The self in the obsessive–compulsive-related disorders: hoarding disorder, body dysmorphic disorder, and trichotillomania

Abstract

Betrayal trauma theory posits that victims of abuse perpetrated by someone close are more likely to dissociate from awareness of the abuse in order to protect the needed relationship. Shame may likewise protect the relationship by turning the victim's attention inward, thereby increasing the likelihood that the abusive environment will be overlooked. In this dissertation, the associations between shame, dissociation, and betrayal trauma were examined in two experimental studies. A third study examined the consequences of chronic shame. Aims were to determine whether shame and dissociation have a unique link with high betrayal traumas (HiBT), to understand the nature of the relationship between shame and dissociation, and to investigate the consequences of chronic shame.In study 1, 124 female trauma survivors were randomly assigned to a high or low betrayal threat condition. Greater exposure to HiBT but not low betrayal traumas (LoBT) predicted increased shame and dissociation following high betrayal threat.Greater exposure to LoBT but not HiBT predicted increased fear following non-betrayal threat. Compared to non-dissociators, dissociators from threat endorsed more negative psychological consequences. v In study 2, 127 female trauma survivors completed a dissociation induction and battery of questionnaires. The bypassed shame theory, which proposes that dissociation serves to disconnect from the pain of shame, was examined. Results partially supported bypassed shame theory. Although feelings of shame led to a larger dissociation response to the induction, dissociation did not interrupt shame but rather led to even higher shame.Implications are discussed for a possible contributing role of shame to betrayal blindness.In study 3, 247 trauma survivors completed online questionnaires addressing chronic shame hypotheses. Regression results revealed that all forms of chronic shame, especially trauma-focused shame, predicted negative health consequences. Correlation results revealed that HiBT was associated with more types of negative outcomes compared to LoBT and that HiBT but not LoBT was associated with chronic shame. Freyd (1994;1996) focuses on the cognitive alterations of dissociation and amnesia for abuse perpetrated by someone upon whom the victim depends for survival. Freyd's work on betrayal trauma theory (BTT) highlights that these alterations may be adaptive, albeit harmful in the long run. This dissertation examines whether feelings of shame may be an affective alteration that, like dissociation and amnesia, serves to protect the relationship in the short-run but has negative long-term consequences.2 Betrayal Trauma TheoryBTT (Freyd, 1996) differentiates between traumatic events involving betrayal by a close other (HiBT; e.g., childhood physical or sexual abuse) and traumatic events typically involving lesser degrees of betrayal (LoBT e.g., sexual assault by a stranger, natural disaster). According to BTT, the higher the betrayal level of the trauma, the more adaptive it may be for the victim to be una...

The role of feared possible selves in obsessive–compulsive and related disorders: A comparative analysis of a core cognitive self‐construct in clinical samples

“…Overall, the current results support the use of the FSQ in both research and clinical settings to measure fear of self‐perceptions in OCD and potentially its usefulness in other disorders as well where shame and self‐loathing stand at the foreground of symptomatology (e.g., see Moulding, Mancuso, Rehm, & Nedeljkovic, ). The measure may also be useful to assess the effects of treatment for these disorders, especially considering the increased focus on the role of self‐themes in clinical disorders as a potential target in treatment (Kyrios et al, ; O'Connor & Aardema, ).…”

How reward and punishment are viewed by individuals experiencing trichotillomania according to revised reinforcement sensitivity theory

“…This interpretation of results supports recent work in therapeutic developments that address cognition and attention (Keijsers, Maas, Van Opdorp, & Van Minnen, 2016;Shareh, 2018). Furthermore, it supports the idea that TTM is relevant to the whole self, rather than an isolated behaviour (Moulding, Mancuso, Rehm, & Nedeljkovic, 2016).…”

Emotional regulation, attachment to possessions and hoarding symptoms

“…In addition, these speculations suggest that direct research on the function of the wider attachment construct in hoarding may be useful (cf. Kellett, et al ., ; Kellett & Holden, ; Moulding, Mancuso, Rehm & Nedeljkovic, accepted), as it has been in the related disorder of Obsessive Compulsive Disorder (see Doron, Moulding, Kyrios, Nedeljkovic & Mikulincer, ; Doron, Moulding, Nedeljkovic, Kyrios, Mikulincer & Sar‐El, ).…”