Reality check : inferential confusion and cognitive confidence as core cognitive factors across the obsessive-compulsive spectrum

Le trouble obsessionnel-compulsif (TOC) se caractérise par la présence d’obsessions et/ou de compulsions. À la lumière de l’hétérogénéité du TOC et de la présence de styles de pensées et de comportements de type TOC chez des personnes présentant d’autres problèmes de santé mentale, certains ont fait valoir la nécessité de créer une catégorie des troubles du spectre obsessionnel-compulsif et d’identifier les processus cognitifs communs qui sous-tendent ces troubles afin d’élaborer des théories et des traitements plus parcimonieux. Une tendance générale à douter de ses sens et de ses facultés cognitives semble être le pivot des troubles obsessionnels. Selon l’approche basée sur les inférences, le doute obsessionnel est suscité par un processus de raisonnement erroné, soit la confusion inférentielle (CI). La CI implique (1) une méfiance vis-à-vis des sens et (2) une importance indue accordée aux possibilités imaginaires. La faible confiance cognitive (CC), un processus cognitif similaire, renvoie à une méfiance par rapport à son attention, sa perception et sa mémoire. Cette thèse a visé à étudier la CI et la faible CC en tant que potentiels facteurs cognitifs transdiagnostiques dans le spectre de l’obsessionnalité. Le premier article constitue une revue systématique avec méta-analyse destinée à évaluer le rôle de la CC pour différents sous-types du TOC et à examiner à quel degré la faible CC est associée aux symptômes du TOC. On a constaté que les individus atteints d’un TOC présentent une plus faible CC que les témoins sains, mais que celle-ci ne semble pas spécifique au TOC. L’article a aussi souligné la nécessité d’employer des tâches idiosyncratiques, ciblant les distorsions de la pensée propres au TOC, afin de bien mesurer la CC. Dans le cadre du deuxième article, le but a été d’approfondir cette piste de recherche en examinant le rôle commun de la faible CC et de la CI pour les différents sous-types du TOC, en procédant à des analyses de grappes avec un échantillon de 128 patients atteints d’un TOC. Alors qu’il a été constaté que la faible CC correspondait davantage aux sous-types de vérification et « tout à fait juste », la CI semble pertinente pour un plus large éventail de profils TOC. Le troisième article examine le rôle de la CI chez les troubles des conduites alimentaires (TCAs) en provoquant la CI expérimentalement. Des participantes atteintes d’un TA (n = 18) et des femmes témoins saines (n = 18) ont été assignées à l’une des deux conditions expérimentales : pour la condition CI élevée, les participantes ont visionné des vidéos où des séquences clés étaient manquantes, ce qui suscitait la CI; pour la condition CI faible, les participantes ont visionné les vidéos intégrales. Chez le groupe TA assigné à la condition CI élevée, on a observé une tendance à présenter un état de CI post-vidéos supérieur, un recours accru au comportement de neutralisation et, enfin, davantage de symptômes TOC. En somme, les résultats de cette thèse soulignent la pertinence de la CI et de la faible CC en tant que facteurs cognitifs transdiagnostiques sur le spectre obsessionnel-compulsif.Obsessive-compulsive disorder (OCD) is a severe mental health disorder that involves obsessions and/or compulsions. In light of the heterogeneity of OCD and of the presence of OCD-like thinking and behaviors in several disorders, some have argued for the necessity of a new category of obsessive-compulsive spectrum disorders. Considering the overlap between various disorders characterized by obsessionality, there is a need for the identification of common cognitive processes that underpin these disorders in order to formulate more parsimonious explanations and treatments for these conditions. A general tendency to doubt the senses and cognitive faculties appears as central to obsessional disorders. According to the inference-based approach, the obsessional doubt is elicited by a faulty reasoning process known as inferential confusion (IC), that implicates (1) a distrust of the senses, and (2) an investment in imaginary possibilities. A similar construct is low cognitive confidence, which is defined as a distrust of one’s attention, perception and memory. The overarching goal of this thesis was to examine IC and low cognitive confidence as potential transdiagnostic cognitive factors across the spectrum of obsessionality. The first thesis article evaluated the role of cognitive confidence across OCD subtypes and examined the extent to which poor cognitive confidence is associated with OCD symptomatology by conducting a systematic review with a meta-analysis. This article led to the conclusion that individuals with OCD have lower cognitive confidence than healthy controls, but that it is unclear if cognitive confidence is specific to OCD, such that the use of idiosyncratic tasks appears to be required in order to correctly capture cognitive confidence in OCD. The second thesis article furthered this investigation by examining the joint role of low cognitive confidence and IC across OCD subtypes by performing cluster analyses using a sample of 128 individuals with OCD. While cognitive confidence was found to more relevant to the checking and “just right” subtypes, IC appeared to be relevant to a wider range of OCD profiles. The third thesis article sought to examine the role of IC in eating disorders by inducing IC experimentally. Female participants with an eating disorder (n = 18) and healthy controls participants (n = 18) were recruited. Participants were assigned to one of two experimental conditions: in the High IC condition, participants watched videos with key sequences missing – provoking a distrust of the senses and lending more space for the imagination, thus triggering IC. In the Low IC condition, participants watched videos without sequences missing. The eating disorder group assigned to the High IC condition demonstrated a trend for higher levels of state IC, greater neutralization behavior and higher OCD symptoms than those who were assigned to the Low IC condition. Taken together, the results of the present thesis underline the relevance of IC and cognitive confidence as transdiagnostic cognitive factors across the obsessive-compulsive spectrum

