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1.
Petrocchi, Nicola; Cosentino, Teresa; Pellegrini, Valerio; Femia, Giuseppe; D’Innocenzo, Antonella; Mancini, Francesco
Compassion-Focused Group Therapy for Treatment-Resistant OCD: Initial Evaluation Using a Multiple Baseline Design Journal Article
In: Frontiers in Psychiatry, 2021, ISSN: 1664-1078.
Abstract | Links | BibTeX | Tag: compassion-focused therapy, compassionate mind training, fear of guilt, multiple baseline design, Obsessive–compulsive disorder, self-compassion, self-reassuring, selfcriticism
@article{Petrocchi2021,
title = {Compassion-Focused Group Therapy for Treatment-Resistant OCD: Initial Evaluation Using a Multiple Baseline Design},
author = {Nicola Petrocchi and Teresa Cosentino and Valerio Pellegrini and Giuseppe Femia and Antonella D’Innocenzo and Francesco Mancini},
editor = {Frontiers in Psychology},
url = {https://apc.it/2021-compassion-focused-group-therapy-2/},
doi = {doi: 10.3389/fpsyg.2020.594277},
issn = {1664-1078},
year = {2021},
date = {2021-01-12},
journal = {Frontiers in Psychiatry},
abstract = {Obsessive–compulsive disorder (OCD) is a debilitating mental health disorder that can easily become a treatment-resistant condition. Although effective therapies exist, only about half of the patients seem to benefit from them when we consider treatment refusal, dropout rates, and residual symptoms. Thus, providing effective augmentation to standard therapies could improve existing treatments. Group compassion-focused interventions have shown promise for reducing depression, anxiety, and avoidance related to various clinical problems, but this approach has never been evaluated for OCD individuals. However, cultivating compassion for self and others seems crucial for OCD patients, given the accumulating research suggesting that fear of guilt, along with isolation and self-criticism, can strongly contribute to the development and maintenance of OCD. The primary aim of this pilot study was to evaluate the acceptability, tolerability, and effectiveness of an 8-week group compassion-focused intervention for reducing OCD symptoms, depression, fear of guilt and self-criticism, and increasing common humanity and compassionate self-reassuring skills in treatment-resistant OCD patients. Using a multiple baseline experimental design, the intervention was evaluated in a sample of OCD patients (N = 8) who had completed at least 6 months of CBT treatment for OCD, but who continued to suffer from significant symptoms. Participants were randomized to different baseline assessment lengths; they then received 8 weekly, 120- min group sessions of compassion-focused therapy for OCD (CFT-OCD), and then
were tested again at post-treatment and at 1 month follow up. Despite the adverse external circumstances (post-treatment and follow-up data collection were carried out, respectively, at the beginning and in the middle of the Italian lockdown due to the COVID19 pandemic), by the end of treatment, all participants demonstrated reliable decreases in OCD symptoms, and these improvements were maintained at 4-week follow-up for seven of eight participants. The intervention was also associated with improvements in fear of guilt, self-criticism, and self-reassurance, but less consistent improvements in depression and common humanity. Participants reported high levels of acceptability of and satisfaction with the intervention. Results suggest that the intervention may be beneficial as either a stand-alone treatment or as an augmentation to other treatments.},
keywords = {compassion-focused therapy, compassionate mind training, fear of guilt, multiple baseline design, Obsessive–compulsive disorder, self-compassion, self-reassuring, selfcriticism},
pubstate = {published},
tppubtype = {article}
}
