I obsessively clean because deontological guilt makes me feel physiologically disgusted!

Ottaviani, Cristina; Collazzoni, Alberto; D’Olimpio, Francesca; Moretta, Tania; Mancini, Francesco

doi:10.1016/j.jocrd.2018.01.004

Cited by 17 publications

(20 citation statements)

References 58 publications

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“…This effect has not been detected in some studies (34), but Reuven et al (35) found it particularly prominent in OCD. Ottaviani et al (36) found that in nonclinical participants, the induction of a specific sense of guilt, the deontological guilt, which is related to having transgressed moral norms, regardless of whether someone has been harmed (37,38) elicits obsessivelike washing behaviors, which reduce guilt and increase positive emotions (39).…”

Section: Introductionmentioning

confidence: 99%

Imagery Rescripting on Guilt-Inducing Memories in OCD: A Single Case Series Study

Tenore¹,

Basile²,

Cosentino³

et al. 2020

Front. Psychiatry

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Background and objectives: Criticism is thought to play an important role in obsessivecompulsive 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.

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Section: Introductionmentioning

confidence: 99%

Imagery Rescripting on Guilt-Inducing Memories in OCD: A Single Case Series Study

Tenore¹,

Basile²,

Cosentino³

et al. 2020

Front. Psychiatry

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“…On the contrary, in one recent study, the inducement of DG but not AG led to the "Lady Macbeth" effect (D'Olimpio and Mancini, 2014) 10 . This study was further replicated by Ottaviani et al (2018a). They found that the inducement of DG, but not AG, involved not only careful washing, but also the physiological activation typical of disgust observed by way of heart rate variability (HRV).…”

Section: The Relationship Between Dg Feeling and Disgustmentioning

confidence: 68%

“…Two other studies (D'Olimpio and Mancini, 2014;Ottaviani et al, 2018a) found that, in non-clinical SS, DG inducement activated obsessive-like checking and washing behaviors to a greater extent than inducement of AG. Giacomantonio et al (2019) found that in the condition of uncertainty, non-clinical participants spent more time in checking behaviors when they experienced DG rather than AG.…”

Section: Implications For Psychopathologymentioning

confidence: 92%

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Deontological and Altruistic Guilt Feelings: A Dualistic Thesis

Mancini

Gangemi

2021

Front. Psychol.

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In this paper we argue in favor of the existence of two different guilt feelings: altruistic guilt (AG) and deontological guilt (DG). AG arises from having harmed, through one's own action or omission, an innocent victim, while DG arises from the transgression of an internalized norm. In most daily experiences of guilt feelings both types are present, but we argue that they are not traceable to each other and that each can be present without the other. We show that the two guilt feelings can be distinguished with reference to behavioral, cognitive, and neurophysiological aspects. Moreover, we demonstrate that they are differently related to other processes and emotions. AG is connected with pain, empathy and ToM. DG is strongly related to disgust. We briefly illustrate some implications for moral psychology and clinical psychology.

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“…One might feel the emotion of guilt based on compassionate/altruistic principles without the transgression of moral norms (i.e., altruistic guilt), or based on the transgression of moral norms without the presence of actual victims (i.e., deontological guilt; Mancini, 2019). Intriguingly, it is the deontological type of guilt, and not the altruistic/compassionate guilt, that is associated with the feeling of disgust, consequently with more washing behaviors (the Lady Macbeth effect), and also is the type experienced (and dreaded) more by OCD patients (D'Olimpio and Mancini, 2014;Ottaviani et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Compassion-Focused Group Therapy for Treatment-Resistant OCD: Initial Evaluation Using a Multiple Baseline Design

et al. 2021

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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 COVID-19 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.

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I obsessively clean because deontological guilt makes me feel physiologically disgusted!

Cited by 17 publications

References 58 publications

Imagery Rescripting on Guilt-Inducing Memories in OCD: A Single Case Series Study

Imagery Rescripting on Guilt-Inducing Memories in OCD: A Single Case Series Study

Deontological and Altruistic Guilt Feelings: A Dualistic Thesis

Compassion-Focused Group Therapy for Treatment-Resistant OCD: Initial Evaluation Using a Multiple Baseline Design

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