The body is a temple: Development of a scale measuring mental contamination in eating disorders

Research shows that individuals with OCD are prone to experience feelings of contamination in response to stimuli or situations involving immorality, yet in the absence of any real contaminant, a phenomenon known as mental contamination. While the construct of mental contamination was originally formulated in the context of OCD, research suggests that mental contamination might be a transdiagnostic symptom domain. One recent study found positive associations between mental contamination (as measured by the Vancouver Obsessive Compulsive Inventory – Mental Contamination Scale; VOCI-MC; Rachman, 2006) and eating disorder symptoms. To our knowledge, this is the only study that examined the relevance of mental contamination to eating disorders. Yet, the link between mental contamination and eating pathology requires further examination, considering that lay notions of morality, purity, food, and thinness are all closely intertwined (“the body as a temple”). The goal of this study is to develop a questionnaire measuring mental contamination in the context of eating disorders and to evaluate its association with measures of eating disorder symptoms and relevant cognitive processes

DOES UNBALANCED SEX RATIO IN ADULT MOOSE AFFECT CALF SIZE IN THE FALL?

It has been suggested that the sex ratio should be close to parity among adult moose to ensure high productivity. When the sex ratio is female biased, the mating period may extend over 2 - 3 estrus cycles and the calving period is delayed. As a result, some calves may be smaller in the fall and less likely to survive over winter. The objective of this study was to test whether an unbalanced adult moose sex ratio affects calf size in the fall. To do so, 8 hunting zones were sampled out of 24 in the province of Québec; their sex ratio among adults was based on aerial surveys. ANOVAs were conducted on 3 body measurements (head width, left ear, and hind foot lengths) on calves collected in the fall by hunters between 1995 and 1997 to compare body measurements from zones with different adult sex ratios. Our results showed that 2 of the measures were positively related to the percentage of males among adults. Consequently, we cannot reject the hypothesis that calves are smaller in the fall when adult sex ratio is unbalanced. However, differences were very small. Assuming that such events occur, we suggest that the impact is weak at the population level, unless affected calves are least likely to survive until fall. However, the productivity (estimated in winter) in the various hunting zones of Québec is not related to the adult sex ratio. Thus, out results indicate that it is not necessary to consider this potential impact in the management of moose populations under the current range of sex ratios observed

Susceptibility to cognitive distortions : the role of eating pathology

Thought-Shape Fusion (TSF) and Thought-Action Fusion (TAF) are cognitive distortions that are associated with eating and obsessional pathology respectively. Both involve the underlying belief that mere thoughts and mental images can lead to negative outcomes. TSF involves the belief that food-related thoughts lead to weight gain, body dissatisfaction, and perceptions of moral wrong-doing. TAF is more general, and involves the belief that merely thinking about a negative event (e.g., a loved one getting into a car accident) can make this event more likely to happen, and leads to perceptions of moral wrong-doing. However, the shared susceptibility across related cognitive distortions—TAF and TSF—has not yet been studied. Method: The effects of TSF and TAF inductions in women with an eating disorder (n = 21) and a group of healthy control women with no history of an eating disorder (n = 23) were measured. A repeated-measures design was employed, with all participants exposed to a TSF, TAF and neutral induction during three separate experimental sessions. Participants’ cognitive and behavioral responses were assessed. Results: Individuals with eating disorders were more susceptible to TSF and TAF than were control participants, demonstrating more neutralization behavior after TSF and TAF inductions (i.e., actions to try to reduce the negative effects of the induction), and reporting higher levels of trait TAF and TSF than did controls. Conclusions: Individuals with eating disorders are particularly susceptible to both TAF and TSF. Clinical implications of these findings will be discussed.Non UBCReviewedFacultyResearcherGraduat

The NOURISHED randomised controlled trial comparing mentalisation-based treatment for eating disorders (MBT-ED) with specialist supportive clinical management (SSCM-ED) for patients with eating disorders and symptoms of borderline personality disorder

Unadjusted mean EDE and ZAN score by treatment group for all post randomisation time points and baseline (time 0). Lowest score if best. Error bars show 95 % CI. EDE Eating Disorder Examination, ZAN Zanarini Rating Scale. (DOCX 74 kb