Guy Doron | The Interdisciplinary Center, Herzliya (original) (raw)

mHealth by Guy Doron

Heliyon, 2023

Relationship Obsessive Compulsive Disorder (ROCD) is a disabling form of obsessive-compulsive dis... more Relationship Obsessive Compulsive Disorder (ROCD) is a disabling form of obsessive-compulsive disorder (OCD) centering on interpersonal relationships. Previous findings suggest ROCD symptoms are particularly detrimental to romantic relationships. In this randomized controlled trial (RCT), we assessed influence a CBT-based mobile application used by both partners on resilience to ROCD symptoms, cognitions, and relationship dissatisfaction. The app consists of brief, daily exercises targeting OCD symptoms, related cognitions and attachment insecurities. Heterosexual couples (N couples = 103; Mage = 26.15) were randomly assigned to individually use a mobile application for 15 days (n = 49 couples) or to a control group (n = 54 couples). All participants completed questionnaires at baseline (T1), 15 days from baseline (T2), and 45 days from baseline (T3). All couples also underwent an ROCD resilience task at T2. Intention-to-treat analyses revealed that, in contrast to the control group, couples who used the app exhibited enhanced resilience in the resilience task, as well as measures of ROCD symptoms, cognitions, and relationship dissatisfaction. These observed effects persisted even at the 1-month follow-up. Concurrent use of brief mobile delivered cognitive training by both romantic partners may foster resilience in romantic couples.

Background and objectives: According to cognitive models, obsessive compulsive symptoms result fr... more Background and objectives: According to cognitive models, obsessive compulsive symptoms result from catastrophic misinterpretations of commonly occurring intrusive experiences and the use of counterproductive strategies to manage them. Obsessive Compulsive Disorder (OCD) related beliefs such as inflated responsibility, importance of thoughts and perfectionism increases the likelihood of such misinterpretations. Consistent with a growing body of literature supporting the usefulness of mobile delivered technologies in fostering cognitive behavior change, the present study assessed the effectiveness of a novel cognitive training exercise designed to challenge OCD-related beliefs. This mobile app training exercise consists of users having to pull statements challenging OCD beliefs towards themselves (downwards) and to throw away (push upwards) contra-productive self-statements. Methods: 36 third-year BA students started the trial. Twenty completed pre and post measures of OCD-beliefs, mood and OCD symptoms including relationship-obsessions. Participants were instructed to complete 3 min of daily training for a period of 15 days. Results: No significant differences were found between completers and non-completers on demographic and most symptom related measures at Time 1. Repeated-measures MANOVA of the 20 completers showed a significant reduction on all OCD symptoms measures and on OCD-beliefs. No significant reduction was found in depression symptoms. Regression analysis showed change in levels of OCD-beliefs was associated with reduction in OCD symptoms at Time 2 over and above OCD symptoms at Time 1. Limitations: The study is an open trial with non-clinical participants. Conclusions: This mobile delivered training exercise may be useful for the reduction and relapse prevention of OCD-related beliefs and symptoms.

JMIR mHealth and uHealth, 2019

Background: Obsessive compulsive disorder (OCD) is a disabling condition with a wide variety of c... more Background: Obsessive compulsive disorder (OCD) is a disabling condition with a wide variety of clinical presentations including contamination fears, fear of harm and relationship-related obsessions. Cognitive behavioral models of OCD propose obsessive-compulsive (OC) symptoms result from catastrophic misinterpretations of commonly occurring intrusive experiences and associated dysfunctional strategies used to manage them. OCD-related maladaptive beliefs including inflated responsibility, importance and control of thoughts, perfectionism and intolerance for uncertainty increase the likelihood of such misinterpretations.
Objective: Consistent with accumulating evidence suggesting mobile health (mHealth) apps based on cognitive-behavioral principles may lead to significant reductions in psychopathological symptom, we assessed the effectiveness of a novel cognitive training app (GGRO) designed to challenge OCD-related beliefs.
Methods: Ninety-seven students were randomized to immediate use (iApp) or delayed use (dApp) groups of GGRO. All participants were requested to complete web-based assessment, with questionnaires relating to maladaptive beliefs, mood and OC symptoms at baseline (T1), 15 days following baseline (T2) and 30 days following baseline (T3). Participants in iApp group started using the app at baseline and continued using the app for 15 consecutive days. They were then requested to stop using the app until T3. Participants in the dApp group were requested to wait for 15 days and only then start using the app (cross-over) for 15 consecutive days.
Results: All participants used the app for a mean 14.07 (SD=1.41) days with a 2.94 levels per day. Replicating previous findings, app use was associated with medium-large effect size reductions in both groups iApp (n=51) and dApp (n=46). In the iApp group, all effects remained significant during 15 days follow-up. Analyses focusing on the first two assessment occasions revealed significant Treatment × Repeated Measures interactions on maladaptive beliefs, several OC symptom measures and self-esteem.
Conclusions: This study provides further evidence for the efficacy of GGRO as a mobile delivered training exercises useful for the reduction of OCD-related beliefs and symptoms. Trial registration: ClinicalTrial.gov ID NCT03571464.

