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Originalia

Erfassung von Metakognitionen bei Zwangsstörungen

Published Online:April 12, 2010https://doi.org/10.1026/0012-1924/a000013

Abstract

Zusammenfassung. In der vorliegenden Studie wurde ein Fragebogen („Zwangsassoziierte Gedanken und Gefühle”) entwickelt, welcher Metakognitionen bei Zwang nach nach dem S-Ref-Modell nach Wells misst. Mittels Faktorenanalysen wurden psychometrische Eigenschaften überprüft (Studie 1, n = 215 Zwangserkrankte). 5 Dimensionen erwiesen sich als plausibel, konsistent und reliabel: (1) Wertlosigkeit, (2) Kontrolle, (3) Zweifel, (4) Toleranz und (5) Gelassenheit. In Studie 2 wurde der Fragebogen auf Validität, Spezifität und Änderungssensitivität überprüft (40 Zwangspatienten; 40 Depressive; 40 Patienten mit Agoraphobie; 55 Zwangspatienten mit komorbider Depression und 39 gesunde Personen). Die Skalen Wertlosigkeit, Kontrolle und Zweifel zeigten klare Gruppenunterschiede: gesunde Personen hatten die niedrigsten Werte, gefolgt von den Personen mit Agoraphobie. Depressive und Zwangspatienten unterschieden sich von diesen deutlich, jedoch wider Erwarten nicht untereinander. Die Skala Wertlosigkeit und die Skala Schuld korrelierten substanziell mit anderen Maßen der Zwangsdiagnostik, ferner mit Ängstlichkeit und Depressivität.


Assessment of metacognitions in obsessive compulsive disorder

Abstract. A questionnaire to measure metacognitions in obsessive-compulsive disorder was developed. The S-Ref-Model of Wells served as theoretical background. After conducting factor analyses (5-factor solution) the questionnaire OCD-Related Thoughts and Feelings (ZAGG) was examined with regard to homogeneity, retest reliability, and other item and scale qualities (study 1, n = 215 persons with OCD). The scales were labelled (1) worthlessness, (2) control, (3) doubt, (4) tolerance, and (5) calmness. In study 2, group differences, differences before and after therapy, and correlations with clinical criteria were tested (patients: 40 OCD, 40 anxiety, 40 depression, 55 OCD comorbid with depression; 39 participants without disorder as control group). All scales revealed characteristic group differences compared with the control group at the lower end, followed by anxiety patients, depressives, and OCD patients. Highest scores were found in OCD patients with comorbid depression. On the other hand the scales were not able to discrimininate between OCD and depression. Correlational analyses revealed high coefficients with relevant intruments to measure OCD, anxiety, or depression.

Literatur

  • Abramowitz, J. S. , Taylor, S. , McKay, D. (2005). Potentials and limitations of cognitive treatment for obsessive-compulsive disorder. Cognitive Behaviour Therapy, 34 (3), 140–147. First citation in articleCrossref, Google Scholar

  • Abramowitz, J. S. , Khandker, M. , Nelson, C. A. , Deacon, B. J. , Rygwall, R. (2006). The role of cognitive factors in the pathogenesis of obsessive-compulsive symptoms: A pro-spective study. Behaviour Research and Therapy, 44 (9), 1361–1374. First citation in articleCrossref, Google Scholar

  • American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders DSM-III (3rd ed.). Washington, DC: American Psychiatric Association. First citation in articleGoogle Scholar

  • American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders DSM-IV (4th ed.). Washington, DC: American Psychiatric Association. First citation in articleGoogle Scholar

  • Beck, A. T. (1976). Cognitive Therapy and the emotional disorders. New York: International University Press. First citation in articleGoogle Scholar

  • Beck, A. T. , Epstein, N. , Brown, G. , Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 65, 893–897. First citation in articleCrossref, Google Scholar

