Ricerca pubblicazioni scientifiche

@article{Demaria2021,

title = {Psychoeducation focused on family accommodation: a practical intervention for parents of children and adolescents with obsessive-compulsive disorder},

author = {Francesco Demaria and Maria Pontillo and Maria Cristina Tata and Prisca Gargiulo and Francesco Mancini and Stefano Vicari},

editor = {BMC},

url = {https://apc.it/2021-mancini-psychoeducation-focused-on-family-accomodation-2/},

doi = {https://doi.org/10.1186/s13052-021-01177-3},

issn = {1824-7288},

year  = {2021},

date = {2021-11-06},

journal = {Italian Journal of Pediatrics},

volume = {47},

number = {224},

abstract = {Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder that is frequently diagnosed in children and adolescents. In pediatric OCD, family plays an important role in the development and maintenance of the disease. In this relationship, both genetic and behavioral factors, such as parental modeling and family accommodation, are significant. Parental modeling concerns the daily enactment of dysfunctional behavioral patterns by a parent with OCD, which may influence children. Family accommodation, in contrast, describes the direct participation of parents in their child’s compulsive rituals, by modifying daily routines or by facilitating avoidance of OCD triggers, to decrease the child’s distress and time spent executing compulsions. Approximately 80–90% of the relatives of OCD patients actively participate in patients’ rituals. The literature demonstrates that a high level of family accommodation is associated with OCD symptom severity, reduced response to cognitive-behavioral treatment (CBT), and a higher risk of therapy dropout.



Despite this, no studies have aimed at delineating practical guidance for psychotherapists to support parents in reducing family accommodation.



The main aim of this paper is to propose a psychoeducation intervention focused on cognitive-behavioral strategies to help families to manage their child’s OCD behaviors without enacting dysfunctional family accommodation behaviors in order to support their child’s successful therapy.},

keywords = {obsessive-compulsive disorder, Psychoeducation focused},

pubstate = {published},

tppubtype = {article}

}

@article{Zaccari2021,

title = {Narrative Review of COVID-19 Impact on Obsessive-Compulsive Disorder in Child, Adolescent and Adult Clinical Populations},

author = {Vittoria Zaccari and Maria Chiara D'Arienzo and Tecla Caiazzo and Antonella Magno and Graziella Amico and Francesco Mancini },

editor = {Frontiers in Psychiatry},

url = {https://apc.it/zaccari-et-al-2021-narrative-review-of-covid-19/},

doi = {doi: 10.3389/fpsyt.2021.673161},

year  = {2021},

date = {2021-05-13},

urldate = {2021-05-13},

journal = {Psychopathology},

abstract = {Background: The COVID-19 pandemic and quarantine had a significant impact on mental health which resulted in an increase of anxiety and depression in adult, child and adolescent clinical populations. Less is known about the potential effect of pandemic on obsessive-compulsive disorder (OCD) so there is a lack of review work to illustrate the impact of the COVID-19 pandemic on OCD.



Purpose: The main objective is to review all the empirical contributions published after March 2020 that dealt with the impact of the COVID-19 pandemic on OCD in adults, children and adolescents, investigating the state-of-the-art literature concerning the impact on OCD and detailing limitations.



Methods: The literature search was conducted using PsycINFO, PsycARTICLES, MEDLINE, Scopus, Web of Science, PubMed, and Google Scholar. This review analyzed all studies from January 2020 to 8 January 2021, focusing on clinical populations of children, adolescents, and adults with OCD.



Results: A total of 102 articles were screened, resulting in the identification of 64 full-text articles to be further scrutinized. Upon closer examination, there was consensus that 39 articles met the study inclusion criteria and 14 of these were selected for study. Analysis of the results revealed that COVID-19 had an impact on OCD in both adults and young people and seems to have caused exacerbation of symptoms, especially of the contamination/washing subtypes. Eight studies in adult samples showed an increase in the severity of obsessive-compulsive symptoms; two studies underlined a minimal impact of COVID-19 on OCD patients and one study showed a slight improvement in symptoms. Two out of three studies on children and adolescents showed an exacerbation of OCD and a worsening even in the presence of an ongoing treatment.



