A Theoretical Integration within Obsessive-Compulsive Disorder (OCD) and Dissociative Spectrums: Obsessional Dissociation

Over the recent three decades, there has been a growing academic interest on significant associations between obsessive compulsive disorder (OCD) and dissociation (Belli, Ural, Vardar, Yesilyurt, & Oncu, 2012; Belli et al., 2013; Fontenelle et al., 2007; Norton, Ross, & Novotny, 1990; Pica, Beere, & Maurer, 1997). In this regard, while the relationships with checking, ordering and symmetry has been widely highlighted from the view of obsessive-compulsive symptoms (Goff, Olin, Jenike, Baer, & Buttolph, 1992; Grabe et al., 1999; Lochner et al., 2004; Rufer, Fricke, Held, Cremer, & Hand, 2006; Watson & Wu, 2002; Watson, Wu, & Cutshall, 2004), the role of absorption / imaginative involvement dimension of dissociative symptoms in the pathophysiology of OCD has been underscored (Aardema & Wu, 2011; Paradisis, Aardema, & Wu, 2015; Soffer-Dudek, 2014; SofferDudek, Lassri, Soffer-Dudek, & Shahar, 2015; Tapancı, Yıldırım, & Boysan, 2018). Nevertheless, to the best of our opinion, a great deal of commonalities and transitions between these two phenomena exist. The overlapping features within these two clinical entities include heterogeneity of symptom structure (Boysan, 2016; Holmes et al., 2005; Mataix-Cols, do Rosario-Campos, & Leckman, 2005; Waller, Putnam, & Carlson, 1996), intrusiveness in nature (Boon, Steele, & van der Hart, 2011; Clark, 2004), ubiquity in general population (Maaranen et al., 2008; Rachman & De Silva, 1978; Ross, Joshi, & Currie, 1990; Salkovskis & Harrison, 1984; Vanderlinden, Van der Hart, & Varga, 1996), serve as defense mechanism in response to heightened stress but become counterproductive in pathological levels (Boysan, 2015; Boysan, Goldsmith, Çavuş, Kayri, & Keskin, 2009; Butler, Duran, Jasiukaitis, Koopman, & Spiegel, 1996), significant linkages to developmental trauma (Chu, 2011; Lochner et al., 2002; Mathews, Kaur, & Stein, 2008; Ogawa, Sroufe, Weinfield, Carlson, & Egeland, 1997; Schimmenti & Caretti, 2016), interpersonal aspects central to the etiological accounts (Aardema et al., 2013; Boysan & Çam, 2016; Doron & Kyrios, 2005; Doron et al., 2012; Guidano & Liotti, 1983; Liotti, 2004), pronounced deficits in memory and attention (Giesbrecht, Lynn, Lilienfeld, & Merckelbach, 2008; Muller & Roberts, 2005), and transdiagnostic characteristics as the hallmark of the psychopathology (Abramowitz, McKay, & Storch, 2017; Dell & O'Neil, 2015; Kadak, Nasiroglu, Boysan, & Aydin, 2013; Lanius et al., 2010). Therefore, more integrative LETTER TO THE EDITOR