Evaluating Knowledge of a Function-based Cognitive-Behavioural Treatment for Obsessive Compulsive Behaviour in Autism Spectrum Disorder

Children with Autism Spectrum Disorder (ASD) have restricted and repetitive behaviours (RRBs) which may be similar to obsessions and compulsions in Obsessive Compulsive Disorder (OCD). These behaviours can be intrusive and interfere in the lives of the child and their family. Preliminary studies have shown success in using adapted Cognitive Behavioural Therapy (CBT) to treat these behaviors in children with high functioning ASD. Using a hypothetical vignette, this thesis attempted to examine procedural knowledge that the children and their parents gained while participating in a CBT treatment that was evaluated in a Randomized Controlled Trial. For both parents and children, there was a significant increase in number of strategies generated from pre to post-treatment. Further, children in the experimental group generated significantly more strategies than the treatment as usual (TAU) group post-intervention. There was no significant correlation between number of strategies generated and the child’s treatment success, age, or IQ.

Éthéréalisation : amorces d'une contre-histoire

Cette thèse est une enquête épistémologique qui s’interroge sur la persistance de « l’éther » dans le champ de la technologie. De façon générale, le mot « éther » évoque un modèle conceptuel de la physique pré-einsteinienne, celui d’un milieu invisible permettant la propagation de la lumière et des ondes électromagnétiques. Or, ce n’est là qu’une des figures de l’éther. Dans plusieurs mythologies et cosmogonies anciennes, le nom « éther » désignait le feu originel contenu dans les plus hautes régions célestes. Aristote nommait « éther », par exemple, le « cinquième être », ou « cinquième élément ». La chimie a aussi sa propre figure de l’éther où il donne son nom à un composé chimique, le C4H10O, qui a été utilisé comme premier anesthésiant général à la fin du XIXe siècle. L’apparition soutenue dans l’histoire de ces figures disparates de l’éther, qui a priori ne semblent pas entretenir de relation entre elles, est pour nous la marque de la persistance de l’éther. Nous défendons ici l’argument selon lequel cette persistance ne se résume pas à la constance de l’attribution d’un mot ou d’un nom à différents phénomènes dans l’histoire, mais à l’actualisation d’une même signature, éthérogène. À l’invitation d’Agamben et en nous inspirant des travaux de Nietzsche et Foucault sur l’histoire-généalogie et ceux de Derrida sur la déconstruction, notre thèse amorce une enquête historique motivée par un approfondissement d’une telle théorisation de la signature. Pour y parvenir, nous proposons de placer l’éther, ou plutôt la signature-éther, au cœur de différentes enquêtes historiques préoccupées par le problème de la technologie. En abordant sous cet angle des enjeux disparates – la légitimation des savoirs narratifs, la suspension des sens, la pseudoscience et la magie, les révolutions de l’information, l’obsession pour le sans-fil, l’économie du corps, la virtualisation de la communication, etc. –, nous proposons dans cette thèse autant d’amorces pour une histoire autre, une contre-histoire.

Étude des intrusions cognitives et des croyances dysfonctionnelles reliées au trouble obsessionnel-compulsif

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

Vers un cinéma de l'absurde : les films de Roman Polanski

La notion de l'absurde a pris dans la pensée et le langage courant un très grand nombre de significations, parfois très éloignées les unes par rapport aux autres. Il est arrivé à au moins deux reprises que le terme « absurde » soit entendu dans le sens d'un courant : dans la philosophie absurde théorisée par Albert Camus en 1942, et dans le Théâtre de l'absurde (Beckett, Ionesco, etc.), qui lui a connu son apogée dans les années cinquante. Ces deux mouvements pourraient être envisagés comme l'expression d'un seul et même courant, l'absurde, qui prend ses racines dans une Europe ébranlée par les horreurs de la guerre et l'affaissement de la religion chrétienne. Pour les contemporains, l'hostilité et le désordre de l'univers, de même que la solitude irrémédiable de l'individu apparaissent comme des vérités à la fois douloureuses et difficile à ignorer. Roman Polanski (1933-), cinéaste à la fois prolifique et éclectique, ouvre à l'absurde de nouveaux horizons, ceux du septième art. L'analyse de son oeuvre (et des éléments autobiographiques qui la sous-tendent parfois) met à jour d'indéniables parentés avec les figures-clés de l'absurde que sont Camus, Kafka, Nietzsche et les dramaturges européens de l'après-guerre. Ces parentés se repèrent tout autant dans les thématiques récurrentes de ses films que dans leurs obsessions formelles.