Objective: Body image disturbance (BID) is common among women, characterized by persistent and di... more Objective: Body image disturbance (BID) is common among women, characterized by persistent and distressing appearance dissatisfaction, and linked with eating disorders. Although effective, cognitive behavioral therapy (CBT) delivered by trained professionals is not easily accessible. This randomized trial evaluated the effects of a CBT-based mobile application designed to increase resilience to body image triggers and reduce BID symptoms. Method: A non-clinical sample of women (N = 90; M age = 23.52) was randomized to use the mobile application for approximately 4 min of daily exercises for two weeks or to a control condition. Body image was measured at baseline, immediately after two weeks of mobile application use, and at 1-month follow-up. To examine whether using the application was associated with increased resilience to common BID triggers, participants completed an Instagram exposure resilience task upon completion and at 1-month follow-up. Results: Relative to those in the control condition, participants who used the application demonstrated increased resiliency and reduced BID symptoms. Theses effects were medium-to-large and were maintained at 1-month follow-up. Conclusion: These results underscore the potential usefulness of brief, low-intensity, portable interventions in reducing BID symptoms and in increasing resilience to thin-ideal body messages often portrayed on social media.

Mobile health apps increase the accessibility of cognitive-behav-ioral-based interventions before... more Mobile health apps increase the accessibility of cognitive-behav-ioral-based interventions before, during, or following treatment. GGOC is a mobile app designed to challenge maladaptive beliefs in obsessive-compulsive disorder (OCD). This single-case study assesses the usefulness of GGOC as a relapse prevention tool for OCD. The patient was a 26-year-old woman with severe contamination and washing/cleaning OCD symptoms (Y-BOCS = 33). GGOC was used for relapse prevention following CBT treatment. The patient completed 47 levels dedicated to OCD-relevant maladaptive beliefs. Before and after GGOC

Body dissatisfaction is prevalent in young women, and is associated with symptoms of body dysmorp... more Body dissatisfaction is prevalent in young women, and is associated with symptoms of body dysmorphic disorder (BDD) and eating disorders (EDs). The aim of the study was to assess the efficacy of a mobile application, based on cognitive behavioral principles, in reducing body dissatisfaction and BDD/ED symptoms in female university students considered at high-risk of developing body image disorders (BIDs). Fifty university students at high-risk of developing BIDs (using self-report questionnaires assessing BIDs and the Structured Clinical Interview for DSM-5 Clinical Version) were randomized in two groups: immediate-use App group (iApp group; n = 25) and delayed-use App group (dApp group; n = 25). The iApp group started using the app at baseline for 16 days (T0 to T1). The dApp group waited for 16 days before starting to use the app (T1 to T2). Participants completed questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2). Repeated measure Analyses of Variance (ANOVAs) showed a Group (iApp vs. dApp) × Time (T0 vs. T1) interaction on BDD symptoms indicating medium effect size (partial eta squared) reductions in the iApp group compared to dApp group at T1; post-intervention means for BDD symptoms were under the cutoff for extreme body dissatisfaction/BDD symptoms in both groups. Pertaining to ED symptoms, no significant Group × Time interaction was detected. Training 3 minutes a day for 16 days with a CBT-based mobile application may lead to reductions in some forms of body dissatisfaction, including BDD symptoms in female university students at high-risk of developing BIDs. On the other hand, effects of the intervention on ED symptoms seem more limited.

Objective: Using real world data, we examined the associations between self-esteem ratings and th... more Objective: Using real world data, we examined the associations between self-esteem ratings and the short, daily use of a cognitive behavioural therapy (CBT)-based mobile application targeting self-esteem related beliefs. The effects of using this application on mood ratings were also assessed. Method: Real world data of GG Self-esteem users were collected from January 2019 until August 2019. Participants' self-esteem and mood scores were evaluated at three-time points corresponding to Levels 1, 20 and 46 of the mobile application. Results: Significant increases in self-esteem ratings were found across all three-time points. Increased mood ratings were only found at Level 20, compared to baseline. Dropout rates across assessment points were associated with younger age, and males showed significantly higher self-esteem scores than women at baseline and the second assessment point. Conclusions: Our findings are consistent with previous controlled trials indicating that using CBT-based mHealth applications targeting maladaptive beliefs may be useful for increasing user's wellness and reducing distress. K E Y W O R D S cognitive behavioural therapy, digital mental health, maladaptive beliefs, mobile apps, real world settings, self-esteem

