Do you Know the Characteristic Traits of Obsessive-Compulsive Disorder?
You may have heard talk about the search for biological components of different mental health problems. There’s the study of the genes responsible for all existing mental disorders. Also, the analysis of the cerebral areas or the neurotransmitters involved. But given the complexity of the human being, biology alone can’t fully explain everything. And that is why clinical psychology has sought out different psychological markers. In the case of Obsessive-Compulsive Disorder (OCD) these markers have a lot of weight in its development.
This article is based on the research carried out by the Spanish Association of Psychopathology and Clinical Psychology on Obsessive-Compulsive Disorder and its psychological markers. Specifically, on the work of Gertrudis Forné, M Ángeles Ruiz-Fernández and Amparo Belloch. These researchers have found that certain symptoms could be predictors of Obsessive-Compulsive Disorder. This includes a sense of incompleteness and sensations of something “not just right.”
We will look at this disorder based on the results of the published research. Their article is entitled, “Sense of incompleteness and “not just right” experiences as motivators for obsessive-compulsive symptoms.” As with every mental disorder, biology is not the only decisive factor. For this reason, medicine alone is not enough for its proper treatment.
What is Obsessive-Compulsive Disorder?
It’s necessary for us to understand what Obsessive-Compulsive Disorder is like before we can explain its psychological markers. This disorder was previously in anxiety disorders within the different diagnostic classifications. But thanks to the evolution of knowledge, it had the status of an entity of its own. This took place in the last update of the Diagnostic and Statistical Manual of Mental Disorders, known as DSM-5.
People who suffer from this type of disorder manifest obsessions. They have recurrent images, thoughts, or impulses which cause anxiety. This is an anxiety they try to relieve through repetitive behaviors or mental acts. For example, a person can be obsessed with the possibility of getting sick due to germs in the environment. Therefore, they wash their hands every time they touch something. They wash their hands so often they end up hurting themselves from rubbing them so much.
Normally, these compulsive rituals cause discomfort to the people who perform them. These people waste a lot of time executing these rituals, as well. On top of that, they recognize these obsessions and/or compulsions are excessive and even irrational. Yet, they are incapable of stopping.
Psychological markers and their importance in Obsessive-Compulsive Disorder
In psychology, from a cognitive-behavioral perspective, which is the one with the most empirical support in the treatment of Obsessive-Compulsive Disorder, the importance of dysfunctional beliefs and avoidance of harm is usually highlighted. This is the fundamental explanation for the genesis of the disorder. But this explanation falls short in terms of the heterogeneity of the dysfunctional beliefs. The ones the patients have about their own symptoms and the necessity of their compulsions.
Due to this limitation, different researchers around the world began to consider other psychological factors from the perspective of diagnostic features for Obsessive-Compulsive Disorder. They concluded that the presence of a sensation of incompleteness is related only to the Obsessive-Compulsive Disorder, in comparison to other anxiety disorders.
The sensation of incompleteness refers to the persistent thought that the task which is being performed is incomplete. In this sense, the task is prolonged over time due to the meticulousness with which it is performed. It also occupies most of the individual’s thoughts since they try to find what is missing. But this, obviously, cannot be found.
Unease leads to repetition
Additionally, researchers have also suggested that the “not just right” experiences would be a central point in this disorder. These experiences make the person think that what they are doing isn’t good enough. Or, it’s not good enough to leave it as it is. So the person constantly repeats each of the steps to ensure they have not forgotten anything. This way, they are trying to reach an impossible perfection.
As we can see, the different researchers have given meanings to compulsive repetition and mental obsession with these concepts. They have taken a step further in the explanation of the heterogeneity of this disorder.
Results of the Spanish studies on OCD’s psychological markers
Given these findings, Gertrudis Forné, M. Ángeles Ruiz-Fernández and Amparo Belloch decided to carry out a Spanish study on these concepts to try to replicate the results. For this purpose, they used the Not Just Right Experiences Questionnaire-Revised (NJREQ-R) and the Vancouver Obsessive-Compulsive Inventory (VOCI).
The results tell us that both the sensation of incompleteness and the “not just right” experiences occur in the general population. But they happen to a greater degree in people with obsessive-compulsive disorder. This would indicate that these experiences could be considered as a factor of vulnerability for the development of these symptoms.
“The sensation of incompleteness and the ‘not just right’ experiences are more ‘internal’, subjective and vague than the intrusiveness and general malaise. These experiences take place when the patient ‘does something’, while obsessive behavior happens in many cases regardless of whether the patient carries out a particular action or not.”
The link between perfectionism and incompleteness
The studies also found associations between the “not just right” experiences and the sensation of incompleteness with a tendency towards perfectionism and intolerance in the face of uncertainty. This discovery could help us design a future intervention which is more advanced and linked to this type of thought.
“In addition, the ‘not just right’ experiences, the sensation of incompleteness and the ‘just right’ symptoms predict all the dimensions of obsessive-compulsive symptoms. Especially beyond the explanatory importance which perfectionism, intolerance towards uncertainty, dysfunctional beliefs, the pathological tendency to worry and the anxious and depressive symptoms can provide. The symptoms regarding order were a notable exception, where anxiety was the most significant predictive factor.”
All of these results lead us to the conclusion that we still have a lot to learn about Obsessive-Compulsive Disorder. Likewise, these results indicate the importance of psychological factors in the origin, course, and treatment of the various mental illnesses.