1
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Brierley MEE, Albertella L, Christensen E, Rotaru K, Jacka FN, Segrave RA, Richardson KE, Lee RS, Kayayan E, Hughes S, Yücel M, Fontenelle LF. Lifestyle risk factors for obsessive-compulsive symptoms and related phenomena: What should lifestyle interventions target? Aust N Z J Psychiatry 2023; 57:379-390. [PMID: 35362326 DOI: 10.1177/00048674221085923] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Understanding the impact of lifestyle on mental illness symptoms is important for informing psycho-education and developing interventions which target mental and physical comorbidities. Obsessive-compulsive and related disorders can have a significant impact on health-related quality of life and physical health. However, our understanding of the impact of lifestyle on obsessive-compulsive symptoms and broader compulsive and impulsive problematic repetitive behaviours is limited. AIMS We investigated whether lifestyle factors predicted change in obsessive-compulsive symptoms and problematic repetitive behaviours in a general population sample over a 3-month period. METHODS Eight hundred thirty-five participants completed an online questionnaire battery assessing lifestyle and mental health. Of these, 538 participants completed the same battery 3 months later. We conducted negative binomial regressions to analyse the association of lifestyle factors at baseline with future (1) obsessive-compulsive symptoms, (2) compulsive problematic repetitive behaviours and (3) impulsive problematic repetitive behaviours, adjusting for baseline obsessive-compulsive symptoms and problematic repetitive behaviours. RESULTS Lower vegetable (p = 0.020) and oily fish (p = 0.040) intake and lower moderate intensity physical activity (p = 0.008) predicted higher obsessive-compulsive symptoms at follow-up. Higher intake of high-fat foods (p < 0.001) predicted higher compulsive problematic repetitive behaviours at follow-up. No lifestyle factors significantly predicted impulsive problematic repetitive behaviours at follow-up. CONCLUSION Our results speak to the potential importance of lifestyle quality screening, education and lifestyle interventions (e.g. an anti-inflammatory diet) for individuals experiencing compulsivity-related behaviours and/or symptoms. Further research into potential mechanisms of action will allow for more targeted approaches to lifestyle interventions for transdiagnostic compulsive behaviours.
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Affiliation(s)
- Mary-Ellen E Brierley
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Erynn Christensen
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Kristian Rotaru
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia.,Monash Business School, Monash University, Caulfield, VIC, Australia
| | - Felice N Jacka
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Food and Mood Centre, Deakin University, Geelong, VIC, Australia
| | - Rebecca A Segrave
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Karyn E Richardson
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Rico Sc Lee
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Edouard Kayayan
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Sam Hughes
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Murat Yücel
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia
| | - Leonardo F Fontenelle
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging Facility, Monash University, Clayton, VIC, Australia.,Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,D'Or Institute for Research and Education, Rio de Janeiro, Brazil
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2
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Fang S, Ding D, Zhang R, Huang M. Psychological mechanism of acceptance and commitment therapy and rational emotive behavior therapy for treating hoarding: Evidence from randomized controlled trials. Front Public Health 2023; 11:1084467. [PMID: 36844862 PMCID: PMC9950404 DOI: 10.3389/fpubh.2023.1084467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 01/16/2023] [Indexed: 02/12/2023] Open
Abstract
Hoarding is a common problem behavior worldwide and is detrimental to the physical and mental health of individuals and groups. Currently, effective interventions for hoarding are cognitive-behavioral therapies, but their post-intervention efficacy is questionable, and the available research does not examine the mediating variables of the effects of interventions on clinical outcomes. Moreover, current research on hoarding has focused on Western countries. Therefore, there is a need to investigate the efficacy of other forms of cognitive behavioral therapy on hoarding as well as other psychological outcomes related to hoarding and mediating variables that contribute to its effectiveness in different cultural contexts. One hundred thirty-nine college students with higher hoarding behaviors were randomly divided into three groups: 45 in the Acceptance and Commitment Therapy (ACT) group, 47 in the Rational Emotive Behavior Therapy (REBT) group, and 47 in the control group. They completed the Saving Inventory-Revised (SI-R), Obsessive-Compulsive Symptom Scale (OCSS), Difficulties in Emotion Regulation Scale (DERS), Experiences in Close Relationships Inventory-Attachment Anxiety Subscale (ECR), Depression Anxiety Stress Scales (DASS-21), Acceptance and Action Questionnaire II (AAQ-II), and Cognitive Fusion Questionnaire (CFQ) before and immediately after the intervention. The results showed that ACT and REBT improved individuals' psychological flexibility, cognitive fusion, acquisition-difficulty discarding, clutter, negative affect (anxiety, depression, stress), attachment anxiety, obsessive-compulsive disorder, and difficulty in emotion regulation compared to the control group. In addition, ACT was more effective than REBT in improving psychological flexibility and reducing hoarding, cognitive fusion, depression, stress, and obsessive-compulsive disorder; there were no significant differences between the two in anxiety and emotion regulation difficulties. Furthermore, psychological flexibility is a mediator of the effect of ACT and REBT on some behavioral and psychological outcomes (hoarding, negative affect, attachment anxiety). Limitations were discussed.