Background: Relationship Obsessive Compulsive Disorder (ROCD) is a presentation of OCD centering ... more Background: Relationship Obsessive Compulsive Disorder (ROCD) is a presentation of OCD centering on inter-personal relationships. The aim of this Randomized Control Trial (RCT) was to assess the efficacy of short, game like, daily cognitive interventions delivered via mobile application in reducing subclinical ROCD symptoms and associated phenomena. Methods: Fifty university students identified as having subclinical levels of ROCD symptoms (using the Structured Clinical Interview for DSM-5 Clinical Version) were randomized into: immediate-use group (iApp group; n = 25) and delayed-use group (dApp group; n = 25). The iApp group started using the evaluated cognitive-behavioral training application at baseline for 15 days (T0 to T1). The dApp group commenced using the application at T1 for 15 days (T1 to T2). All participants completed questionnaires at baseline (T0), 15 days from baseline (T1), and 30 days from baseline (T2). Results: Repeated measure MANOVAs showed significant Group (iApp vs. dApp) × Time (T0 vs. T1) interactions. These interactions indicated greater decrease in ROCD symptoms, OCD beliefs and social anxiety symptoms , as well as a greater increase in self-esteem in the iApp group compared to dApp group at T1. Moreover, the Reliable Change Index (RCI) indicated reliable change on ROCD symptoms for a significant portion of participants (42-52%). Limitations: Sample size and the use of self-report measures limits the generalizability of the results. Conclusions: Short, daily cognitive training interventions delivered via mobile applications may be useful in reducing subclinical ROCD symptoms and associated features. Further testing is needed for clinical populations.

Background: Obsessive-compulsive disorder (OCD) is a disabling condition with a wide variety of c... more Background: Obsessive-compulsive disorder (OCD) is a disabling condition with a wide variety of clinical presentations including contamination fears, fear of harm, and relationship-related obsessions. Cognitive behavioral models of OCD suggest that OC symptoms result from catastrophic misinterpretations of commonly occurring intrusive experiences and associated dysfunctional strategies used to manage them. OCD-related maladaptive beliefs including inflated responsibility, importance and control of thoughts, perfectionism, and intolerance for uncertainty increase the likelihood of such misinterpretations.

ROCD by Guy Doron

Obsessive-compulsive symptoms focusing on interpersonal relationships may include obsessive doubt... more Obsessive-compulsive symptoms focusing on interpersonal relationships may include obsessive doubts and preoccupation centered on the relationship (i.e., relationship-centered) or the relationship partner (i.e. partner-focused). Although general obsessive beliefs have been associated with relationship obsessive-compulsive disorder (ROCD), perfectionism and catastrophic relationship beliefs may particularly relevant to the maintenance and development of such symptoms. We assessed the unique contributions of specific perfectionism dimensions and catastrophic relationship beliefs to relationship-centered and partner-focused ROCD symptoms. Participants included 124 individuals recruited online reporting that they had received a diagnosis of ROCD by a qualified clinician completed a battery of questionnaire tapping maladaptive beliefs previously associated with obsessive-compulsive disorder (OCD), multidimensional perfectionism and catastrophic relationship beliefs. Perfectionistic concern over mistakes and doubts about actions, catastrophic beliefs regarding being in the wrong relationship and of being alone were found to be unique predictors of relationship-centered ROCD symptoms over and above mood symptoms. Only catastrophic fears of being in the wrong relationships predicted partner-focused ROCD symptoms. Perfectionistic tendencies as well as specific relationship-related beliefs may be more strongly implicated than OCD-related maladaptive beliefs in the development and maintenance of relationship-centered ROCD symptom. More research is needed to identify more specific beliefs associated with partner-focused ROCD symptoms.

Journal of Obsessive-Compulsive and Related Disorders, 2017

Parent-child obsessive-compulsive (OC) symptoms involve obsessive preoccupation on perceived flaw... more Parent-child obsessive-compulsive (OC) symptoms involve obsessive preoccupation on perceived flaws in one’s child. Such preoccupation is often accompanied by compulsive behaviors aimed at alleviating the resulting distress. Parent-child OC symptoms can be construed as an additional presentation of Relationship Obsessive Compulsive Disorder (ROCD), a presentation of obsessive compulsive disorder (OCD) in which symptoms are centered on a significant other. In this study, a self-report scale for assessing parent-child ROCD symptoms (the PROCSI-PC) was created on the bases of an existing partner-focused ROCD scale. Confirmatory Factor Analysis conducted on a sample of 350 parents supported a five factor solution of the PROCSI-PC corresponding to five perceived-flaw domains: appearance, intelligence, competence, morality, and sociability-stability. The PROCSI-PC total score was associated with parental OCD and mood symptoms, and with parental stress. Moreover, the PROCSI-PC was associated with greater depression above and beyond the effect of parental OCD symptoms, and with greater parental stress above and beyond the effects of OCD symptoms and depression. Finally, the PROCSI-PC was linked to self-reported disability resulting from obsessive preoccupation of parents on their child’s perceived flaws. The results indicate the parent-child OC symptoms may be a prevalent source of unique distress that is especially challenging for parents.

