Papers by Jessica Grisham
Journal of Experimental Psychopathology, 2018
The inference-based approach (IBA) is a cognitive account of the etiology and maintenance of obse... more The inference-based approach (IBA) is a cognitive account of the etiology and maintenance of obsessivecompulsive disorder (OCD). According to the IBA, individuals with OCD confuse an imagined possibility with an actual probability, which leads them to become immersed in their obsessions. To investigate the relationship between OCD and the cognitive factors proposed to add to immersion, we used the Choice Blindness Paradigm (CBP). This paradigm is an experimental reasoning task designed to induce confabulatory reasoning. Undergraduate participants with high levels of OCD symptoms (n ¼ 29) were compared to those with low levels of OCD symptoms (n ¼ 32) with respect to their performance on the CBP. Compared to low-OCD participants, the results indicated that high-OCD participants were more certain (one aspect of immersion) when reasoning about falsely occurring events. However, the cognitive factors proposed by the IBA to underpin immersion did not mediate the relationship between OCD status and certainty regarding false events. Replication and refinement of the current study will help to determine the significance of these cognitive factors in obsessions.
Journal of Anxiety Disorders, May 1, 2020
Visual perspective may have an important role in the phenomenology of intrusive images relevant t... more Visual perspective may have an important role in the phenomenology of intrusive images relevant to psychological disorders such as obsessive-compulsive disorder (OCD). The aim of the current study was to examine the subjective and behavioural effects of manipulating visual perspective, to either field or observer, on intrusive images related to doubting and contamination concerns. One hundred and twelve undergraduate participants with high levels OCD symptoms were asked to identify and imagine an intrusive image related to either doubting or contamination concerns. We then randomly assigned them to re-visualise their image from either a field (firstperson) or observer (third-person) visual perspective. Participants shifted towards using an observer perspective demonstrated a greater decrease on ratings of subjective measures of image-related distress, prospective likelihood of the image occurring, and urges to suppress the image, relative to those shifted to a field perspective. In addition, those in the observer perspective evidenced a greater decrease on behavioural indices relevant to OCD, such as reduced frequency of the intrusive image and decreased efforts to neutralise the image. We discuss implications for imagery in OCD.
Journal of Anxiety Disorders, Apr 1, 2019
The inference-based approach (IBA) is one cognitive model that aims to explain the aetiology and ... more The inference-based approach (IBA) is one cognitive model that aims to explain the aetiology and maintenance of obsessive-compulsive disorder (OCD). The model proposes that certain reasoning processes lead an individual with OCD to confuse an imagined possibility with an actual probability, a state termed inferential confusion. One such reasoning process is inverse reasoning, in which hypothetical causes form the basis of conclusions about reality. Although previous research has found associations between a selfreport measure of inferential confusion and OCD symptoms, evidence of a specific association between inverse reasoning and OCD symptoms is lacking. In the present study, we developed a task-based measure of inverse reasoning in order to investigate whether performance on this task is associated with OCD symptoms in an online sample. The results provide some evidence for the IBA assertion: greater endorsement of inverse reasoning was significantly associated with OCD symptoms, even when controlling for general distress and OCD-related beliefs. Future research is needed to replicate this result in a clinical sample and to investigate a potential causal role for inverse reasoning in OCD.
Journal of Obsessive-Compulsive and Related Disorders, Jul 1, 2022
Journal of Behavior Therapy and Experimental Psychiatry, Sep 1, 2019
Journal of Behavior Therapy and Experimental Psychiatry, Jun 1, 2022
BACKGROUND AND OBJECTIVES Excessive reassurance seeking (ERS) in OCD increases following scenario... more BACKGROUND AND OBJECTIVES Excessive reassurance seeking (ERS) in OCD increases following scenarios with high threat and personal responsibility, but the mechanism via which ERS addresses these concerns is unclear. We investigated whether reassurance following OCD-related threats facilitated temporary threat re-appraisal and/or transferred responsibility to others. We also examined the 'checking by proxy' theory of OCD ERS by comparing the functional mechanisms of reassurance and checking behaviour. METHODS Community participants (N = 398) were recruited through MTurk and randomised to one of four conditions: ambiguous object-derived (checking) information, ambiguous person-derived (reassurance) information, unambiguous object-derived information and unambiguous person-derived information. Participants read scenarios that conveyed a risk of harm or contamination before imagining receiving reassurance or checking information as per their condition. Ratings of personal and external responsibility, threat likelihood and uncertainty were made before and after receiving the information. RESULTS In support of a checking by proxy hypothesis of ERS, participants in the unambiguous information conditions reported decreased uncertainty, decreased estimated threat likelihood and increased responsibility of others, regardless of whether they imagined checking or receiving reassurance. Those in the ambiguous conditions reported no changes in threat estimation or responsibility beliefs. OCD symptom level moderated responses to ambiguity: unlike low OCD, high OCD participants did not respond differentially to ambiguous versus unambiguous reassurance. LIMITATIONS The study was performed online due to Covid-19 restrictions and utilised non-clinical participants. CONCLUSIONS Like checking, reassurance facilitates short-term threat re-appraisal and diffuses responsibility following obsessive threats. Differentiated responses to reassurance ambiguity disappear as OC symptoms increase.