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Affiliation(s)
- Shuanghu Fang
- School of Educational Science, Anhui Normal University, Wuhu, China
| | - Dongyan Ding
- School of Educational Science, Anhui Normal University, Wuhu, China
| | - Ru Zhang
- School of Educational Science, Anhui Normal University, Wuhu, China
| | - Mingjie Huang
- School of Educational Science, Anhui Normal University, Wuhu, China
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3
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Frost RO, Steketee G. Hoarding mysteries Jack would appreciate. J Behav Ther Exp Psychiatry 2022; 77:101766. [PMID: 36113903 DOI: 10.1016/j.jbtep.2022.101766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/26/2022] [Accepted: 07/14/2022] [Indexed: 11/24/2022]
Abstract
Hoarding disorder (HD) is a multifaceted problem that presents challenges both for understanding its dimensions and for developing effective treatments. We are grateful to have known Dr. Stanley J. Rachman and his incredibly thoughtful approach to clinical psychology and research on anxiety, obsessive-compulsive disorders (OCD) and their treatment. His work has helped set the stage for our own efforts to study this challenging condition. The discussion below reviews a range of mysteries we and others have encountered in working with people who exhibit HD symptoms. Of particular interest to us are questions about biological vulnerabilities like heritability and the high rate of concurrent health problems and whether hoarded objects might serve as safety signals that protect people from traumatic life events. We are curious about the attachment process in HD and whether attachment to objects is related to early parental experiences that affect self-concept. We raise questions about the several information processing problems often seen in people with HD - attention focusing, memory, and associative responses to objects and information. Raising many questions are observations about strong emotional attachments to objects and multiple reasons given for saving them, as well as what sometimes appears to be remarkable aesthetic appreciation and creative interest in objects. Emotions in HD seem to range more widely than in some psychological disorders as both positive and negative reactions appear to reinforce excessive acquisition and difficulty discarding. Clutter blindness may be an effort to avoid confrontation with overwhelming clutter in the home. Finally, we comment on difficulty achieving more positive outcomes following a carefully designed cognitive and behavioral treatment for HD and encourage the next generation of researchers to follow in Jack Rachman's footsteps as they try to unravel these mysteries.
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4
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Lydecker JA, Grilo CM, Hamilton A, Barnes RD. Digital self-harm is associated with disordered eating behaviors in adults. Eat Weight Disord 2022; 27:2129-2136. [PMID: 35066861 PMCID: PMC9288535 DOI: 10.1007/s40519-021-01355-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/28/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Eating-disorder psychopathology is associated with self-harm behaviors. With much time spent and many social interactions taking place online, self-cyberbullying has emerged as a new form of self-harm that is digital. The current study examined digital self-harm in adults and its associations with eating-disorder psychopathology and behaviors. METHODS Participants were adults (N = 1794) who completed an online cross-sectional survey. Participants reported whether they had ever posted mean things about themselves online, whether they had ever anonymously bullied themselves online and completed measures of eating-disorder psychopathology and disordered eating behaviors. RESULTS Digital self-harm was reported by adults across demographic characteristics and across the lifespan, although there were some significant differences in demographic characteristics associated with reported digital self-harm. Participants who engaged in digital self-harm were younger than those denying digital self-harm. Eating-disorder psychopathology and disordered eating behaviors were significantly higher among individuals reporting digital self-harm compared with age-matched controls. CONCLUSIONS This was the first study to examine digital self-harm among adults and the first study to examine associations of digital self-harm with eating-disorder psychopathology and disordered eating behaviors. Importantly, digital self-harm is reported by adults and therefore is not limited to youth. Our findings that digital self-harm is associated with disordered eating suggests that digital self-harm is a clinically significant topic that needs further research to inform clinical practice and clinical research. LEVEL OF EVIDENCE Level III, Evidence obtained from well-designed cohort or case-controlled analytic studies.