Relationship obsessive-compulsive disorder (ROCD) symptoms are characterized by obsessive doubts ... more Relationship obsessive-compulsive disorder (ROCD) symptoms are characterized by obsessive doubts and preoccupation centered on the relationship (i.e., relationship-centered) or the relationship partner (i.e. partner-focused). Such obsessions often lead to significant distress and are associated with compulsive behaviors (e.g., compulsive checking and reassurance seeking) aimed at mitigating this distress. The current study examined the reciprocal relationship between partner-focused and relationship-centered obsessive-compulsive (OC) symptoms over time. Participants (N = 141) completed measures of partner-focused and relationship-centered OC symptoms at two time points one year apart. Partner-focused symptoms were associated with a relative increase in relationship-centered symptoms one year later. Relationship-centered symptoms were associated with the persistence of partner-focused symptoms one year later, but only among individuals in long-lasting relationships. The potentially detrimental effects of ROCD symptoms within romantic relationships are discussed.

Background: Obsessive preoccupation, doubts, and compulsive behaviors focusing on one's romantic ... more Background: Obsessive preoccupation, doubts, and compulsive behaviors focusing on one's romantic relationship and partner are receiving increasing clinical, theoretical, and empirical attention. Commonly referred to as relationship obsessive–compulsive disorder (ROCD), such symptoms have been linked with decreased relational and sexual functioning and lower mood, even after controlling for other obsessive–compulsive disorder (OCD) symptoms. To date, however, these symptoms have been studied in community samples alone. In the present study, we compared levels of interference, OCD, and mood symptoms between clinical participants with ROCD, OCD, and community controls. We also examined group differences in maladaptive beliefs previously linked with OCD and ROCD. Method: Participants included 22 ROCD clients, 22 OCD clients, and 28 community controls. The Mini International Neuropsychiatric Interview was used to attain clinical diagnoses of OCD and ROCD. The Yale–Brown Obsessive–Compulsive Scale was used to evaluate primary-symptoms severity. All participants completed measures of symptoms and dysfunctional beliefs. results: ROCD clients reported more severe ROCD symptoms than the OCD and control groups. ROCD and OCD clients did not differ in severity of their primary-symptoms. ROCD clients scored higher than the other groups on maladaptive OCD-related and relationship-related beliefs. Finally, ROCD clients showed more severe depression symptoms than community controls. conclusion: ROCD is a disabling presentation of OCD that warrants research attention. Maladaptive OCD-related and relationship-related beliefs may be implicated in the development and maintenance of ROCD.

Background: Relationship-related obsessive-compulsive phenomena (ROCD) are encountered frequently... more Background: Relationship-related obsessive-compulsive phenomena (ROCD) are encountered frequently in the clinic, and involve severe consequences to personal and relational well-being. One common presentation of ROCD involves disabling preoccupation and doubts focusing on intimate partner's flaws (partner-focused obsessions). It was previously suggested that individuals perceiving their partner's failures or flaws as reflecting on their own self-worth may be more sensitive to intrusive thoughts pertaining to their partner's qualities and characteristics. In the current studies, we assessed the link between partner-focused OC symptoms and self-esteem contingent on partner-value. Methods: In two studies we assessed the impact of experimentally induced partner-focused intrusions on self-esteem. In Study 1, we assessed individuals' self-esteem after one of three primes: (a) intrusion about one’s partner comparing unfavorably with others of the same sex (i.e., alternative partners), (b) intrusion about one’s partner comparing unfavorably to oneself, (c) and a neutral prime. In study 2, we tried to replicate Study 1 and also examine whether favorable intrusions of one’s partner
would have an opposite effect on self-esteem than unfavorable intrusions. Results: Compared with the other groups, participants who were primed with intrusions of their partner being unfavorably compared to others reported lower self esteem, but only if they had high levels of partner-focused symptoms. Favorable intrusions of partner to others
did not have a positive effect on self-esteem among individuals with high levels of partner-focused symptoms. Conclusions: Partner-value self-sensitivity may be one of the perpetuating mechanisms involved in partner-focused OC phenomena.

Journal of Behavior Therapy and Experimental Psychiatry

Background: Relationship-related obsessive-compulsive phenomena (ROCD) are encountered frequently... more Background: Relationship-related obsessive-compulsive phenomena (ROCD) are encountered frequently in the clinic, and involve severe consequences to personal and relational well-being. One common presentation of ROCD involves disabling preoccupation and doubts focusing on intimate partner's flaws (partner-focused obsessions). It was previously suggested that individuals perceiving their partner's failures or flaws as reflecting on their own self-worth may be more sensitive to intrusive thoughts pertaining to their partner's qualities and characteristics. In the current studies, we assessed the link between partner-focused OC symptoms and self-esteem contingent on partner-value. Methods: In two studies we assessed the impact of experimentally induced partner-focused intrusions on self-esteem. In Study 1, we assessed individuals' self-esteem after one of three primes: (a) intrusion about one’s partner comparing unfavorably with others of the same sex (i.e., alternative partners), (b) intrusion about one’s partner comparing unfavorably to oneself, (c) and a neutral prime. In study 2, we tried to replicate Study 1 and also examine whether favorable intrusions of one’s partner would have an opposite effect on self-esteem than unfavorable intrusions. Results: Compared with the other groups, participants who were primed with intrusions of their partner being unfavorably compared to others reported lower self-esteem, but only if they had high levels of partner-focused symptoms. Favorable intrusions of partner to others did not have a positive effect on self-esteem among individuals with high levels of partner-focused symptoms. Conclusions: Partner-value self-sensitivity may be one of the perpetuating mechanisms involved in partner-focused OC phenomena.