Mort et renaissances de l’écrivain maudit : lectures de l’œuvre et de la figure d’Hubert Aquin dans l’essai québécois contemporain

Le présent article s’attache à deux des modes de lecture de l’oeuvre aquinienne qui traversent la critique et l’essai québécois contemporains. La lecture biographique, plus volontiers mythifiante, de certains essayistes et biographes aquiniens permettra, d’une part, de réfléchir à la fascination qu’exerce encore aujourd’hui le sacrifice d’Aquin sur ses lecteurs contemporains. D’autre part, il s’agira de mieux cerner l’inscription de l’oeuvre aquinienne dans les dossiers que la revue « Liberté » a fait paraître entre 2006 et 2012. En réactualisant la dimension politique de l’oeuvre d’Aquin, les auteurs de la revue réfléchissent à la fois sur la quasi-disparition de l’engagement politique dans la sphère culturelle et sur le décentrement de la parole littéraire à l’époque contemporaine. D’un point de vue comme de l’autre, Aquin et son oeuvre méritent d’être relus, d’être tirés de la bibliothèque ou du tombeau afin de répondre, ne serait-ce que par la négative, aux angoisses et aux obsessions des contemporains. Nous entendons en somme dépasser certaines idées reçues sur la construction des figures auctoriales, lesquelles viseraient selon certains auteurs à « simplifier [l’oeuvre] pour [la] rendre comestible ». Malgré ses limites évidentes, le mythe offre à l’oeuvre une possible survie dans le concert des médias contemporains et permet de saisir les enjeux d’une certaine représentation, historique sans doute, de la littérature québécoise.

Joan Miró : una lectura filosófica a través de 'La Masia'.

Se presenta un estudio hermenéutico sobre la obra de Joan Miró. La obra mironiana posibilita establecer algunas relaciones con la obra esotérica de 'El Bosco' y con la mística obra de Kandisky. El estudio tienta desvelar las fuentes místico-semitas, cuyas verdades dirigieron la vida y el quehacer creativo de Miró, siempre movido por una responsabilidad ética. Esta lectura conjuga conocimientos sobre la teoría del arte y el poder creativo del espíritu humano y su capacidad simbólica. El estudio procesa un continuo diálogo entre el arte y la filosofía/psicología, de modo que el saber filosófico fenomenológico o existencial ayuda a entender la obra de Miró, y ésta, a su vez, ilumina la verdad del conocimiento filosófico-existencial. El estudio se divide en cuatro partes. En las tres primeras se pretende desvelar los significados de: los 20 signos de su 'Cortège des obsessions', siempre recurrentes en su obra y cuyo simbolismo cabalístico definiría el espíritu semita-catalán de su autor (I Parte); 'La Masia', como 'metáfora mayor del habitar (existir, en sentido heideggeriano) poético- mí(s)tico del artista' (II Parte) y los 'Autorretratos', cuyo discurso poético 'traduce el acaecer concreto y real del devenir de su ser humano y artístico' (III Parte). Las conclusiones de esta lectura interpretativa son expuestas en la IV Parte del estudio. Se pretende descubrir cuál sería el alcance estético-creador y ético del hecho Miró. Se comentan los pros y contras de la equívoca denominación de Estética para designar la Filosofía del Arte, la Modernidad del lenguaje mironiano (saber estético) y el contenido de su moderna conciencia existencial (saber ético) .

Fifty Years After Angicos : Paulo Freire, Popular Education and the Struggle for a Better World that is Possible

The main thesis of this paper is that Freire’s original experience in Angicos anticipated a grand design for social transformation of educational systems. As such it brought together two key concepts that formulated the basis of his educational system: popular culture as an counter-hegemonic project and popular education, more particularly what was later called citizen schools or public popular education as keystone of his new educational system. I use the term Paulo Freire System to show that his original attempts were not only to challenge pedagogical the prevailing banking education system that was so pervasive in Brazil and Latin American at the time. In challenging the hegemony of banking education, its narrative, theoretical foundations, epistemology and methodology, Freire and his team sought to create a new system that could replace the old one. They saw banking education not only as obsolete in terms of modernization of systems but also oppressive in gnoseological, epistemological and political terms. In the conclusion of this paper I will discuss the twins obsessions of Freire, already present in the Angicos experience and that will stay with him throughout his life: the relationship between democracy, citizenship and education, and education as a postcolonial ethical act of social transformation. I would like to emphasize therefore that the Paulo Freire system, as conceived in the Angicos experience and its aftermath was a much larger and comprehensive system that originally considered, even by his critics.

