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Yucens B, Erdogan NO, Gündüz M, Tumkaya S. Comparison of autogenous and reactive type obsessive-compulsive disorders in terms of clinical characteristics: A meta-analysis study. J Psychiatr Res 2024; 176:338-347. [PMID: 38917724 DOI: 10.1016/j.jpsychires.2024.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/08/2024] [Accepted: 06/10/2024] [Indexed: 06/27/2024]
Abstract
Obsessive-compulsive disorder (OCD) has been divided into two subgroups autogenous and reactive types, based on obsessive symptoms. To our knowledge, no meta-analysis study compares sociodemographic and clinical characteristics. Investigation of the differences between the two groups in terms of these basic characteristics may provide information about the accuracy of this classification. This is the first meta-analysis to examine gender, age at onset and some clinical differences between patients with autogenous and reactive OCD. Electronic bibliographic databases of Scopus and PubMed were searched up to March 2024. Random effect models were conducted for this meta-analysis. The analysis was carried out using the standardized mean difference as the outcome measure. Publication bias was evaluated using the Begg and Eggers funnel plot, and fail-safe N calculation using the Rosenthal approach. The current meta-analysis summarizes the data from primary studies comparing the gender rates, age at onset of OCD, severity of obsessive-compulsive symptoms, and severity of depression and anxiety symptoms between autogenous and reactive types of OCD. The results of this study showed that the rate of male gender was higher in the autogenous type OCD. In addition, increased severity of anxiety, and depression were associated with autogenous type OCD. There was no significant difference between groups regarding the severity of obsessive-compulsive symptoms. Age of OCD onset findings were insignificant, but excluding an outlier study suggested earlier onset in autogenous type OCD. These results support the distinction between autogenous and reactive type OCD.
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Affiliation(s)
- Bengu Yucens
- Pamukkale University, Faculty of Medicine, Department of Psychiatry, Kınıklı, Denizli, Turkey
| | - Nilgun Oktar Erdogan
- Pamukkale University, Faculty of Medicine, Department of Psychiatry, Kınıklı, Denizli, Turkey
| | - Muhammet Gündüz
- Department of Psychiatry, Government Hospital of Bolvadin, Bolvadin, Turkey
| | - Selim Tumkaya
- Pamukkale University, Faculty of Medicine, Department of Psychiatry, Kınıklı, Denizli, Turkey; Pamukkale University, Faculty of Medicine, Department of Neuroscience, Kınıklı, Denizli, Turkey.
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2
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Bardakçı MR, Şahin Can M. Early maladaptive schemas in autogenous and reactive subtypes of obsessive-compulsive disorder. Nord J Psychiatry 2024; 78:541-547. [PMID: 39002145 DOI: 10.1080/08039488.2024.2374416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/21/2024] [Accepted: 06/24/2024] [Indexed: 07/15/2024]
Abstract
AIMS The aim of this study is to identify early maladaptive schemas in patients with obsessive-compulsive disorder (OCD) and to determine the use of these schemas in OCD autogenous and reactive subtypes. METHODS The study population included 40 healthy volunteers, and 90 patients diagnosed with OCD. The Yale-Brown Obsession-Compulsion Scale (Y-BOCS) was administered to the OCD group to determine the severity of the disorder, and the Y-BOCS Symptom Checklist was applied to determine the patients with autogenous (n = 37) and reactive (n = 53) subtypes of OCD. Young Schema Questionnaire-Short Form 3 (YSQ-SF3) scales were applied to all participants. RESULTS When autogenous and reactive subtype groups of OCD were compared with each other, the schema domains of disconnection (p = 0.004), high standards (p = 0.008), other-directedness (p < 0.001) and the schema dimensions of failure (p < 0.001), emotional deprivation (p < 0.001), defectiveness (p = 0.007), approval seeking (p = 0.007) and punishment (p = 0.001) were found to be more dominant in the autogenous group. CONCLUSIONS The findings of the study support that there are differences between autogenous and reactive subtypes of OCD in terms of dominant schemas. Therefore, its thought that the use of Schema Therapy methods in which schemas appropriate for subtypes are investigated in the treatment of OCD patients will contribute favorably to the treatment response.
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Affiliation(s)
| | - Merve Şahin Can
- Department of Psychiatry, Balıkesir University Faculty of Medicine, Balıkesir, Türkey
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3
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Kahya Y, Inozu M, Clark DA. Thematic Content Analysis of Repugnant Intrusions in Highly Religious Canadian and Turkish Samples. JOURNAL OF RELIGION AND HEALTH 2024; 63:2821-2846. [PMID: 36737537 DOI: 10.1007/s10943-023-01747-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
The degree of religiosity, a culturally relevant concept, has been associated with obsessive phenomena such as obsessional symptoms, the nature of unwanted intrusive thoughts, and responses to intrusive thoughts. Although previous research reported that repugnant (i.e., sexual and religious) intrusions had the lowest endorsement rates, these were also the most difficult to control and more likely to turn into obsessions. Highly religious individuals are more likely to be distressed by repugnant intrusions as the repugnant nature of intrusive thoughts critically threatens the perceived self. Thus, individuals with high religiosity may be more likely to respond to repugnant intrusions with dysfunctional strategies and thus become more vulnerable to OCD. This study presents the endorsement rates and qualitative features of sexual and religious intrusions among highly religious Canadian and Turkish samples. Highly religious participants were interviewed using the International Intrusive Thoughts Interview Schedule (IITIS). Thematic content analysis of the IITIS data was conducted with MAXQDA. Sexual intrusion themes of Forceful Sex, Gay Sex, Immoral Sex, and Sex with Undesirable People were identified in both samples. Religious intrusion themes of Questioning, How They Are Perceived by God, Violating Religious Doctrines, Punishment by God, and Worship also emerged in both samples. The percentages of these themes suggested the presence of cross-cultural qualitative similarities and differences.