  • Beck, A. T. , Rush, A. J. , Shaw, B. F. , Emery, G. (1979). Cognitive theory of depression. New York: Guilford Press. First citation in articleGoogle Scholar

  • Bortz, J. (1999). Statistik für Sozialwissenschaftler (5. Aufl). Berlin: Springer. First citation in articleGoogle Scholar

  • Clark, D. A. (2005). Focus on „cognition” in cognitive behaviour therapy for OCD: is it really necessary? Cognitive Behaviour Therapy, 34 (3), 131–139. First citation in articleCrossref, Google Scholar

  • Clark, D. A. , Beck, A. T. (with Alford, B. ) (1999). Scientific foundations of cognitive theory and therapy of depression. New York: Wiley. First citation in articleGoogle Scholar

  • Clark, D. A. , Purdon, C. , Wang, A. (2003). The Meta-Cognitive Beliefs Questionnaire: development of a measure of obsessional beliefs. Behaviour Research and Therapy, 41, 655–669. First citation in articleCrossref, Google Scholar

  • Ecker, W. (2001). Verhaltenstherapie bei Zwängen – Grundlagen und Praxis. Lengerich: Pabst. First citation in articleGoogle Scholar

  • Derogatis, L. R. (1992). The SCL-90-R. Administration, scoring and procederes manual-II. Clinical Psychometrics Research, Inc.,Towson. First citation in articleGoogle Scholar

  • Fisher, P. L. , Wells, A. (2005). How effective are cognitive and behavioral treatments for obsessive-compulsive disorder? A clinical significance analysis. Behaviour Research and Therapy, 43, 1543–1558. First citation in articleCrossref, Google Scholar

  • Franke, G. H. (2002). Die Symptom-Checkliste von Derogatis – Deutsche Version (2., rev. und erw. Aufl.). Göttingen: Beltz. First citation in articleGoogle Scholar

  • Freeston, M. H. , Ladouceur, R. , Gagnon, F. , Thibodeau, N. (1993). Beliefs about obsessional thoughts. Journal of Psychopathology and Behavioral Assessment, 15 (1), 1–21. First citation in articleCrossref, Google Scholar

  • Goodman, W. K. , Price, L. , Rasmussen, S. A. , Mazure, L. , Fleishman, R. L. , Hill, C. L. , Henninger, G. R. , Charney, D. S. (1989a). Yale-Brown Obsessive Compulsive Scale. I. Development, use and reliability. Archives of General Psychiatry, 46, 1006–1011. First citation in articleCrossref, Google Scholar

  • Hand, I. , Büttner-Westphal, H. (1991). Die Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Ein halbstrukturiertes Interview zur Beurteilung des Schweregrades von Denk- und Handlungszwängen. Verhaltenstherapie, 1, 226–233. First citation in articleCrossref, Google Scholar

  • Hautzinger, M. , Bailer, M. , Worall, H. , Keller, F. (1994). Beck–Depressions-Inventar (BDI) Testhandbuch. Bern: Huber. First citation in articleGoogle Scholar

  • Hedlund, S. , Oppelt, B. (1998). Intermediate-level beliefs in OCD: A new instrument to evaluate cognitive specifity. Poster Presentation at the Annual Convention of the Association for Advancement of Behavior Therapy in Washington, DC. First citation in articleGoogle Scholar

  • Hiller, W. , von Bose, M. , Dichtl, G. , Agerer, D. (1990). Reliability of checklist-guided diagnoses for DSM-III-R affective and anxiety disorders. Journal of Affective Disorders, 20, 235–247. First citation in articleCrossref, Google Scholar

  • Hiller, W. , Zaudig, M. , Mombour, W. (1995). IDCL. Internationale Diagnose Checklisten für ICD-10 und DSM-IV. Bern: Huber. First citation in articleGoogle Scholar

