Biomedical subjects

R Ladouceur

Publications and source records attributed to R Ladouceur.

At least 19 recordsLinked to original sources

PubMed2000

Functional and dysfunctional perfectionists: are they different on compulsive-like behaviors?

Both perfectionism and excessive responsibility have been linked to obsessive compulsive disorder (OCD). Up to now however, a greater number of studies have focused on the role of responsibility. The present study compared compulsive-like behavior of people with different styles of perfectionism. Sixteen functional perfectionists (FP) and 16 dysfunctional perfectionists (DP) were compared on three different tasks in order to explore OC type behavior such as doubting, checking and intrusions. Results show that DP participants, compared to FP participants, scored higher on an OC behavior scale, took significantly more time to complete a precision task and precipitated their decision when confronted with ambiguity. The two groups also tended to differ in their intrusive thoughts following an unsolved problem; FP participants were more preoccupied about solving the problem than about the quality of their performance, contrary to DP subjects. Results are discussed according to theoretical models of OCD.

Adult↗

PubMed2000

Differences and similarities between obsessive intrusive thoughts and worry in a non-clinical population: study 1.

Worry is the central characteristic of Generalized Anxiety Disorder (GAD) and obsessions are a central feature of Obsessive-Compulsive Disorder (OCD). There are strong similarities between these disorders: repetitive cognitive intrusions, negative emotions, difficulty dismissing the intrusion and finally, loss of mental control. Direct comparisons between obsessions and worries are almost non-existent in the literature but key distinctions have been proposed. The study attempted to specify the differences between obsessive intrusive thoughts and worry in a nonclinical population across a series of variables drawn from current models (appraisal, general descriptors and emotional reactions). 254 students participated in the study. They first identified an obsession-like intrusion and a worry and then evaluated them with the Cognitive Intrusion Questionnaire. Within-subject comparisons demonstrated significant differences on several variables: frequency, duration, percentage of verbal and image content, interference, egodystonic nature, stimuli awareness, emotions, etc. Most of these differences remained significant after controlling for frequency of thought. Discriminant analysis demonstrated a low classification error rate when using nine variables to categorize thoughts as obsessions or worries. Results generally support the differences postulated in the literature with the exception that obsessive intrusive thoughts are better controlled. The egodystonic/egosyntonic dimension emerged as an important variable in understanding obsessions and worry.

Adult↗

PubMed2000

Differences and similarities between obsessive intrusive thoughts and worry in a non-clinical population: study 2.

Differences between obsessions and worry have been clearly demonstrated on several variables [Langlois, F., Freeston, M. H., & Ladouccur, R. (2000). Differences and similarities between obsessive intrusive thoughts and worry in a non-clinical population: study 1. Behaviour Research and Therapy, 38, 157-173.]. Previous factor analysis of obsessions or worries have typically been used in developing measures for OCD and GAD symptoms. These studies generally support the distinctiveness of obsessions and worries but there have been no direct comparisons of the factor structure of obsession and worry on the same measure. This study aimed to compare the general structure of worry and obsessional intrusions. It also attempted to identify the relations between the respective factors identified in the appraisals of intrusions and the factor structures of coping strategies used in reaction to the thoughts. 254 students participated in the study. They first identified an obsession-like intrusion and a worry and then evaluated them with the Cognitive Intrusion Questionnaire. Different factor structures were obtained for worry and obsessive intrusive thoughts. However, the factor structure for the strategies used to counter the thoughts were highly similar for both types of thought. Furthermore, regression analysis identified interesting relationships between the strategies, the thought characteristics and appraisal. Thus, despite the ability to find differences between obsessive intrusive thoughts and worry, and even to accurately categorize them based on these differences, there may in fact exist common processes that are shared over much of a continuum. Sharp differences in the processes involved may only become clear in prototypical cases. The implications for models of cognitive intrusion are discussed.

Adaptation, Psychological↗

PubMed2000

Experimental manipulation of intolerance of uncertainty: a study of a theoretical model of worry.