Handbook of Obsessive-Compulsive Disorder Across the Lifespan, edited by J. Abramowitz, D. McKay, & E. Storch, Hoboken, NJ: Wiley.

Journal of Sexual Medicine, Jan 1, 2014

Introduction. Relationship Obsessive Compulsive Disorder (ROCD) is marked by the presence of obse... more Introduction. Relationship Obsessive Compulsive Disorder (ROCD) is marked by the presence of obsessions and compulsions focusing on romantic relationships. ROCD
symptoms were previously linked with decreased relationship quality and might interfere with sexual functioning.
Aim. To examine the association between ROCD symptoms and sexual satisfaction.
Methods. Participants completed an online survey assessing ROCD symptoms, relationship and sexual satisfaction levels. Depression, general worry, obsessive compulsive disorder (OCD) symptoms and attachment orientation were also
measured.
Results. ROCD symptoms were associated with decreased sexual satisfaction over and above symptoms of depression, general worry, OCD and attachment orientation. The link between ROCD symptoms and sexual satisfaction was mediated by relationship satisfaction.
Conclusions. Identifying and addressing ROCD symptoms may be important for treatment of sexual functioning.

Journal of Obsessive-Compulsive and Related Disorders. http://dx.doi.org/10.1016/j.jocrd.2013.12.005, Aug 1, 2014

Obsessive compulsive disorder(OCD) is a disabling and prevalent disorder with a variety of clinic... more Obsessive compulsive disorder(OCD) is a disabling and prevalent disorder with a variety of clinical presentations and obsessional themes. Recently, research has begun to investigate relationship-related obsessive–compulsive (OC) symptoms including relationship-centered and partner-focused OC symptoms. In this paper, we present relationship obsessive–compulsive disorder(ROCD), delineate its main features, and describe its phenomenology. Drawing on recent cognitive-behavioral models of OCD, social psychology and attachment research, we present a model of the development and maintenance of ROCD. The role of personality factors, societal influences, parenting, and family environments in the etiology and preservation of ROCD symptoms is also evaluated. Finally, the conceptual and empirical links between ROCD symptoms and related constructs are explored and theoretically driven assessment and intervention procedures are suggested.

Heliyon, 2023

JMIR mHealth and uHealth, 2019

Journal of Obsessive-Compulsive and Related Disorders, 2017

Journal of Behavior Therapy and Experimental Psychiatry

Background: Relationship-related obsessive-compulsive phenomena (ROCD) are encountered frequently... more Background: Relationship-related obsessive-compulsive phenomena (ROCD) are encountered frequently in the clinic, and involve severe consequences to personal and relational well-being. One common presentation of ROCD involves disabling preoccupation and doubts focusing on intimate partner's flaws (partner-focused obsessions). It was previously suggested that individuals perceiving their partner's failures or flaws as reflecting on their own self-worth may be more sensitive to intrusive thoughts pertaining to their partner's qualities and characteristics. In the current studies, we assessed the link between partner-focused OC symptoms and self-esteem contingent on partner-value. Methods: In two studies we assessed the impact of experimentally induced partner-focused intrusions on self-esteem. In Study 1, we assessed individuals' self-esteem after one of three primes: (a) intrusion about one’s partner comparing unfavorably with others of the same sex (i.e., alternative partners), (b) intrusion about one’s partner comparing unfavorably to oneself, (c) and a neutral prime. In study 2, we tried to replicate Study 1 and also examine whether favorable intrusions of one’s partner would have an opposite effect on self-esteem than unfavorable intrusions. Results: Compared with the other groups, participants who were primed with intrusions of their partner being unfavorably compared to others reported lower self-esteem, but only if they had high levels of partner-focused symptoms. Favorable intrusions of partner to others did not have a positive effect on self-esteem among individuals with high levels of partner-focused symptoms. Conclusions: Partner-value self-sensitivity may be one of the perpetuating mechanisms involved in partner-focused OC phenomena.

Handbook of Obsessive-Compulsive Disorder Across the Lifespan, edited by J. Abramowitz, D. McKay, & E. Storch, Hoboken, NJ: Wiley.

Journal of Sexual Medicine, Jan 1, 2014

Journal of Obsessive-Compulsive and Related Disorders. http://dx.doi.org/10.1016/j.jocrd.2013.12.005, Aug 1, 2014

Journal of Obsessive- …, Jan 1, 2012

Obsessive-compulsive disorder (OCD) is a disabling anxiety disorder with a wide range of clinical... more Obsessive-compulsive disorder (OCD) is a disabling anxiety disorder with a wide range of clinical presentations. Previous research has examined a variety of obsessional themes within OCD including contamination fears, sexual or aggressive obsessions and scrupulosity. Absent from current literature of OCD, however, is an investigation of obsessive-compulsive (OC) symptoms centering on intimate relationships. The present investigation reports on the development and evaluation of the Relationship Obsessive Compulsive Inventory (ROCI), a 12-item measure assessing the severity of OC symptoms centering on three relationship dimensions: the individual’s feelings towards his or her partner, the partner’s feelings towards the individual, and the ‘‘rightness’’ of the relationship experience. Factor analysis supports a 3-factor structure of the ROCI above two alternative measurement models (Study 1). The ROCI was found to be internally consistent and showed the expected associations with OCD related symptoms and cognitions, mood and relationship variables (Study 2). Moreover, the ROCI significantly predicted depression and relationship related distress, over-and-above common OCD symptoms, and other mental health and relationship insecurity measures. Relationship-centered OC symptoms may be an important theme for further OCD research.

