Biomedical subjects

R Ladouceur

Publications and source records attributed to R Ladouceur.

At least 37 records · Page 2Linked to original sources

PubMed2000

Strategies used with intrusive thoughts: a comparison of OCD patients with anxious and community controls.

Models of intrusive thoughts attribute a key role to strategies used by people to cope with their unwanted cognitions. In an extension of previous work, the authors conducted structured interviews with 38 people with obsessive-compulsive disorder, 38 people with another anxiety disorder, and 19 healthy volunteers. The interview identified the repertoire of strategies used with the participant's most troubling thought. The 2 clinical groups reported significantly more strategies than the nonclinical group. The clinical groups also reported significantly greater intensity of the thought and their emotional response and lower efficacy for the strategies. People with OCD reported a significantly higher proportion of strategies that were specifically linked to the thought content (as distinct from nonspecific strategies that were only linked sequentially in time). The results identify both common and differential characteristics of intrusive cognition in anxiety disorders.

Adult↗

PubMed2000

Efficacy of a cognitive-behavioral treatment for generalized anxiety disorder: evaluation in a controlled clinical trial.

Recent advances in the understanding of worry have led to the development of treatments for generalized anxiety disorder (GAD). The present study tested a GAD treatment that targeted intolerance of uncertainty, erroneous beliefs about worry, poor problem orientation, and cognitive avoidance. Twenty-six primary GAD patients were randomly allocated to a treatment condition (n = 14) or a delayed treatment control condition (n = 12). Self-report, clinician, and significant other ratings assessed GAD and associated symptoms. The results show that the treatment led to statistically and clinically significant change at posttest and that gains were maintained at 6- and 12-month follow-ups. Furthermore, 20 of 26 participants (77%) no longer met GAD diagnostic criteria following treatment. With regard to the treatment's underlying model, the results show that intolerance of uncertainty significantly decreased over treatment and that gains were maintained at both follow-ups. Although nonspecific factors were not significant predictors of treatment outcome, their role in the treatment of GAD requires further investigation.

Adult↗

PubMed1999

Responsibility and perfectionism in OCD: an experimental study.

Cognitive models of obsessive-compulsive disorder (OCD) suggest a number of different variables that may play a role in the development and maintenance of obsessive compulsive symptoms [Freeston, M. H., Rhéaume, J., & Ladouceur, R. (1996) Correcting faulty appraisals of obsessional thoughts. Behaviour Research and Therapy, 34, 433-446]. This study's aim was to verify the effect of perfectionism and excessive responsibility on checking behaviors and related variables. Twenty-four moderately perfectionistic subjects (MP) and 27 highly perfectionistic subjects (HP) were submitted to a manipulation of responsibility (low and high). After each manipulation, they had to perform a classification task during which checking behaviors were observed. Results indicate that more checking behaviors (hesitations, checking) occurred in the high responsibility condition than in the low responsibility condition for subjects of both groups. After executing the task in the high responsibility condition, HP subjects reported more influence over and responsibility for negative consequences than MP subjects. These results suggest that high perfectionistic tendencies could predispose individuals to overestimate their perceived responsibility for negative events. Furthermore, perfectionism could be conceived as playing a catalytic role in the perception of responsibility. Results are discussed according to cognitive models of OCD.

Adult↗

PubMed1999

Prevalence of problem gambling: a replication study 7 years later.

OBJECTIVES: To investigate the relationship between availability of gambling activities and participation in gambling, maximum amount of money lost in 1 day to gambling, and number of pathological gamblers. METHOD: Two random samples (1002 and 1257 adults) were surveyed 7 years apart using the South Oaks Gambling Screen to identify pathological gamblers. RESULTS: Seven years later, significantly more people reported having gambled, and the number of pathological gamblers had increased by 75%. CONCLUSIONS: These findings support the hypothesis that increases in the availability of gambling are related to increases in the number of problem gamblers.

Adult↗

PubMed1998

Generalized anxiety disorder: a preliminary test of a conceptual model.

This study presents a preliminary test of a conceptual model of Generalized Anxiety Disorder (GAD) which is theoretically driven and has clear clinical implications. The model's main features are intolerance of uncertainty, beliefs about worry, poor problem orientation and cognitive avoidance, Subjects were 24 GAD patients and 20 non clinical control subjects. The results show that all main components of the model were highly related to the discriminant function and that intolerance of uncertainty was pivotal in distinguishing GAD patients from non clinical subjects. Further, the discriminant function derived from these four process variables was very effective for classifying GAD patients and non clinical subjects into their respective groups. Overall, 82% of subjects were correctly classified as 18 of 24 subjects in the GAD group and 18 of 20 subjects in the non clinical group were properly identified. The results are discussed in terms of the proposed model of GAD and its clinical implications.

