Past Projects

Redefining object attachment: Development and validation of a new scale

We developed a new questionnaire called the Object Attachment Security Measure (OASM). This questionnaire has 10 items and and measures secure object attachment (5 items) and insecure object attachment (5 items). Secure object attachment is characterised by an emotional bond with possessions, whereas insecure object attachment is characterised by an inability to part with possessions and being more attached to object than people. When using this measure, we found that insecure object attachment was more strongly associated with hoarding and compulsive buying behaviours when compared to secure object attachment. This suggests that individuals who hoard and/or compulsively shop seem to do so because of their strong insecure attachment to objects.

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A critical review of cognitive behavioural therapy for hoarding disorder: How can we improve outcomes?

In this review, we examined current cognitive behavioural therapy for hoarding disorder. We looked at all hoarding treatment studies that have been published. We found that all treatments have followed a cognitive behavioural framework and have included strategies to improve motivation, problem-solving, sorting and organising, and time management. Cognitive strategies and behavioural experiments have been used to help people challenge unhelpful thoughts that encourage them to acquire and save possessions they do not need, while exposure activites have been used to help people realise that the distress associated with discarding decreases over time. Treatments including these strategies have resulted in an approximate 25% reduction in hoarding symptoms. Less than a third of individuals with hoarding disorder who complete therapy experience a reliable and meaningful decrease in their symptoms. In this paper, we also review recent research which suggests that hoarding therapy might be improved by incorporating strategies to bolster emotion regulation and social functioning. We also suggest that modification to currently included treatment strategies may further improve outcomes. 

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A mixed methods study of an online intervention to reduce perfectionism

Perfectionism involves setting high standards and critical evaluations of oneself and others. The Perfectionism Social Disconnection Model proposes that individuals with perfectionism are socially disconnected from others due to off-putting behaviours in their relationships with others. The current study developed and pilot tested the efficacy of an educational resource to help university students manage their perfectionism. Seventy participants completed the 'Intentional Imperfection Program'. Participants completed questionnaires related to perfectionism, behaviours towards others, and social isolation before and after the program. The findings showed small to moderate reductions in perfectionism, hostile behaviours towards others, sensitivity to rejection, depression, and anxiety symptoms, and a small increase in social connectedness. Participants also reported that the educational resource was feasible, enjoyable, and useful. As such, a randomised controlled trial is needed to further test the efficacy of the program in helping university students manage their perfectionism.

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A scoping review of psychosocial interventions to reduce internalised shame

We investigated how to improve treatment outcomes for people experiencing shame by conducting a review of published papers on therapist-delivered interventions that aimed to reduce internalised shame. Internalised shame involves feeling unworthy, small, and powerless due to another person's disdain or disgust, which can be either real or imagined. Internalised shame has consistently been linked to mental health problems and predicts poor treatment outcomes. We searched six online databases for studies that measured internalised shame before and after treatment. We screened 6846 abstracts.  Forty-two papers looked potentially eligible for this review. After reading those 42 papers, we discovered only 16 studies met inclusion criteria. Four studies compared a shame treatment to a control condition. These studies suggested that shame interventions may be more effective than no treatment or treatment as usual, but not more effective than another bonefide treatment.  Examination of the 12 studies that only looked at shame levels before and after treatment (i.e. no comparison was made to another condition), showed that shame interventions may lead to small to moderate reductions in shame.  When a study suggested that a treatment may be effective, it included psychoeducation, experiential exercises, and techniques to increase social support. However, our findings must be interepreted with caution. The quality of the studies included in this review ranged from weak to moderate. Further high-quality research is definitely warranted.

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The causes and consequences of shame in obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) has primarily been studied from an anxiety perspective. However, recent research suggests that some individuals with OCD may experience shame associated with their intrusive thoughts and may perform compulsions to alleviate these feelings of shame. An experimental study was conducted to explore if and how shame might fit in our understanding of OCD. We administered four scenarios mimicking harm, sexual, contamination, and symmetry obsessions to 55 participants experiencing either clinical or sub-clinical OCD symptoms. These participants also competed questionnaires related to their emotional states and urges to perform compulsions or engage in avoidance behaviours. We found that participants reported the most shame and anxiety for the harm and sexual scenarios compared to the contamination and symmetry scenarios. We also found that shame responses were associated with compulsion and avoidance behaviours, irrespective of anxiety. Given these findings, shame may play a role in OCD and treatment should be adapted to address shame.