Entrevista a Francisco Proaño Arandi: se trataba de crear en el lector una sensación de angustia frente a la realidad (Homenaje)

En este diálogo entre el escritor Francisco Proaño Arandi (Premio latinoamericano José María Arguedas, La Habana, 2010) y el lúcido crítico y ensayista Alejandro Moreano, se pasa revista a los años de formación del narrador, la década de los 60, los tzántzicos, la creación de la revista La bufanda del sol, el Frente Cultural en Quito. Proaño, hurgando en la memoria, reconstruye los diversos momentos de lo que fue el debate político y literario de esos años, el peso de la Revolución cubana, las ideas y las propuestas del compromiso del filósofo Jean-Paul Sartre, las luchas anticolonialistas en África, Mayo del 68 y su repercusión en la juventud del mundo, los escritores del boom de la narrativa latinoamericana, su experiencia como diplomático de carrera durante procesos y gobiernos que se sucedieron en el Ecuador en los años 80 y 90. El escritor también da cuenta de lo que es su universo narrativo, las obsesiones, la presencia de una ciudad como Quito en sus diversas novelas y cuentarios, así como la reflexión que a través de sus personajes realiza de las complejas relaciones de la pareja. Diálogo que no solo significó el encuentro de escritores de una misma generación, sino de dos amigos que han sabido compartir la pasión por la escritura de manera vital.

The treatment of mental contamination: a case series

The recommended treatment for obsessive-compulsive disorder (OCD) is cognitive behavior therapy (CBT) incorporating exposure and response prevention (ERP), which is effective for approximately 50% of patients. However, there has been little advance in treatment outcomes since the introduction of ERP in 1979. It has been suggested that some progress can be made in treating contamination obsessions and washing compulsions by addressing feelings of dirtiness and contamination that arise without physical contact with a tangible contaminant. To date, the treatment of these “mental contamination” fears in OCD has not been systematically explored. This paper reports on a case series of 12 participants with OCD who received 10 to 20 sessions of a CBT-based treatment for mental contamination. At the end of treatment, 7 participants no longer met the diagnostic criteria for OCD and mental contamination and these gains were maintained at 6-month follow-up. The clinical implications of these findings are discussed.

The classification of involuntary musical imagery: the case for earworms

Involuntary musical imagery (INMI) is the subject of much recent research interest. INMI covers a number of experience types such as musical obsessions and musical hallucinations. One type of experience has been called earworms, for which the literature provides a number of definitions. In this paper we consider the origins of the term earworm in the German language literature and compare that usage with the English language literature. We consider the published literature on earworms and conclude that there is merit in distinguishing between earworms and other types of types of involuntary musical imagery described in the scientific literature: e.g. musical hallucinations, musical obsessions. We also describe other experiences that can be considered under the term INMI. The aim of future research could be to ascertain similarities and differences between types of INMI with a view to refining the classification scheme proposed here.

Development and validation of the Morphing Fear Questionnaire (MFQ)

Morphing fears (also called transformation obsessions) involve concerns that a person may become contaminated by and acquire undesirable characteristics of others. These symptoms are found in patients with OCD and are thought to be related to mental contamination. Given the high levels of distress and interference morphing fears can cause, a reliable and valid assessment measure is needed. This article describes the development and evaluation of the Morphing Fear Questionnaire (MFQ), a 13-item measure designed to assess for the presence and severity of morphing fears. A sample of 900 participants took part in the research. Of these, 140 reported having a current diagnosis of OCD (SR-OCD) and 760 reported never having had OCD (N-OCD; of whom 24 reported a diagnosis of an anxiety disorder and 23 reported a diagnosis of depression). Factor structure, reliability, and construct and criterion related validity were investigated. Exploratory and confirmatory factor analyses supported a one-factor structure replicable across the N-OCD and SR-OCD group. The MFQ was found to have high internal consistency and good temporal stability, and showed significantly greater associations with convergent measures (assessing obsessive-compulsive symptoms, mental contamination, thought-action fusion and magical thinking) than with divergent measures (assessing depression and anxiety). Moreover, the MFQ successfully discriminated between the SR-OCD sample and the N-OCD group, anxiety disorder sample, and depression sample. These findings suggest that the MFQ has sound psychometric properties and that it can be used to assess morphing fear. Clinical implications are discussed.