Adult↗

PubMed1998

Cognitive treatment of pathological gamblers.

This study evaluates the efficacy of a cognitive treatment for pathological gambling. Five pathological gamblers were treated in a multiple baseline across subjects design. Cognitive correction targeted the erroneous perceptions towards the notion of randomness. Four subjects reported a clinically significant decrease in the urge to gamble, an increase in their perception of control, and no longer met the DSM-IV criteria for pathological gambling. Therapeutic gains were maintained at the 6 month follow-up. Results suggest that cognitive therapy targeting the misconception of the notion of randomness is a promising treatment for pathological gambling, a refractory disorder to most therapeutic interventions.

Adult↗

PubMed1998

Stimulus-control: nonpharmacologic treatment for insomnia.

OBJECTIVES: To evaluate the efficacy and applicability of a behavioural treatment for insomnia that can be administered by family physicians in various clinical settings. DESIGN: Efficacy of the treatment was evaluated by single-case experimental designs (multiple baseline across subjects). Applicability was assessed through semistructured interviews with physicians. SETTING: Two private offices, two offices in community health centres, and one office in a family medicine unit. PARTICIPANTS: Six general practitioners and 24 chronic insomniac patients recruited through media advertisements and from physicians' practices. Of an initial 38 subjects screened, six were excluded for sleep-onset latency less than 30 minutes, five for psychological conditions, one for physical handicaps, and two for other reasons. INTERVENTIONS: Physicians used stimulus-control treatment during individual therapeutic sessions. Patients using hypnotics were encouraged to taper off their medications after treatment was initiated. MAIN OUTCOME MEASURES: Time it took patients to get to sleep (sleep-onset latency), amount of hypnotic use, and practitioners' evaluation of the treatment. RESULTS: Fifteen patients completed the treatment; 80% of them reduced their sleep-onset latency. Six of the seven patients using hypnotics at the beginning of the study reduced or stopped their medications. All therapeutic gains were maintained at 3 and 6 months. Physicians thought stimulus-control treatment could be used in medical practice, but specified that it was most useful for highly motivated patients. CONCLUSION: Family physicians can use stimulus-control treatment effectively for patients with chronic insomnia. This nonpharmacologic approach could help motivated patients reduce their use of hypnotics.

Adult↗

PubMed1997

What do patients do with their obsessive thoughts?

Current models of Obsessive-Compulsive Disorder (OCD) accord a key role to neutralization in the maintenance of obsessional thoughts. Although overt compulsions are well known and have frequently been described in the literature, their cognitive equivalents have not been described to any great extent. This study systemically described the repertoire of strategies used by 29 OCD patients with dominant obsessive thoughts. Extensive repertoires were reported, characterized by low to moderate mean efficacy in removing the thoughts. The majority of strategies were not cognitive rituals nor neutralization in the narrow sense of 'attempts at putting right', even though they were effortful, intentional, and deployed in a strategic way. The results are discussed in terms of the need for a broad definition of neutralization that includes all strategies including coping strategies. Clinical implications are discussed and comprehensive response prevention is recommended for the treatment of obsessive thoughts.

Adaptation, Psychological↗

PubMed1997

Excessive responsibility in obsessional concerns: a fine-grained experimental analysis.

Excessive responsibility has been suggested as a central cognitive variable associated with Obsessive-Compulsive Disorder (OCD) (Rachman, 1993, Behaviour Research and Therapy, 31, 149-154; Salkovskis, 1985, Behaviour Research and Therapy, 23, 571-583; Salkovskis, 1989, Behaviour Research and Therapy, 27, 677-682; Salkovskis, 1995, Current controversies in the anxiety disorders). Several studies using questionnaires (e.g. Rhéaume, Freeston, Dugas, Letarte & Ladouceur, 1995, Behaviour Research and Therapy, 33, 785-794) and experimental manipulations (Ladouceur et al., 1995, Behaviour Research and Therapy, 33, 937-946; Lopatka & Rachman, 1995, Behaviour Research and Therapy, 33, 673-684) have shown evidence for such a link between responsibility and obsessive-compulsive symptoms. Responsibility has been defined as the belief of possessing a pivotal power to provoke or preventing crucial negative consequences (Salkovskis et al., 1992 cited in Salkovskis, 1995, Current controversies in the anxiety disorders). This definition emphasizes two related cognitive distortions: personal influence and potential negative consequences. The respective roles of each component and their potential interaction need to be clarified. The present study tests the effects of an experimental manipulation of both influence and negative consequences on perceived responsibility and checking behavior during a classification task. Seventy-seven subjects were divided into four experimental conditions: the Combined condition, the Influence condition, the Negative Consequences condition and the Control condition. After the experimental manipulation, subjects from each condition had to classify capsules in semi-transparent bottles. Results showed that personal influence is the best predictor of perceived responsibility. Although increased potential negative consequences were sufficient to trigger hesitations, combined influence and negative consequences were necessary to produce modifications. These results are consistent with the results obtained by the questionnaires (e.g. Rhéaume, Ladouceur, Freeston & Letarte, 1995a, Behaviour Research and Therapy, 33, 159-169) and previous manipulations (e.g. Ladouceur et al., 1995).