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Affiliation(s)
- Yasemin Kahya
- Department of Psychology, Faculty of Social Sciences and Humanities, Social Sciences University of Ankara, Hükümet Meydanı No: 2, 06050, Ulus, Altındağ, Ankara, Turkey.
| | - Mujgan Inozu
- Department of Psychology, Hacettepe University, Ankara, Turkey
| | - David A Clark
- Department of Psychology, University of New Brunswick, Fredericton, Canada
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Weiss F, Schwarz K, Endrass T. Exploring the relationship between context and obsessions in individuals with obsessive-compulsive disorder symptoms: a narrative review. Front Psychiatry 2024; 15:1353962. [PMID: 38419899 PMCID: PMC10899460 DOI: 10.3389/fpsyt.2024.1353962] [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: 12/11/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
Obsessions in obsessive-compulsive disorder (OCD) have long been proposed to differ from intrusive thoughts in unaffected individuals based on appraisal of the thoughts. However, more recent research indicates that cognitive processes behind obsessions may differ significantly from those in healthy individuals concerning their contextual relationship. This narrative literature review summarizes current evidence for the role of context-relatedness for obsessions in OCD and intrusive thoughts in affected and unaffected individuals. The review encompasses a total of five studies, two of which include individuals diagnosed with OCD (one study also includes a group of unaffected control individuals), while the other three studies investigate the relationship between OCD symptoms and context in unaffected individuals. As assessed by mainly self-reports, the review examines the connection between thoughts and their context, shedding light on how the repetition and automaticity of thoughts, as well as their detachment from context over time contribute to defining obsessions in contrast to intrusive thoughts. However, the link with context depends on the content of the obsessions. We propose the term "decontextualization of thoughts" to describe the phenomenon that obsessions gradually lose their connection with external context during the development of OCD. Future research should investigate whether this hypothesis can be supported by experimental evidence and identify whether this shift might be more likely a cause or a consequence of the disorder.
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Affiliation(s)
- Franziska Weiss
- Chair of Addiction Research, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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5
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Sandstrom A, Krause S, Ouellet-Courtois C, Kelly-Turner K, Radomsky AS. What's control got to do with it? A systematic review of control beliefs in obsessive-compulsive disorder. Clin Psychol Rev 2024; 107:102372. [PMID: 38091769 DOI: 10.1016/j.cpr.2023.102372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/15/2023] [Accepted: 12/01/2023] [Indexed: 01/17/2024]
Abstract
Current conceptualizations of control-related beliefs in Obsessive-Compulsive Disorder (OCD) have largely been limited to beliefs about the need to control thoughts. Although growing evidence supports the notion of considering broader control-related constructs in this disorder, there has been limited research aimed at integrating findings across studies, making it difficult to determine how different control-related beliefs may influence OCD symptoms. The current review sought to systematically analyze findings from all studies investigating the relationship between control beliefs and OCD. The systematic search identified 157 eligible articles that assessed the relationship between control beliefs and OCD symptoms. Results suggested that certain control beliefs (e.g., importance of/need to control of thoughts, sense of control, beliefs about losing control) may be more closely associated with OCD than others (e.g., locus of control, and desire for control). In general, control beliefs were positively associated with OCD, with effect sizes ranging from small to large depending on the symptom domain. Based on limited studies, the only control belief which demonstrated specificity to OCD was ICT. Findings support the importance of integrating additional control beliefs in conceptualizations of OCD and provide evidence to support the benefits of targeting these beliefs in cognitive behavioural therapy.
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Affiliation(s)
- Andrea Sandstrom
- Concordia University, Department of Psychology, 7141 Rue Sherbrooke Ouest, Montreal, Quebec H4B 1R6, Canada
| | - Sandra Krause
- Concordia University, Department of Psychology, 7141 Rue Sherbrooke Ouest, Montreal, Quebec H4B 1R6, Canada
| | - Catherine Ouellet-Courtois
- Concordia University, Department of Psychology, 7141 Rue Sherbrooke Ouest, Montreal, Quebec H4B 1R6, Canada
| | - Kenneth Kelly-Turner
- Concordia University, Department of Psychology, 7141 Rue Sherbrooke Ouest, Montreal, Quebec H4B 1R6, Canada
| | - Adam S Radomsky
- Concordia University, Department of Psychology, 7141 Rue Sherbrooke Ouest, Montreal, Quebec H4B 1R6, Canada.