… of Obsessive-Compulsive …, Jan 1, 2012

Obsessive-compulsive disorder (OCD) is a disabling disorder with a variety of clinical presentati... more Obsessive-compulsive disorder (OCD) is a disabling disorder with a variety of clinical presentations. Recently, research has begun to explore relationship-centered obsessive-compulsive (OC) symptoms, which include obsessions, checking, and reassurance seeking behaviors centered on an individual’s feelings towards his or her partner and the ‘‘rightness’’ of their relationship. The present investigation extends previous research by examining OC symptoms focused on one’s partner’s perceived flaws. We report on the development and validation of the Partner-Related Obsessive-Compulsive Symptoms Inventory (PROCSI), a 24-item self-report scale assessing the severity of partner-focused OC symptoms in six domains: physical appearance, sociability, morality, emotional stability, intelligence and competence. The PROCSI was found to be internally consistent, and its factorial structure was supported by confirmatory factor analysis. Moreover, the PROCSI showed the expected associations
with measures of OCD symptoms and cognitions, negative affect and relationship functioning, and significantly predicted depression and relationship-related distress over and above other symptom and relationship measures (Study 1). In addition, longitudinal analyses suggested reciprocal links between
relationship-centered OC symptoms and partner-focused OC symptoms. Links between body dysmorphic concerns and partner-focused OC symptoms were also found (Study 2). Implications for theory and treatment are discussed.

Journal of Behavior Therapy and Experimental Psychiatry, 2013

Background and Objectives: Obsessive preoccupation and doubts centering on one’s intimate relatio... more Background and Objectives: Obsessive preoccupation and doubts centering on one’s intimate relationship may have a negative impact on the romantic dyad and lead to significant distress. In this research we investigated whether the co-occurrence of attachment anxiety and overreliance on intimate relationships
for self-worthd what we call double relationship-vulnerabilityd is linked with relationship-centered obsessions and obsessive-compulsive tendencies. Methods: Study 1 employed a correlational design to examine the link between double relationship vulnerability and relationship-centered obsessions. Study 2 employed an experimental design to assess response to subtle threats to the relationship self-domain among individuals with double relationship-vulnerability. Results: Study 1 supported the link between double relationship-vulnerability and relationship-centered obsessions. Study 2 showed that when confronted with subtle threats to the relationship self-domain, individuals with double relationship-vulnerability are more likely to experience distress and engage in mitigating behavior in response to relationship doubts and fears. Limitations: Our studies were conducted with non-clinical samples. Conclusions: These findings suggest that double relationship-vulnerability may make individuals more susceptible to the development and maintenance of relationship-centered obsessions and compulsions.

Journal of anxiety disorders, Jan 1, 2007

Journal of Cognitive …, Jan 1, 2007

Journal of behavior therapy and …, Jan 1, 2012

Journal of Social and …, Jan 1, 2009

Obsessive-compulsive disorder (OCD) is one of the most disabling and highly prevalent anxiety dis... more Obsessive-compulsive disorder (OCD) is one of the most disabling and highly prevalent anxiety disorders. Cognitive models implicate maladaptive beliefs such as inflated sense of responsibility, perfectionism, importance/control of thoughts in the maintenance of the disorder, but little research has investigated factors that may lead to these beliefs. This paper investigated whether a dysfunctional attachment system may be one such factor, by examining how adult attachment orientations (dimensions of attachment anxiety and ...

Abstract In recent years, attachment insecurities in the form of anxiety and avoidance have been ... more Abstract In recent years, attachment insecurities in the form of anxiety and avoidance have been found to be associated with Obsessive Compulsive (OC) symptoms and cognitions. The hypothesized buffering role of attachment security on OC-related processes, however, has yet to be assessed. In the current study, we examined the effects of experimentally-enhanced attachment security (" security priming") on OC-related washing tendencies in a non-clinical sample (N= 85).

Behaviour research and therapy, Jan 1, 2007

Journal of anxiety …, Jan 1, 2008

Canadian Journal of …, Jan 1, 2009

Abstract 1. Although control-related cognitions have often been implicated in discussions of obse... more Abstract 1. Although control-related cognitions have often been implicated in discussions of obsessive compulsive disorder (OCD), empirical investigations of the relationship between control constructs and OCD symptoms have been relatively limited. This article investigated the hypothesis that OCD symptoms may be linked with a higher desire for control (DC), but a lower sense of control (SC) over the self and environment, leading to motivation for compulsive symptoms. It also investigated whether this effect was direct, or mediated ...

