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Dynamic conceptualizations of threat in obsessive-compulsive disorder (OCD)

Published online by Cambridge University Press:  01 October 2015

OLIVIA KNAPTON*
Affiliation:
The University of Birmingham
*
Address for correspondence: Dept. English Language and Applied Linguistics, The University of Birmingham, Edgbaston Campus, Edgbaston, Birmingham, B15 2TT, United Kingdom. tel: +44 (0)121 415 8346; e-mail: o.knapton@bham.ac.uk

Abstract

Obsessive-compulsive disorder (OCD) is a severe mental health problem of a heterogeneous nature. To add to discussions around defining coherent subtypes of OCD, this paper uses qualitative, cognitive linguistic analysis to show how episodes of OCD can be differentiated based on their underlying conceptualizations of threat. Spoken narratives of OCD episodes told by people with OCD were analyzed using image schema theory and cognitive approaches to deixis in discourse. Through an exploration of the participants’ subjective experiences of time, space, and uncertainty in their recounted OCD episodes, the findings demonstrate that perceptions of threats fluctuate as OCD episodes unfold, and that it is the perceived movement (or not) of the threat that induces distress. Moreover, the dynamism of the threat is conceptualized differently for different subtypes of OCD. This variation can in part be explained by the role of two image schemas in structuring OCD episodes: the SOURCE–PATH–GOAL image schema and the CONTAINER image schema. It is argued that the blanket notion of threat as often investigated in clinical models of OCD is not sensitive enough to capture these shifting perspectives. It is thus recommended that threat perception in OCD is researched as a dynamic, evolving, and highly subjective experience.

Type
Research Article
Copyright
Copyright © UK Cognitive Linguistics Association 2015 