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Fenlon EE, Pinciotti CM, Jones AC, Rippey CS, Wild H, Hubert TJJ, Tipsword JM, Badour CL, Adams TG. Assessment of Comorbid Obsessive-Compulsive Disorder and Posttraumatic Stress Disorder. Assessment 2024; 31:126-144. [PMID: 37904505 DOI: 10.1177/10731911231208403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are commonly comorbid and share prominent features (e.g., intrusions, safety behaviors, and avoidance). Excellent self-report and clinician-administered assessments exist for OCD and PTSD individually, but few assess both disorders, and even fewer provide instruction on differential diagnosis or detection of comorbid OCD and PTSD. To address this gap in the literature, the current paper aims to (1) highlight diagnostic and functional similarities and differences between OCD and PTSD to inform differential diagnosis, (2) outline assessment recommendations for individuals with suspected comorbid OCD and PTSD, OCD with a significant trauma history or posttraumatic symptoms, or PTSD with significant obsessive-compulsive symptoms, and (3) explore future directions to evaluate and improve methods for assessing co-occurring OCD and PTSD.
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Affiliation(s)
| | | | - Alyssa C Jones
- Ralph H. Johnson VA Health Care System, Charleston, SC, USA
- Medical University of South Carolina, Charleston, USA
| | | | | | | | | | | | - Thomas G Adams
- University of Kentucky, Lexington, USA
- Yale School of Medicine, New Haven, CT, USA
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7
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Gargano SP, Santos MG, Taylor SM, Pastis I. A closer look to neural pathways and psychopharmacology of obsessive compulsive disorder. Front Behav Neurosci 2023; 17:1282246. [PMID: 38033477 PMCID: PMC10687174 DOI: 10.3389/fnbeh.2023.1282246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 10/12/2023] [Indexed: 12/02/2023] Open
Abstract
The intricate neural pathways involved in obsessive-compulsive disorder (OCD) affect areas of our brain that control executive functioning, organization, and planning. OCD is a chronic condition that can be debilitating, afflicting millions of people worldwide. The lifetime prevalence of OCD in the US is 2.3%. OCD is predominantly characterized by obsessions consisting of intrusive and unwanted thoughts, often with impulses that are strongly associated with anxiety. Compulsions with OCD encompass repetitive behaviors or mental acts to satisfy their afflicted obsessions or impulses. While these factors can be unique to each individual, it has been widely established that the etiology of OCD is complex as it relates to neuronal pathways, psychopharmacology, and brain chemistry involved and warrants further exploration.
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Affiliation(s)
- Steven P. Gargano
- East Carolina University Brody School of Medicine, Greenville, NC, United States
| | - Melody G. Santos
- Internal Medicine and Psychiatry Combined Program, Department of Psychiatry and Behavioral Medicine, East Carolina University, Greenville, NC, United States
| | - Sydney M. Taylor
- East Carolina University Brody School of Medicine, Greenville, NC, United States
| | - Irene Pastis
- Department of Psychiatry and Behavioral Medicine, East Carolina University, Greenville, NC, United States
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8
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Fan J, Xia J, Liu Q, Wang X, Du H, Gao F, Han Y, Yu Q, Lu J, Xiao C, Tan C, Zhu X. Neural substrates for dissociation of cognition inhibition in autogenous- and reactive-type obsessive-compulsive disorder. J Psychiatr Res 2023; 165:150-157. [PMID: 37499486 DOI: 10.1016/j.jpsychires.2023.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/13/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND The taxonomy of autogenous- and reactive-type obsessive-compulsive disorder (OCD) (AO vs. RO) is one of the most valid subtyping approaches to the heterogeneity of OCD. The present study aimed to seek evidence of neural substrates supporting the dissociation of cognition inhibition in AO and RO which was revealed by our previous behavioral and electrophysiological work. METHODS A total of 165 patients with OCD (86 AO versus 79 RO), and 79 healthy controls (HC) underwent resting-state functional magnetic resonance imaging scans. Within-network connectivity, node strength, and edge-wise functional connectivity (FC) in cognition and response inhibition networks were calculated. Results from 3 cognition and 2 response inhibition network atlases were compared to confirm the robustness of the findings. RESULTS Both AO and RO showed lower within-network connectivity in response inhibition networks, while lower within cognition inhibition network connectivity was only detected in AO. Besides shared weaker node strength in the anterior insula (AI), anterior cingulate cortex (ACC), and supplementary motor area (SMA), AO had a broader range of nodes within cognition inhibition networks exhibiting weaker strength, including nodes in right inferior frontal gyrus (IFG), left parietal and occipital regions. Decreased FC of left AI-CC, left IFG-ACC, and frontal-parietal regions in cognition inhibition networks were found in AO. CONCLUSIONS Findings indicate that unlike deficits in connectivity within response inhibition networks which may reflect a common pathology in AO and RO, deficits in connectivity within cognition inhibition networks were more pronounced in AO. These findings strengthen our insight into the heterogeneity in OCD.
