i.e., preoccupations with relationships) had higher SI due to negative performance consequences. Women with contamination symptoms had higher SI due to performance failure but lower SI due to performance consequences. The present preliminary findings suggest that sexual arousal impairment should be evaluated during the assessment of OCD patients, and gender-based effects of attachment styles and contamination symptoms should be considered during personalized treatment planning.

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Is it more disgusting if I think about it? Examining the interaction of obsessive beliefs and disgust propensity in clinical obsessive-compulsive disorder

Journal of Obsessive-Compulsive and Related Disorders ◽

10.1016/j.jocrd.2016.09.001 ◽

2016 ◽

Vol 11 ◽

pp. 74-81 ◽

Cited By ~ 4

Author(s):

Gabriele Melli ◽

Richard Moulding ◽

Andrea Poli

Keyword(s):

Obsessive Compulsive Disorder ◽

Obsessive Beliefs ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Disgust Propensity

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Propensity to Sexual Response among Adults with Obsessive-Compulsive Disorder

Clinical Practice and Epidemiology in Mental Health ◽

10.2174/1745017901915010126 ◽

2019 ◽

Vol 15 (1) ◽

pp. 126-133

Author(s):

Andrea Pozza ◽

Donatella Marazziti ◽

Federico Mucci ◽

Davide Dèttore

Keyword(s):

Obsessive Compulsive Disorder ◽

Sexual Functioning ◽

Antidepressant Treatment ◽

Well Being ◽

Sexual Response ◽

Psychological Processes ◽

Obsessive Compulsive ◽

Sexual Excitation ◽

Compulsive Disorder ◽

Performance Consequences

Background: Propensity to sexual excitation and inhibition is one of the key dimensions of sexuality. Clinicians working with Obsessive-Compulsive Disorder (OCD) patients rarely assess this and other aspects of sexuality, since treatment targets generally symptom reduction. Literature on sexual functioning in OCD patients is scarce and no study has focused on symptom subtypes, nor investigated the psychological processes related to sexual response. Objective: In the present short report, we describe an exploratory study investigating the association between symptom subtypes and propensity towards sexual excitation/inhibition in OCD patients, controlling for gender, age and antidepressant treatment. Methods: Seventy-two OCD patients (mean age = 34.50 years, 37.50% women) completed the Obsessive-Compulsive Inventory-Revised and the Sexual Inhibition/Sexual Excitation Scales. Results: Patients with more severe compulsive washing habit had a lower propensity towards excitation and a higher one towards inhibition due to threat of performance consequences (i.e., contamination with sexually transmitted diseases/having an unwanted pregnancy). Patients with more severe symptoms of checking showed a higher propensity towards inhibition due to the threat of performance consequences. Gender, age and antidepressant treatment were not related to sexual functioning. Conclusion: Specific OCD symptom subtypes may be associated with some psychological processes involved in sexual response. Sexual well-being should be carefully evaluated by practitioners and should be regarded as a treatment target. Future studies should investigate more comprehensively the processes involved in sexuality.

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Technology Supported Mindfulness for Obsessive Compulsive Disorder: The Role of Obsessive Beliefs

Journal of Anxiety Disorders ◽

10.1016/j.janxdis.2021.102405 ◽

2021 ◽

pp. 102405

Author(s):

Lance L. Hawley ◽

Neil A. Rector ◽

Margaret A. Richter

Keyword(s):

Obsessive Compulsive Disorder ◽

Obsessive Beliefs ◽

Obsessive Compulsive ◽

Compulsive Disorder

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Obsessive Beliefs Predict Cognitive Behavior Therapy Outcome for Obsessive Compulsive Disorder

Cognitive Behaviour Therapy ◽

10.1080/16506073.2011.621969 ◽

2012 ◽

Vol 41 (3) ◽

pp. 203-211 ◽

Cited By ~ 21

Author(s):

Thomas G. Adams ◽

Bradley C. Riemann ◽

Chad T. Wetterneck ◽

Josh M. Cisler

Keyword(s):

Obsessive Compulsive Disorder ◽

Behavior Therapy ◽

Cognitive Behavior Therapy ◽

Therapy Outcome ◽

Cognitive Behavior ◽

Obsessive Beliefs ◽

Obsessive Compulsive ◽

Compulsive Disorder

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Disgust sensitivity predicts obsessive-compulsive disorder symptoms above and beyond anxiety sensitivity and negative affectivity

European Psychiatry ◽

10.1016/s0924-9338(11)71856-9 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 145-145

Author(s):

P. Chorot ◽

B. Sandin ◽

M.A. Santed ◽

R.M. Valiente ◽

M. Olmedo ◽

...