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Affiliation(s)
- Janet A Lydecker
- Department of Psychiatry, Yale School of Medicine, 301 Cedar Street, New Haven, CT, 06519, USA.
| | - Carlos M Grilo
- Department of Psychiatry, Yale School of Medicine, 301 Cedar Street, New Haven, CT, 06519, USA
| | - Antonia Hamilton
- Department of Psychiatry, Yale School of Medicine, 301 Cedar Street, New Haven, CT, 06519, USA
| | - Rachel D Barnes
- Department of Psychiatry, Yale School of Medicine, 301 Cedar Street, New Haven, CT, 06519, USA.,Health Psychology, Division of General Internal Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
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5
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Akbari M, Seydavi M, Mohammadkhani S, Turchmanovych N, Chasson GS, Majlesi N, Hajialiani V, Askari T. Emotion dysregulation and hoarding symptoms: A systematic review and meta‐analysis. J Clin Psychol 2022; 78:1341-1353. [DOI: 10.1002/jclp.23318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/03/2021] [Accepted: 01/12/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Mehdi Akbari
- Department of Clinical Psychology, Faculty of Psychology and Education Kharazmi University Tehran Iran
| | - Mohammad Seydavi
- Department of Clinical Psychology, Faculty of Psychology and Education Kharazmi University Tehran Iran
| | - Shahram Mohammadkhani
- Department of Clinical Psychology, Faculty of Psychology and Education Kharazmi University Tehran Iran
| | | | - Gregory S. Chasson
- Department of Psychology Illinois Institute of Technology Chicago Illinois USA
| | - Noshin Majlesi
- Department of Clinical Psychology, Faculty of Psychology and Education Kharazmi University Tehran Iran
| | - Vahid Hajialiani
- Department of Clinical Psychology, Faculty of Psychology and Education Kharazmi University Tehran Iran
| | - Tahereh Askari
- Department of Clinical Psychology, Faculty of Psychology and Education Kharazmi University Tehran Iran
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6
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Vanzhula IA, Kinkel-Ram SS, Levinson CA. Perfectionism and Difficulty Controlling Thoughts Bridge Eating Disorder and Obsessive-Compulsive Disorder Symptoms: A Network Analysis. J Affect Disord 2021; 283:302-309. [PMID: 33578342 DOI: 10.1016/j.jad.2021.01.083] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/10/2021] [Accepted: 01/30/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Eating disorders (ED) and obsessive-compulsive disorder (OCD) are highly comorbid, but little is known about how this comorbidity is maintained. Prior research suggests that obsessive thoughts and perfectionism may be shared maintenance factors for EDs and OCD. METHODS The current study used network analysis to (1) identify bridge pathways in an ED-OCD comorbidity network and (2) test if perfectionism symptoms bridge between ED-OCD symptoms in a combined network model including ED, OCD, and Perfectionism symptoms. Participants (N = 1,619) were a mixed sample of undergraduate students and individuals diagnosed with EDs. RESULTS Difficulty controlling thoughts was the symptom with the highest bridge centrality in both models, connecting with ED-related worry and doubts. In the ED-OCD-Perfectionism comorbidity network, doubts about simple everyday things and repeating things over and over bridged between ED and OCD symptoms. Additionally, specific and distinct pathways were identified between OCD and two types of ED pathology: restricting (checking compulsions and rigidity around food) and binge eating (hoarding and binge eating symptoms). LIMITATIONS Due to the cross-sectional nature of the data, no directional inferences can be made. Due to a higher OCD symptom prevalence rate than reported in previous studies, our undergraduate sample may not be representative of other college populations. CONCLUSIONS The presence of intrusive cognitions and maladaptive perfectionism may contribute to the maintenance of co-occurring ED and OCD symptoms. These findings begin to delineate specific pathways among OCD and ED symptoms, which can be used in the development of interventions to disrupt connections among these disorders.
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Affiliation(s)
- Irina A Vanzhula
- University of Louisville, Department of Psychological & Brain Sciences
| | | | - Cheri A Levinson
- University of Louisville, Department of Psychological & Brain Sciences.
