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Revision of the Padua Inventory of obsessive compulsive disorder symptoms: Distinctions between worry, obsessions, and compulsions

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Abstract

The Padua Inventory (PI), a self-report measure of obsessive and compulsive symptoms, is increasingly used in obsessive compulsive disorder (OCD) research. Freeston, Ladouceur, Rheaume, Letarte, Gagnon and Thibodeau (1994) [Behaviour Research and Therapy, 32, 29-36], however, recently showed that the PI measures worry in addition to obsessions. In an attempt to solve this measurement problem, this study used a content distinction between obsessions and worry to revise the PI. The revision was constructed to measure five content dimensions relevant to OCD i.e. (1) obsessional thoughts about harm to oneself or others; (2) obsessional impulses to harm oneself or others; (3) contamination obsessions and washing compulsions; (4) checking compulsions; and (5) dressing/grooming compulsions. A total of 5010 individuals participated in the study, 2970 individuals completing the PI and the Penn State Worry Questionnaire (PSWQ) and an additional 2040 individuals completing only the PI. The results provided support for the reliability and validity of the revision. In addition, the revision of the PI was more independent of worry, as measured by the PSWQ, than the original PI. Support was thus found for the validity of the content distinction between obsessions and worry. The importance of this content distinction is also discussed for the evaluation of other hypothesized distinctions between obsessions and worry.
Padua Inventory – Washington State University Revision
Reference for the revision:
Burns, G.L. (1995). Padua Inventory-Washington State University Revision.
Pullman, WA: Author. (Available from G. Leonard Burns, Department of
Psychology, Washington State University, Pullman, WA 99164-4820)
Subscales:
1. Contamination obsessions and washing compulsions subscale:
Items: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10
2. Dressing/grooming compulsions subscale:
Items: 11, 12, 13
3. Checking compulsions subscale:
Items: 14, 15, 16, 17, 18, 19, 20, 21, 22, 23
4. Obsessional thoughts of harm to self/others subscale:
Items: 24, 25, 26, 27, 28, 29, 30
5. Obsessional impulses to harm self/others subscale:
Items: 31, 32, 33, 34, 35, 36, 37, 38, 39
Reference for the psychometric properties of the revision:
Burns, G.L., Keortge, S., Formea, G., & Sternberger, L.G. (1996). Revision of the Padua
Inventory of obsessive compulsive disorder symptoms: Distinctions between
worry, obsessions, and compulsions. Behavior Research and Therapy, 34, 163-
173.
The following statements refer to thoughts and behaviors which may occur to everyone in everyday life. For each statement,
Choose the reply which best seems to fit you and the degree of disturbance which such thoughts or behaviors may create.
1 I feel my hands are dirty when I touch money. Not at All A little Quite
A Lot
2 I think even slight contact with bodily secretions (perspiration, saliva
urine, etc.) may contaminate my clothes or somehow harm me.
Not at All A little Quite A
Lot
3 I find it difficult to touch an object when I know it has been touched
by strangers or by certain people.
Not at All A little Quite a
Lot
4 I find it difficult to touch garbage or dirty things. Not at All A little Quite a
Lot
5 I avoid using public toilets because I am afraid of disease and
contamination.
Not at All A little Quite a
Lot
6 I avoid using public telephones because I am afraid of contagion and
disease.
Not at All A little Quite a
Lot
7 I wash my hands more often and longer than necessary. Not at All A little Quite a
Lot
8 I sometimes have to wash or clean myself simply because I think I
may be dirty or “contaminated”.
Not at All A little Quite a
Lot
9 If I touch something I think is “contaminated”, I immediately have to
wash or clean myself.
Not at All A little Quite a
Lot
10 If an animal touches me, I feel dirty and immediately have to wash
myself or change my clothing.
Not at All A little Quite a
Lot
11 I feel obliged to follow a particular order in dressing, undressing, and
washing myself.
Not at All A little Quite a
Lot
12 Before going to sleep, I have to do certain things in a certain order. Not at All A little Quite a
Lot
13 Before going to bed, I have to hang up or fold my clothes in a special
way.