Intolerance of uncertainty has been identified as an important variable related to worry and Generalized Anxiety Disorder (GAD) [Dugas, M. J., Gagnon, F., Ladouceur, R., & Freeston, M. H. (1998). Generalized anxiety disorder: a preliminary test of a conceptual model. Behaviour Research and Therapy, 36, 215-226; Ladouceur, R., Dugas, M. J., Freeston, M. H., Rhéaume, J., Blais, F., Boisvert, J.-M., Gagnon, F., & Thibodeau, N. (1999). Specificity of Generalized Anxiety Disorder symptoms and processes. Behavior Therapy, 30, 197-207]. The goal of the present study was to clarify the relationship between this cognitive process and worry by experimentally manipulating intolerance of uncertainty. A gambling procedure was used to increase intolerance of uncertainty in one group (N = 21) and to decrease intolerance of uncertainty in another group (N = 21). The results indicate that participants whose level of intolerance of uncertainty was increased showed a higher level of worry, compared to participants whose level of intolerance of uncertainty was decreased. These results provide some initial clarifications as to the causal nature of the link between intolerance of uncertainty and worry. These results are coherent with our theoretical model of worry and GAD (Dugas et al., 1998), which stipulates that intolerance of uncertainty plays a key role in the acquisition and maintenance of excessive worry.

Adolescent↗

PubMed2000

Prevalence of problem gambling among community service users.

The prevalence of pathological gambling has been investigated in many countries over the past 10 years. In the United States and Canada, it is estimated that between 1 and 2% of the general population suffer from excessive gambling (Ladouceur, Jacques, Ferland, & Giroux, 1999; Shaffer, Hall, & Vander Bilt, 1997). Some researchers have argued that telephone surveys underestimate the prevalence of this disorder given that many gamblers may be unable to participate in them. Using the South Oaks Gambling Screen, the present study assessed the prevalence of pathological gambling among 87 individuals who rely on community assistance for their survival. The findings indicate that 17.2% meet the criteria for pathological gambling; a prevalence that is approximately 8 times greater than that of the general population. The social implications of these results are discussed.

Adolescent↗

PubMed2000

Treatment of GAD. Targeting intolerance of uncertainty in two types of worry.

This study evaluates the efficacy of a cognitive-behavioral treatment for generalized anxiety disorder (GAD) that addresses two types of worries: (a) those about situations that are amenable to problem solving, and (b) those about situations that are not. The treatment's goal is to help patients become more tolerant of uncertainty by discriminating between both types of worry and applying the correct strategy to each type. A multiple baseline design was used and subjects were 4 adults with a primary diagnosis of GAD. Treatment outcome was assessed with daily self-monitoring, self-report questionnaires, and standardized clinician ratings. At posttest and 6-month follow-up, 3 of 4 subjects no longer met diagnostic criteria for GAD and had attained high end-state functioning. At 12-month follow-up, none of the subjects met GAD diagnostic criteria but end-state functioning was variable. The results also show that treatment outcome was highly related to change in intolerance of uncertainty.

Adaptation, Psychological↗

PubMed2000

Impact of availability on gambling: a longitudinal study.

OBJECTIVE: Legalized gambling opportunities have markedly increased in most industrialized countries. While most authors agree that the rate of pathological gamblers is related to the accessibility of gambling activities, no published studies have yet empirically estimated the impact of the introduction of new gambling activities within a longitudinal study. Thus, we evaluate the impact of the opening of a casino on gambling activities among nearby inhabitants. METHOD: A random sample of 457 respondents from the Hull area (experimental group) and 423 respondents from the Quebec City area (control group) completed the South Oaks Gambling Screen and related questions, both before the opening of the Casino de Hull and 1 year later. Within each household contacted, a resident was randomly chosen by selecting the adult whose birthday was next. RESULTS: The experimental group exposed to the new casino showed a significant increase in 1) gambling on casino games, 2) the maximum amount of money lost in 1 day on gambling, 3) reluctance toward the opening of a local casino, and 4) the number of participants who reported knowing a person who has developed a gambling problem in the last 12 months. CONCLUSION: The impact of legalized gambling is discussed in relation to the availability of gambling.