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7
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Mathes BM, Schmidt NB. An investigation of the impact of social exclusion on attachment to possessions and saving behaviors. J Behav Ther Exp Psychiatry 2020; 69:101588. [PMID: 32535407 DOI: 10.1016/j.jbtep.2020.101588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 04/29/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Hoarding disorder (HD) is a debilitating mental illness characterized by extreme difficulty parting with possessions and clutter that can result in dangerous living conditions. One hypothesis about why individuals with HD save possessions is that they possess a pathological attachment to their belongings, which may serve to compensate for unfulfilling interpersonal relationships. However, there is a dearth of empirical work examining this. The current study examined the impact of an experimental manipulation of social exclusion on attachment to possessions and saving behaviors in a sample of individuals with elevated hoarding symptoms. METHODS Participants (n = 117) were selected for scoring above the non-clinical mean on a measure of hoarding symptoms. Participants were randomized to either be included or excluded in a game of Cyberball. They completed a behavioral discarding task and object attachment measure before and after completion of the game. RESULTS Study condition was unrelated to in vivo attachment to possessions and saving behaviors during the discarding task. However, a post hoc mediation model showed that greater feelings of rejection, regardless of condition, were associated with greater in vivo attachment to possessions and subsequent number of items saved during the lab task. LIMITATIONS Limitations include the use of a non-clinical and homogeneous sample. CONCLUSIONS Taken together, individuals prone to feelings of rejection may be at risk for developing HD as they may use possessions to cope with interpersonal stress. Results will be discussed in light of implications for theoretical models and potential treatment targets in HD.
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8
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Yap K, Grisham JR. Object attachment and emotions in hoarding disorder. Compr Psychiatry 2020; 100:152179. [PMID: 32402421 DOI: 10.1016/j.comppsych.2020.152179] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/03/2020] [Accepted: 04/30/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND AIMS Object attachment is a core feature of hoarding disorder (HD), but it also occurs in people without HD. It is therefore critical to clarify differences between normal and abnormal object attachment. Although previous studies show that HD is associated with high emotional reactivity, no study to date has examined the nature and intensity of discrete emotions in people with and without HD in relation to object attachment. METHOD Individuals with HD (n = 93) and matched controls (n = 93) were recruited via MTurk. They identified and described a possession of low monetary value that they were emotionally attached to and found difficult to discard. Participants rated their object attachment and the intensity of emotions when imagining being with the object (Scenario A) and irretrievably losing the same object (Scenario B). RESULTS Unexpectedly, there were no significant between-group differences on object attachment; however, the HD group experienced more incongruent emotions about their possessions; they reported significantly higher disgust, anxiety and anger than controls when they imagined being with their chosen object (Scenario A) and were more relaxed compared to controls when the object was lost (Scenario B). There were no significant differences between groups on congruent emotions (i.e., positive emotions in Scenario A or negative emotions in Scenario B). CONCLUSION People with and without HD experience similar emotional attachment for sentimental items but people with HD experience more mixed emotions, consistent with an insecure object attachment.
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Affiliation(s)
- Keong Yap
- University of New South Wales, School of Psychology, Sydney, NSW 2034, Australia; Australian Catholic University, School of Behavioural and Health Sciences, Strathfield, NSW 2035, Australia.
| | - Jessica R Grisham
- University of New South Wales, School of Psychology, Sydney, NSW 2034, Australia
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9
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Davidson EJ, Dozier ME, Pittman JOE, Mayes TL, Blanco BH, Gault JD, Schwarz LJ, Ayers CR. Recent Advances in Research on Hoarding. Curr Psychiatry Rep 2019; 21:91. [PMID: 31410591 PMCID: PMC7294597 DOI: 10.1007/s11920-019-1078-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW The purpose of the following paper is to review recent literature trends and findings in hoarding disorder (HD). Our goal is to highlight recent research on etiology, associated features, and empirically based treatments. RECENT FINDINGS Recent literature has added support for cognitive differences as a risk factor for HD; however, there is evidence that individuals with HD may overestimate their level of cognitive impairment. Several associated features have been highlighted in recent studies, including emotion regulation, intolerance of uncertainty and distress intolerance, and attachment. Finally, several psychotherapeutic treatments for hoarding have been recently validated, including group-based therapy and treatments using the cognitive-behavioral model. Although recent research demonstrates that hoarding can be effectively treated with available psychotherapeutic modalities, the effectiveness of current treatments is not as robust as that for other psychiatric disorders and more work is needed in treatment precision.