Adult↗

PubMed1997

Psychological characteristics of volunteers in studies on gambling.

Advertisements were published in local newspapers asking for volunteers to participate in a study on gambling. A battery of eleven questionnaires was mailed to the subjects assessing pathological gambling behavior, sociodemographic characteristics, motivation to gamble, erroneous perceptions about gambling, superstitious beliefs, depressive symptoms, social anxiety and avoidance, alcohol and drug abuse, problem-solving skills, and marital satisfaction. Subjects received $10 when they returned the questionnaires fully completed. Response rate was over 95%. Surprisingly, 29% of the respondents met the criterion for probable pathological gambling (score of 5 or more on the SOGS) and a further 16% were identified as potential pathological gamblers (scores of 3 or 4). The potential and probable pathological gamblers showed significant differences on motivational and cognitive variables related to gambling compared to those subjects who showed no signs of pathological gambling. The probable pathological gamblers reported significantly more signs of poor psychosocial functioning than the other two groups, including depressive symptoms, poor problem orientation, drug and alcohol abuse, and interpersonal conflict. The practical and theoretical implications of these results are discussed.

Journal Article↗

PubMed1997

Cognitive-behavioral treatment of obsessive thoughts: a controlled study.

Twenty-nine patients with obsessive-compulsive disorder as diagnosed in accordance with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; American Psychiatric Association, 1987) who did not have overt compulsive rituals were randomly assigned to treatment and waiting-list conditions. Patients in the treatment condition received cognitive-behavioral therapy consisting of a detailed explanation of the occurrence and maintenance of obsessive thoughts, exposure to obsessive thoughts, response prevention of all neutralizing strategies, cognitive restructuring, and relapse prevention. Compared with waiting-list patients, treated patients improved significantly on measures of severity of obsessions, current functioning, self-report obsessive-compulsive symptoms, and anxiety. When waiting-list patients were subsequently treated, the combined group improved on all outcome measures. Treatment gains were maintained at 6-month follow-up. Results indicate that cognitive-behavioral therapy is effective in the treatment of patients with obsessive thoughts, a group that has often been considered resistant to treatment.

Adult↗

PubMed1997

Cognitive and behavioral treatment of pathological gambling: a controlled study.

This study evaluated the efficacy of a cognitive-behavioral treatment package for pathological gambling. Twenty-nine men who met criteria for pathological gambling in accordance with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; DSM-III-R; American Psychiatric Association, 1987) were randomly assigned to treatment or wait-list control. The treatment included 4 components: (a) cognitive correction of erroneous perceptions about gambling, (b) problem-solving training, (c) social skills training, and (d) relapse prevention. The dependent variables were the South Oaks Gambling Screen, perception of control, frequency of gambling, perceived self-efficacy, desire to gamble, and number of DSM-III-R criteria met by participants. Posttest results indicated highly significant changes in the treatment group on all outcome measures, and analysis of data from 6- and 12-month follow-ups revealed maintenance of therapeutic gains. Recommendations for clinical interventions are discussed and focus on the cognitive correction of erroneous perceptions of gambling.

Adult↗

PubMed1997

Behavioral expressions of intolerance of uncertainty in worry. Experimental findings.

Intolerance of uncertainty has been related to increased worry in recent conceptual models of Generalized Anxiety Disorder (GAD). The present study examines the relationship between a measure of intolerance of uncertainty, the Intolerance of Uncertainty scale (IU), and behaviors associated with GAD, such as slowness of execution and amount of evidence required before decision making. A total of 49 individuals participated in the study. Three experimental tasks varying in level of ambiguity and difficulty were used. The analyses show a positive correlation between scores on the IU and number of cues required before responding in a moderately ambiguous inference task. However, scores on the IU were not significantly related to responses in an unambiguous task (regardless of the level of difficulty) or in a highly ambiguous task. The results suggest that high worriers have a lower threshold of tolerance of uncertainty for intermediate levels of ambiguity. The results are discussed in terms of theoretical models of GAD.

Adult↗

PubMed1996

Correction of inflated responsibility in the treatment of obsessive-compulsive disorder.