Conclusions: The studies reviewed are few. There are more studies on adult OCD than on children and adolescents. The results are controversial: few studies examined OCD subtypes; in most studies the typology of treatment was not clear and the samples covered a wide age range; a large number of studies did not use the same monitoring period or quantitative measures, both of which make it difficult to compare or rely on the results.},

keywords = {adolescents, adults, children, coronavirus, COVID-19, narrative review, obsessive-compulsive disorder, obsessive-compulsive symptoms},

pubstate = {published},

tppubtype = {article}

}

@article{Tenore2020,

title = {Imagery Rescripting on Guilt-Inducing Memories in OCD: A Single Case Series Study},

author = {Katia Tenore and Barbara Basile and Teresa Cosentino and Brunetto De Sanctis and Stefania Fadda and Giuseppe Femia and Andrea Gragnani and Olga Ines Luppino and Valerio Pellegrini and Claudia Perdighe and Giuseppe Romano and Angelo Maria Saliani and Francesco Mancini},

editor = {Pedro Morgado, University of Minho, Portugal},

url = {https://apc.it/2020-mancini-imagery-rescripting-on-guilt-frontiers/},

doi = {10.3389/fpsyt.2020.543806 },

issn = {1664-0640   },

year  = {2020},

date = {2020-09-30},

urldate = {2020-09-30},

journal = {Frontiers in Psychiatry},

volume = {11},

pages = {1018},

abstract = {Background and objectives: Criticism is thought to play an important role in obsessive-compulsive disorder (OCD), and obsessive behaviors have been considered as childhood strategies to avoid criticism. Often, patients with OCD report memories characterized by guilt-inducing reproaches. Starting from these assumptions, the aim of this study is to test whether intervening in memories of guilt-inducing reproaches can reduce current OCD symptoms. The emotional valence of painful memories may be modified through imagery rescripting (ImRs), an experiential technique that has shown promising results.



Methods: After monitoring a baseline of symptoms, 18 OCD patients underwent three sessions of ImRs, followed by monitoring for up to 3 months. Indexes of OCD, depression, anxiety, disgust, and fear of guilt were collected.



Results: Patients reported a significant decrease in OCD symptoms. The mean value on the Yale−Brown Obsessive Compulsive Scale (Y-BOCS) changed from 25.94 to 14.11. At the 3-month follow-up, 14 of the 18 participants (77.7%) achieved an improvement of ≥35% on the Y-BOCS. Thirteen patients reported a reliable improvement, with ten reporting a clinically significant change (reliable change index = 9.94). Four reached the asymptomatic criterion. Clinically significant changes were not detected for depression and anxiety.



Conclusions: Our findings suggest that after ImRs intervention focusing on patients’ early experiences of guilt-inducing reproaches there were clinically significant changes in OCD symptomatology. The data support the role of ImRs in reducing OCD symptoms and the previous cognitive models of OCD, highlighting the role of guilt-related early life experiences in vulnerability to OCD.},

keywords = {criticism, guilt, imagery rescripting, memories, obsessive-compulsive disorder},

pubstate = {published},

tppubtype = {article}

}

@article{Petrucci2019,

title = {Doubts about me, doubts about you: a case of comorbid obsessivecompulsive and paranoid personality disorders},

author = {Manuel Petrucci and Andrea Gragnani},

editor = {Edizioni Erickson},

url = {https://apc.it/petrucci-gragnani-2019-a-case-of-comorbid-ocd-and-paranoid-personality/},

year  = {2019},

date = {2019-01-01},

journal = {Psicoterapia Cognitiva e Comportamentale},

volume = {25},

number = {3},

pages = {359-375},

abstract = {The case formulation and cognitive-behavior therapy of a patient whose pathology fulfills criteria for both obsessive-compulsive (OCD) and paranoid personality disorders (PPD) is described. Case formulation encompasses all the relevant cognitive, emotional and motivational factors underlying he disorders, emphasizing interactions between processes and strategies aimed at investigating and disconfirming feared scenarios, and reconstructing the ontogeny of pathological beliefs and themes n the patient’s life history. The treatment targeted rumination and dysfunctional interpersonal cycles hat maintained and reinforced pathology, promoting awareness, critical insights, risk acceptance and

progressive decline of maladaptive control strategies. The challenges to the therapeutic alliance due to paranoid ideation towards the therapist and the relational strategies used to overcome them are also reported. The case offers clear indications about effective interventions that address both common and specific mechanisms involved in OCD and PPD, and provides observations that might foster future theoretical conceptualizations and research on the involvement of guilt, shame and humiliation in the two conditions. },

keywords = {guilt, Humiliation, obsessive-compulsive disorder, Paranoid personality, Risk acceptance},

pubstate = {published},

tppubtype = {article}

}

@article{Luppino2018,

title = {A theorical integration of Schema Therapy and Cognitive Therapy in OCD tratment: goals and beliefs of the Obsessive Mind (part 1)},

author = {Olga Ines Luppino and Katia Tenore and Francesco Mancini and Barbara Basile},

editor = {Scientific Research Publishing},

url = {https://apc.it/2018-a-theoretical-integration-part-1/},

doi = {http://doi.org/10.4236/psych.2018.99129},

issn = {2152-7199},

year  = {2018},

date = {2018-09-11},

journal = {Psychology},

volume = {9},

number = {9},

pages = {2261-2277},

abstract = {The present work is the first of a trilogy of articles whose purpose, as a whole, is to present a theoretical conceptualization of OCD functioning, which results from the integration between the Cognitive Therapy model, as proposed by Mancini (2018), and the Schema Therapy Mode model. In particular, this first paper aims to synthetically present the cognitive model of OCD functioning.

