Obsessions and compulsions: normative data on the Padua Inventory from an Italian non-clinical adolescent sample
Introduction
Recent research has shown that the obsessive–compulsive disorder (OCD) is not so infrequent as was believed up to only 15 years ago. The numerous epidemiological studies carried out on adolescent subjects have produced a wide range of different prevalence values: Flament et al. (1988) found an OCD point prevalence of 1.0% (±0.5% S.D.) and a lifetime prevalence of 1.9% (±0.7% S.D.); Zohar et al. (1992) found a much higher point preference than Flament, namely 3.56% (±0.72% S.D.); Valleni-Basile et al. (1994) found a prevalence of 2.95%, higher for males (3.26%) than for females (2.64%).
The results of the various studies are not always in agreement with regard to the expression of OCD symptoms in children and adolescents. Some authors consider that in most cases both obsessions and compulsions are present in both sexes ( Flament et al., 1988 ; Swedo, Rapaport, Leonard, Lenane & Cheslow, 1989; Riddle et al., 1990 ), while Zohar et al. (1992) found that 50% of adolescents with OCD display only obsessions. On the other hand, Valleni-Basile et al. (1994) , who studied young adolescents, found that compulsive symptoms prevailed in females and obsessive symptoms in males.
Analysis of the literature ( Hollingsworth, Tanquay, Grossman & Pabst, 1980 ; Flament et al., 1988 ; Swedo et al., 1989 ; Rapaport, 1989 ; Burke, Burke, Regier & Rae, 1990 ; Riddle et al., 1990 ; Zohar et al., 1992 ; Valleni-Basile et al., 1994 ; Ravizza, Bogetto & Maina, 1997 ) reveals a high scatter of experimental data, particularly as far as onset, manifestation and trend of obsessive–compulsive symptoms are concerned, as well as both a quantitative and qualitative difference between the sexes. Furthermore, while considerable attention seems to be focused on the clinical manifestations of OCD, there is little apparent interest in the description and observation of obsessive and compulsive symptoms, above all in adolescent populations, although the epidemiological studies converge towards a prevalent onset of OCD in adolescence.
Current models of OCD ( Rachman & de Silva, 1978 ; Rachman & Hodgson, 1980 ; Salkovskis, 1989 ) propose the existence of a continuum between normal intrusive thoughts and clinical obsessions which would enable the study of obsessive phenomena in non-clinical populations. Salkovskis's model begins with the assertion that clinical obsessions represent the extreme end of a continuum of normal, unpleasant, unwanted, intrusive cognition.
The first aim of the present study is to highlight trends of obsessive and compulsive traits in non-clinical Italian adolescents, with special reference to their phenomenological expression both between the sexes and with variations in age.
A number of a self reported measures of obsessive–compulsive symptoms have been developed, including the Maudsley Obsessive–Compulsive Inventory (MOCI, Hodgson & Rachman, 1977 ), the Leyton Obsessional Inventory (LOI, Cooper, 1970 ) and the Compulsive Activity Checklist (CAC, Philpott, 1975 ). The limitation of these measures consists in the difficulty in generalizing the results as each of them measures mainly only a small number of OCD sub-types. Sanavio (1988) has developed the Padua Inventory (PI), which has the advantage of allowing the most important types of obsessive–compulsive disorders to be measured. The PI is a 60-item self-report inventory, which measures intrusive thoughts, doubts, checking and cleaning behaviours, urges, repetitive thinking about low-probability dangers and recurrent repugnant images. Sanavio (1988) reported a factor analysis of data 967 non-clinical adults. Factor analysis identified 4 factors which were used to derive 4 sub-scales: (1) impaired control over mental activities; (2) becoming contaminated; (3) checking behaviours and (4) urges and worries.
In recent years a number of studies have been carried out to analyse and verify the dimensional structure and the convergent and divergent validity of the PI ( van Oppen, 1992 ; Kyrios, Bhar & Wade, 1996). Some research ( Sternberger & Burns, 1990 ; van Oppen, 1992 ; Kyrios et al., 1996 ) points to a high internal consistency between total score and the various sub-scales (Cronbach's coefficient, α>0.80) but not for the `urges and worries' sub-scale, for which conflicting evidence has been found. For concurrent validity Sternberger & Burns, (1990) , van Oppen (1992) and Kyrios et al. (1996) found a high correlation (range 0.65–0.75) between total PI score and total MOCI and LOI scores. High correlation was found also for the sub-scales: between PI `mental activities' and MOCI `doubt' (range 0.68–0.69), between PI `becoming contaminated' and MOCI `cleaning' (range 0.53–0.74) and between PI `checking behaviours' and MOCI `checking' (range 0.67–0.84), while for the PI `urges and worries' scale it was found to be more difficult to trace concurrent validity using customary OCD assessment tools owing to the lack of an equivalent scale in these tests.
