Atypical symptom presentations in children and adolescents with obsessive compulsive disorder

Obsessive compulsive disorder: overview of the condition and its nursing management

Obsessive compulsive disorder (OCD) is a complex condition characterised by intrusive and distressing thoughts (obsessions) and repetitive behaviours or mental acts (compulsions). The symptoms of OCD cause significant distress and anxiety and can have a debilitating effect on a person's daily functioning. This article gives an overview of OCD, including its prevalence, aetiology, symptoms and treatment strategies, with the aim of enhancing nurses' understanding of the condition and its adverse effects on a person's life. The author also discusses some of the ways in which nurses in any setting can support a person with OCD.

Sensory over-responsivity and obsessive-compulsive disorder: Measuring habituation and sensitivity through self-report, physiological and behavioral indices

Individuals with obsessive-compulsive disorder (OCD) may report Sensory Over Responsivity (SOR), but evidence for specific shared mechanism is limited. This study investigated a habituation-sensitivity mechanism in individuals with OCD (n = 30). Sensory habituation and sensitivity were compared with a neurotypical sample, divided to high (n = 30) and low (n = 30) obsessive-compulsive symptoms (HOCS and LOCS). Participants completed self-report sensory questionnaires and a physiological protocol measuring Electro Dermal Activity (EDA) while presenting aversive and neutral sounds in two conditions: Aversive stimuli followed by neutral stimuli (AVfirst), or neutral stimuli followed by aversive stimuli (NEfirst). In addition, participants could shorten the stimulus duration by pressing a key. LOCS differed from HOCS and OCD in most sensory self-report scores, with no significant difference between OCD and HOCS. HOCS had no significant differences in habituation patterns across conditions, while OCD had no differences in habituation patterns in AVfirst (p = .08) but significantly slower habituation patterns to the NEfirst neutral stimuli (p < .001). Condition order determined sensitivity for LOCS (AVfirst p = .017; NEfirst p = .045) but not for OCD and HOCS. HOCS and OCD shortened aversive stimuli by key pressing more than LOCS, with no significant difference between OCD and HOCS. The habituation process of individuals with OCD and HOCS was more influenced by stimulus type than by condition order, which might be due to a cognitive bias of prediction. Individuals with elevated OCS have difficulty relying upon sensory input to respond adaptively to the environment. This process can explain the avoidant behavior and complains of individuals with OCD not being able to ignore and to habituate to the sensory environment. These evidence warrants design of psychoeducation and intervention methods for relying on prior sensory information to improve functioning in individuals with OCD and SOR.

The Prevalence and Severity of Misophonia in a UK Undergraduate Medical Student Population and Validation of the Amsterdam Misophonia Scale

Misophonia is a condition of abnormal emotional responses to specific auditory stimuli. There is limited information available on the prevalence of this condition. This study aimed to estimate the prevalence of misophonia in an undergraduate medical student population at the University of Nottingham. A secondary aim of this study was to assess the psychometric validity of the Amsterdam Misophonia Scale (A-Miso-S) questionnaire tool in this population. The A-Miso-S was administered online to medical students at the University of Nottingham. To assess the validity of the A-Miso-S, a factor analysis was conducted. To determine prevalence and severity the results of the questionnaire were quantitatively analysed using SPSS. Actor analysis was conducted. Free text responses to one questionnaire item were analysed using a thematic approach. Responses were obtained from 336 individuals. Clinically significant misophonic symptoms appear to be common, effecting 49.1% of the sample population. This is statistically significantly higher prevalence than previous studies have found (p < 0.00001). Using the classification of the A-Miso-S, mild symptoms were seen in 37%, moderate in 12%, severe in 0.3% of participants. No extreme cases were seen. The A-Miso-S was found to be a uni-factorial tool, with good internal consistency. This study has provided new information on misophonia and validity of the A-Miso-S questionnaire in a sample population of UK undergraduate medical students. The results indicate that misophonia is a phenomenon that a significant proportion of medical students experience though only a small subset experience it severely.