According to the frame offered by Mancini, we will provide some evidence demonstrating the central role of deontological guilt and disgust as proximal psychological determinants in the genesis and maintenance of obsessive symptoms. The theoretical assumptions and the dynamics of the recursive processes at the basis of the maintenance of OCD will be clarified

through a clinical exemplification and the clinical intervention goals will be presented. In order to plan an intervention on the experiences representing the historical vulnerability of OCD, the work also aims to present the important

role played by particular kinds of early experiences in sensitizing to deontological guilt and disgust. To summarize, the current work presents the theoretical bases of a cognitive OCD conceptualization, in terms of goals and beliefs that are the drivers of obsessive behaviors. This introduction is preparatory to our proposal of integration between the cognitive model and the Schema Therapy Mode model that will be developed in the next two articles.

},

keywords = {cognitive therapy, Deontological guilt, Disgust, obsessive-compulsive disorder},

pubstate = {published},

tppubtype = {article}

}

@article{Tenore2018,

title = {A Theoretical Integration of Schema Therapy and Cognitive Therapy in OCD Treatment: Conceptualization and Rationale (Part II)},

author = {Katia Tenore and Barbara Basile and Francesco Mancini and Olga Ines Luppino},

editor = {Scientific Research Publishing},

url = {https://apc.it/2018-a-theoretical-integration-part-2/},

doi = {https://doi.org/10.4236/psych.2018.99130},

isbn = {2152-7199},

year  = {2018},

date = {2018-09-11},

journal = {Psychology},

volume = {9},

number = {9},

pages = {2278-2295},

abstract = {Cognitive Behavioral Therapy has been identified as the first choice treatment for Obsessive Compulsive Disorder (OCD). Although a significant proportion of patients benefit from Cognitive Behavioral Therapy, another still fails to respond to CBT. To improve outcomes, new targets of intervention have been broadened, but no clear and comprehensive conceptualizations of the disorder have been suggested. In the last few years, in the context of Schema Therapy (ST), several specific models have been proposed for the treatment of Axis I diagnostic categories (according to the classification of DSM IV), in addition to the more well-known conceptualizations related to Personality Disorders. Concerning OCD, several studies have investigated the effectiveness of ST in the treatment of OCD, but only few have tried to elaborate a

conceptualization of the disorder in terms of modes. This lack of knowledge and shared conceptualization might lead to difficulties in planning and evaluating effective interventions. The aim of this work is to present a conceptualization of the Obsessive Compulsive Disorder that results from the integration

between the Cognitive Therapy framework, as proposed by Mancini and

collaborators, and the framing in terms of modes, in line with ST, starting

from the research data available. In particular, the rationale of the intervention

will be proposed, aimed at accepting the risk of committing mistakes or

of coming into contact with disgusting substances. This general aim will then

be articulated in sub-aims, which may direct it, in a more specific way, on the

basis of the different modes that characterize the experience of obsessive patients},

keywords = {Acceptance, cognitive therapy, obsessive-compulsive disorder, Schema therapy},

pubstate = {published},

tppubtype = {article}

}

@article{Basile2018b,

title = {A Theoretical Integration of Schema Therapy and Cognitive Therapy in OCD Treatment: Experiential Techniques and Cognitive-Based Interventions in Action (Part III)},

author = {Barbara Basile and Olga Ines Luppino and Francesco Mancini and Katia Tenore},