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Affiliation(s)
- Jie Fan
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan, 410011, China; National Clinical Research Center for Mental Disorders, Changsha, 410011, Hunan, China; National Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Jie Xia
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Qian Liu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Hongyu Du
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Feng Gao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Yan Han
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Quanhao Yu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Jingjie Lu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Chuman Xiao
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Changlian Tan
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Xiongzhao Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan, 410011, China; National Clinical Research Center for Mental Disorders, Changsha, 410011, Hunan, China; National Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China.
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9
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Burnley A, St Clair M, Bedford R, Wren Y, Dack C. Understanding the prevalence and manifestation of anxiety and other socio-emotional and behavioural difficulties in children with Developmental Language Disorder. J Neurodev Disord 2023; 15:17. [PMID: 37322422 PMCID: PMC10268478 DOI: 10.1186/s11689-023-09486-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/30/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND It is well-documented that children with Developmental Language Disorder (DLD) have a higher likelihood of experiencing anxiety, as well as other socio-emotional and behavioural (SEB) difficulties. Despite this, there is little consensus as to how these difficulties manifest. This study aims to understand the prevalence of broader SEB difficulties and anxiety, informing intervention development by understanding the relationships between them. METHODS A mixed-methods, case-control study was conducted. First, an online survey was completed by 107 parents of either children with DLD ("DLD sample"; n = 57) or typically developing children ("typical sample"; n = 50), aged 6-12 years old. Binary SEB statements informed by previous qualitative work (e.g. "my child requires routine/sameness"; "my child has frequent tantrums") provided an insight into the prevalence of SEB difficulties in both DLD and typical samples. Validated measures of anxiety, emotion regulation, intolerance of uncertainty, insistence on sameness, family stress and coping mechanisms were also collected. Correlation and mediation analyses were run using these validated measures to understand the manifestation of anxiety in children with DLD in more detail. Qualitative interviews were then carried out with a select panel of survey respondents (n = 4). RESULTS The DLD sample scored significantly higher on all binary SEB statements than the typical sample: experiencing anxiety (80.7%, p < .05), requiring routine and sameness (75.4%, p < .001) and emotional dysregulation (75.4%; p < .001) were the most common difficulties reported for children with DLD. Using the validated scales, family stress and coping mechanisms were found to only correlate with the manifestation of anxiety in the typical group, not the DLD group. "Intolerance of uncertainty" and "insistence on sameness" were found to fully mediate the relationship between DLD diagnosis and symptoms of anxiety. Parent's interviews provided contextual support for the analysis, as well as highlighting sensory sensitivities as a focus for future research. CONCLUSIONS Parents of children with DLD appear to cope well with their children's complex SEB needs. Intervention focussing on intolerance of uncertainty may help the management of difficulties with anxiety. Behaviours such as insistence on sameness should be investigated further, as potential indicators for anxiety amongst children with DLD.
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Affiliation(s)
- Annabel Burnley
- Department of Psychology, University of Bath, Bath, Somerset County UK
| | - Michelle St Clair
- Department of Psychology, University of Bath, Bath, Somerset County UK
| | - Rachael Bedford
- Department of Psychology, University of Bath, Bath, Somerset County UK
| | - Yvonne Wren
- Bristol Dental School, University of Bristol, Bristol, Bristol County UK
| | - Charlotte Dack
- Department of Psychology, University of Bath, Bath, Somerset County UK
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10
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Fernandez SJ, Daffern M, Moulding R, Nedeljkovic M. Exploring predictors of aggressive intrusive thoughts and aggressive scripts: Similarities and differences in phenomenology. Aggress Behav 2023; 49:141-153. [PMID: 36408970 PMCID: PMC10100145 DOI: 10.1002/ab.22061] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022]
Abstract
Experiencing a thought about harming or injuring another person is commonly reported by the general population. Aggressive intrusive thoughts (AITs) and aggressive scripts are two constructs commonly used to define the experience of thinking about harming another person. However, they are generally investigated separately and with two significantly different population groups; respectively, individuals with obsessive-compulsive disorder and people with a history of violent behavior. AITs and aggressive scripts are assumed to have very different implications for violence risk assessment, but conceptual overlap and an absence of empirical research renders this assumption premature. Using a battery of self-report measures, this study aimed to investigate the differential predictors of AITs and aggressive script rehearsal in a nonclinical sample. Additionally, using regression analyses, the predictors of self-reported aggressive behavior were explored in a sample of 412 adults (73% females; Mage = 31.96 years, SD = 11.02). Violence-supportive beliefs and frequency of anger rumination predicted the frequency of aggressive script rehearsal, and aggressive script rehearsal, anger rumination, and violence-supportive beliefs predicted a history of aggressive behavior. In contrast, obsessive beliefs were predictive of AITs, and only AITs were related to ego-dystonicity. Both AITs and aggressive script rehearsal were related to the use of thought control strategies. These findings support the contributions that maladaptive beliefs have in the experience of aggressive scripts and AITs. Beliefs about violence, a history of aggressive behavior, and ego-dystonicity appear to differentiate aggressive scripts from AITs.