The PI has also been used in a number of surveys concerning the phenomenology of the obsessive–compulsive disorder in several different countries: Italy ( Sanavio, 1988 ), Germany ( van Oppen, 1992 ; van Oppen, Hoekstra & Emmelkamp, 1993 ), USA ( Sternberger & Burns, 1991 ) and Australia ( Hafner & Miller, 1990 ; Kyrios et al., 1996 ). In the wake of these studies, our second aim is to increase the currently scant availability of normative data for the PI in adolescents.
Section snippets
Subjects and procedure
The present study involves a sample comprising upper middle school pupils. All the subjects live in cities in central-southern Italy.
The sample comprises 566 adolescents aged 15–18 years, with a mean age of 16.84 (±0.93 S.D.), 290 (51.2%) males and 276 (48.8%) females. The sample was subdivided into four groups on the basis of age: 15 years, with a total numerosity of 35 (13 females, 22 males); 16 years, with a total numerosity of 192 subjects (94 females, 98 males); 17 years, comprising 169
Results
The mean total and sub-scale scores (±S.D.) obtained from the sample were as follows: `total' 51.28 (±27.87 S.D.); `mental activities' 16.43 (±11.36 S.D.); `becoming contaminated' 12.20 (±7.25 S.D.); `checking behaviours' 8.16 (±5.75 S.D.) and `urges and worries' 3.75 (±4.92 S.D.).
A series of one-way ANOVAs with sex and age as independent variables allowed significant differences to be observed. For the variable sex the following significant differences were observed with regard to both total
Discussion
The results of our survey, carried out using the Padua Inventory, indicate a high level of obsessive–compulsive features in the non-clinical adolescent population. We consequently agree with the hypothesis put forward by several authors ( Rachman & de Silva, 1978 ; Rachman & Hodgson, 1980 ; Salkovskis & Harrison, 1984 ; Sanavio, 1988 ; Salkovskis, 1989 ) concerning a connection between normal and pathological obsessions and thus a similarity in
References (27)
- et al.
The utilization of nonpatient samples in the study of obsessive compulsive disorder
Behav. Res. Ther.
(1995) - et al.
OCD in adolescent: an epidemiological study
J. Am. Acad. Child Adol. Psychiatry
(1988) - et al.
Obsessional–compulsive complaints
Behav. Res. Ther.
(1977) - et al.
Long term outcome of obsessive–compulsive disorder in childhood
J. Am. Acad. Child Psychiatry
(1980) - et al.
The assessment of obsessive–compulsive phenomena: psychometric and normative data on the Padua Inventory from an australian non-clinical student sample
Behav. Res. Ther.
(1996) - et al.
Obsessions and compulsions across time in 79 children and adolescent with obsessive–compulsive disorder
J. Am. Acad. Child Adol. Psychiatry
(1992) - et al.
Obsessive–compulsive disorder in children and adolescents: phenomenology and family history
J. Am. Acad. Child Adol. Psychiatry
(1990) - et al.
Abnormal and normal obsessions: a replication
Behav. Res. Ther.
(1984) Obsession and compulsion: the Padua Inventory
Behav. Res. Ther.
(1988)- et al.
Obsessions and compulsions: psychometric properties of the Padua Inventory with an american college sample
Behav. Res. Ther.
(1990)
Frequency of obsessive–compulsive disorder in a community sample of young adolescents
J. Am. Acad. Child Adol. Psychiatry
Obsessions and compulsions: dimensional structure, reliability, convergent and divergent validity of the Padua Inventory
Behav. Res. Ther.
An epidemiological study of obsessive–compulsive disorder and related disorders in Israeli adolescents
J. Am. Acad. Child Adol. Psychiatry
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2016, Comprehensive PsychiatryCitation Excerpt :First, our study found an association between higher obsessive–compulsive symptoms and female gender. Associations between female gender and higher Padua Inventory total scores have been observed in several previous studies conducted in young adult populations using the same instrument [2,37], and also other obsessive–compulsive questionnaires [38]. One explanation could be that higher obsessive–compulsive symptoms reflect a disposition towards harm avoidance type temperament.
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