Not at All A little Quite a
Lot
14 I have to do things several times before I think they are properly
done.
Not at All A little Quite a
Lot
15 I tend to keep on checking things more often than necessary. Not at All A little Quite a
Lot
16 I check and recheck gas and water taps and light switches after
turning them off.
Not at All A little Quite a
Lot
17 I return home to check doors, windows, drawers, etc., to make sure
they are properly shut.
Not at All A little Quite a
Lot
18 I keep on checking forms, documents, checks, etc., in detail to make
sure I have filled them in correctly.
Not at All A little Quite a
Lot
19 I keep on going back to see that matches, cigarettes, etc, are properly
extinguished.
Not at All A little Quite a
Lot
20 When I handle money, I count and recount it several times. Not at All A little Quite a
Lot
21 I check letters carefully many times before posting them. Not at All A little Quite a
Lot
22 Sometimes I am not sure I have done things which in fact I knew I Not at All A little Quite a
have done. Lot
23 When I read, I have the impression I have missed something
important and must go back and reread the passage at least two or
three times.
Not at All A little Quite a
Lot
24 I imagine catastrophic consequences as a result of absent-
mindedness or minor errors which I make.
Not at All A little Quite a
Lot
25 I think or worry at length about having hurt someone without
knowing it.
Not at All A little Quite a
Lot
26 When I hear about a disaster, I think it is somehow my fault. Not at All A little Quite a
Lot
27 I sometimes worry at length for no reason that I have hurt myself or
have some disease.
Not at All A little Quite a
Lot
28 I get upset and worried at the sight of knives, daggers, and other
pointed objects.
Not at All A little Quite a
Lot
29 When I hear about a suicide or a crime, I am upset for a long time
and find it difficult to stop thinking about it.
Not at All A little Quite a
Lot
30 I invent useless worries about germs and disease. Not at All A little Quite a
Lot
31 When I look down from a bridge or a very high window, I feel an
impulse to throw myself into space.
Not at All A little Quite a
Lot
32 When I see a train approaching, I sometimes think I could throw
myself under its wheels.
Not at All A little Quite a
Lot
33 At certain moments, I am tempted to tear off my clothes in public. Not at All A little Quite a
Lot
34 While driving, I sometimes feel an impulse to drive the car into
someone or something.
Not at All A little Quite A
Lot
35 Seeing weapons excites me and makes me think violent thoughts. Not at All A little Quite a
Lot
36 I sometimes feel the need to break or damage things for no reason. Not at All A little Quite a
Lot
37 I sometimes have an impulse to steal other people’s belongings, even
if they are of no use to me.
Not at All A little Quite a
Lot
38 I am sometimes almost irresistibly tempted to steal something from
the supermarket.
Not at All A little Quite a
Lot
39 I sometimes have an impulse to hurt defenseless children or animals. Not at All A little Quite a
Lot
... Neither Einstein and Menzies (2004) Inventory (PI; Sanavio, 1988) as a measure of OCD symptoms. The PI shares a considerable variance with worry (Wells & Papageorgiou, 1998;Bums, Keortge, Formea & Sternberger, 1996), and the Importance of Thoughts subscale of the PI, that demonstrates the greatest overlap with worry (Bums et al., 1996), demonstrated the strongest association with magical thinking. Magical thinking may therefore be involved to some extent with worry (Einstein & Menzies, 2004). ...
... A possible explanation for the unexpected findings was the use of the PI-R (Bums et al., 1996) as a single measure of OCD symptoms. OCD is argued to be a multidimensional and heterogeneous disorder (Calamari et al., 2004), and measures of OCD that are based upon specific symptom clusters, may omit other key symptoms. ...
... Previous studies (Einstein & Menzies, 2000,2004 use the original PI (Sanavio, 1988) and this measure is demonstrated to overlap considerably with worry Magical thinking in OCD 89 (Bums et al., 1996). Total scores on the original PI are heavily weighted towards scores on the 'Importance of Controlling Mental Activities' subscale, and this subscale is the most problematic in the overlap between symptoms of OCD and worry (Bums et al., 1996). ...
