Hellriegel, J; (2014) ‘Not just right experience’ (NJRE) in obsessive-compulsive disorder: Is NJRE a manifestation of autistic traits? Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Aims: Harm avoidance (HA) and ‘not just right experience’ (NJRE) have been proposed to be two core motivational processes underlying obsessive-compulsive disorder (OCD). This study was interested in exploring the less well understood construct NJRE in OCD. The study hypothesized that NJRE demarcates a neurodevelopmental OCD subgroup distinct from HA related to autistic traits and/or to a broader phenotype of cognitive rigidity and sensory processing difficulties. In addition, it was hypothesized that NJRE would be associated with an earlier age of OCD onset. It was also predicted that HA, unlike NJRE, would be related to responsibility attitudes, which are characteristic of the traditional cognitive behavioural understanding of OCD. Method: The constructs of NJRE and HA were assessed in an outpatient OCD sample (N=25). A correlational design investigated whether NJRE and HA are distinct entities in OCD and explored their relationships to a range of variables including ASD traits, sensory processing, set-shifting, age of OCD onset, and responsibility attitudes. Results: NJRE was found to be only moderately (r=.34) correlated to HA. Significance was not established in this study. Consistent with predictions, NJRE was associated with sensory processing difficulties and an earlier age of OCD onset, but was not related to responsibility beliefs. No significant relationships were found between NRJE and ASD traits or set-shifting difficulties. Conclusions: There was a lack of evidence demonstrating NJRE as a manifestation of autistic traits. However, NJRE was associated with sensory abnormalities and early onset of OCD, suggesting it may be a marker for difficulties of developmental origin. The role of NJRE as a developmental, and possibly neurodevelopmental, risk factor for OCD warrants further investigation.

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