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Affiliation(s)
- Stephanie J Fernandez
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Melbourne, Australia.,Centre for Forensic Behavioural Science, Swinburne University of Technology, Alphington, Melbourne, Australia
| | - Michael Daffern
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Melbourne, Australia.,Centre for Forensic Behavioural Science, Swinburne University of Technology, Alphington, Melbourne, Australia
| | | | - Maja Nedeljkovic
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Melbourne, Australia
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11
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Alcolado GM, Rowa K, Milosevic I, McCabe RE. Do all obsessions contradict personal values to the same degree? A pilot investigation. Bull Menninger Clin 2023; 87:291-312. [PMID: 37695881 DOI: 10.1521/bumc.2023.87.3.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Although much is known about how intrusive thoughts become obsessions, the factors that determine which particular thoughts do so is not. The degree to which intrusions are personally significant may be such a determinant. Obsessive-compulsive disorder (OCD) is heterogeneous; thus, it is possible that contradictions of personal values may play a varying role in the development of obsessions depending on which OCD symptoms manifest and may change differentially following treatment. Archival data were examined. Patients with a diagnosis of OCD (N = 62) reported their most upsetting obsession and the degree to which it violated values both pre- and postparticipation in group cognitive-behavioral therapy for OCD. At pretreatment, contradiction ratings differed across symptom domains, such that participants with primary symptoms of obsessions/checking exhibited contradiction ratings that were significantly greater than did participants with other primary symptoms. Contradiction ratings did not change posttreatment. Implications for the conceptualization of OCD are discussed.
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Affiliation(s)
- Gillian M Alcolado
- Assistant professor in the Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Canada
| | - Karen Rowa
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Canada
- Associate Professors in the Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Irena Milosevic
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Canada
- Associate Professors in the Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Randi E McCabe
- Anxiety Treatment and Research Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Canada
- Professor in the Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
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12
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Hellberg SN, Abramowitz JS, Ojalehto HJ, Butcher MW, Buchholz JL, Riemann BC. Co-occurring depression and obsessive-compulsive disorder: A dimensional network approach. J Affect Disord 2022; 317:417-426. [PMID: 36055534 DOI: 10.1016/j.jad.2022.08.101] [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: 12/11/2021] [Revised: 05/26/2022] [Accepted: 08/26/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Depressive and obsessive-compulsive (OCD) symptoms often co-occur and a number of possible explanations for this co-occurrence have been explored, including shared biological and psychosocial risk factors. Network approaches have offered a novel hypothesis for the link between depression and OCD: functional inter-relationships across the symptoms of these conditions. The few network studies in this area have relied largely on item, rather than process-level constructs, and have not examined relationships dimensionally. METHODS Network analytic methods were applied to data from 463 treatment-seeking adults with OCD. Patients completed self-report measures of OCD and depression. Factor analysis was used to derive processes (i.e., nodes) to include in the network. Networks were computed, and centrality, bridge, and stability statistics examined. RESULTS Networks showed positive relations among specific OCD and depressive symptoms. Obsessions (particularly repugnant thoughts), negative affectivity, and cognitive-somatic changes (e.g., difficulty concentrating) were central to the network. Unique relations were observed between symmetry OCD symptoms and cognitive-somatic changes. No direct link between harm-related OCD symptoms and depression was observed. CONCLUSIONS Our results bring together prior findings, suggesting that both negative affective and psychomotor changes are important to consider in examining the relationship between OCD and depression. Increased consideration of heterogeneity in the content of OCD symptoms is key to improving clinical conceptualizations, particularly when considering the co-occurrence of OCD with other disorders.
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Affiliation(s)
- Samantha N Hellberg
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, USA.
| | - Jonathan S Abramowitz
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, USA
| | - Heidi J Ojalehto
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, USA
| | - Megan W Butcher
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, USA
| | - Jennifer L Buchholz
- Department of Psychology & Neuroscience, University of North Carolina, Chapel Hill, USA
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13
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Factors Predicting the Effectiveness of Cognitive-Behavioral Group Therapy in the Treatment of Obsessive–Compulsive Disorder. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2022. [DOI: 10.1007/s10942-022-00456-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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14
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Visvalingam S, Crone C, Street S, Oar EL, Gilchrist P, Norberg MM. The causes and consequences of shame in obsessive-compulsive disorder. Behav Res Ther 2022; 151:104064. [DOI: 10.1016/j.brat.2022.104064] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 11/02/2022]
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15
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Abstract
The present study aimed to examine gender differences in the experience of eating disorder-related intrusive thoughts (EDITs; i.e., frequency, content, emotional consequences, & control strategies). In addition, differences in the experience of EDITs across those atrisk of developing an eating disorder and those who are not atrisk were investigated. Six hundred and seventy-one adults completed self-report measures assessing the experience of EDITs, disordered eating attitudes and behaviours, and body dissatisfaction. It was found that females experienced EDITs more frequently and with higher levels of distress compared with males. With regard to control strategies, females tended to use distraction and thought suppression, whereas males were likely to do nothing in response. Participants in the at-risk group experienced EDITs more frequently, with higher distress, and responded by using obsessive-compulsive rituals or doing what the intrusion dictated significantly more than non-risk participants. Relationships between body dissatisfaction and EDITs related to bodily appearance were found to be stronger for men, whereas women revealed a stronger relationship between disordered eating and purging EDITs. The findings of this study support the growing literature regarding EDITs as a distinct clinical feature of eating disorders, and the developing evidence base regarding intrusive thoughts as a transdiagnostic mechanism.