editor = {Scientific Research Publishing},

url = {https://apc.it/2018-a-theoretical-integration-part-3/},

doi = {https://doi.org/10.4236/psych.2018.99131},

issn = {2152-7199},

year  = {2018},

date = {2018-09-11},

journal = {Psychology},

volume = {9},

number = {9},

pages = {2296-2311},

abstract = {This final article is part of the trilogy presenting a possible integration of Schema Therapy (ST) and Cognitive Therapy (CT) in Obsessive-compulsive disorder (OCD) treatment. It aims at describing how experiential and cognitive based acceptance techniques might be applied to treat this psychopathological condition. In the first article published in this special issue ( Luppino et al., 2018 ) we reported the main data supporting the role of proximal psychological determinants in the genesis and maintenance of the obsessive symptomatology, highlighting the role of deontological guilt and disgust, and of the Not Just Right Experience. According to these, we described the internal profile of the disorder as conceptualized by Mancini’s (2018)cognitive model. In the second manuscript ( Tenore et al., 2018 ) we proposed a conceptualization of OCD, in terms of schemas and modes (as proposed by ST), integrating it with the previously described cognitive model. In agreement with these two articles, the aim of this work is to explain how experiential and cognitive techniques can be integrated to explain obsessive functioning and to achieve a successful treatment. We first describe emotion focused-experiential procedures derived from the ST framework, specifically focusing on imagery techniques, such as diagnostic imagery, rescripting and Healthy Adult imagery. Secondly we explain how chairwork can be applied to change obsessive dysfunctional schema modes. Finally, we focus on cognitive based acceptance intervention aimed at reducing the typical feelings of deontological guilt and disgust, two core emotions in OCD. In the conclusion we briefly resume the major aspects proposed in the three articles, and we present some potential further applications of a joined approach applied to other psychopathological conditions.},

keywords = {Acceptance, Chairwork, cognitive therapy, Imagery with Rescripting, obsessive-compulsive disorder, Schema therapy},

pubstate = {published},

tppubtype = {article}

}

@article{Ottaviani2018,

title = {I obsessively clean because deontological guilt makes me feel physiologically disgusted!},

author = {Cristina Ottaviani and Alberto Collazzoni and Francesca D'Olimpio and Tania Movetta and Francesco Mancini},

editor = {Elsevier},

url = {https://apc.it/2019-i-obsessively-clean-because-deontological-guilt-me-feel-ottaviani-et-all-3/},

doi = {https://doi.org/10.1016/j.jocrd.2018.01.004},

year  = {2018},

date = {2018-05-07},

urldate = {2018-05-07},

journal = {Journal of Obsessive-Compulsive and Related Disorders},

abstract = {The emotions of guilt and disgust play a pivotal role in obsessive-compulsive disorder (OCD). The present study hypothesized the existence of a distinctive relation between deontological (but not altruistic) guilt and subjective and physiological correlates of disgust. Moreover, we aimed at testing whether the evoked emotion of disgust may activate OCD-like washing behaviors. Gender-matched healthy participants were randomly assigned to altruistic (n = 31) or deontological guilt (n = 30) inductions followed by a cleaning task, while their electrocardiogram was continuously recorded to derive vagally-mediated heart rate variability (HRV). At baseline and after each experimental condition, participants’ momentary emotional state was assessed by visual analog scales (VAS). Compared to altruistic guilt, deontological guilt had the effect of: a) enhancing the physiological correlate of disgust (i.e. augmented HRV); b) increasing OCD-like washing behaviors (e.g. checking). In both groups, washing behaviors had the effect to reduce the physiological correlate of disgust. These effects were stronger in participants with higher OC tendencies, as indicated by scores on the dispositional questionnaires. Results support previous reports on a distinctive relation between deontological guilt and both disgust and OCD symptoms.},

keywords = {Altruistic guilt, Deontological guilt, Disgust, Heart rate variability, obsessive-compulsive disorder},

pubstate = {published},

tppubtype = {article}

}

@article{Basile2017,

title = {Schema Therapy mode model applied to OCD},

author = {Barbara Basile and Katia Tenore and Olga Ines Luppino and Francesco Mancini},

editor = {Giovanni Fioriti Editore},

url = {https://apc.it/wp-content/uploads/2017/12/2017-schema-therapy-mode-Basile-et-al-clinical-neuropsychiatry.pdf},

year  = {2017},

date = {2017-11-01},

journal = {Clinical Neuropsychiatry},

volume = {14},

number = {6},

pages = {407-414},

abstract = {Objective: Schema Therapy (ST) places particular emphasis on affective experiences, therapeutic relationship and early life experiences. Ad hoc ST conceptualizations for specific psychological conditions, mainly focusing on personality disorders, have been suggested in the last decade. The aim of this study was to explore schemas, modes and coping styles in outpatients with Obsessive-Compulsive Disorder (OCD). Method: thirty-four patients with OCD [DSM5 criteria, mean age(SD)=33(8.38) years; 12 females] were recruited. Schemas, modes and coping styles were measured. Indexes of OCD symptoms’, guilt and disgust levels were also collected. Descriptive, correlation and multiple regression analyses were performed.

Results: OCD symptoms’ severity was significantly associated with social isolation, failure, subjugation and punishment schemas, and with the punitive parent mode. A positive relationship was also detected between OCD severity, and avoidance and intra-psychic coping styles and disgust intensity. Regression analyses revealed that the social isolation and punitiveness schemas, the punitive parent mode and behavioral avoidance coping style predicted OCD severity, with behavioral avoidance playing a significant mediation role between dysfunctional schemas and symptoms.