Obsessive–compulsive disorder (OCD) is a debilitating mental health disorder that can easily become a treatment-resistant condition. Although effective therapies exist, only about half of the patients seem to benefit from them when we consider treatment refusal, dropout rates, and residual symptoms. Thus, providing effective augmentation to standard therapies could improve existing treatments. Group compassion-focused interventions have shown promise for reducing depression, anxiety, and avoidance related to various clinical problems, but this approach has never been evaluated for OCD individuals. However, cultivating compassion for self and others seems crucial for OCD patients, given the accumulating research suggesting that fear of guilt, along with isolation and self-criticism, can strongly contribute to the development and maintenance of OCD. The primary aim of this pilot study was to evaluate the acceptability, tolerability, and effectiveness of an 8-week group compassion-focused intervention for reducing OCD symptoms, depression, fear of guilt and self-criticism, and increasing common humanity and compassionate self-reassuring skills in treatment-resistant OCD patients. Using a multiple baseline experimental design, the intervention was evaluated in a sample of OCD patients (N = 8) who had completed at least 6 months of CBT treatment for OCD, but who continued to suffer from significant symptoms. Participants were randomized to different baseline assessment lengths; they then received 8 weekly, 120- min group sessions of compassion-focused therapy for OCD (CFT-OCD), and then
were tested again at post-treatment and at 1 month follow up. Despite the adverse external circumstances (post-treatment and follow-up data collection were carried out, respectively, at the beginning and in the middle of the Italian lockdown due to the COVID19 pandemic), by the end of treatment, all participants demonstrated reliable decreases in OCD symptoms, and these improvements were maintained at 4-week follow-up for seven of eight participants. The intervention was also associated with improvements in fear of guilt, self-criticism, and self-reassurance, but less consistent improvements in depression and common humanity. Participants reported high levels of acceptability of and satisfaction with the intervention. Results suggest that the intervention may be beneficial as either a stand-alone treatment or as an augmentation to other treatments.
were tested again at post-treatment and at 1 month follow up. Despite the adverse external circumstances (post-treatment and follow-up data collection were carried out, respectively, at the beginning and in the middle of the Italian lockdown due to the COVID19 pandemic), by the end of treatment, all participants demonstrated reliable decreases in OCD symptoms, and these improvements were maintained at 4-week follow-up for seven of eight participants. The intervention was also associated with improvements in fear of guilt, self-criticism, and self-reassurance, but less consistent improvements in depression and common humanity. Participants reported high levels of acceptability of and satisfaction with the intervention. Results suggest that the intervention may be beneficial as either a stand-alone treatment or as an augmentation to other treatments.
2.
Basile, Barbara; Mancini, Francesco; Macaluso, Emiliano; Caltagirone, Carlo; Bozzali, Marco
Abnormal processing of deontological guilt in obsessive--compulsive disorder Journal Article
In: Brain Structure and Function, vol. 219, no 4, pp. 1321–1331, 2013, ISSN: 1863-2661.
Abstract | Links | BibTeX | Tag: Altruistic guilt, Deontological guilt, Emotional processing, guilt, Neuroimaging, Obsessive–compulsive disorder
@article{andBozzali2013,
title = {Abnormal processing of deontological guilt in obsessive--compulsive disorder},
author = {Barbara Basile
and Francesco Mancini
and Emiliano Macaluso
and Carlo Caltagirone
and Marco Bozzali},
editor = {Springer Berlin Heidelberg},
url = {https://apc.it/wp-content/uploads/2013/06/Basile_Mancini_2013_Guilt_in_OCD_fMRI.pdf},
doi = {10.1007/s00429-013-0570-2},