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Affiliation(s)
- Nicole Thaiposri
- Discipline of Psychological Sciences, Australian College of Applied Psychology, Sydney, Australia
| | - John Reece
- Discipline of Psychological Sciences, Australian College of Applied Psychology, Melbourne, Australia
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16
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Qing X, Gu L, Li D. Abnormalities of Localized Connectivity in Obsessive-Compulsive Disorder: A Voxel-Wise Meta-Analysis. Front Hum Neurosci 2021; 15:739175. [PMID: 34602998 PMCID: PMC8481585 DOI: 10.3389/fnhum.2021.739175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 08/26/2021] [Indexed: 01/20/2023] Open
Abstract
Background: A large amount of resting-state functional magnetic resonance imaging (rs-fMRI) studies have revealed abnormalities of regional homogeneity (ReHo, an index of localized intraregional connectivity) in the obsessive-compulsive disorder (OCD) in the past few decades, However, the findings of these ReHo studies have remained inconsistent. Hence, we performed a meta-analysis to investigate the concurrence across ReHo studies for clarifying the most consistent localized connectivity underpinning this disorder. Methods: A systematic review of online databases was conducted for whole-brain rs-fMRI studies comparing ReHo between OCD patients and healthy control subjects (HCS). Anisotropic effect size version of the seed-based d mapping, a voxel-wise meta-analytic approach, was adopted to explore regions of abnormal ReHo alterations in OCD patients relative to HCS. Additionally, meta-regression analyses were conducted to explore the potential effects of clinical features on the reported ReHo abnormalities. Results: Ten datasets comprising 359 OCD patients and 361 HCS were included. Compared with HCS, patients with OCD showed higher ReHo in the bilateral inferior frontal gyri and orbitofrontal cortex (OFC). Meanwhile, lower ReHo was identified in the supplementary motor area (SMA) and bilateral cerebellum in OCD patients. Meta-regression analysis demonstrated that the ReHo in the OFC was negatively correlated with illness duration in OCD patients. Conclusions: Our meta-analysis gave a quantitative overview of ReHo findings in OCD and demonstrated that the most consistent localized connectivity abnormalities in individuals with OCD are in the prefrontal cortex. Meanwhile, our findings provided evidence that the hypo-activation of SMA and cerebellum might be associated with the pathophysiology of OCD.
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Affiliation(s)
- Xiuli Qing
- Department of Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children in Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Li Gu
- Department of Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children in Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Dehua Li
- Nursing Department, West China Second University Hospital, Sichuan University, Chengdu, China
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17
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Llorens-Aguilar S, Arnáez S, Aardema F, García-Soriano G. The relationship between obsessions and the self: Feared and actual self-descriptions in a clinical obsessive-compulsive disorder sample. Clin Psychol Psychother 2021; 29:642-651. [PMID: 34342058 DOI: 10.1002/cpp.2656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/11/2021] [Accepted: 07/29/2021] [Indexed: 11/08/2022]
Abstract
Cognitive models of obsessive-compulsive disorder (OCD) posit the relevance of the self in OCD, although the nature of this association is still unclear. We aimed to explore actual and feared selves and its association with obsessions and intrusions in a group of OCD patients. A group of 58 patients with OCD identified their most upsetting obsession and intrusion (non-clinical obsession) experienced in the past 3 months. These cognitions were classified as either moral-based or autogenous (obsessions n = 32; intrusions n = 26) or non-moral-based or reactive, depending on their content. Next, patients described their actual self and their feared self, that is, the person they feared being or becoming, and whether they believed these descriptions were associated with their obsessions/intrusions. Results indicate that individuals with OCD described themselves as insecure, anxious and fearful, but also as good and nice. They particularly feared a selfish, aggressive, bad, liar, coward, insecure and arrogant self. Two-thirds of the patients believed that their obsessions said something about their actual self (65.52%) and that their obsessions brought them closer to the person they do not want to be (62.06%). A third of patients believed their intrusions said something about their actual self (actual self: 30.35%; feared self: 25%), which was a significantly lower percentage than for obsessions. These associations existed independent from the content of the obsession and/or intrusion, although patients with obsessions with moral-based contents more often tended to believe that their obsessions brought them closer to the person they do not want to be. Results suggest the relevance of the real and feared selves in the maintenance of obsessions.