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References

references

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders fifth edition (DSM-V). Washington: American Psychiatric Association.Google Scholar
Bloch, M. H., Landeros-Weisenberger, A., Rosario, M. C., Pittenger, C., & Leckman, J. F. (2008). Meta-analysis of the symptom structure of obsessive-compulsive disorder. American Journal of Psychiatry, 165, 15321542.Google Scholar
Brown, B., Crawford, P., Nerlich, B., & Koteyko, N. (2008). The habitus of hygiene: discourses of cleanliness and infection control in nursing work. Social Science & Medicine, 67, 10471055.Google Scholar
Bühler, K. (1982). The deictic field of language and deictic words. In Jarvella, R. J. & Klein, W. (Eds.), Speech, place, and action: studies in deixis and related topics (pp. 930). New York: John Wiley & Sons.Google Scholar
Calamari, J. E., Wiegartz, P. S., Riemann, B. C., Cohen, R. J., Greer, A., Jacobi, D. M., … Carmin, C. (2004). Obsessive-compulsive disorder subtypes: an attempted replication and extension of a symptom-based taxonomy. Behaviour Research and Therapy, 42, 647670.CrossRefGoogle ScholarPubMed
Cameron, L. (2007). Confrontation or complementarity? Metaphor in language use and cognitive metaphor theory. Annual Review of Cognitive Linguistics, 5, 107135.CrossRefGoogle Scholar
Cameron, L., Maslen, R., Todd, Z., Maule, J., Stratton, P., & Stanley, N. (2009). The discourse dynamics approach to metaphor and metaphor-led discourse analysis. Metaphor and Symbol, 24(2), 6389.CrossRefGoogle Scholar
Campbell, R., & Longhurst, R. (2013). Obsessive-compulsive disorder (OCD): gendered metaphors, blogs and online forums. New Zealand Geographer, 69, 8393.CrossRefGoogle Scholar
Campkin, B. (2007). Degradation and regeneration: theories of dirt and the contemporary city. In Campkin, B. & Cox, R. (Eds.), Dirt: new geographies of cleanliness and contamination (pp. 6879). London: IB Tauris.Google Scholar
Cap, P. (2013). Proximization: the pragmatics of symbolic distance crossing. Amsterdam: John Benjamins.CrossRefGoogle Scholar
Capps, L., & Ochs, E. (1995). Constructing panic: the discourse of agoraphobia. Cambridge, MA: Harvard University Press.Google Scholar
Chafe, W. L. (1980). The deployment of consciousness in the production of a narrative. In Chafe, W. L. (Ed.), The pear stories: cognitive, cultural and linguistic aspects of narrative production (pp. 950). Norwood, NJ: Ablex.Google Scholar
Chafe, W. L. (1998). Things we can learn from repeated tellings of the same experience. Narrative Inquiry, 8(2), 269285.CrossRefGoogle Scholar
Charteris-Black, J. (2012). Shattering the bell jar: metaphor, gender, and depression. Metaphor and Symbol, 27(3), 199216.Google Scholar
Chilton, P. (2004). Analysing political discourse. London: Routledge.Google Scholar
Chilton, P. (2005). Vectors, viewpoint and viewpoint shift. Annual Review of Cognitive Linguistics, 3, 78116.CrossRefGoogle Scholar
Dancygier, B. (1998). Conditionals and prediction: time, knowledge and causation in conditional constructions. Cambridge: Cambridge University Press.Google Scholar
Davidson, J. (2000). '...the world was getting smaller': women, agoraphobia and bodily boundaries. Area, 32(1), 3140.Google Scholar
Davis, L. J. (2008). Obsession: a history. Chicago and London: University of Chicago Press.Google Scholar
Declerck, R. (2011). The definition of modality. In Patard, A. & Brisard, F. (Eds.), Cognitive approaches to tense, aspect and modality (pp. 2144). Amsterdam: John Benjamins.CrossRefGoogle Scholar
Evans, V., & Green, M. (2006). Cognitive linguistics: an introduction. Edinburgh: Edinburgh University Press.Google Scholar
Fennell, D., & Liberato, A. S. Q. (2007). Learning to live with OCD: labeling, the self, and stigma. Deviant Behavior, 28(4), 305331.Google Scholar
Fillmore, C. J. (1982). Towards a descriptive framework for spatial deixis. In Jarvella, R. J. & Klein, W. (Eds.), Speech, place, and action: studies in deixis and related topics (pp. 3159). New York: John Wiley & Sons.Google Scholar
Gee, J. P. (1986). Units in the production of narrative discourse. Discourse Processes, 9, 391422.CrossRefGoogle Scholar
Georgakopoulou, A. (2007). Small stories, interaction and identities. Amsterdam: John Benjamins.Google Scholar
Giele, C. L., van den Hout, M. A., Engelhard, I. M., Dek, E. C. P., & Klein Hofmeijer, F. (2011). Obsessive-compulsive reasoning makes an unlikely catastrophe more credible. Journal of Behavior Therapy and Experimental Psychiatry, 42, 293297.Google Scholar
Hart, C. (2007). Critical Discourse Analysis and conceptualisation: mental spaces, blended spaces and discourse spaces in the British National Party. In Hart, C. & Lukeš, D. (Eds.), Cognitive Linguistics in Critical Discourse Analysis: application and theory (pp. 107131). Newcastle: Cambridge Scholars Publishing.Google Scholar
Hart, C. (2011). Force-interactive patterns in immigration discourse: a cognitive linguistic approach to CDA. Discourse & Society, 22(3), 269286.CrossRefGoogle Scholar
Hart, C. (2014). Discourse, grammar and ideology: functional and cognitive perspectives. London: Bloomsbury.Google Scholar
Hart, C. (2015). Viewpoint in linguistic discourse. Critical Discourse Studies, 12(3), 238260.Google Scholar
Johnson, M. (1987). The body in the mind: the bodily basis of meaning, imagination and reason. Chicago: Chicago University Press.CrossRefGoogle Scholar
Keong, Y., Mogan, C., & Kyrios, M. (2012). Obsessive-compulsive disorder and comorbid depression: the role of OCD-related and non-specific factors. Journal of Anxiety Disorders, 26(5), 565573.Google Scholar
Knapton, O. (2015). Experiences of obsessive-compulsive disorder (OCD): activity, state and object episodes. Qualitative Health Research. Online: DOI: 10.1177/1049732315601666.Google Scholar