Keyword(s):

Negative Affect ◽

Obsessive Compulsive Disorder ◽

Anxiety Sensitivity ◽

Sensitivity Index ◽

State University ◽

Disgust Sensitivity ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Future Studies ◽

Compulsive Disorder

Introduction and aimsBoth anxiety sensitivity (AS) and negative affect (NA) are significant general predictors of anxiety disorders, including the obsessive-compulsive disorder (OCD; Taylor, 1999). Recently, our group reported preliminary findings suggesting that disgust sensitivity was able to predict OCD symptoms, particularly contamination obsessions and washing compulsions, when controlling for AS and NA (Sandín et al., 2008). The present study examines whether disgust domains of the Cuestionario de Sensibilidad al Asco (CSA) [Disgust Sensitivity Questionnaire] predict obsessive-compulsive symptoms above and beyond AS and NA.MethodA sample of undergraduates completed the CSA (see Valiente et al.), the Padua Inventory-Whasington State University Revision (Burns et al., 1996), the Anxiety Sensitivity Index-3 (Taylor et al., 2007; Sandín et al., 2007), and the Positive and Negative Affect Schedule (Watson et al., 1988, Sandín et al., 1999).ResultsHierarchic regression analysis revealed that CSA was a better predictor of contamination obsessions and washing compulsions than anxiety sensitivity and negative affect. Also, CSA domains predicted differentially each obsessive-compulsive dimension.ConclusionsContamination-based OCD symptoms appears to be particularly associated to disgust sensitivity, specially with the CSA dimension of hygiene (it includes items such as “Seeing someone spit”, Touching the clothes of a beggar or homeless”). Assuming that contamination-based OCD is a very prevalent type of OCD, future studies on implication of this dimension in its development and/or maintenance is warranted.

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The Association of Trait Mindfulness and Self-compassion with Obsessive-Compulsive Disorder Symptoms: Results from a Large Survey with Treatment-Seeking Adults

Cognitive Therapy and Research ◽

10.1007/s10608-019-10049-4 ◽

2019 ◽

Vol 44 (1) ◽

pp. 120-135 ◽

Cited By ~ 1

Author(s):

Tamara Leeuwerik ◽

Kate Cavanagh ◽

Clara Strauss

Keyword(s):

Obsessive Compulsive Disorder ◽

Distress Tolerance ◽

Treatment Seeking ◽

Trait Mindfulness ◽

Obsessive Beliefs ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Self Compassion ◽

Clinically Significant ◽

Anxiety Depression

Abstract Little is known about the role of mindfulness and self-compassion in obsessive-compulsive disorder. This cross-sectional study examined associations of mindfulness and self-compassion with obsessive-compulsive disorder symptoms and with the obsessive beliefs and low distress tolerance thought to maintain them. Samples of treatment-seeking adults (N = 1871) and non-treatment-seeking adults (N = 540) completed mindfulness, self-compassion, obsessive-compulsive disorder, anxiety, depression, obsessive beliefs and distress tolerance questionnaires. Participants with clinically significant obsessive-compulsive disorder symptoms reported lower trait mindfulness and self-compassion compared to participants with clinically significant anxiety/depression and to non-clinical controls. Among the clinical sample, there were medium-large associations between mindfulness and self-compassion and obsessive-compulsive disorder symptoms, obsessive beliefs and distress tolerance. Mindfulness and self-compassion were unique predictors of obsessive-compulsive disorder symptoms, controlling for depression severity. Once effects of obsessive beliefs and distress tolerance were controlled, a small effect remained for mindfulness (facets) on obsessing symptoms and for self-compassion on washing and checking symptoms. Directions for future research and clinical implications are considered in conclusion.

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