Journal of Behavior Therapy and Experimental Psychiatry, Dec 1, 2017
Journal of Obsessive-Compulsive and Related Disorders, Jul 1, 2022
Journal of Behavior Therapy and Experimental Psychiatry, Jun 1, 2022
BACKGROUND AND OBJECTIVES Excessive reassurance seeking (ERS) in OCD increases following scenario... more BACKGROUND AND OBJECTIVES Excessive reassurance seeking (ERS) in OCD increases following scenarios with high threat and personal responsibility, but the mechanism via which ERS addresses these concerns is unclear. We investigated whether reassurance following OCD-related threats facilitated temporary threat re-appraisal and/or transferred responsibility to others. We also examined the 'checking by proxy' theory of OCD ERS by comparing the functional mechanisms of reassurance and checking behaviour. METHODS Community participants (N = 398) were recruited through MTurk and randomised to one of four conditions: ambiguous object-derived (checking) information, ambiguous person-derived (reassurance) information, unambiguous object-derived information and unambiguous person-derived information. Participants read scenarios that conveyed a risk of harm or contamination before imagining receiving reassurance or checking information as per their condition. Ratings of personal and external responsibility, threat likelihood and uncertainty were made before and after receiving the information. RESULTS In support of a checking by proxy hypothesis of ERS, participants in the unambiguous information conditions reported decreased uncertainty, decreased estimated threat likelihood and increased responsibility of others, regardless of whether they imagined checking or receiving reassurance. Those in the ambiguous conditions reported no changes in threat estimation or responsibility beliefs. OCD symptom level moderated responses to ambiguity: unlike low OCD, high OCD participants did not respond differentially to ambiguous versus unambiguous reassurance. LIMITATIONS The study was performed online due to Covid-19 restrictions and utilised non-clinical participants. CONCLUSIONS Like checking, reassurance facilitates short-term threat re-appraisal and diffuses responsibility following obsessive threats. Differentiated responses to reassurance ambiguity disappear as OC symptoms increase.
Clinical Psychologist, Mar 1, 2019
Behaviour Research and Therapy
Psychological Medicine, 2020
BackgroundCognitive behavior therapy (CBT) is effective for most patients with a social anxiety d... more BackgroundCognitive behavior therapy (CBT) is effective for most patients with a social anxiety disorder (SAD) but a substantial proportion fails to remit. Experimental and clinical research suggests that enhancing CBT using imagery-based techniques could improve outcomes. It was hypothesized that imagery-enhanced CBT (IE-CBT) would be superior to verbally-based CBT (VB-CBT) on pre-registered outcomes.MethodsA randomized controlled trial of IE-CBT v. VB-CBT for social anxiety was completed in a community mental health clinic setting. Participants were randomized to IE (n = 53) or VB (n = 54) CBT, with 1-month (primary end point) and 6-month follow-up assessments. Participants completed 12, 2-hour, weekly sessions of IE-CBT or VB-CBT plus 1-month follow-up.ResultsIntention to treat analyses showed very large within-treatment effect sizes on the social interaction anxiety at all time points (ds = 2.09–2.62), with no between-treatment differences on this outcome or clinician-rated seve...
Journal of Obsessive-Compulsive and Related Disorders, Oct 1, 2019
The cognitive-behavioural model of hoarding posits that maladaptive beliefs play a causal role in... more The cognitive-behavioural model of hoarding posits that maladaptive beliefs play a causal role in saving behaviours. These beliefs may operate as interpretive biases to save in ambiguous situations in which hoarding individuals must decide whether to discard an item. We used a novel interpretative cognitive bias modification paradigm (CBM-I) to modify hoarding-related interpretive biases in a sample of undergraduates with high hoarding symptoms (N = 95). Participants were randomly allocated to either a positive CBM-I training condition, which was designed to reduce hoarding-related biases, or a neutral (control) CBM-I training condition. They completed self-report measures of hoarding symptoms and beliefs, and behavioural measures of discarding before and after training. Although there were no differences between conditions on post-training behavioural tasks, the positive condition reported reduced hoarding symptoms and beliefs one week after CBM-I training compared to the neutral condition. We review these findings in light of previous research and consider potential clinical implications.
Behaviour Research and Therapy, Jul 1, 2007
A group of patients with compulsive hoarding (n ¼ 30) was compared to a mixed clinical group (n ¼... more A group of patients with compulsive hoarding (n ¼ 30) was compared to a mixed clinical group (n ¼ 30) and a nonclinical community group (n ¼ 30) on laboratory tests of information-processing features hypothesized to be central to hoarding (memory, attention, and decision-making). Hoarding patients demonstrated slower and more variable reaction time, increased impulsivity, greater difficulty distinguishing targets and nontargets, and worse spatial attention relative to comparison groups. Multiple regression analyses demonstrated that slower reaction time and increased impulsivity were significantly related to hoarding symptoms over and above the effect of depression, schizotypy, and other obsessivecompulsive disorder (OCD) symptoms. There were no group differences on a test of emotion-based decision-making. Results are discussed in terms of previous findings and theoretical models of compulsive hoarding.