Koteyko, N., Brown, B., & Crawford, P. (2008). The dead parrot and the dying swan: the role of metaphor scenarios in UK press coverage of avian flu in the UK in 2005–2006. Metaphor and Symbol, 23, 242261.Google Scholar
Lakoff, G. (1987). Women, fire, and dangerous things. Chicago: University of Chicago Press.Google Scholar
Lakoff, G., & Johnson, M. (1980). Metaphors we live by. Chicago: University of Chicago Press.Google Scholar
Lakoff, G., & Johnson, M. (1999). Philosophy in the flesh. New York: Basic Books.Google Scholar
Langacker, R. (2008). Cognitive Grammar: a basic introduction. Oxford: Oxford University Press.CrossRefGoogle Scholar
Langlotz, A. (2015). Creating social orientation through language: a socio-cognitive theory of situated social meaning. Amsterdam: John Benjamins.Google Scholar
Levitt, H., Korman, Y., & Angus, L. (2000). A metaphor analysis in treatments of depression: metaphor as a marker of change. Counselling Psychology Quarterly, 13(1), 2335.Google Scholar
Lochner, C., & Stein, D. J. (2006). Does work on obsessive-compulsive spectrum disorders contribute to understanding the heterogeneity of obsessive-compulsive disorder. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 30, 353361.Google Scholar
Lyons, J. (1977). Semantics. Cambridge: Cambridge University Press.Google Scholar
McKay, D. M., Abramowitz, J. S., Calamari, J. E., Kyrios, M., Radomsky, A. S., Sookman, D., … Wilhelm, S. (2004). A critical evaluation of obsessive-compulsive disorder subtypes: symptoms versus mechanisms. Clinical Psychology Review, 24, 283313.CrossRefGoogle ScholarPubMed
McMullen, L. M., & Conway, J. B. (2002). Conventional metaphors for depression. In Fussell, S. R. (Ed.), The verbal communication of emotions: interdisciplinary perspectives (pp. 167181). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Nerlich, B. (2011). The role of metaphor scenarios in disease management discourses: foot and mouth disease and avian influenza. In Handl, S. & Hans-Jörg, S. (Eds.), Windows to the mind (pp. 115142). Berlin: Mouton de Gruyter.Google Scholar
O'Connor, K. (2002). Intrusions and inferences in obsessive compulsive disorder. Clinical Psychology and Psychotherapy, 9, 3846.Google Scholar
OCCWG (1997). Cognitive assessment of obsessive-compulsive disorder. Behaviour Research and Therapy, 35(7), 667681.Google Scholar
Riessman, C. K. (1990). Strategic uses of narrative in the presentation of self and illness: a research note. Social Science & Medicine, 30(11), 11951200.Google Scholar
Riskind, J. H. (1997). Looming vulnerability to threat: a cognitive paradigm for anxiety. Behaviour Research & Therapy, 35(8), 685702.Google Scholar
Riskind, J. H., Abreu, K., Strauss, M., & Holt, R. (1997). Looming vulnerability to spreading contamination in subclinical OCD. Behaviour Research & Therapy, 35(5), 405414.Google Scholar
Riskind, J. H., Rector, N. A., & Cassin, S. E. (2011). Examination of the convergent validity of looming vulnerability in the anxiety disorders. Journal of Anxiety Disorders, 25(8), 989993.Google Scholar
Salkovskis, P. M. (1985). Obsessional-compulsive problems: a cognitive behavioural analysis. Behaviour Research and Therapy, 25, 571583.Google Scholar
Salkovskis, P. M. (1989). Cognitive-behavioural factors and the persistence of intrusive thoughts in obsessional problems. Behaviour Research and Therapy, 27(6), 677682.Google Scholar
Sanders, J., & Redeker, G. (1996). Perspective and the representation of speech and thought in narrative discourse. In Fauconnier, G. & Sweetser, E. (Eds.), Spaces, worlds and grammar (pp. 290317). Chicago: University of Chicago Press.Google Scholar
Schank, R., & Abelson, R. (1977). Scripts, plans, goals, and understanding: an inquiry into human knowledge structure. Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
Segal, E. M. (1995). Narrative comprehension and the role of Deictic Shift Theory. In Duchan, J. F., Bruder, G. A., & Hewitt, L. E. (Eds.), Deixis in narrative: a cognitive science perspective (pp. 317). London: Routledge.Google Scholar
Segrott, J., & Doel, M. A. (2004). Disturbing geography: obsessive-compulsive disorder as spatial practice. Social & Cultural Geography, 5(4), 597614.Google Scholar
Semino, E., Demjén, Z., Demmen, J., Koller, V., Payne, S., Hardie, A., & Rayson, P. (2015). The online use of Violence and Journey metaphors by patients with cancer, as compared with health professionals: a mixed methods study. BMJ Supportive & Palliative Care, 0, 17. Online: doi:10.1136/bmjspcare-2014-000785.Google Scholar
Steedman, M. J. (1982). Reference to past time. In Jarvella, R. J. & Klein, J. D. (Eds.), Speech, place, and action: studies in deixis and related topics (pp. 125157). New York: John Wiley & Sons.Google Scholar
Sweetser, E. (1990). From etymology to pragmatics: metaphorical and cultural aspects of semantic structure. Cambridge: Cambridge University Press.Google Scholar
Talmy, L. (2000). Toward a cognitive semantics, Vol. I. Cambridge, MA: MIT Press.Google Scholar
Tay, D. (2013). Metaphor in psychotherapy. Amsterdam: John Benjamins.Google Scholar
Tolin, D. F., Worhunsky, P., & Maltby, N. (2004). Sympathetic magic in contamination-related OCD. Journal of Behavior Therapy and Experimental Psychiatry, 35, 193205.Google Scholar
Van Schalkwyk, G. I., Bhalla, I. P., Griepp, M., Kelmendi, B., Davidson, L., & Pittenger, C. (2015). Toward understanding the heterogeneity of obsessive-compulsive disorder: evidence from narratives in adult patients. Australian and New Zealand Journal of Psychiatry, Online: DOI: 0004867415579919, 18.Google Scholar
Verschueren, J. (1999). Understanding pragmatics. London: Arnold.Google Scholar