issn = {1863-2661},
year = {2013},
date = {2013-12-01},
journal = {Brain Structure and Function},
volume = {219},
number = {4},
pages = {1321--1331},
abstract = {Guilt plays a significant role in the occurrence and maintenance of obsessive--compulsive disorder (OCD). Two major types of guilt have been identified: one deriving from the transgression of a moral rule (deontological guilt DG), another (altruistic guilt AG), relying on the assumption of having compromised a personal altruistic goal. Clinical evidence suggests that OCD patients are particularly sensitive to DG, but not AG. In this functional magnetic resonance imaging (fMRI) study, we investigated brain response of OCD patients while processing DG and AG stimuli. A previously validated fMRI paradigm was used to selectively evoke DG and AG, and anger and sadness, as control emotions in 13 OCD patients and 19 healthy controls. Patients' behavioral results showed a prominent attitude to experience guilt, compared to controls, while accomplishing task. fMRI results revealed that patients have reduced activation in the anterior cingulate (ACC) and frontal gyrus when experiencing guilt, regardless of its specific type (DG or AG). When separately considering each type of guilt (against each of its control), patients showed decreased activation in the ACC, the insula and the precuneus, for DG. No significant differences were observed between groups when processing AG, anger or sad stimuli. This study provides evidence for an abnormal processing of guilt, and specifically DG, in OCD patients. We suggest that decreased activation may reflect patients' cerebral efficiency, which derives from their frequent exposure to guilty feelings (``neural efficiency hypothesis''). In conclusion, our study confirms a selective abnormal processing of guilt, and specifically DG, in OCD.},
keywords = {Altruistic guilt, Deontological guilt, Emotional processing, guilt, Neuroimaging, Obsessive–compulsive disorder},
pubstate = {published},
tppubtype = {article}
}
Guilt plays a significant role in the occurrence and maintenance of obsessive--compulsive disorder (OCD). Two major types of guilt have been identified: one deriving from the transgression of a moral rule (deontological guilt DG), another (altruistic guilt AG), relying on the assumption of having compromised a personal altruistic goal. Clinical evidence suggests that OCD patients are particularly sensitive to DG, but not AG. In this functional magnetic resonance imaging (fMRI) study, we investigated brain response of OCD patients while processing DG and AG stimuli. A previously validated fMRI paradigm was used to selectively evoke DG and AG, and anger and sadness, as control emotions in 13 OCD patients and 19 healthy controls. Patients' behavioral results showed a prominent attitude to experience guilt, compared to controls, while accomplishing task. fMRI results revealed that patients have reduced activation in the anterior cingulate (ACC) and frontal gyrus when experiencing guilt, regardless of its specific type (DG or AG). When separately considering each type of guilt (against each of its control), patients showed decreased activation in the ACC, the insula and the precuneus, for DG. No significant differences were observed between groups when processing AG, anger or sad stimuli. This study provides evidence for an abnormal processing of guilt, and specifically DG, in OCD patients. We suggest that decreased activation may reflect patients' cerebral efficiency, which derives from their frequent exposure to guilty feelings (``neural efficiency hypothesis''). In conclusion, our study confirms a selective abnormal processing of guilt, and specifically DG, in OCD.
3.
Mancini, Francesco; Gangemi, Amelia; Perdighe, Claudia; Marini, Chiara
Not just right experience: Is it influenced by feelings of guilt? Journal Article
In: Journal of Behavior Therapy and Experimental Psychiatry, vol. 39, no 2, pp. 162 - 176, 2008, ISSN: 0005-7916.
