Obsessive-compulsive disorder (OCD) is a complex psychological condition, and those who suffer from it experience severe reduction in their quality of life. A new study in Springer's journal Cognitive Therapy and Research now shows that OCD sufferers need to adopt adaptive coping skills rather than the maladaptive strategies often used such as repetitive, compulsive actions or creating emotional distance from a situation, in order to effectively manage their condition. The research was led by Steffen Moritz of the University Hospital Hamburg in Germany.
Moritz and his colleagues compared the behaviour of 60 patients suffering from OCD with 110 people with depression and 1050 adults in a control group. All participants completed anonymous online surveys in which their medical and psychological history was ascertained, along with their levels of compulsivity and ability to cope in specific situations. They answered a questionnaire that covered different adaptive and maladaptive coping styles that someone might use to deal with problematic situations.
The participants also responded to the Maladaptive and Adaptive Coping Styles Questionnaire (MAX) that Moritz and his colleagues recently developed. This questionnaire measures coping styles using three dimensions: maladaptive coping (such as thought suppression, rumination), adaptive coping (e.g. problem-solving, acceptance), and avoidance. Participants gave information about coping strategies they adopt against their OCD symptoms such as problem-solving and rumination, as well as other coping styles that have only recently been adopted in therapy, such as acceptance and suppression.
Participants with OCD were found to possess more maladaptive coping skills than all others, including those suffering from depression. They also possessed fewer functional skills to help them cope and adapt. Those who lacked adaptive coping were also likely to have a resistance to symptoms, and poor insight about their condition.
"Patients with OCD are characterized by both more maladaptive coping and less adaptive coping relative to controls," Moritz explains.
"Coping skills are important for many aspects of daily life beyond mental health. Teaching children skills such as how to cope with bullying at school, poor performance or problems with their parents, for example, in the framework of general cognitive preventative treatment and resilience training in school, may help children to better deal with emotional turmoil and challenging situations during adolescence. It may also prevent the progression of a vulnerability to later obsessive-compulsive disorder or depression as well as other disorders," says Moritz.
Although the study explains some of the skills that patients with OCD lack, Moritz says further research is needed to find out to what extent improving such coping skills during childhood and adolescence through cognitive behavioural therapy or similar interventions may indeed improve a sufferer's life.
Moritz, S. et al. Obsessive-compulsive disorder is characterized by a lack of adaptive coping rather than an excess of maladaptive coping. Cognitive Therapy and Research, 2018 DOI: 10.1007/s10608-018-9902-0