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Affiliation(s)
- Sara Llorens-Aguilar
- Departament de Personalitat, Avaluació i Tractaments Psicològics, Facultat de Psicologia, Universitat de València, Valencia, Spain
| | - Sandra Arnáez
- Departamento de Psicología de la Personalidad, Evaluación y Tratamientos Psicológicos, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | - Frederick Aardema
- Department of Psychiatry, University of Montreal, Montréal, Quebec, Canada.,Mental Health University Institute of Montreal, Montréal, Quebec, Canada
| | - Gemma García-Soriano
- Departament de Personalitat, Avaluació i Tractaments Psicològics, Facultat de Psicologia, Universitat de València, Valencia, Spain
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18
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Danışman Sonkurt M, Altınöz AE, Köşger F, Yiğitaslan S, Güleç G, Eşsizoğlu A. Are there differences in oxidative stress and inflammatory processes between the autogenous and reactive subtypes of obsessive-compulsive disorder? A controlled cross-sectional study. ACTA ACUST UNITED AC 2021; 44:171-177. [PMID: 34190826 PMCID: PMC9041960 DOI: 10.1590/1516-4446-2021-1740] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 04/17/2021] [Indexed: 11/22/2022]
Abstract
Objective: To date, no study has investigated whether autogenous and reactive obsessive-compulsive disorder (OCD) types are different entities in terms of oxidative stress and inflammatory processes. The aim of this study is to compare them in terms of these features. Methods: The study was conducted in subjects with reactive OCD (n=19), autogenous OCD (n=14), and a control group (n=17). All participants were non-smokers. Sociodemographic data were collected and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Obsessive Beliefs Questionnaire (OBQ), and Overvalued Ideas Scale (OVIS) were administered. High-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), paraoxonase (PON1), total oxidant status (TOS), and total antioxidant status (TAS) were measured. Results: There were no significant differences in TAS, TOS, or oxidative stress index (OSI) between the OCD and control groups. PON1 and hs-CRP levels were higher in the OCD group, whereas IL-6 and IL-10 levels were lower. Comparison across the three groups revealed no differences in TAS, TOS, OSI, or PON1 levels; however, hs-CRP was significantly higher while IL-6 and IL-10 were significantly lower in the reactive group compared to controls. Conclusion: Our results show that, although inflammatory processes may play a role in OCD, the autogenous and reactive subtypes do not differ from each other in these respects. The classification of OCD into autogenous and reactive subtypes should be reevaluated.
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Affiliation(s)
- Melis Danışman Sonkurt
- Department of Psychiatry, Faculty of Medicine, Ağrı Training and Research Hospital, Ağrı, Turkey
| | - Ali E Altınöz
- Department of Psychiatry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Ferdi Köşger
- Department of Psychiatry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Semra Yiğitaslan
- Department of Pharmacology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Gülcan Güleç
- Department of Psychiatry, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
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19
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Sharma P, Rosário MC, Ferrão YA, Albertella L, Miguel EC, Fontenelle LF. The impact of generalized anxiety disorder in obsessive-compulsive disorder patients. Psychiatry Res 2021; 300:113898. [PMID: 33812219 DOI: 10.1016/j.psychres.2021.113898] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 03/20/2021] [Indexed: 01/09/2023]
Abstract
Despite generalized anxiety disorder (GAD) being one of the most prevalent comorbidities in obsessive-compulsive disorder (OCD), few studies have researched its impact on the OCD phenotype. The present study investigated how the sociodemographic and clinical profile of people with OCD with comorbid GAD differs from people with OCD without comorbid GAD. We hypothesised that the phenotype of the comorbid group would be closely related to GAD, in that it would more likely be female, have an earlier age at onset of OCD, and show an increased severity of fear-related OCD symptoms (aggressive, sexual/religious, and contamination dimensions), more avoidant behaviours, greater suicidality, more severe anxiety symptoms, and increased rates of comorbid anxiety and mood disorders. The study included 867 participants with OCD, with GAD being comorbid in 33.56%. Mann-Whitney U tests, chi-square tests with continuity correction, and logistic regressions were performed. Results showed that comorbid GAD was uniquely associated with an increased number of avoidant behaviours, greater anxiety severity, panic disorder without agoraphobia, social phobia, specific phobia, and type II bipolar disorder. These results illustrate the clinical severity associated with this comorbidity and highlight markers that can aid diagnosis of GAD in OCD. Future studies should investigate whether this comorbidity has an impact on the treatment of OCD.
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Affiliation(s)
- Prerika Sharma
- Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
| | - Maria C Rosário
- Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), Brazil
| | - Ygor A Ferrão
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre (UFCSPA)
| | - Lucy Albertella
- Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
| | - Euripedes C Miguel
- Obsessive-Compulsive Spectrum Disorders Program (PROTOC), Department and Institute of Psychiatry, University of São Paulo (USP), Brazil
| | - Leonardo F Fontenelle
- Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia; Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro & D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
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20
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Latent structure of obsessions: A taxometric analysis. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-020-01247-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Wang P, Cao W, Chen T, Gao J, Liu Y, Yang X, Meng F, Sun J, Li Z. Mediating Role of Rumination and Negative Affect in the Effect of Mind-Wandering on Symptoms in Patients With Obsessive-Compulsive Disorder. Front Psychiatry 2021; 12:755159. [PMID: 34721118 PMCID: PMC8551573 DOI: 10.3389/fpsyt.2021.755159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
To explore the relationship between negative affect, mind-wandering, rumination and obsessive-compulsive symptoms, 100 patients with obsessive-compulsive disorder and 100 healthy controls were assessed using the Obsessive-Compulsive Inventory, the Beck Anxiety Inventory, the Beck Depression Inventory, the Mind Wandering Scale and the Ruminative Response Scale. The results show that (i) patients diagnosed with obsessive-compulsive disorder displayed higher obsessive-compulsive symptoms, negative affect, mind-wandering and rumination compared with healthy controls; (ii) negative affect, mind-wandering and rumination were positively correlated with the severity of obsessive-compulsive symptoms; (iii) mind-wandering predicted the severity of obsessive-compulsive symptoms (both directly and indirectly); (iv) rumination and negative affect mediated the relationship between mind-wandering and obsessive-compulsive symptoms. The results preliminarily reveal the relationship between mind-wandering and psychopathological obsessive-compulsive symptoms, providing a reference for exploring novel psychological treatments for obsessive-compulsive disorder.
