October webinar summary: How may Obsessive Compulsive Disorder vary in different cultures
It has been a month since we, the EFPSA Research Programme, conducted our third webinar. This time we had a chance to focus on the topic of Obsessive Compulsive Disorder. During the hour-long meeting, participants had the opportunity to learn about recent findings related to OCD. The webinar had around 30 active participants. It was led by Fulya Özcanlı, Ph.D. Here are some key takeaways from the meeting.
Basic facts you need to know
The Obsessive Compulsive Disorder, known as OCD, “is characterised by the presence of persistent obsessions or compulsions, or most commonly both. Obsessions are repetitive and persistent thoughts, images, or impulses that are intrusive, unwanted and are commonly associated with anxiety. The individual attempts to ignore or suppress obsessions or to neutralize them by performing compulsions. Compulsions are repetitive behaviours including repetitive mental acts that the individual feels driven to perform in response to an obsession, according to rigid rules, or to achieve a sense of ‘completeness’ “ (ICD 11). The most common areas of obsessions and compulsions are:
How does it work?
You may say, such things happen to all of us. It’s true that negative and anxious thoughts, or repeatedly checking if you’ve closed the door before leaving the house, can happen to anyone. However, what’s crucial is the extent to which these thoughts or behaviours occur in our daily lives, and how much they affect our ability to function normally. According to the cognitive-behavioral model of OCD (Wilhelm & Stekatee, 2006), it is the interpretation of these thoughts that often creates problems. It’s common to worry about things like whether you turned off the gas in the kitchen. Thoughts of your house burning down might cross your mind, but it’s natural to dismiss them. However, people with OCD can interpret those thoughts as a personal attack. They may start to accuse themselves of being a pyromaniac or think they cause danger to the society and may burn down the whole neighbourhood. In addition, such thoughts are accompanied by strong negative emotions like guilt or anxiety. This can lead to the consolidation of obsessions and compulsions as well as to a pattern of avoidance and protection as you can see in the graph below.
How can our society and tradition affect the obsessive thoughts that we encounter?
It is commonly known that the cultural beliefs and practices that surround us have a huge impact on the type of OCD thoughts that we tend to have. It is important to distinguish the two types of agencies that people might develop: personal agency and shared agency. Personal agency is the sense that I am the one who is causing or generating an action. It is usually connected with the individualistic type of culture and allows an individual to perceive himself/herself as a subject influencing their surroundings. The concept of shared agency refers to a situation where an individual has a strong sense of belonging to their local community, society, or country. This is more prevalent in collective cultures, and it implies that we perceive our actions as having an impact on the people we live among, and we are also influenced by them. Simply put, the shared agency describes the feeling of being part of a greater whole and recognizing the interconnectedness of our actions and impacts on the community around us. That being said, it is not so difficult to guess, that the OCD thoughts related to self, for example, fear of being harmed, getting sick, or being fair or unfair, may occur more frequently in people with a sense of personal agency, while obsessions related to the concern of protection of the social and spiritual values of our society are more common in people with a sense of shared agency.
Recent studies based on Belgian and Turkish samples
During the webinar, we also had a chance to listen to our speaker’s findings on the cross-cultural examination of obsessive thoughts in Turkish and Belgian samples. Below are some research inquiries and their corresponding outcomes that provide answers to them.
1) To what extent are the meanings of obsessions similar in Belgium and in Turkey?
Despite many differences in the structural models that were the best in both samples, they managed to find four groups of obsessions that occur both in Belgian and in Turkey. Those are aggressive obsessions, sexual nature obsessions, contamination obsessions, and just-right obsessions. (Ozcanli et al., 2019)
2) Are there any differences in the frequency of intrusive thoughts among both investigated samples?
According to the results, bad-self obsessions, especially the ones connected with aggression, were more frequent in Belgian samples, and bad-outcome obsessions related to contamination were reported more often in Turkish samples. These results match the previously mentioned personal and shared agency mortality in both countries. (Ozcanli et al., 2019)
3) Are the results from non-clinical samples consistent with the clinical samples?
As it comes to the frequency of the obsessions and distress made by them, only the results for the aggressive obsessions – scores higher in the Belgian sample in both cases – were found significant in clinical samples.
4) Can cultural differences in obsessions be understood through the dominant moral concepts in the culture?
We may predict that the contamination obsessions found more frequently in Turkish samples, can be linked to the sense of purity, which is crucial moral concept in this collective culture.
Bad-self obsessions: sexual nature, religious nature, aggressive nature;
Bad-outcome obsessions: causing harm, contamination, just-right thoughts
Bibliography:
1. World Health Organization. (2019). International Classification od Diseases, Eleventh Revision (ICD-11). https://icd.who.int/
2. Ozcanli, F., Ceulemans, E., Hermans, D., Claes, L., Mesquita, B. (2019). Obsessions Across Two Cultures: A Comparison of Belgian and Turkish Non-clinical Samples. Frontiers in Psychology. Volume 10. doi: 10.3389/fpsyg.2019.00657
3. Wilhelm, S., Staketee G.S. (2006). Cognitive Therapy for Obsessive– Compulsive Disorder: A Guide for Professionals, Oakland, CA: New Harbinger Publications