Treatment seeking by individuals with obsessive-compulsive disorder from the British Psychiatric Morbidity Survey of 2000

Objective: For several reasons, many individuals with obsessive-compulsive disorder (OCD) do not seek treatment. However, data on treatment seeking from community samples are scant. This study analyzed service use by adults with OCD living in private households in Great Britain. Methods: Data from the British Survey of Psychiatric Morbidity of 2000, in which 8,580 individuals were surveyed, were analyzed. Service use was compared for those with OCD, with other neuroses, with different subtypes of OCD (only obsessions, only compulsions, or both), and with OCD and comorbid neuroses. Results: Persons with OCD (N=114) were more likely than persons with other neuroses (N=1,395) to be receiving treatment (40% compared with 23%, p<.001). However, those with OCD alone (N=38) were much less likely than those with OCD and a comorbid disorder to be in treatment (14% compared with 56%, p<.001). In the previous year, 9.4% of persons with OCD had seen a psychiatrist and 4.6% had seen a psychologist. Five percent were receiving cognitive-behavioral therapy, 2% were taking selective serotonin reuptake inhibitors, and 10% were taking tricyclics. Conclusions: Most persons with OCD were not in contact with a mental health professional, and apparently very few were receiving appropriate treatments. Very few persons with noncomorbid OCD were receiving treatment. Individuals with OCD who are in treatment may not be disclosing their obsessions and compulsions and may be discussing other emotional symptoms, leading to inappropriate treatment strategies. Public awareness of OCD symptoms should be raised, and primary care professionals should inquire about them with all patients who have depressive or anxiety disorders.

Obsessive-compulsive symptoms in patients with panic disorder

Comorbidity studies have shown an important association between panic disorder (PD) and obsessive-compulsive disorder (OCD). The aim of the current study was to evaluate the prevalence of obsessive-compulsive symptoms (OCS) and OCD in patients with PD. Forty-eight consecutive PD cases (DSM-IV diagnostic criteria) referred to a Brazilian university hospital clinic were studied. The Yale Brown Obsessive Compulsive scale (Y-BOCS) checklist was used to identify the OCS. Subclinical OCD was considered when subjects met all but one DSM-IV criteria for OCD (symptoms did not cause significant distress and interference, did not last more than 1 hour per day, or were not considered excessive or irrational), and OCS when only the criterion for presence of obsessions or compulsions was met. Twenty-nine (60.4%) of the 48 patients evaluated (19 men and 29 women) had at least one OCS: nine (18.8%) had mild OCS, 11 (22.9%) had subclinical OCD, and nine (18.8%) had comorbid OCD. Therefore, 41.7% of the patients had either clinical or subclinical OCD. OCS occurred more frequently in women and, in 70.4% of the cases, preceded the onset of PD. Our results suggest that it is important to evaluate systematically the co-occurrence of OCS in patients with PD, due to the considerable overlap found in symptoms, which may have therapeutic implications. As panic symptoms are usually the main complaint, OCS are often found only when directly investigated. (C) 2004 Elsevier B.V. All rights reserved.

Obsessive-compulsive disorder: Prevalence, comorbidity, impact, and help-seeking in the British National Psychiatric Morbidity Survey of 2000

Objective: There is little information about obsessive-compulsive disorder in large representative community samples. The authors aimed to establish obsessive-compulsive disorder prevalence and its clinical typology among adults in private households in Great Britain and to obtain generalizable estimates of impairment and help-seeking.Method: Data from the British National Psychiatric Morbidity Survey of 2000, comprising 8,580 individuals, were analyzed using appropriate measurements. The study compared individuals with obsessive-compulsive disorder, individuals with other neurotic disorders, and a nonneurotic comparison group. ICD-10 diagnoses were derived from the Clinical Interview Schedule-Revised.Results: the authors identified 114 individuals (74 women, 40 men) with obsessive-compulsive disorder, with a weighted 1-month prevalence of 1.1%. Most individuals (55%) in the obsessive-compulsive group had obsessions only. Comorbidity occurred in 62% of these individuals, which was significantly greater than the group with other neuroses (10%). Co-occurring neuroses were depressive episode (37%), generalized anxiety disorder (31%), agoraphobia or panic disorder (22%), social phobia (17%), and specific phobia (15%). Alcohol dependence was present in 20% of participants, mainly men, and drug dependence was present in 13%. Obsessive-compulsive disorder, compared with other neurotic disorders, was associated with more marked social and occupational impairment. One-quarter of obsessive-compulsive disorder participants had previously attempted suicide. Individuals with pure and comorbid obsessive-compulsive disorder did not differ according to most indices of impairment, including suicidal behavior, but pure individuals were significantly less likely to have sought help (14% versus 56%).Conclusions: A rare yet severe mental disorder, obsessive-compulsive disorder is an atypical neurosis, of which the public health significance has been underestimated. Unmet need among individuals with pure obsessive-compulsive disorder is a cause for concern, requiring further investigation of barriers to care and interventions to encourage help-seeking.

Sex differences in the phenotypic expression of obsessive-compulsive disorder: an exploratory study from Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)