Conclusions: Our data confirm previous findings on Schema model applied to OCD. An important limitation of the study is represented by the lack of an Italian control group. },

keywords = {coping strategies, Early maladaptive schemas, modes, obsessive-compulsive disorder, Schema therapy},

pubstate = {published},

tppubtype = {article}

}

@article{Mancini2017,

title = {Obsessive patients and deontological guilt: a review},

author = {Francesco Mancini and Amelia Gangemi},

editor = {Psychopathology Review},

url = {https://apc.it/wp-content/uploads/2018/03/2017-obsessive-patients-and-deontological-guilt-a-review-Gangemi-paper-1.pdf},

doi = {http://dx.doi.org/10.5127/pr.045916},

issn = {2051-8315},

year  = {2017},

date = {2017-04-17},

journal = {Psychopathology Review},

volume = {4},

number = {2},

pages = {155-168},

abstract = {In line with the Appraisal Theories of Obsessive-Compulsive Disorder (OCD), in this review we present some experiments aimed at demonstrating the role of fear of guilt in OCD. What kind of guilt do OC patients want to prevent? Several studies suggest the existence of two different types of guilt emotions, namely deontological guilt and altruistic guilt. This research suggests that the former, more than the latter, is involved in OCD. Moreover, it demonstrates that the deontological guilt is related to disgust, and that this relationship could explain why both fear of contamination and fear of guilt are often co-present in obsessive patients. Finally, research shows that the Not Just Right Experience (NJRE) in OCD can be influenced by the deontological guilt. Future research should further verify the actual role of deontological guilt in OCD, and its therapeutical implications

},

keywords = {Apparaisal theories, Deontological guilt, fear of contamination, Not just right experience, obsessive-compulsive disorder},

pubstate = {published},

tppubtype = {article}

}

@article{Barcaccia2016,

title = {Obsessive-compulsive disorder: the strength of psycological models of mental illness},

author = {Barbara Barcaccia and Francesco Mancini},

editor = {Franco Angeli},

url = {https://apc.it/wp-content/uploads/2017/02/2016-obsessive-compusive-disorder-Barcaccia_Mancini-1.pdf},

year  = {2016},

date = {2016-01-01},

volume = {13},

number = {6},

pages = {85-87},

abstract = {From the first compelling psychoanalytic formulation at the biginning of last century by Sigmund Freud, to the latest cognitive-behavioural models, psychology has been at the forefront of the understanding of Obsessive-Compulsive Dosorder (OCD). Psychological accounts of the disorder have been proven to be sound and accurate, explaining many facets of OCD, and having important implications for treatment.},

keywords = {cognitive-behavioural therapy, EABCT, obsessive-compulsive disorder, psychological models},

pubstate = {published},

tppubtype = {article}

}

@article{Cosentino2015,

title = {Family accommodation in obsessive-compulsive disorder: a study on associated variables},

author = {Teresa Cosentino and Palmira Faraci and Daniela Coda and Rosaria D’Angelo and Lorena Assunta De Pari and Maria Rosaria di 

Crescenzo and Luisa Esposito and Amalia Scelza},

editor = {Giovanni Fioriti Editore s.r.l.},

url = {https://apc.it/wp-content/uploads/2016/01/2015-family-accommodation.-cosentino-et-all.pdf},

year  = {2015},

date = {2015-05-01},

journal = {Clinical Neuropsychiatry},

volume = {12},

number = {5},

pages = {128-134},

abstract = {The present study aimed to examine family accommodation in relatives of obesessive-compulsive disease (OCD) patients. Accommodation was assessed in a sample of 31 relatives of OCD patients by means of the Family Accommodation Scale. Other variables measured as predictor of accommodation were tendency of a familymember to feel guilty, sensitivity to guilt, anxiety sensitivity and the prevalence of a passive communication style.

Accommodation was found to be rather widespread in the family members who took part in our study, and they tended to show more accommodation the greater their sensitivity to guilt and the stable tendency to experience this emotion as well as anxiety sensitivity and passive communication style. Multiple linear regression analyses showed that, among the variables considered, the family member's sensitivity to guilt is the only factor which can predict accommodation with regard to the patient's demands for involvement. On the other hand, the small number of family members in the sample and the lack of clinical data of patients (such as the severity, typology and duration of their obsessive-compulsive disorder) pose limits to the generalizability of the results and point to the need for further research.},

keywords = {family, family accommodation, guilt, obsessive-compulsive disorder, relatives},

pubstate = {published},

tppubtype = {article}

}

@article{C.2015,

title = {Individual differences in guilt sensitivity scale (GSS)},

author = {Claudia Perdighe and Teresa Cosentino and Palmira Faraci and Andrea Gragnani and Angelo Maria Saliani and Francesco Mancini },