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Affiliation(s)
- Eliza J Davidson
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive 116B, San Diego, CA, 92161, USA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Mary E Dozier
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive 116B, San Diego, CA, 92161, USA
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- Psychology Service, South Texas Veterans Health Care System, San Antonio, TX, USA
| | - James O E Pittman
- Mental Healthcare Line, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA
| | - Tina L Mayes
- Mental Healthcare Line, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA
| | - Brian H Blanco
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive 116B, San Diego, CA, 92161, USA
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA
| | - John D Gault
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive 116B, San Diego, CA, 92161, USA
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA
| | - Lauren J Schwarz
- Research Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive 116B, San Diego, CA, 92161, USA
| | - Catherine R Ayers
- Mental Healthcare Line, VA San Diego Healthcare System, San Diego, CA, USA.
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, USA.
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10
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Worden B, Levy HC, Das A, Katz BW, Stevens M, Tolin DF. Perceived emotion regulation and emotional distress tolerance in patients with hoarding disorder. J Obsessive Compuls Relat Disord 2019; 22:100441. [PMID: 32818134 PMCID: PMC7430655 DOI: 10.1016/j.jocrd.2019.100441] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Emotional distress tolerance (EDT) and emotion regulation (ER) appear to be highly relevant to hoarding pathology, as excessive saving and/or acquiring may be motivated by emotional avoidance or other attempts to regulate negative affect. While findings with nonclinical samples have suggested and EDT/ER predicts hoarding symptoms, there is little data on clinical samples. The aim of the current study was to examine several self-report measures of EDT and ER in individuals with HD (n = 87) and age-matched nonclinical controls (n = 46), and to explore whether this was predictive of treatment compliance and/or outcome in group CBT for HD. Results suggested that, the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004) total score, DERS goals and awareness subscales, and Intolerance of Uncertainty Scale (IUS; Buhr & Dugas, 2002) were predictive of hoarding severity. However, EDT/ER did not change with treatment, did not mediate treatment outcome, and did not predicted treatment retention, compliance, or outcome. Results suggest that some EDT/ER constructs, such as uncertainty intolerance, difficulty persisting in goal behaviors when upset, and low emotional awareness, may explain significant variance in HD symptoms, although they did not appear to be mechanisms of change in CBT for HD.
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Affiliation(s)
| | | | | | | | - Michael Stevens
- Institute of Living, Hartford, CT
- Yale University School of Medicine
| | - David F. Tolin
- Institute of Living, Hartford, CT
- Yale University School of Medicine
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11
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Fontenelle LF, Zeni-Graiff M, Quintas JN, Yücel M. Is There A Role For Lifestyle Interventions In Obsessive-Compulsive And Related Disorders? Curr Med Chem 2019; 25:5698-5711. [DOI: 10.2174/0929867325666180104150854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 12/01/2017] [Accepted: 12/08/2017] [Indexed: 01/12/2023]
Abstract
Many of the currently available treatments for obsessive-compulsive and related
disorders (OCRDs) such as pharmacotherapy augmentation strategies, partial hospitalization
programs, deep brain stimulation, and neurosurgery are efficacious for individuals
suffering from more severe forms of these conditions. Unfortunately, the application
of these treatments in milder forms of illness and subclinical samples, which affect a
substantial portion of the population, is not justifiable by their costs (e.g. cognitivebehavioral
therapy) and/or potential for side effects (serotonin-reuptake inhibitors associated
sexual side effects). As such, there is an urgent need to develop simple yet effective
treatments, such as modifiable lifestyle interventions, that can be employed on a broader
scale. Here, we review the current state of evidence that supports or refutes the efficacy of
lifestyle approaches for OCRDs. We focus on dimensions of lifestyle that are deemed important
for cardiovascular diseases; namely, physical activity, stress, sleep, diet and eating
behaviors, alcohol consumption, and smoking. Despite the relative scarcity of welldesigned
randomized controlled trials targeting unhealthy life styles in OCRDs, we found
meditation-based therapies and interventions focusing on eliminating sedentarism to be
promising approaches. In the future, these strategies may represent valid alternative for
subjects with subthreshold symptoms or at risk for OCRDs or other “compulsive” disorders.