Adolescent↗

PubMed2000

Strategies used with intrusive thoughts: a comparison of OCD patients with anxious and community controls.

Models of intrusive thoughts attribute a key role to strategies used by people to cope with their unwanted cognitions. In an extension of previous work, the authors conducted structured interviews with 38 people with obsessive-compulsive disorder, 38 people with another anxiety disorder, and 19 healthy volunteers. The interview identified the repertoire of strategies used with the participant's most troubling thought. The 2 clinical groups reported significantly more strategies than the nonclinical group. The clinical groups also reported significantly greater intensity of the thought and their emotional response and lower efficacy for the strategies. People with OCD reported a significantly higher proportion of strategies that were specifically linked to the thought content (as distinct from nonspecific strategies that were only linked sequentially in time). The results identify both common and differential characteristics of intrusive cognition in anxiety disorders.

Adult↗

PubMed2000

Efficacy of a cognitive-behavioral treatment for generalized anxiety disorder: evaluation in a controlled clinical trial.

Recent advances in the understanding of worry have led to the development of treatments for generalized anxiety disorder (GAD). The present study tested a GAD treatment that targeted intolerance of uncertainty, erroneous beliefs about worry, poor problem orientation, and cognitive avoidance. Twenty-six primary GAD patients were randomly allocated to a treatment condition (n = 14) or a delayed treatment control condition (n = 12). Self-report, clinician, and significant other ratings assessed GAD and associated symptoms. The results show that the treatment led to statistically and clinically significant change at posttest and that gains were maintained at 6- and 12-month follow-ups. Furthermore, 20 of 26 participants (77%) no longer met GAD diagnostic criteria following treatment. With regard to the treatment's underlying model, the results show that intolerance of uncertainty significantly decreased over treatment and that gains were maintained at both follow-ups. Although nonspecific factors were not significant predictors of treatment outcome, their role in the treatment of GAD requires further investigation.

Adult↗

PubMed1999

Responsibility and perfectionism in OCD: an experimental study.

Cognitive models of obsessive-compulsive disorder (OCD) suggest a number of different variables that may play a role in the development and maintenance of obsessive compulsive symptoms [Freeston, M. H., Rhéaume, J., & Ladouceur, R. (1996) Correcting faulty appraisals of obsessional thoughts. Behaviour Research and Therapy, 34, 433-446]. This study's aim was to verify the effect of perfectionism and excessive responsibility on checking behaviors and related variables. Twenty-four moderately perfectionistic subjects (MP) and 27 highly perfectionistic subjects (HP) were submitted to a manipulation of responsibility (low and high). After each manipulation, they had to perform a classification task during which checking behaviors were observed. Results indicate that more checking behaviors (hesitations, checking) occurred in the high responsibility condition than in the low responsibility condition for subjects of both groups. After executing the task in the high responsibility condition, HP subjects reported more influence over and responsibility for negative consequences than MP subjects. These results suggest that high perfectionistic tendencies could predispose individuals to overestimate their perceived responsibility for negative events. Furthermore, perfectionism could be conceived as playing a catalytic role in the perception of responsibility. Results are discussed according to cognitive models of OCD.

Adult↗

PubMed1999

Prevalence of problem gambling: a replication study 7 years later.

OBJECTIVES: To investigate the relationship between availability of gambling activities and participation in gambling, maximum amount of money lost in 1 day to gambling, and number of pathological gamblers. METHOD: Two random samples (1002 and 1257 adults) were surveyed 7 years apart using the South Oaks Gambling Screen to identify pathological gamblers. RESULTS: Seven years later, significantly more people reported having gambled, and the number of pathological gamblers had increased by 75%. CONCLUSIONS: These findings support the hypothesis that increases in the availability of gambling are related to increases in the number of problem gamblers.

Adult↗

PubMed1998

Generalized anxiety disorder: a preliminary test of a conceptual model.