url = {https://apc.it/wp-content/uploads/2013/03/Perdighe-et-al._2015.pdf},

doi = {10.4473/TPM22.3.3},

year  = {2015},

date = {2015-05-01},

urldate = {2015-05-01},

journal = {Testing, Psychometrics, Methodology in Applied Psychology},

volume = {22},

number = {3},

pages = {349-362},

abstract = {Individual differences can be observed in the propensity to experience certain emotions; for some emotions, most notably anxiety and disgust, the notion of sensitivity was also explored, namely one's tendency to evaluate negatively a given emotion and its effects. Based on observations made in the clinical practice, the authors suggest that this distinction may be usefully applied also to guilt, creating a specific instrument to measure guilt sensitivity. In the wake of such considerations, the authors developed the Guilt Sensivity Scale, a 10-item scale. It evaluates subjective sensitivity to guilt feelings by investigating: the tendency to avoid this feeling, its influence on the patient's life, and his/her ability to tolerate it. The major goal of this study is testing the psychometric properties of this scale. To this end, the scale was administered to a sample of 916 participants. In terms of psychometric properties, the instrument seems to be characterized by a significant, promising reliability and validity.},

keywords = {guilt, Guilt scale, Individual differenc es, obsessive-compulsive disorder, Sensitivity},

pubstate = {published},

tppubtype = {article}

}

@article{Mancini2015157,

title = {Deontological guilt and obsessive compulsive disorder},

author = {Francesco Mancini and Amelia Gangemi},

editor = {ELSEVIER ScienceDirect},

url = {https://apc.it/wp-content/uploads/2013/03/Mancini-Gangemi-rev1.pdf},

doi = {10.1016/j.jbtep.2015.05.003},

issn = {0005-7916},

year  = {2015},

date = {2015-01-01},

journal = {Journal of Behavior Therapy and Experimental Psychiatry},

volume = {49, Part B},

pages = {157 - 163},

abstract = {Background and objectives The emotion of guilt plays a pivotal role in the genesis and maintenance of Obsessive-Compulsive Disorder (OCD). But what kind of guilt do OC patients want to prevent? Several studies suggest the existence of two different types of guilt emotions, namely deontological and altruistic guilt. This research suggests that the former, more than the latter, is involved in OCD. Studies in which people must hypothetically choose between killing one person to save a few (consequentialist choice) or take no action and allow things to take their course (omission choice), have found that the latter is consistent with the “Do not play God” moral principle whereas the former is consistent with altruistic motivations. This paper is aimed at verifying whether both OC patients, with no induction, and nonclinical participants, after the induction of deontological guilt prefer omission more often than a consequentialist option. It is hypothesized that people with OCD will be motivated to avoid feeling deontological guilt and thus will be more likely to opt for omission. Similarly, nonclinical participants who receive a deontological guilt induction will also be more likely to choose omission. Method In two studies participants were given seven scenarios (four moral dilemmas, three control scenarios). Twenty patients with OCD, 20 anxious controls, and 20 healthy participants took part in study 1. In study 2, we recruited 70 healthy participants who were randomly assigned to receive a deontological guilt or a control induction. Results Consistent with hypotheses, in Study 1 OC patients preferred omission, instead of the consequentialist option, moreso than did the clinical and nonclinical controls. In Study 2, the group receiving the deontological guilt induction preferred omission to a greater extent than did the altruistic group. Limitations The present study cannot establish that the goal of preventing or neutralizing deontological guilt actually drives obsessions and compulsions. Conclusions These results provide further evidence that people with OCD are more sensitive to deontological guilt, compared to other people. They thus contribute to improve the moral appraisal theory of OCD.},

note = {Special Issue: Innovations in Understanding and Treating Obsessive-Compulsive Disorder},

keywords = {Altruistic guilt emotion, Deontological guilt emotion, Moral trolley dilemma, obsessive-compulsive disorder},

pubstate = {published},

tppubtype = {article}

}

@article{Basile2014,

title = {Neurobiological mechanisms underlying abnormal processing of guilt, disgust and intentionality in obsessive-compulsive disorder: A critical review},

author = {Barbara Basile and Francesco Mancini},

editor = {Giovanni Fioriti Editore},

url = {https://apc.it/wp-content/uploads/2018/05/2014-neurobiological-mechanism-basile-mancini.pdf},

