Thought-action fusion in obsessive-compulsive disorder and its relationship with schizotypy and autistic traits

ABSTRACT Objective: The relationship between mental disorders and thought-action fusion, schizotypality and autistic traits has attracted attention for many years. In this study, we aimed to investigate the relationships between OCD and thought-action fusion, schizotypality and autistic traits. Method: Voluntary patients who were admitted to Aydın Adnan Menderes University Hospital Mental Health and Diseases Outpatient Clinic or followed up in inpatient psychiatry service, who met the diagnostic criteria of OCD with DSM-IV Structured Clinical Interview-I (SCID-I) for Axis I disorders, who had Yale-Brown Obsession Compulsion Rating Scale (Y-BOCS) score ≥ 16, who met the inclusion criteria and who did not meet any of the exclusion criteria were included in the study. Sociodemographic data form, DSM-IV Structured Clinical Interview-I Scale for Axis I disorders, Yale-Brown Obsession Compulsion Rating Scale, Beck Depression Rating Inventory (BDI), Thought Action Fusion Scale (TAFS), Autism Spectrum Questionnaire (OSA), Beck Anxiety Inventory (BAI), Schizotypal Personality Questionnaire. (SPQ) applied to all participants. Thus, the relationships between thought-action fusion, schizotypality and autistic characteristics in OCD patients were analysed. Results: Positive correlations were found between the total and all three dimensions of the TAFS and BAI, YBOCS total and subscale scores. A positive relationship was found between the total and morality dimensions of the TAFS and BDI. Positive correlations were found between the total and cognitive-perceptual, disorganised dimensions of the SPQ and the total and all three subscales of the TAFS, and between the interpersonal dimension of the SPQ and the total and moral dimension of the TAFS. Positive correlations were found between TAFS total and all three dimensions and OSA attention to detail dimension; between TAFS total and morality, contingency itself dimensions and OSA attention shifting dimension; between TAFS total and contingency itself dimension and OSA total. Positive correlations were also found between the TAFS self-possibility dimension and the OSA communication dimension. Positive correlations were found between OSA total and shifting attention, attention to detail, communication dimensions and SPQ total and cognitive perceptual, disorganised dimensions. Statistically significant positive correlations were found between the interpersonal dimension of SPQ and the OSA total and communication, social skills, attention shifting, attention to detail dimensions. Positive correlations were found between the total and attention shifting dimensions of the SPQ and BAI, and between the total and social skills, attention shifting, attention to detail, and communication dimensions of the SPQ and BDI. Statistically significant positive correlations were found between the total and all three dimensions of the SPQ and BAI, BDI, YBOCS total, obsessions and compulsions scores. In the linear regression analysis performed to determine the variables related to the TAFS, a statistically significant relationship was found between the cognitive perceptual dimension of the SPQ and the YBOCS obsession score. In the linear regression analysis performed to determine the variables associated with the morality dimension of the TAFS, a statistically significant relationship was found between the cognitive perceptual dimension of the SPQ and the YBOCS compulsion dimension. In the linear regression analysis performed to determine the variables related to the variables related to the self-likelihood dimension of the TAFS, a statistically significant relationship was found between the cognitive perceptual dimension of the SPQ and the YBOCS obsession score. In the linear regression analysis performed to determine the variables associated with the TAFS likelihood others dimension, a statistically significant relationship was found between the OSA attention to detail dimension and the YBOCS obsession dimension. The effect of cognitive perceptual schizotypic personality traits and YBOCS obsession scores on TAFS total scores were evaluated; it was found that cognitive perceptual schizotypy scores had a partial mediating effect on the relationship between TAFS total scores and YBOCS obsession scores; 1 unit increase in YBOCS obsession score increased TAFS total score by 2. 096 points and a 1-unit increase in the cognitive perceptual schizotypy score increased the total score of the TAFS by 0.856 points. The effect of cognitive perceptual schizotypic personality traits and YBOCS compulsion scores on TAFS morality scores was evaluated; it was found that cognitive perceptual schizotypy scores had a partial mediating effect on the relationship between TAFS morality scores and YBOCS compulsion scores; 1 unit increase in YBOCS compulsion score increased TAFS morality score by 1. 206 points and 1 unit increase in the cognitive perceptual schizotypy score increased the TAFS morality score by 0.588 points. The effect of cognitive perceptual schizotypic personality traits and YBOCS obsession scores on TAFS likelihood self-scores were evaluated; it was found that cognitive perceptual schizotypy scores had a partial mediating effect on the relationship between TAFS likelihood self-scores and YBOCS obsession scores; 1 unit increase in YBOCS obsession score increased TAFS likelihood self-score by 0. 451 points and a 1-unit increase in the cognitive perceptual schizotypy score increased the TAFS likelihood itself score by 0.138 points. The effect of OSA attention to detail scores and YBOCS obsession scores on TAFS likelihood others scores were evaluated; it was found that the independent variable YBOCS obsession score did not predict the mediator. It was concluded that the TAFS likelihood others dimension had an independent effect on the OSA attention to detail and YBOCS obsession scores separately. Conclusion: To our knowledge, there is no study evaluating the relationship between thought-action fusion, schizotypy and autistic traits in obsessive-compulsive disorder. According to the findings of our study; some relationships were found between TAF, schizotypal characteristics and autistic characteristics in OCD patients. A partial effect of cognitive perceptual schizotypy was found on the dimensions of TAF and morality, likelihood itself. In addition, it was observed that the OSA attention to detail dimension was not mediator on the TAF likelihood others dimension. Although some of these relationships are compatible with the literature, further studies are needed to confirm and support some of them with new data. Keywords: Obsessive Compulsive Disorder, Thought Action Fusion , Schizotypal Personality Trait , Autistic Traits