  • Leplow, B. (2004). Neuropsychologie der Zwangsstörung. In S. Lautenbacher, S. Gauggel (Hrsg.), Neuropsychologie psychischer Störungen. Berlin: Springer. First citation in articleCrossref, Google Scholar

  • Margraf, J. , Ehlers, A. (2007). Das Beck Angst-Inventar (BAI). Fankfurt: Harcourt Test Services. First citation in articleGoogle Scholar

  • Möbius, J. , Margraf, J. (2003). Beck-Angstinventar (BAI). In J. Hoyer, J. Margraf (Hrsg.), Angstdiagnostik – Grundlagen und Testverfahren. Berlin: Springer. First citation in articleGoogle Scholar

  • Müller-Svitak, S. , Rief, W. , Reinecker, H. , Fichter, M. (2002). Kognitiv-verhaltenstherapeutische Behandlung von Patienten mit Zwangsstörungen: Ein stationäres Gruppentherapieprogramm. Verhaltenstherapie, 12,108–115. First citation in articleCrossref, Google Scholar

  • Neumann, A. , Geissner, E. (2007). Die Bedeutung von Metakognitionen für das Verständnis und die Psychotherapie von Zwang. Verhaltenstherapie, 17 (2), 116–121. First citation in articleCrossref, Google Scholar

  • Obsessive Compulsive Cognitions Working Group (2001). Development and initial validation of the Obsessive Beliefs Questionnaire and the Interpretations of Intrusions Inventory. Behaviour Research and Therapy, 39, 987–1006. First citation in articleCrossref, Google Scholar

  • Obsessive Compulsive Cognitions Working Group (2003). Psychometric validation of the Obsessive Beliefs Questionnaire and the Interpretations of Intrusions Inventory: part I. Behaviour Research and Therapy, 41, 863–878. First citation in articleCrossref, Google Scholar

  • Oppelt, B. (1997). Metakognitionen bei Zwangspatienten – Klinische Vergleichsstudie unbehandelter ZwangspatientInnen mit depressiven PatientInnen und Kontrollpersonen. Unveröffentlichte Diplomarbeit, Universität Konstanz. First citation in articleGoogle Scholar

  • Purdon, C. , Clark, D. A. (1999). Metacognition and obsessions. Clinical Psychology and Psychotherapy, 6, 102–110. First citation in articleCrossref, Google Scholar

  • Reinecker, H. (1994). Lehrbuch der klinischen Psychologie (2. Aufl.). Göttingen: Hogrefe. First citation in articleGoogle Scholar

  • Salkovskis, P. M. (1996). Cognitive-behavioural approaches to the understanding of obsessive-compulsive problems. In R. M. Rapee (Ed.), Current controversies in the anxiety disorders (pp.103–133). New York: Guilford. First citation in articleGoogle Scholar

  • Tolin, F. A. , Worhunsky, P. , Maltby, N. (2006). Are „obsessive” beliefs specific to OCD? A comparison across anxiety disorders. Behaviour Research and Therapy, 44, 469–480. First citation in articleCrossref, Google Scholar

  • Weissman, M. M. , Bland, R. C. , Canino, G. J. , Greenwald, S. , Hwu, H.-G. , Lee, C. K. , Newman, S. C. , Oakley-Brown, M. A. , Rubio-Stipec, M. , Wickramaratne, P. J. , Wittchen, H.-U. , Yeh, E.-K. (1994). The cross national epidemiology of obsessive-compulsive disorder. Journal of Clinical Psychiatry, 55 (Suppl), 5–10. First citation in articleGoogle Scholar

  • Wells, A. (2000). Emotional disorders and metacognition – innovative cognitive therapy. Chichester: John Wiley. First citation in articleGoogle Scholar

  • Wittchen, H.-U. , Saß, H. , Zaudig, M. , Koehler, K. (1989). Diagnostisches und Statistisches Manual Psychischer Störungen DSM-III-R. Weinheim: Beltz. First citation in articleGoogle Scholar