This study presents a preliminary test of a conceptual model of Generalized Anxiety Disorder (GAD) which is theoretically driven and has clear clinical implications. The model's main features are intolerance of uncertainty, beliefs about worry, poor problem orientation and cognitive avoidance, Subjects were 24 GAD patients and 20 non clinical control subjects. The results show that all main components of the model were highly related to the discriminant function and that intolerance of uncertainty was pivotal in distinguishing GAD patients from non clinical subjects. Further, the discriminant function derived from these four process variables was very effective for classifying GAD patients and non clinical subjects into their respective groups. Overall, 82% of subjects were correctly classified as 18 of 24 subjects in the GAD group and 18 of 20 subjects in the non clinical group were properly identified. The results are discussed in terms of the proposed model of GAD and its clinical implications.

Adult↗

PubMed1998

Cognitive treatment of pathological gamblers.

This study evaluates the efficacy of a cognitive treatment for pathological gambling. Five pathological gamblers were treated in a multiple baseline across subjects design. Cognitive correction targeted the erroneous perceptions towards the notion of randomness. Four subjects reported a clinically significant decrease in the urge to gamble, an increase in their perception of control, and no longer met the DSM-IV criteria for pathological gambling. Therapeutic gains were maintained at the 6 month follow-up. Results suggest that cognitive therapy targeting the misconception of the notion of randomness is a promising treatment for pathological gambling, a refractory disorder to most therapeutic interventions.

Adult↗

PubMed1998

Stimulus-control: nonpharmacologic treatment for insomnia.

OBJECTIVES: To evaluate the efficacy and applicability of a behavioural treatment for insomnia that can be administered by family physicians in various clinical settings. DESIGN: Efficacy of the treatment was evaluated by single-case experimental designs (multiple baseline across subjects). Applicability was assessed through semistructured interviews with physicians. SETTING: Two private offices, two offices in community health centres, and one office in a family medicine unit. PARTICIPANTS: Six general practitioners and 24 chronic insomniac patients recruited through media advertisements and from physicians' practices. Of an initial 38 subjects screened, six were excluded for sleep-onset latency less than 30 minutes, five for psychological conditions, one for physical handicaps, and two for other reasons. INTERVENTIONS: Physicians used stimulus-control treatment during individual therapeutic sessions. Patients using hypnotics were encouraged to taper off their medications after treatment was initiated. MAIN OUTCOME MEASURES: Time it took patients to get to sleep (sleep-onset latency), amount of hypnotic use, and practitioners' evaluation of the treatment. RESULTS: Fifteen patients completed the treatment; 80% of them reduced their sleep-onset latency. Six of the seven patients using hypnotics at the beginning of the study reduced or stopped their medications. All therapeutic gains were maintained at 3 and 6 months. Physicians thought stimulus-control treatment could be used in medical practice, but specified that it was most useful for highly motivated patients. CONCLUSION: Family physicians can use stimulus-control treatment effectively for patients with chronic insomnia. This nonpharmacologic approach could help motivated patients reduce their use of hypnotics.

Adult↗

PubMed1997

What do patients do with their obsessive thoughts?

Current models of Obsessive-Compulsive Disorder (OCD) accord a key role to neutralization in the maintenance of obsessional thoughts. Although overt compulsions are well known and have frequently been described in the literature, their cognitive equivalents have not been described to any great extent. This study systemically described the repertoire of strategies used by 29 OCD patients with dominant obsessive thoughts. Extensive repertoires were reported, characterized by low to moderate mean efficacy in removing the thoughts. The majority of strategies were not cognitive rituals nor neutralization in the narrow sense of 'attempts at putting right', even though they were effortful, intentional, and deployed in a strategic way. The results are discussed in terms of the need for a broad definition of neutralization that includes all strategies including coping strategies. Clinical implications are discussed and comprehensive response prevention is recommended for the treatment of obsessive thoughts.

Adaptation, Psychological↗

PubMed1997

Excessive responsibility in obsessional concerns: a fine-grained experimental analysis.

