قسمت 2. آنها می ترسانند چون برای ما مهم است: رابطه بین افکار مزاحم وسواسی و ارزیابی و استراتژی های کنترل در سراسر 15 شهر

Cognitive models of Obsessive Compulsive Disorder (OCD) purport that obsessions are normal intrusive thoughts that are misappraised as significant, leading to negative emotional responses and maladaptive attempts to control the thoughts and related emotions. This paper utilised a large multi-national dataset of interview data regarding intrusive thoughts, to investigate three questions related to the cognitive model of OCD and to its stability across cultures. First, the paper aimed to investigate the implicit yet-hitherto-untested assumption of cognitive models that misappraisals and control strategies for intrusive thoughts relate similarly across cultures. Second, this study aimed to build upon recent studies categorising intrusive thoughts into repugnant and non-repugnant categories, by investigating whether the content of intrusive thought moderates the relationship between the thoughts and appraisals and control strategies. Finally, this study aimed to provide further evidence regarding whether general beliefs implicated in cognitive models of OCD (e.g., responsibility, importance of thoughts) influence the occurrence of intrusions via maladaptive appraisals and control strategies. Overall, it was found that while overall intrusive thought frequency, distress, ease and importance of dismissal all varied significantly by site, their relationship with appraisals and control strategies did not. Generally, appraisals and action taken to confront the thought were the more consistent predictors, with the notably caveat that the relationship between thought frequency and appraisals was not strong. Second, repugnant vs. non-repugnant thought-content differed only with respect to thought frequency, but thought-content did not moderate the relationship between intrusive thoughts and control strategies and appraisals. Finally, appraisals and control strategies generally partially mediated the relationship between general OCD-related beliefs and the occurrence of, and distress associated with, intrusive thoughts. The results are taken to add credence to cognitive models of OCD and their validity across cultures.

It is now well accepted that the occurrence of Obsessive Compulsive Disorder (OCD) is not restricted to a specific culture or particular era (de Silva, 2006 and Nedeljkovic et al., 2012). Cultural and geographically-diverse clinical and epidemiological data have shown remarkable consistency both with respect to the presence and to the characteristics of OCD symptoms (for review, see Nedeljkovic et al., 2012). Cognitive models of OCD suggest that the construction of meaning and interpretations of common intrusive phenomena play large roles in the development and maintenance of specific obsessive and compulsive symptoms (e.g., Clark, 2004). As meaning construction itself varies cross-culturally – how one perceives oneself, one׳s body, and one׳s health, along with how one defines constructs such as disorder and normality, and how one conducts social interactions (e.g., Fabrega, 1989, Marsella and Yamada, 2000 and Marsella et al., 2002) – culture might be important both in determining the manifestation of OCD symptoms and in influencing their underlying mechanisms.