This study evaluates the efficacy of a cognitive treatment for obsessive-compulsive disorder (OCD). Four patients with OCD whose major complaints were checking rituals were treated in a multiple baseline across subjects design. Cognitive correction targeted inflated responsibility, without any exposure or response prevention. All subjects reported a clinically significant decrease in interference caused by rituals, a 52-100% reduction in Y-BOCS scores, and a decrease in perceived responsibility. Therapeutic gains were maintained at follow-up (6 and 12 months) for three patients. Results suggest that cognitive therapy targeting inflated responsibility is a promising alternative to exposure-based treatment.

Adult↗

PubMed1996

Obsessive-compulsive disorder. Diagnosis and management.

We present three diagnostic tools to identify overt compulsive rituals, obsessional thinking, and neutralizing behaviours in obsessive-compulsive disorder (OCD) and describe the most effective cognitive-behavioural technique for treating obsessional thinking without overt rituals. Basic dysfunctional beliefs that lead to OCD are explained and integrated in the treatment model. We suggest how combined therapy can be used to tread OCD.

Antidepressive Agents↗

PubMed1995

Inflated responsibility in obsessive compulsive disorder: validation of an operational definition.

An excessive sense of responsibility has been identified in obsessive-compulsive disorder (OCD) where patients evaluate their thoughts in terms of the harm they could cause to themselves or others. In a new definition, responsibility was defined as the belief that one possesses pivotal power to provoke or prevent subjective crucial negative outcomes. In order to empirically test the validity of this definition, two studies used a semi-idiographic design to evaluate responsibility across ambiguous situations related to major OCD themes like contamination, verification, somatic concerns, loss of control, making errors, sexuality and magical thinking. In the first study, 397 volunteer adults participated in the experiment. For each situation, subjects briefly described a possible negative outcome and then rated this outcome on four dimensions: (1) probability; (2) severity; (3) influence; and (4) pivotal influence, using a 9-point Likert scale. Finally Ss rated perceived responsibility and personal relevance. Highly relevant situations were retained for the final analysis. Regression analysis suggested that influence and pivotal influence were better predictors of responsibility ratings than probability and severity. The second study examined the effect of the order of the questions on the responsibility ratings. A first group of Ss (n = 85) answered the Responsibility Questionnaire (RQ) in the original order, while a second group (n = 53) rated responsibility before the other ratings. Regression analysis showed that although proportion of variance explained diminished when the order was reversed, pivotal influence was still the best predictor of responsibility. Results are discussed in terms of current models of OCD and implications for future research and cognitive treatment are identified.

Adolescent↗

PubMed1995

Perfectionism, responsibility and obsessive-compulsive symptoms.

Although both perfectionism and responsibility have been associated with OCD at a theoretical level, responsibility has been the focus of a number of recent articles. This study was conducted in order to empirically test the relative importance of perfectionism and responsibility in Obsessive-Compulsive symptoms. Perfectionism and two measures of responsibility showed moderate correlations with Obsessive-Compulsive symptoms. A hierarchical regression analysis revealed that although responsibility accounted for more variance, perfectionism was still a significant predictor of Obsessive-Compulsive symptoms, once responsibility had been partialled out. These results suggest that although responsibility is related to OC symptoms, perfectionism is also independently associated. While responsibility has received much attention lately from OCD theorists and clinicians, perfectionism may also play a significant if underestimated role in some OC patients. The results are discussed in terms of their implications for current cognitive models and treatment procedures that give responsibility a central role in OCD. A new definition of perfectionism is also proposed.

Adult↗

PubMed1995

Experimental manipulations of responsibility: an analogue test for models of obsessive-compulsive disorder.

Several authors attribute excessive responsibility a predominant role in Obsessive-Compulsive Disorder (OCD) [Salkovskis, P. M. (1985) Behaviour Research and Therapy, 23, 571-583; Rachman, S. (1993) Behaviour Research and Therapy, 31, 149-154; van Oppen, P. & Arntz, A. (1994) Behaviour Research and Therapy, 32, 79-87]. The present studies aimed at demonstrating the link between different levels of perceived responsibility and checking behaviors by experimentally manipulating responsibility in non-clinical Ss. In the first study, a sound recognition task was used to compare checking behaviors in Ss with high (HR) and low (LR) perceived responsibility. Only one variable was significantly different, Ss from the HR group reporting more anxiety during the task than Ss from the LR group. Results did not support a link between responsibility and checking behavior. In a second study HR and LR Ss were compared on a manual classification task. Subjects from the HR group hesitated and checked more, and reported more preoccupation with errors and anxiety during the task than Ss from the LR group. Since perceived severity of the outcome was the most variable affected by the manipulation, the implications for current models of OCD are discussed and an alternative explanation is attempted. Finally, clinical implications are examined and suggestions are made for future directions of research.

Adult↗