‘Not just right’ experiences and incompleteness in body dysmorphic disorder

The Brown Incompleteness Scale (BINCS): Measure development and initial evaluation

“…Items on the task completion subscale encompass difficulty with initiating and completing tasks including related difficulties with prioritization and perfectionism. Consistent with behavioral research on incompleteness (Summers et al, 2014, 2017) the sensory subscale taps phenomena across multiple sensory modalities.…”

“…Clinical experience suggests that manifestations of incompleteness can range from procrastination and perfectionism with excessive attention to marked difficulty with planning and lost productivity leading to the inability to sustain goal directed behavior (Pallanti, Barnes, Pittenger, & Eisen, 2017; Rasmussen, Eisen, & Greenberg, 2013). Thus, it is not surprising that incompleteness is broadly associated with OC spectrum disorders including OCD (Sibrava, Boisseau, Eisen, Mancebo, & Rasmussen, 2016), body dysmorphic disorder (Summers, Matheny, & Cougle, 2017), and compulsive hoarding (Pertusa & Fonseca, 2014) and with characteristics such as perfectionism (Ecker, Kupfer, & Gönner, 2014), and sensory phenomena and tic-like experiences (Miguel et al, 2000). The clinical significance of incompleteness is also underscored by its associations with poor treatment outcome, increased comorbidity, and higher degrees of functional impairment (Sibrava et al, 2016).…”

“…Complementing theses existing scales is a growing body of behavioral research investigating novel paradigms designed to elicit incompleteness experiences in laboratory settings (Cougle, Goetz, Fitch, & Hawkins, 2011; Fitch & Cougle, 2013; Pietrefesa & Coles, 2008; Summers et al, 2014, 2017). For example, Summers et al (2017) used in vivo visual, auditory and tactile NJRE tasks aimed at evoking the sensations that things do not look, sound, or feel right and found strong correspondence between behavioral task ratings and self-reported ratings of incompleteness. Such research underscores the unique affective correlates of incompleteness experiences (Pietrefesa & Coles, 2008) and demonstrates the potential added benefit of in vivo NJRE assessment in predicting compulsive behavior (Cougle, Goetz, Fitch, & Hawkins, 2011).…”

Not Just Right Experiences in Obsessive-Compulsive and Related Disorders

“…Additionally, individuals diagnosed with body dysmorphic disorder have reported greater levels of perfectionism than control samples (Hartmann, Thomas, Greenberg, Matheny, & Wilhelm, 2014) and have demonstrated appearance-related symmetrical concerns (Hart & Phillips, 2013;Reese, McNally, & Wilhelm, 2010) akin to OCD-related symmetry symptomology. A recent study found that individuals diagnosed with body dysmorphic disorder reported more severe NJREs compared to control participants (Summers, Matheny, & Cougle, 2017 potential presence of an underlying transdiagnostic mechanism related to NJREs.…”

“…Future studies might benefit from use of in-vivo NJRE inductions such as seating participants in front of a cluttered desk and instructing them not to organize anything. Previous studies have effectively used lab-based paradigms to induce NJREs and have found associations between in-vivo NJRE induction and both OCD (Coles, Heimberg, Frost, & Steketee, 2005;Cougle et al, 2013;Summers, Fitch, & Cougle, 2014) and body dysmorphic disorder symptoms (Summers et al, 2017). Studies that mirror such methodology and include measurement of other OCRDs can further enhance understanding of the associations between NJREs and OCRD symptoms.…”