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Affiliation(s)
- Leonardo F. Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Maiara Zeni-Graiff
- Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Julliana N. Quintas
- Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Murat Yücel
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Victoria, Australia
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12
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Taylor JK, Theiler S, Nedeljkovic M, Moulding R. A qualitative analysis of emotion and emotion regulation in hoarding disorder. J Clin Psychol 2018; 75:520-545. [PMID: 30431647 DOI: 10.1002/jclp.22715] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 09/04/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The role of emotion regulation (ER) has been receiving increased attention in relation to various forms of psychopathology including hoarding disorder (HD). However, questionnaire designs are limited to finding associations of ER with symptoms or symptom groups, without finding out how such constructs might be involved in the disorder. METHODS This study was a qualitative investigation of ER in a clinical HD sample (N = 11). RESULTS Prominent themes provided support for ER difficulties in hoarding. In particular, difficulties with identifying and describing feelings, unhelpful attitudes toward the emotional experience, the use of avoidance-based strategies, and a perceived lack of effective ER strategies were prominent themes. Furthermore, emotional factors were identified as being associated with the onset and/or exacerbation of hoarding behavior, and possessions and acquiring behavior appeared to serve an ER function. CONCLUSION The current paper provides a nuanced account of the role of ER in hoarding difficulties.
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Affiliation(s)
- Jasmine K Taylor
- School of Psychology, Swinburne University of Technology; Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Stephen Theiler
- School of Psychology, Swinburne University of Technology; Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Maja Nedeljkovic
- School of Psychology, Swinburne University of Technology; Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Richard Moulding
- School of Psychology, Deakin University, Geelong; Deakin University Centre for Drug Use, Addictive and Anti-Social Behaviour Research (CEDAAR), Geelong, Victoria, Australia
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13
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Babbs RK, Kelliher JC, Scotellaro JL, Luttik KP, Mulligan MK, Bryant CD. Genetic differences in the behavioral organization of binge eating, conditioned food reward, and compulsive-like eating in C57BL/6J and DBA/2J strains. Physiol Behav 2018; 197:51-66. [PMID: 30261172 DOI: 10.1016/j.physbeh.2018.09.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 12/25/2022]
Abstract
Binge eating (BE) is a heritable symptom of eating disorders associated with anxiety, depression, malnutrition, and obesity. Genetic analysis of BE could facilitate therapeutic discovery. We used an intermittent, limited access BE paradigm involving sweetened palatable food (PF) to examine genetic differences in BE, conditioned food reward, and compulsive-like eating between C57BL/6J (B6J) and DBA/2J (D2J) inbred mouse strains. D2J mice showed a robust escalation in intake and conditioned place preference for the PF-paired side. D2J mice also showed a unique style of compulsive-like eating in the light/dark conflict test where they rapidly hoarded and consumed PF in the preferred unlit environment. BE and compulsive-like eating exhibited narrow-sense heritability estimates between 56 and 73%. To gain insight into the genetic basis, we phenotyped and genotyped a small cohort of 133 B6J × D2J-F2 mice at the peak location of three quantitative trait loci (QTL) previously identified in F2 mice for sweet taste (chromosome 4: 156 Mb), bitter taste (chromosome 6: 133 Mb) and behavioral sensitivity to drugs of abuse (chromosome 11: 50 Mb). The D2J allele on chromosome 6 was associated with greater PF intake on training days and greater compulsive-like PF intake, but only in males, suggesting that decreased bitter taste may increase BE in males. The D2J allele on chromosome 11 was associated with an increase in final PF intake and slope of escalation across days. Future studies employing larger crosses and genetic reference panels comprising B6J and D2J alleles will identify causal genes and neurobiological mechanisms.
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Affiliation(s)
- Richard K Babbs
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA 02118, United States
| | - Julia C Kelliher
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA 02118, United States
| | - Julia L Scotellaro
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA 02118, United States; Boston University Undergraduate Research Opportunity Program (UROP), United States
| | - Kimberly P Luttik
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA 02118, United States; Boston University Undergraduate Research Opportunity Program (UROP), United States
| | - Megan K Mulligan
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - Camron D Bryant
- Laboratory of Addiction Genetics, Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA 02118, United States.
