Background & Aims: Studies conducted in the field of obsessive-compulsive disorder (OCD) show that various cognitive components play a role in this disorder. Researchers have identified three main levels of cognition in people with OCD: obsessive thoughts, cognitive appraisals, and underlying assumptions. These cognitive levels mutually affect each other and form an integrated system. In other words, primary obsessive thoughts are influenced by the person's cognitive evaluations of these thoughts, and these evaluations are also formed based on the basic assumptions of the person about himself, the world, and the future. Therefore, it can be said that certain cognitive patterns, especially false and extreme beliefs about responsibility, threat, and perfectionism, are characteristic features of people with OCD. Cognitive models of obsessive-compulsive disorder (OCD) believe that people with this disorder have an exaggerated and inaccurate interpretation of their thoughts, images, and impulses. These misinterpretations are rooted in dysfunctional beliefs that a person has about himself, the world, and the future. Beliefs such as feeling too much responsibility, worrying about catastrophic events, needing complete control, and perfectionism are among the common beliefs observed in people with OCD. These beliefs make the person consider obsessive thoughts as a serious threat and try to avoid unpleasant consequences by performing compulsive behaviors. Studies have shown that this process acts as a vicious cycle. At first, the person experiences thoughts that are unpleasant and threatening to him. Then, according to his dysfunctional beliefs, he evaluates these thoughts severely and gives them great importance. Finally, to reduce the anxiety caused by these thoughts, he turns to compulsive behaviors. But instead of reducing anxiety, these behaviors strengthen it and help maintain the disorder. Different researchers have identified different cognitive dimensions in people with OCD. McFall and Wollersheim (1979) have emphasized the role of beliefs such as one's ability, need for certainty, and avoidance of criticism. On the other hand, Warren and Guides (1979) have emphasized the importance of beliefs such as perfectionism, the need for certainty, and not accepting unpleasant thoughts in OCD. People with obsessive-compulsive disorder (OCD) typically experience unwanted and intrusive thoughts that cause them anxiety and distress. To cope with these thoughts, people with OC form dysfunctional beliefs that reinforce these thoughts and help perpetuate the disorder. Studies show that three main beliefs play a role in people with OCD: Overresponsibility and Exaggeration of Threat: People with OCD often feel that they are responsible for preventing bad events from happening and that they are to blame if they do happen. will be Also, they overestimate the probability of these events and consider the consequences to be much more serious than they are. The importance and controllability of thoughts: People with OCD believe that their obsessive thoughts are very important and meaningful and indicate the presence of a serious problem in them. Also, they believe that they can and should control their thoughts. Perfectionism and the need for certainty: People with OCD strongly value perfectionism and certainty. They cannot cope with uncertainty and doubt and therefore, seek to perform compulsive behaviors to achieve reassurance. Obsessive compulsive disorder is a very common and chronic disease associated with significant global disability.While there are many quantitative studies that examine the clinical characteristics and treatment methods of OCD, qualitative research that examines the lived experience of people with OCD is limited. Therefore, the aim of this study was to analyze the cognitive lived experience in people with obsessive-compulsive disorder in the form of a phenomenological study.
Methods: The study method was a qualitative and phenomenological research. The statistical population of the research included all people referring to the clinics and counseling centers of Rafsanjan city. By using the purposeful sampling method, the referring people who were diagnosed with obsessive-compulsive disorder based on clinical psychology interview, psychiatrist and DSM-5 diagnostic semi-structured clinical interview, were invited to the research as participants, using the descriptive phenomenological research method. Answer the question of what are the most important cognitive elements and components in their lived experiences. For this purpose, 12 people (6 men and 6 women) diagnosed with OCD disorder and aged 18-50 were interviewed from among the clients referred to the centers until the saturation of information was reached. Data analysis After recording and transcribing the interviews, coding concepts were extracted and reported using the Claysey method of main and secondary themes.
Results: What was determined from the extracted codes from the interview was the biocognitive experience in people with obsessive-compulsive disorder, which was based on 6 main themes and 54 sub-themes. The main themes were obtained in the form of individual, social, economic, cultural, emotional and operational consequences. Also, sub-themes extracted from these main themes based on the biological experiences of people, including lack of mental efficiency and extreme work of the mind, extreme responsibility, strict adherence to rules, academic perfectionism, compulsion to do tasks repeatedly, giving additional explanations in all tasks, He was sensitive to heartache and anxiety, the feeling of being annoyed when not doing things, extreme hatred of people, feeling of distrust, feeling of loneliness, control of thoughts, etc.
Conclusion: The results of the present study, while extracting and explaining lived experiences based on cognitive processes in people with OCD disorder, provided additional evidence in defense of the interpretative role of the informational element of cognition in predicting the tendency to this disorder. In such a way that by improving the cognitive processes and components of people with OCD disorder, the cognitive tendency of these people towards all kinds of obsessions can be managed. Therefore, obsessions continue as long as these misinterpretations and cognitive deviations exist. In fact, the cognitive interpretation of people with OCD is such that those thoughts form the basis of the tendency to perform compulsive actions in order to neutralize the anxiety caused by these thoughts and cognitive processes. Therefore, it is necessary for therapists and specialists in this field to pay attention to these lived experiences in cognitive dimensions and to use them to determine their treatment strategies.