year  = {2014},

date = {2014-12-01},

journal = {Clinical Neuropsychiatry},

volume = {11},

number = {6},

pages = {187-193},

abstract = {Many different and innovative neuroimaging techniques have been developed in the last decades. Functional neuroimaging allows detecting what is happening in our brain at rest or while performing a specific cognitive or emotional task, while structural methods are concerned with the physical organization of the brain, considering both micro- and macro-structural aspects. Starting from these recent developments, neuroimaging techniques have been applied to healthy individuals, as well as to clinical populations. Functional and quantitative imaging research has also focused on what is going in the brain of patients suffering from Obsessive-Compulsive Disorder (OCD). There is consisting clinical and experimental evidence showing that patients suffering from OCD are particularly sensitive to guilt and disgust emotions, with both contributing to the disorder’s onset and maintenance. Further, OCD patients also show impairment in the ability to consciously control, or inhibit, specific behaviors, resulting in compulsive acting. In this review we want to provide some neurobiological evidence on the cerebral mechanisms underlying guilt and disgust processing in OCD, also considering the neural aspects of motor intentionality. Overall, neuroimaging studies suggest that the Fronto-Parieto-sub-Cortical circuit, including both cortical and sub-cortical regions, as well as their inter-connecting fibers, is involved in OCD. Overall, findings show more frontal regions, extending to the insular cortices, to be involved, in action monitoring, error detection, decision making, and in guilt and disgust processing, while the midbrain, including basal ganglia and extending to more parietal areas, is involved in movement selection, correction and inhibition, in intentionality and social cognition. We think these data might contribute in explaining the neurobiological substrate underlying some core aspects of OCD clinical manifestation, which does not necessarily rely upon a dysfunction of the central nervous system. We suggest here, that eventual OCD patients’ psychological processes may affect neuronal responses, contributing to the peculiarities observed. },

keywords = {Disgust, emotion processing, guilt, intentionality, Neuroimaging, obsessive-compulsive disorder},

pubstate = {published},

tppubtype = {article}

}

@article{Barcaccia2014,

title = {Towards a deeper understanding of Obsessive-Compulsive Disorder},

author = {Barbara Barcaccia and Francesco Mancini},

editor = {Giovanni Fioriti Editore S.r.l.},

url = {https://apc.it/wp-content/uploads/2013/03/2014-towards-a-deeper-understanding-of-ocd.pdf},

year  = {2014},

date = {2014-05-01},

journal = {Clinical Neuropsychiatry},

volume = {11},

number = {6},

pages = {149-151},

abstract = {Obsessive-Compulsive Disorder (OCD) has been ranked by the World Health Organization as one of the ten most handicapping illnesses by lost income and decreased quality of life (Veale 2007). It is well known that the disorder is not limited to one culture or one period of time, since it has been found in different culture or one period of time, since it has been found in different cultures and in different parts of the world, with its basic characteristics transcending cultures and eras (de Silva 2006).},

keywords = {obsessive-compulsive disorder},

pubstate = {published},

tppubtype = {article}

}

@article{Mancini2014,

title = {Do we need a cognitive theory for obsessive-compulsive disorder? Yes, we do},

author = {Francesco Mancini and Barbara Barcaccia},

editor = {Giovanni Fioriti Editore s.r.l.},

url = {http://www.clinicalneuropsychiatry.org/pdf/14-6Mancini.pdf},

year  = {2014},

date = {2014-05-01},

journal = {Clinical Neuropsychiatry},

volume = {11},

number = {6},

pages = {197-203},

abstract = {Nowadays a general trend in psychiatry and clinical psychology, claming to explain mental illness and Obsessive-Compulsive Disorder (OCD) in particular as a neurological disease, seems to be in ascendant. The purpose of this position paper is to rebut this perspective on OCD and demonstrate that an Appraisal Theory (AT) of the disorder, is necessary and sufficient in order to account for proximal determinants in the genesis (proximal determinants) and maintenance of OC sympomatology.},

keywords = {appraisal theory, beliefs, cognitive deficits, goals, obsessive-compulsive disorder},

pubstate = {published},

tppubtype = {article}

}

@article{vandenHout2014489,

title = {Behavior as information about threat in anxiety disorders: A comparison of patients with anxiety disorders and non-anxious controls},

author = {Marcel van den Hout and Amelia Gangemi and Francesco Mancini and Iris M. Engelhard and Marleen M. Rijkeboer and Marcel van Dams and Irene Klugkist},

editor = {Elsevier},

url = {http://www.sciencedirect.com/science/article/pii/S0005791614000524, citation