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Mathes BM, Norr AM, Allan NP, Albanese BJ, Schmidt NB. Cyberchondria: Overlap with health anxiety and unique relations with impairment, quality of life, and service utilization. Psychiatry Res 2018; 261:204-211. [PMID: 29324396 DOI: 10.1016/j.psychres.2018.01.002] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/04/2017] [Accepted: 01/01/2018] [Indexed: 11/29/2022]
Abstract
Cyberchondria refers to a clinical phenomenon in which repeated Internet searches regarding medical information result in excessive concerns about physical health. Cyberchondria is positively associated with symptoms of health anxiety, though it remains unclear as to whether cyberchondria poses a unique public burden. The current study replicated previous findings regarding the relationship between cyberchondria and health anxiety, and extended those findings to examine the extent to which health anxiety and cyberchondria may be differentially associated with public health outcomes, including impairment, quality of life, and service utilization. Community participants (N = 462) recruited via online crowdsourcing completed a battery of self-report questionnaires assessing cyberchondria, health anxiety, and measures of public health outcomes, including the WHOQOL and SDS. Bifactor latent variable modeling indicated that cyberchondria was closely related to, yet importantly distinct from, health anxiety. Moreover, when accounting for overlap with health anxiety, cyberchondria was associated with increased functional impairment and healthcare utilization. Results provide further support for the identification of cyberchondria as a distinct set of clinical symptoms that may pose a significant public health burden. Future research should determine ways in which to treat and/or prevent symptoms.
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Affiliation(s)
- Brittany M Mathes
- Department of Psychology, Florida State University, 1107W. Call Street, Tallahassee 32306-4301, FL, USA
| | - Aaron M Norr
- Department of Psychology, VA Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA, USA
| | | | - Brian J Albanese
- Department of Psychology, Florida State University, 1107W. Call Street, Tallahassee 32306-4301, FL, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, 1107W. Call Street, Tallahassee 32306-4301, FL, USA.
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15
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Raines AM, Oglesby ME, Allan NP, Mathes BM, Sutton CA, Schmidt NB. Examining the role of sex differences in obsessive-compulsive symptom dimensions. Psychiatry Res 2018; 259:265-269. [PMID: 29091827 DOI: 10.1016/j.psychres.2017.10.038] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 10/13/2017] [Accepted: 10/22/2017] [Indexed: 12/18/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a notably heterogeneous disorder. As such, there has been increased interest in subtyping OCD into homogeneous entities using biological characteristics such as sex. Whereas there is large consensus in the literature regarding sex differences in the phenotypic expression of OCD, there are numerous disadvantages to how OCD has been previously measured and assessed. The present investigation explored potential sex differences in OCD symptoms using the Dimensional Obsessive Compulsive Scale (DOCS), a redesigned measure that more reliably assesses the four most commonly replicated OCD symptom dimensions. A large sample of community participants with elevated levels of OCD symptoms (N = 297) was recruited from an online crowdsourcing marketplace. Surprisingly, no differences in means were observed across sexes. However, results did reveal sex differences when examining relations between OCD dimensions. In particular, correlations between the OCD symptom dimensions were stronger in males compared to females. The common perception of OCD as a heterogeneous disorder may hold for females more so than for males. Future research should seek to replicate these findings using multimethod approaches including clinical, behavioral, and neuroimaging assessments.
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Affiliation(s)
- Amanda M Raines
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA
| | - Mary E Oglesby
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA
| | - Nicholas P Allan
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA
| | - Brittany M Mathes
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA
| | - Carson A Sutton
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL 32306-4301, USA.
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Is the first cut really the deepest? Frequency and recency of nonsuicidal self-injury in relation to psychopathology and dysregulation. Psychiatry Res 2018; 259:392-397. [PMID: 29120848 PMCID: PMC5767158 DOI: 10.1016/j.psychres.2017.10.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 09/10/2017] [Accepted: 10/21/2017] [Indexed: 01/27/2023]
Abstract
Research on nonsuicidal self-injury (NSSI) has moved beyond examination of factors that associate with the mere presence or absence of the behavior, and into more nuanced examination of which discrete features of NSSI behavior relate to pathology. This study examined two features of NSSI, frequency of occurrence and recency, as cross-sectional predictors of psychopathology in a large community sample of adults with a history of NSSI (N = 315). Results of 2 × 2 factorial ANOVAs testing the interactive effects of NSSI frequency (clinical, subclinical) and recency (current, past) revealed that current NSSI was consistently associated with poorer emotional and behavioral health (e.g., greater symptoms of depression, panic, and anxiety, worse emotion regulation, greater alcohol misuse). Results for NSSI frequency were more variable, though preliminary evidence suggested significant interactions of current NSSI and clinical frequency on emotion dysregulation, general anxiety, and panic. Possible clinical and empirical implications of the NSSI disorder frequency criteria proposed in DSM-5 are discussed.