Attachment & Human Development, 2011

This study explored the relation between mothers' and their children's secure base scripts in two... more This study explored the relation between mothers' and their children's secure base scripts in two samples of school-aged children: a community sample (N = 29; mean age 8.9) and a sample of children diagnosed with ADHD (N = 50; mean age 8.9). Using the Attachment Script Representation Task, mothers and children were asked to construct narratives using word prompt outlines. In addition, mothers and children completed questionnaires focusing on symptoms. The results revealed that while the link between mothers' and children's scriptedness was significant in the community, no significant association was found in the ADHD sample. In the ADHD group, maternal reports of children's symptoms were negatively linked to children's secure-base scriptedness. Implications of these findings for theory and intervention are discussed.

Journal of counseling …, Jan 1, 2010

Australasian …, Jan 1, 2009

Journal of anxiety disorders, Jan 1, 2009

Clinical psychology review, Jan 1, 2005

Perspectives on …, Jan 1, 2010

British Journal of …, Jan 1, 2010

Journal of anxiety …, Jan 1, 2007

Depression and …, Jan 1, 2008

Israel Journal of Psychiatry and related …, Jan 1, 2009

Health Informatics Journal

Background: Tinnitus may be a disabling, distressing disorder whereby patients report of sounds, ... more Background: Tinnitus may be a disabling, distressing disorder whereby patients report of sounds, in the absence of external stimulus. Recent evidence supports the effectiveness of psychological interventions, particularly, cognitive behavioral therapy (CBT) based intervention for the reduction of tinnitus-related distress and disability. This study assessed the effectiveness of mobile delivered cognitive training exercises to reduce tinnitus-related distress. Materials and Methods: Out of 26 patients diagnosed with tinnitus, 14 participants completed all 48 levels of the app. Levels of pre-post intervention tinnitus intrusiveness and handicap were evaluated using the short Hebrew version of the Tinnitus Handicap Inventory (H-THI). Mood was assessed using a Visual Analogue Scale (VAS). Participants were instructed to complete 3–4 min of daily training for 14 days. Results: Repeated-measures ANOVA of completers showed a significant large-effect size reduction on H-THI scores. 50% of c...

Frontiers in Psychiatry

Infant socioemotional development and underlying brain maturation occur primarily within the cont... more Infant socioemotional development and underlying brain maturation occur primarily within the context of early caregiver-infant relationships. Perinatal research demonstrates detrimental impact of postpartum pathology, including postnatal onset of maternal OCD—on the mother-infant relationship. The present study is the first to examine postnatal onset of a particular dimension of OCD symptoms focusing on close interpersonal relationships (relationship-OCD, i.e., ROCD) within a general population sample. Specifically, we assessed whether symptoms of Parent-Child ROCD (PC-ROCD), may onset postnatally, thus yielding symptoms of Parent-Infant ROCD (PI-ROCD). We adapted the previously validated Parent-Child ROCD measure for use during infancy to assess symptoms of PI-ROCD. The adapted measure, Parent-Infant Relationship Obsessive Compulsive Symptoms Inventory (PI-PROCSI), was administered to 143 mothers from the general population at 4-months postpartum. We investigated concurrent associa...

Journal of Affective Disorders

Aspects of self-concept have been implicated in recent empirical and theoretical investigations o... more Aspects of self-concept have been implicated in recent empirical and theoretical investigations of Obsessive-Compulsive Disorder (OCD). This article extends previous theory and research by investigating the proposal that specific self-structures may be linked with OCD (e.g., Doron & Kyrios, 2005). In particular, it was hypothesized that individuals who value the domains of morality, job and scholastic competence, and social acceptability, but who feel incompetent in these domains (i.e. “sensitive” domains of self), would hold a greater level of OC-related beliefs and display more OC-symptoms. The study was performed in 198 non-clinical participants, using a multidimensional measure of self-concept. As predicted, it was found that sensitivity in the four domains was related to higher levels of OC-related beliefs. Sensitivity in the domains of morality, job competence and social acceptability also related to higher levels of OC-symptoms. Further, these findings were generally maintain...

Clinical Psychologist, 2020

International Journal of Clinical and Health Psychology, 2019

Nature Climate Change, 2015

Journal of Obsessive-Compulsive and Related Disorders, 2014

Obsessive-Compulsive Disorder (OCD) is characterized by repeated and persistent attempts by the i... more Obsessive-Compulsive Disorder (OCD) is characterized by repeated and persistent attempts by the individual to control their thoughts and by taking action through rituals in order to prevent feared or personally distressing outcomes. While cognitive theories of OCD have generated supportive research findings and effective treatments, they have not considered broader control beliefs that may motivate aspects of OC-phenomenology. We have previously proposed that broader control beliefs, specifically desire for control and sense of control, may play a role in OC-symptoms (Moulding & Kyrios, in press). In the present study, non-clinical participants (N=219) were presented with four hypothetical scenarios relevant to an OCD-checking concern, and using a manipulation paradigm, the relationship between control constructs and appraisals hypothesized to be relevant to OCD (threat, responsibility) was examined. Desire for control was moderately affected to responsibility and threat appraisals,...