Thesis
p>Magical thinking is suggested to be a core component in Obsessive Compulsive Disorder (OCD) that underpins the cognitive bias of Thought-Action Fusion (TAF). The literature review considers evidence that TAF is involved in the development and maintenance of OCD, and that TAF-likelihood and magical thinking are associated. It is suggested that magical thinking OCD are also associated, and a review of the evidence for the centrality of magical thinking in OCD is presented. The limitations of previous research are discussed, highlighting the need for experimental investigation, and controlling for the effect of anxiety and depression. It is hypothesised that magical thinking may also be demonstrated in the neutralising behaviours in response to intrusive thoughts in OCD. The experimental paper investigates whether the use of neutralising behaviours in response to a TAF-induction experiment is linked to magical thinking. In a sample of 50 undergraduate students, 74.0% of participants demonstrated at least one form of neutralising behaviour. Individuals that used neutralising strategies demonstrated significantly greater levels of magical thinking, however, there was no difference in the level of OCD symptoms. Magical thinking was significantly associated with OCD symptoms, however it is suggested that the overlap between magical thinking and worry might account for this association. Unexpectedly, no significant association was found between TAF-likelihood and OCD, although, a significant relationship was demonstrated between TAF-moral and OCD symptoms. The effects of the TAF-induction paradigm are discussed, and it is suggested that the paradigm may not be an appropriate model for OCD.</p
... Items are scored on a 5-point Likert-type scale ranging from 0 (not at all) to 4 (very much). The Padua Inventory demonstrated adequate internal consistency [15]. Validated versions of the Padua Inventory were available in English [15], French [38], German [89], Spanish [57], and Turkish [101]. ...
... The Padua Inventory demonstrated adequate internal consistency [15]. Validated versions of the Padua Inventory were available in English [15], French [38], German [89], Spanish [57], and Turkish [101]. The questionnaire was translated in the other languages with the same methodology as described above. ...
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... Revision of the Padua Inventory (PI) (8-items) [4]. The complete PI inventory is composed of 39 items rated on a 5-point Likert scale from 0 ("not at all") to 4 ("very much") and measures symptoms of obsessions and compulsions. ...
... Coping behaviours during the COVID-19 pandemic (7-items). Items were created using a Likert scale of frequency ["never" (0) to "very frequently" (4)]. The items included the following: i) preventive measures, such as disinfecting packages, consuming over-the-counter medicines/vitamins to avoid contracting an illness, and panic shopping (i.e., buying several products at once for fear of shortage), ii) avoidance behaviours (e.g., avoiding social contact outside the household, such as meeting friends, going out, etc.) and iii) worrying about oneself or people one care about contracting an illness or believing themselves or those they care about to be more vulnerable to the virus in comparison to other people. ...
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... However, progesterone was measured from saliva samples via immunoassays, which is a method that has recently been criticized for having relatively modest validity when measuring changes in progesterone levels during the menstrual cycle (Arslan et al., 2022). To address this potential limitation, Stern and Shiramizu (2022) tested whether 257 women's scores on the pathogen disgust subscale of the Three Domain Disgust Scale and scores on the contamination subscale of the Revised Padua Obsessive-Compulsive Inventory (Burns et al., 1996) increased on days of the menstrual cycle where progesterone was high when liquid chromatography-mass spectrometry was used to measure progesterone level from saliva. Using this method, Stern and Shiramizu (2022) found no evidence that pathogen disgust tracked changes in progesterone and also found no evidence for increased pathogen disgust during the luteal phase of the menstrual cycle. ...
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... However, progesterone was measured from saliva samples via immunoassays, which is a method that has recently been criticized for having relatively modest validity when measuring changes in progesterone levels during the menstrual cycle (Arslan et al., 2022). To address this potential limitation, Stern and Shiramizu (2022) tested whether 257 women's scores on the pathogen disgust subscale of the Three Domain Disgust Scale and scores on the contamination subscale of the Revised Padua Obsessive-Compulsive Inventory (Burns et al., 1996) increased on days of the menstrual cycle where progesterone was high when liquid chromatography-mass spectrometry was used to measure progesterone level from saliva. ...
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