Frontiers in Psychology, May 4, 2023
Introduction: Pilots are a unique occupational group who perform a specialised job and face signi... more Introduction: Pilots are a unique occupational group who perform a specialised job and face significant stressors. Pilot mental health has received increased attention since Germanwings Flight 9525; however, this research has largely focused on general anxiety, depression, and suicide and relied on a questionnairebased methodology. This approach is likely to miss various mental health issues that may affect pilot wellbeing, leaving the prevalence of mental health issues in aviation unclear. In addition, the COVID-19 pandemic is likely to have a particular impact on the mental health and wellbeing of pilots, who experienced the devastating effect of COVID-19 on the industry. In the present study, we conducted a comprehensive assessment of 73 commercial pilots during the COVID-19 pandemic, using the DIAMOND semistructured diagnostic interview and explored possible associated vulnerability and protective factors, including life event stressors, personality, passion, lifestyle factors, and coping strategies. The COVID-19 pandemic had a significant impact on aviation during the time of this study, affecting 95% of participants. The diagnostic results revealed over one third of pilots had symptoms of a diagnoseable mental health disorder. Anxiety disorders were the most commonly found disorders, followed by Attention Deficit Hyperactivity Disorder (ADHD), Adjustment Disorder, and Depressive Disorders. Pilots' high life event scores placed them at an increased risk for the development of stress-related illness, though did not explain which pilots had mental health difficulties in this study. Regression analysis supported a diathesis-stress model for pilot mental health, with disagreeableness and obsessive passion contributing to pilots' development of mental health issues, and nutrition as the most important protective factor. frontiersin.org Ackland et al. 10.3389/fpsyg.2023.1073857 Discussion: This study, though limited to the COVID-19 pandemic, provides a valuable precedent for a more thorough assessment of pilot mental health, and contributes to the broader understanding of pilot mental health, including suggestions to target factors associated with the development of mental health issues.
Journal of Obsessive-Compulsive and Related Disorders, Apr 1, 2023
Journal of Obsessive-Compulsive and Related Disorders, 2023
Aerospace medicine and human performance, Sep 1, 2022
INTRODUCTION: Pilots’ mental health has received increased attention following Germanwings Flight... more INTRODUCTION: Pilots’ mental health has received increased attention following Germanwings Flight 9525 in 2015, where the copilot intentionally crashed the aircraft into the French Alps, killing all on board. An investigation of this incident found that the pilot had a depressive disorder.METHODS: This systematic review investigated peer reviewed studies of pilot mental health published since 1980. A total of 58 papers were identified.RESULTS: Two main methodologies have been employed: questionnaires and database record searches. Anxiety, depression, and suicide were the most commonly investigated mental health conditions. There were almost an equal number of studies that found a higher prevalence of psychological symptoms in pilots as those that found a lower prevalence, relative to controls or the general population. Prevalence rates were higher in studies relying solely on questionnaires than in studies employing database record searches.DISCUSSION: Prevalence estimates are closely associated with methodology, so it is difficult to determine the true rate. Factors that might account for low prevalence estimates include under-reporting of symptoms by pilots and a reluctance to diagnose on the part of health professionals. Factors that might account for high prevalence estimates include anonymous assessment, the use of questionnaires that do not align with clinical disorders, and inconsistent cut-off scores. It is recommended that future studies on prevalence use well-validated clinical measures, and that more research be conducted on the effects of particular disorders on job performance.Ackland CA, Molesworth BRC, Grisham JR, Lovibond PF. Pilot mental health, methodologies, and findings: a systematic review. Aerosp Med Hum Perform. 2022; 93(9): 696–708.
Journal of Experimental Psychopathology, Jul 1, 2018
The Macbeth effect is a proposed phenomenon, whereby feelings of immorality activate a desire to ... more The Macbeth effect is a proposed phenomenon, whereby feelings of immorality activate a desire to cleanse. Extensions of this theory suggest that cleansing alleviates immoral feelings, thus reducing the urge to engage in compensatory behaviors, such as volunteering. We examined the Macbeth effect and volunteerism in undergraduate students with high levels of obsessive-compulsive disorder contamination concerns (n ¼ 164). Participants underwent an immorality, anxiety, or neutral emotion-induction condition and subsequently cleansed their hands or performed a control task. For participants in the immorality condition, increased ratings of distress were associated with increased accessibility of cleansing words. Furthermore, individuals in the immorality condition who cleansed volunteered for significantly less time than those who did not cleanse. We discuss findings in relation to the literature on the Macbeth effect and mental contamination.
Journal of affective disorders reports, Dec 1, 2022
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Papers by Jessica Grisham