1.
Enhancing mental health literacy in obsessive-compulsive disorder and reducing stigma via smartphone: A randomized controlled trial protocol.
Chaves, A, Arnáez, S, Castilla, D, Roncero, M, García-Soriano, G
Internet interventions. 2022;:100560
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a disabling disorder that can be successfully treated. However, individuals with OCD do not seek or delay seeking treatment. This delay may be explained by poor mental health literacy and stigmatizing attitudes toward OCD in community. In order to work on these variables, a gamified mental health mobile application (app) called esTOCma has been developed. The purpose of this study is to describe the protocol for a study to test the efficacy of esTOCma, increasing mental health literacy and help-seeking intention, reducing the stigmatizing attitudes and social distance suffered by people with OCD, as well as the distress associated with obsessive-compulsive symptoms. METHODS A randomized controlled trial with a crossover design with two conditions (immediate-use App group versus delayed-use App group) will be conducted on a non-clinical adult sample of the community of a minimum size of 200 participants. Participants in the immediate-use App group will start using the app at baseline until completion (10 days); whereas participants in the delayed-use App group will wait 10 days, and then start using the app until completion (10 days). The outcomes will be measured at four assessment points (baseline; 10 days from baseline; and 20 days from baseline; and after 3 months). The following instruments will be administered: Attribution Questionnaire, General Help-Seeking Questionnaire, Social Distance Scale, Mental Health Literacy, Psychoeducation Questionnaire, Social Desirability Scale, Single-Item Self-esteem Scale, and Obsessive-Compulsive Inventory-Revised. DISCUSSION This protocol presents the first study to describe a randomized control trial of a mental health app focused on changing mental health literacy, stigmatizing attitudes, social distance and help-seeking intention associated with OCD. An app intervention of these characteristics is especially relevant nowadays as the COVID-19 pandemic has increased obsessive-compulsive symptoms and severity. An improvement in general knowledge about OCD and a reduction in stigma could be associated with earlier OCD detection and an increase in help-seeking intention, which could result in greater wellbeing. Moreover, normalizing intrusions and knowledge about the cognitive OCD model could serve as a protective variable in vulnerable individuals. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04777292. Registered February 23, 2021, https://clinicaltrials.gov/ct2/show/NCT04777292.
2.
Teachers' Knowledge and Stigmatizing Attitudes Associated With Obsessive-Compulsive Disorder: Effectiveness of a Brief Educational Intervention.
Chaves, A, Arnáez, S, Roncero, M, García-Soriano, G
Frontiers in psychiatry. 2021;:677567
Abstract
Because children and adolescents are vulnerable to developing obsessive-compulsive disorder (OCD), classroom teachers play an important role in the early identification and intervention in students with OCD. The present study aims to explore the recognition of OCD, general knowledge about this disorder, implications in the classroom, and stigmatizing attitudes among teachers, as well as the effectiveness of a brief educational intervention about OCD. Participants (n = 95; mean age = 43. 29 years old; 64.3% female) were primary and secondary school teachers who were randomly assigned to an experimental group or a control group. All of them completed a set of self-report questionnaires, read an educational fact sheet (either about OCD in the experimental group or about a healthy diet in the control group), and again completed the questionnaires. Results show that prior to the intervention, most of the teachers identified the contamination and order OCD symptoms described in a vignette as specific to OCD (82.1%) and would recommend talking about the problem (98.9%) and seeking help (94.7%). However, only a few (36.8%) knew about the most effective OCD treatments or identified compulsions as a main OCD symptom (33%). Moreover, only about half of the teachers correctly identified OCD's possible interference in classroom routines, such as delays to achieve perfection or concentration problems, and strategies for dealing with OCD, such as continuing with the class rhythm. Stigma levels were from low to moderate. After the brief educational intervention, participants in the experimental group increased their knowledge about OCD, improved their strategies for managing a student with OCD symptoms, and had fewer stigmatizing attitudes associated with pity (p < 0.05). These changes were not observed in the control group. We can conclude that this brief and easy-to-administer intervention is an effective educational intervention to significantly improve teachers' knowledge and attitudes, at least in the short-term. These results are especially relevant because OCD is associated with high interference and long delays in seeking treatment, and teachers have a unique opportunity to help with prevention, early identification, and recommending an adequate intervention for OCD.
3.
Are the Motives for Food Choices Different in Orthorexia Nervosa and Healthy Orthorexia?
Depa, J, Barrada, JR, Roncero, M
Nutrients. 2019;11(3)
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More than 20 years ago the term “orthorexia nervosa” (OrNe) was coined for people whose intention to eat healthily becomes an unhealthy obsession. OrNe is not recognized in the Diagnostic and Statistical Manual and no official diagnostic criteria exists. Research has been limited by the use of different questionnaires used to establish OrNe. The newly developed Teruel Orthorexia Scale (TOS) also distinguishes between “healthy orthorexia” (HeOr) and OrNe, whereby HeOr is seen as a healthy interest with diet, healthy behaviour with regard to diet, and eating healthily as part of one’s identity, and is not associated with disordered eating, perfectionism, and obsessive-compulsive behaviour. OrNe and HeOr are not thought to be a continuum from people who do not care at all about eating healthily, followed by people who eat healthily (HeOr), and, finally, those who care excessively (OrNe), confirmed by the fact that there is only a low association between HeOr and OrNe. The aim of this study was to find further evidence for this hypothesis, and to evaluate the motives associated with the two types of orthorexia. 460 Spanish students participated in the study, 82% female, 18% male, with a mean age of 21. Participants completed two online questionnaires, the TOS and the Food Choice Questionnaire (FCQ) which assessed the following food choice motives: Weight Control; Sensorial Appeal; Convenience, Health Content; Price; Affect Regulation (e.g. “helps me relax”; Socio-political (e.g. country of food origin). The authors found that HeOr was positively related to Health Content and negatively related to Sensory Appeal and Price. OrNe, on the other hand, was positively related to Weight Control and Affect Regulation, and negatively related to Sensory Appeal and age.
Abstract
Recent research points to the bidimensional nature of orthorexia, with one dimension related to interest in healthy eating (healthy orthorexia) and another dimension related to a pathological preoccupation with eating healthily (orthorexia nervosa). Research was needed to provide further support for this differentiation. We examined the food-choice motives related to both aspects of orthorexia. Participants were 460 students from a Spanish university who completed the Teruel Orthorexia Scale and the Food Choice Questionnaire. By means of structural equation modeling, we analyzed the relationship between orthorexia, food-choice motives, gender, body mass index, and age. The motives predicting food choices in orthorexia nervosa and healthy orthorexia were quite different. In the case of orthorexia nervosa, the main motive was weight control, with sensorial appeal and affect regulation also showing significant associations. For healthy orthorexia, the main motive was health content, with sensorial appeal and price also showing significant associations. This supports the hypothesis that orthorexia nervosa is associated with maladaptive eating behavior motived more by weight control than by health concerns.