Abstract | Links | BibTeX | Tag: guilt, Not just right experience, Obsessive–compulsive disorder, Obsessive–compulsive features, Trait-guilt
@article{Mancini2008162,
title = {Not just right experience: Is it influenced by feelings of guilt?},
author = {Francesco Mancini and Amelia Gangemi and Claudia Perdighe and Chiara Marini},
editor = {Elsevier ScienceDirect},
url = {https://apc.it/wp-content/uploads/2013/06/2008_Non-just-right-experience_is-it-influenced-by-feelings-of-guilt.pdf},
doi = {10.1016/j.jbtep.2007.02.002},
issn = {0005-7916},
year = {2008},
date = {2008-01-01},
journal = {Journal of Behavior Therapy and Experimental Psychiatry},
volume = {39},
number = {2},
pages = {162 - 176},
abstract = {Individuals with obsessive–compulsive disorder (OCD) experience increased guilt. Further, these individuals often report uncomfortable sensations of things being not quite right (“not just right experiences”—NJREs). As to the relation between these psychological phenomena, it was hypothesized that feelings of guilt may enhance NJRE. In two experiments, we demonstrated that the induction of a guilty emotion resulted in increased NJRE, and this finding was qualified by an interaction with trait guilt. Induced guilt was followed by stronger feelings of things being not just right only in high-trait-guilt participants. In the low-trait-guilt participants NJRE was weaker. Moreover, we found a meaningful relationship between both NJRE and trait guilt and OCD features.},
keywords = {guilt, Not just right experience, Obsessive–compulsive disorder, Obsessive–compulsive features, Trait-guilt},
pubstate = {published},
tppubtype = {article}
}
Individuals with obsessive–compulsive disorder (OCD) experience increased guilt. Further, these individuals often report uncomfortable sensations of things being not quite right (“not just right experiences”—NJREs). As to the relation between these psychological phenomena, it was hypothesized that feelings of guilt may enhance NJRE. In two experiments, we demonstrated that the induction of a guilty emotion resulted in increased NJRE, and this finding was qualified by an interaction with trait guilt. Induced guilt was followed by stronger feelings of things being not just right only in high-trait-guilt participants. In the low-trait-guilt participants NJRE was weaker. Moreover, we found a meaningful relationship between both NJRE and trait guilt and OCD features.
4.
Mancini, Francesco; Gragnani, Andrea; Orazi, Floriana; Pietrangeli, Maria Grazia
Obsessions and compulsions: normative data on the Padua Inventory from an Italian non-clinical adolescent sample Journal Article
In: Behaviour Research and Therapy, vol. 37, no 10, pp. 919 - 925, 1999, ISSN: 0005-7967.
Abstract | Links | BibTeX | Tag: Adolescent, Italian, Obsessive–compulsive disorder, Padua Inventory
@article{Mancini1999919,
title = {Obsessions and compulsions: normative data on the Padua Inventory from an Italian non-clinical adolescent sample},
author = {Francesco Mancini and Andrea Gragnani and Floriana Orazi and Maria Grazia Pietrangeli},
url = {https://apc.it/wp-content/uploads/2012/11/PI%20and%20Adolescent%20199.pdf},
doi = {10.1016/S0005-7967(98)00195-8},
issn = {0005-7967},
year = {1999},
date = {1999-01-01},
journal = {Behaviour Research and Therapy},
volume = {37},
number = {10},
pages = {919 - 925},
abstract = {In the present study the structure of obsessive–compulsive phenomena in non-clinical adolescents was investigated by `The Padua Inventory' (PI). The PI is a self-report measure of obsessive and compulsive symptoms which is used in clinical and research settings. The use of PI in adolescents has been limited by the lack of normative data. Consequently, adolescent validation has both theoretical and practical implications. PI was administered to 566 normal Italian high school subjects, ranging in age from 15 to 18 years. The mean total score of PI and the mean score of `mental activities', `becoming contaminated' and `urges and worries' sub-scales points to significant differences between males and females. Females reported more obsessions and cleaning rituals than males. Males show more urges and fears than females. Moreover, our data underline that younger subjects get higher mean scores than older subjects in all scales.},
keywords = {Adolescent, Italian, Obsessive–compulsive disorder, Padua Inventory},
pubstate = {published},
tppubtype = {article}
}
In the present study the structure of obsessive–compulsive phenomena in non-clinical adolescents was investigated by `The Padua Inventory' (PI). The PI is a self-report measure of obsessive and compulsive symptoms which is used in clinical and research settings. The use of PI in adolescents has been limited by the lack of normative data. Consequently, adolescent validation has both theoretical and practical implications. PI was administered to 566 normal Italian high school subjects, ranging in age from 15 to 18 years. The mean total score of PI and the mean score of `mental activities', `becoming contaminated' and `urges and worries' sub-scales points to significant differences between males and females. Females reported more obsessions and cleaning rituals than males. Males show more urges and fears than females. Moreover, our data underline that younger subjects get higher mean scores than older subjects in all scales.