https://apc.itwp-content/uploads/2013/03/replication-Gangemi.pdf, article},

doi = {10.1016/j.jbtep.2014.07.002       },

issn = {0005-7916},

year  = {2014},

date = {2014-01-01},

journal = {Journal of Behavior Therapy and Experimental Psychiatry},

volume = {45},

number = {4},

pages = {489 - 495},

abstract = {AbstractBackground Gangemi, Mancini, and van den Hout (2012) argued that anxious patients use safety behaviors as information that the situation in which the safety behaviors are displayed is dangerous, even when that situation is objectively safe. This was concluded from a vignette study in which anxious patients and non-clinical controls rated the dangerousness of scripts that were safe or dangerous and in which the protagonist did or did not display safety behaviors. Patients were more likely to take safety behavior as evidence that the situation was dangerous, especially in safe situations. Their non-clinical group may not have been psychologically naïve. We critically replicated the Gangemi et al. study using a psychologically non-informed control group. Method The same materials were used and patients (Obsessive Compulsive Disorder, Panic Disorder, Social Phobia; n = 30 per sub-group) were compared to matched non-patients. Using Bayesian statistics, data from the Gangemi et al. samples and the present groups were (re-)analyzed testing the hypothesis relative to non-patients, patients infer threat from safety behaviors, especially if displayed in safe situations. Results The Gangemi et al. data yielded a Bayes factor of 3.31 in support of the hypothesis. The present Bayes Factor was smaller (2.34), but strengthened the support for the hypothesis expressed by an updated Bayes factor of 3.31 × 2.34 = 7.75. Conclusions The finding that anxious patients infer threat from safety behaviors, in particular in safe contexts, was corroborated, suggesting one way in which safety behaviors are involved in the maintenance of anxiety disorders.},

keywords = {Anxiety disorders, Behavior as information, obsessive-compulsive disorder, Panic disorder, Safety-seeking behaviors, Social phobia},

pubstate = {published},

tppubtype = {article}

}

@article{D’Olimpio01112014,

title = {Role of Deontological Guilt in Obsessive-Compulsive Disorder–Like Checking and Washing Behaviors},

author = {Francesca D’Olimpio and Francesco Mancini},

url = {https://apc.it/2014-role-of-deontological-giult-dolimpio-mancini/

},

doi = {10.1177/2167702614529549},

year  = {2014},

date = {2014-01-01},

journal = {Clinical Psychological Science},

volume = {2},

number = {6},

pages = {727-739},

abstract = {Questa è una bozza quindi questa versione non corrisponde esattamente all'orginale.



Obsessions and compulsions are driven by the goal of preventing or neutralizing guilt. We investigated whether inducing deontological versus altruistic guilt in healthy volunteers could activate checking behaviors and physical cleaning. Participants were asked to listen to stories that induced deontological guilt, altruistic guilt, or a neutral control state, and then were asked to classify 100 colored capsules into 12 small pots (Study 1) or to clean a Plexiglas cube (Study 2). Before and after hearing the story and after completing the task, participants completed a visual analog scale that assessed their current emotions. Finally, participants completed a self-report questionnaire about discomfort, doubts, and perceived performance. Participants in the deontological group checked more (Study 1), cleaned the cube more times (Study 2), and scored higher in doubts and discomfort than did participants in the altruistic or control groups. These data suggest that deontological guilt is the mental state specifically related to checking and cleaning compulsions.},

keywords = {cognition and emotion, guilt, obsessive-compulsive disorder},

pubstate = {published},

tppubtype = {article}

}

@article{D’Olimpio2013,

title = {Obsessive-compulsive disorder and propensity to guilt feelings and to disgust},

author = {Francesca D’Olimpio and Teresa Cosentino and Barbara Basile and Katia Tenore and Andrea Gragnani and Francesco Mancini},

editor = {Giovanni Fioriti Editore s.r.l.},

url = {https://apc.it/wp-content/uploads/2013/06/obsessive-compulsive-disorder-and-propensity-to-guilt.pdf},

year  = {2013},

date = {2013-10-18},

journal = {Clinical Neuropsychiatry},

volume = {10},

number = {3},

pages = {20-29},

abstract = {Objective: According to a large scientific literature, propensity to guilt feeling and to disgust plays an important role in pathogenesis and maintenance of OCD. However it is still not completely clear whether OC patients show greater guilt and disgust propensity, when compared to healthy subjects and other anxiety disorders, whether checkers and washers OCD subtypes show some differences in their guilt and disgust propensity, whether there is an association between guilt and disgust propensity and OC symptoms severity. The aim of the present research is to answer to these questions.

Method: We recruited 73 OCD patients (11 washers, 49 checkers, 13 both), 19 other-anxiety disorders patients and 87 non-clinical controls (NCC).

Results: Results confirmed that OCD patients were more prone to guilt feelings and disgust than both anxious and NCC. There were no differences between OC subtypes. Propensity to guilt feelings and to disgust was significantly correlated with OC symptom severity. Moreover, propensity to guilt feelings was significantly correlated to disgust propensity only in OCD group. 

Conclusions: These findings are in line with results of other research suggesting that OCD patients suffer of deontological guilt, which is strictly connected to disgust},

keywords = {checking, disgust propensity, guilt feelings, obsessive-compulsive disorder, washing compulsions},

pubstate = {published},

tppubtype = {article}

}