A study of the Repeated Actions Diary in patients suffering from obsessive compulsive disorder

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Date

2019-12-27

Authors

Bouvard, Martine
Fournet, Nathalie
Denis, Anne
Achachi, Ouafae
Purdon, Christine

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Publisher

Wiley

Abstract

The structured Repeated Action Diary (RAD) collects in vivo data on compulsions and their various characteristics. Certain compulsions (i.e., those ending because the patient feels certain that it is safe to stop) are then compared with uncertain compulsions. The compulsion profile in patients with obsessive compulsive disorder (OCD) was assessed by using the RAD. Thirty-two patients from two sources participated in the study. Before pooling the two subgroups, we checked that they did not differ significantly with regard to demographic and clinical variables. Patients reported several categories of compulsion. The most frequently reported compulsions were washing and checking. In a given person, checking compulsions (in contrast to washing compulsions) were often produced by several different obsessions. Almost all the patients reported repeating the compulsions because of a need to feel sure. There were far more “certain” compulsions than “uncertain” compulsions. The number of repetitions was significantly lower for certain compulsions than for uncertain compulsions. The person felt greater relief from guilt and responsibility and a greater decrease in discomfort at the end of a compulsive episode for certain compulsions than for uncertain compulsions. In conclusion, the need to ritualize (prompted by uncertainty, i.e., potential danger) might explain the maintenance (or posttreatment recurrence) of OCD in many patients. The need for certainty in the completion of a compulsion may be worth considering as a therapeutic tool. The development of an approach based on the need for certainty might help to improve treatment outcomes.

Description

This is the peer reviewed version of the following article: Bouvard, M., Fournet, N., Denis, A., Achachi, O., & Purdon, C. (2020). A study of the Repeated Actions Diary in patients suffering from obsessive compulsive disorder. Clinical Psychology & Psychotherapy, 27(2), 228–238. https://doi.org/10.1002/cpp.2422, which has been published in final form at https://doi.org/10.1002/cpp.2422. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

Keywords

compulsions, intolerance for uncertainty, obsessive compulsive disorder, repeated action diary

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