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Novara C, Bottesi G, Dorz S, Sanavio E. Hoarding Symptoms Are Not Exclusive to Hoarders. Front Psychol 2016; 7:1742. [PMID: 27891104 PMCID: PMC5102881 DOI: 10.3389/fpsyg.2016.01742] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 10/24/2016] [Indexed: 11/20/2022] Open
Abstract
Hoarding disorder (HD) was originally conceptualized as a subcategory of obsessive compulsive disorder (OCD), and numerous studies have in fact focused exclusively on investigating the comorbidity between OCD and HD. Hoarding behavior can nevertheless also be found in other clinical populations and in particular in patients with eating disorders (ED), anxiety disorders (AD), major depression (MD), and psychotic disorders (PD). The current study was carried out with the aim of investigating, using a validated instrument such as the Saving Inventory-Revised (SI-R), the presence of HD symptoms in patients diagnosed with ED, AD, MD, and PD. Hoarding symptomatology was also assessed in groups of self-identified hoarders and healthy controls. The results revealed that 22.5% of the ED patients exceeded the cut-off for the diagnosis of HD, followed by 7.7% of the patients with MD, 7.4% of the patients with AD, and 5.9% of the patients with PD. The patients with ED had significantly higher SI-R scores than the other groups in the Acquisition and Difficulty Discarding scales while the AD, MD, and PD patients were characterized exclusively by Difficulty Discarding. These data suggest to clinicians that hoarding symptoms should be assessed in other types of patients and especially in those affected by Bulimia and Binge eating.
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Affiliation(s)
- Caterina Novara
- Department of General Psychology, University of Padova Padova, Italy
| | - Gioia Bottesi
- Department of General Psychology, University of Padova Padova, Italy
| | | | - Ezio Sanavio
- Department of General Psychology, University of Padova Padova, Italy
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Williams MT, Brown TL, Sawyer B. Psychiatric Comorbidity and Hoarding Symptoms in African Americans With Obsessive-Compulsive Disorder. JOURNAL OF BLACK PSYCHOLOGY 2016. [DOI: 10.1177/0095798416639438] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated comorbidity and hoarding symptoms in a sample of African American adults with obsessive-compulsive disorder ( N = 75). For lifetime disorders, 87.9% of participants had at least one other comorbid condition. The most prevalent comorbidities were mood disorders (67.1%), anxiety disorders (51.4%), and substance abuse disorders (38.0%). There was low comorbidity with eating disorders, as only 4.1% had binge-eating disorder and none met criteria for anorexia or bulimia nervosa. In terms of gender differences, females were more likely to have posttraumatic stress disorder and males were more likely to have a comorbid alcohol use disorder. Over half of the participants had hoarding compulsions (56.0%) as indicated by the Yale-Brown Obsessive-Compulsive Scale. Individuals with hoarding compulsions were more likely to have comorbid anxiety-related disorders than those without, and experienced greater indecisiveness, pathological slowness, and doubting; they also had less education and earning power than those without these behaviors. African Americans with obsessive-compulsive disorder tend to have high rates of comorbid disorders, with patterns that resemble findings in non-Hispanic White populations.
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Abstract
Crowdsourcing has had a dramatic impact on the speed and scale at which scientific research can be conducted. Clinical scientists have particularly benefited from readily available research study participants and streamlined recruiting and payment systems afforded by Amazon Mechanical Turk (MTurk), a popular labor market for crowdsourcing workers. MTurk has been used in this capacity for more than five years. The popularity and novelty of the platform have spurred numerous methodological investigations, making it the most studied nonprobability sample available to researchers. This article summarizes what is known about MTurk sample composition and data quality with an emphasis on findings relevant to clinical psychological research. It then addresses methodological issues with using MTurk--many of which are common to other nonprobability samples but unfamiliar to clinical science researchers--and suggests concrete steps to avoid these issues or minimize their impact.
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Affiliation(s)
- Jesse Chandler
- Mathematica Policy Research.,Institute for Social Research
| | - Danielle Shapiro
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan 48103;
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20
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From covalent bonds to eco-physiological pharmacology of secondary plant metabolites. Biochem Pharmacol 2015; 98:269-77. [DOI: 10.1016/j.bcp.2015.07.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 07/30/2015] [Indexed: 01/08/2023]
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