Behaviour Research and Therapy, 2020

OBJECTIVE Body image disturbance (BID) is common among women, characterized by persistent and dis... more OBJECTIVE Body image disturbance (BID) is common among women, characterized by persistent and distressing appearance dissatisfaction, and linked with eating disorders. Although effective, cognitive behavioral therapy (CBT) delivered by trained professionals is not easily accessible. This randomized trial evaluated the effects of a CBT-based mobile application designed to increase resilience to body image triggers and reduce BID symptoms. METHOD A non-clinical sample of women (N = 90; Mage = 23.52) was randomized to use the mobile application for approximately 4 min of daily exercises for two weeks or to a control condition. Body image was measured at baseline, immediately after two weeks of mobile application use, and at 1-month follow-up. To examine whether using the application was associated with increased resilience to common BID triggers, participants completed an Instagram exposure resilience task upon completion and at 1-month follow-up. RESULTS Relative to those in the control condition, participants who used the application demonstrated increased resiliency and reduced BID symptoms. Theses effects were medium-to-large and were maintained at 1-month follow-up. CONCLUSION These results underscore the potential usefulness of brief, low-intensity, portable interventions in reducing BID symptoms and in increasing resilience to thin-ideal body messages often portrayed on social media.

Journal of Obsessive-Compulsive and Related Disorders, 2018

Nature Climate Change, 2016

Frontiers in Psychology, 2016

Cognitive Therapy and Research, 2013

The Wiley Handbook of Obsessive Compulsive Disorders, 2017

Journal of Affective Disorders, 2020

BACKGROUND Relationship Obsessive Compulsive Disorder (ROCD) is a presentation of OCD centering o... more BACKGROUND Relationship Obsessive Compulsive Disorder (ROCD) is a presentation of OCD centering on interpersonal relationships. The aim of this Randomized Control Trial (RCT) was to assess the efficacy of short, game like, daily cognitive interventions delivered via mobile application in reducing subclinical ROCD symptoms and associated phenomena. METHODS Fifty university students identified as having subclinical levels of ROCD symptoms (using the Structured Clinical Interview for DSM-5 Clinical Version) were randomized into: immediate-use group (iApp group; n = 25) and delayed-use group (dApp group; n = 25). The iApp group started using the evaluated cognitive-behavioral training application at baseline for 15 days (T0 to T1). The dApp group commenced using the application at T1 for 15 days (T1 to T2). All participants completed questionnaires at baseline (T0), 15 days from baseline (T1), and 30 days from baseline (T2). RESULTS Repeated measure MANOVAs showed significant Group (iApp vs. dApp) × Time (T0 vs. T1) interactions. These interactions indicated greater decrease in ROCD symptoms, OCD beliefs and social anxiety symptoms, as well as a greater increase in self-esteem in the iApp group compared to dApp group at T1. Moreover, the Reliable Change Index (RCI) indicated reliable change on ROCD symptoms for a significant portion of participants (42-52%). LIMITATIONS Sample size and the use of self-report measures limits the generalizability of the results. CONCLUSIONS Short, daily cognitive training interventions delivered via mobile applications may be useful in reducing subclinical ROCD symptoms and associated features. Further testing is needed for clinical populations.

Behavior Therapy, 2020

Body dissatisfaction is prevalent in young women, and is associated with symptoms of body dysmorp... more Body dissatisfaction is prevalent in young women, and is associated with symptoms of body dysmorphic disorder (BDD) and eating disorders (EDs). The aim of the study was to assess the efficacy of a mobile application, based on cognitive behavioral principles, in reducing body dissatisfaction and BDD/ED symptoms in female university students considered at high-risk of developing body image disorders (BIDs). Fifty university students at high-risk of developing BIDs (using self-report questionnaires assessing BIDs and the Structured Clinical Interview for DSM-5 Clinical Version) were randomized in two groups: immediate-use App group (iApp group; n = 25) and delayed-use App group (dApp group; n = 25). The iApp group started using the app at baseline for 16 days (T0 to T1). The dApp group waited for 16 days before starting to use the app (T1 to T2). Participants completed questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2). Repeated measure Analyses of Variance (ANOVAs) showed a Group (iApp vs. dApp) × Time (T0 vs. T1) interaction on BDD symptoms indicating medium effect size (partial eta squared) reductions in the iApp group compared to dApp group at T1; post-intervention means for BDD symptoms were under the cut-off for extreme body dissatisfaction/BDD symptoms in both groups. Pertaining to ED symptoms, no significant Group × Time interaction was detected. Training 3 minutes a day for 16 days with a CBT-based mobile application may lead to reductions in some forms of body dissatisfaction, including BDD symptoms in female university students at high-risk of developing BIDs. On the other hand, effects of the intervention on ED symptoms seem more limited.

Clinical Psychology & Psychotherapy, 2014