Excessive responsibility has been suggested as a central cognitive variable associated with Obsessive-Compulsive Disorder (OCD) (Rachman, 1993, Behaviour Research and Therapy, 31, 149-154; Salkovskis, 1985, Behaviour Research and Therapy, 23, 571-583; Salkovskis, 1989, Behaviour Research and Therapy, 27, 677-682; Salkovskis, 1995, Current controversies in the anxiety disorders). Several studies using questionnaires (e.g. Rhéaume, Freeston, Dugas, Letarte & Ladouceur, 1995, Behaviour Research and Therapy, 33, 785-794) and experimental manipulations (Ladouceur et al., 1995, Behaviour Research and Therapy, 33, 937-946; Lopatka & Rachman, 1995, Behaviour Research and Therapy, 33, 673-684) have shown evidence for such a link between responsibility and obsessive-compulsive symptoms. Responsibility has been defined as the belief of possessing a pivotal power to provoke or preventing crucial negative consequences (Salkovskis et al., 1992 cited in Salkovskis, 1995, Current controversies in the anxiety disorders). This definition emphasizes two related cognitive distortions: personal influence and potential negative consequences. The respective roles of each component and their potential interaction need to be clarified. The present study tests the effects of an experimental manipulation of both influence and negative consequences on perceived responsibility and checking behavior during a classification task. Seventy-seven subjects were divided into four experimental conditions: the Combined condition, the Influence condition, the Negative Consequences condition and the Control condition. After the experimental manipulation, subjects from each condition had to classify capsules in semi-transparent bottles. Results showed that personal influence is the best predictor of perceived responsibility. Although increased potential negative consequences were sufficient to trigger hesitations, combined influence and negative consequences were necessary to produce modifications. These results are consistent with the results obtained by the questionnaires (e.g. Rhéaume, Ladouceur, Freeston & Letarte, 1995a, Behaviour Research and Therapy, 33, 159-169) and previous manipulations (e.g. Ladouceur et al., 1995).

Adult↗

PubMed1997

Cognitive-behavioral treatment of obsessive thoughts: a controlled study.

Twenty-nine patients with obsessive-compulsive disorder as diagnosed in accordance with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; American Psychiatric Association, 1987) who did not have overt compulsive rituals were randomly assigned to treatment and waiting-list conditions. Patients in the treatment condition received cognitive-behavioral therapy consisting of a detailed explanation of the occurrence and maintenance of obsessive thoughts, exposure to obsessive thoughts, response prevention of all neutralizing strategies, cognitive restructuring, and relapse prevention. Compared with waiting-list patients, treated patients improved significantly on measures of severity of obsessions, current functioning, self-report obsessive-compulsive symptoms, and anxiety. When waiting-list patients were subsequently treated, the combined group improved on all outcome measures. Treatment gains were maintained at 6-month follow-up. Results indicate that cognitive-behavioral therapy is effective in the treatment of patients with obsessive thoughts, a group that has often been considered resistant to treatment.

Adult↗

PubMed1997

Cognitive and behavioral treatment of pathological gambling: a controlled study.

This study evaluated the efficacy of a cognitive-behavioral treatment package for pathological gambling. Twenty-nine men who met criteria for pathological gambling in accordance with the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; DSM-III-R; American Psychiatric Association, 1987) were randomly assigned to treatment or wait-list control. The treatment included 4 components: (a) cognitive correction of erroneous perceptions about gambling, (b) problem-solving training, (c) social skills training, and (d) relapse prevention. The dependent variables were the South Oaks Gambling Screen, perception of control, frequency of gambling, perceived self-efficacy, desire to gamble, and number of DSM-III-R criteria met by participants. Posttest results indicated highly significant changes in the treatment group on all outcome measures, and analysis of data from 6- and 12-month follow-ups revealed maintenance of therapeutic gains. Recommendations for clinical interventions are discussed and focus on the cognitive correction of erroneous perceptions of gambling.

Adult↗