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Affiliation(s)
- Pengchong Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Wenwen Cao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Tao Chen
- Brain and Mind Center, The University of Sydney, Sydney, NSW, Australia.,School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Jian Gao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yifan Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiangyun Yang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fanqiang Meng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jing Sun
- Menzies Health Institute Queensland and School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia
| | - Zhanjiang Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Centre for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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22
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Emotion generation and regulation following an intrusion induction: Implications for taboo or autogenous obsessions. J Behav Ther Exp Psychiatry 2020; 69:101593. [PMID: 32574801 DOI: 10.1016/j.jbtep.2020.101593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/26/2020] [Accepted: 06/05/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Research demonstrates that autogenous (AO) and reactive obsessions (RO) differ in obsessional content; however, no experimental research has examined differences in emotion generation and regulation. Characterizing this taxonomy with respect to emotion generation and regulation could refine conceptualizations of obsessionality and optimize clinical interventions. METHODS Seventy undergraduates were randomly assigned to imagine a personally-relevant AO or RO. Subsequently, emotional reactivity was assessed. Participants then rated their emotion regulation efforts and the degree to which the intrusion violated their values. RESULTS Broadly aligning with expectations, bootstrapped linear regression models indicated that AOs led to a significant increase in self-conscious emotions (guilt, shame, and embarrassment), and these effects were stronger for those whose values were more severely threatened by the intrusion. A conditional process analysis revealed that the relationship between the AO condition and emotion regulation difficulties was explained by an increase in negative emotional reactivity, and the strength of this effect depended upon the degree of conflict with participants' values. LIMITATIONS The use of an analogue sample, and minimal emotional reactivity in the RO condition, threaten the ecological and external validity of the study. CONCLUSIONS The current study employed a novel experimental design demonstrating a meaningful relationship between AOs and both emotional activation and regulation. Results highlight the relevance of self-conscious emotions to the conceptualization of AOs and the utility of addressing them in the context of exposure therapy.
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23
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Validation and Measurement Invariance of the Leuven Obsessional Intrusions Inventory in Two Different Cultures. Psychol Belg 2020; 60:347-361. [PMID: 33117552 PMCID: PMC7566505 DOI: 10.5334/pb.537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Obsessions - recurrent unwanted intrusive thoughts - are one of the two pillars of the Obsessive Compulsive Disorder (OCD). Although OCD has been reported across many different cultures, research on these cultural variations is hampered by the lack of cross-culturally sound instruments to assess intrusive thoughts. The aim of the current study is to investigate the psychometric properties of the recently developed Leuven Obsessional Intrusions Instrument (LOII) in two different cultural contexts. Turkish (N = 663) and Belgian (N = 496) participants were sampled from non-clinical student populations. Results from confirmatory factor analyses yielded a shortened version of the LOII (i.e., LOII-R) with a four-factor solution - aggressive, sexual, and contamination intrusions, and 'just-right' doubts - as the best fitting model across both cultures. The model met most criteria for strong measurement invariance, and proved to be both valid and reliable. The results of this study suggest that the LOII-R is a good candidate for cross-cultural studies on obsessional intrusions.
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24
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Han W, Chen BB. An evolutionary life history approach to understanding mental health. Gen Psychiatr 2020; 33:e100113. [PMID: 33089066 PMCID: PMC7534052 DOI: 10.1136/gpsych-2019-100113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 07/05/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022] Open
Abstract
In recent years, evolutionary life history theory has been used as a heuristic framework to understand mental health. This article reviews the life history theory and its integration with mental disorders and then introduces representative research methods and related empirical studies in the field of evolutionary psychopathology. In the end, this article concludes with future directions for further research examining and developing the evolutionary psychopathological framework.
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Affiliation(s)
- Wen Han
- Department of Psychology, Fudan University, Shanghai, China
| | - Bin-Bin Chen
- Department of Psychology, Fudan University, Shanghai, China
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25
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Llorens-Aguilar S, García-Soriano G, Arnáez S, Aardema F, O'Connor K. Is context a crucial factor in distinguishing between intrusions and obsessions in patients with obsessive-compulsive disorder? J Clin Psychol 2020; 77:804-817. [PMID: 32946616 DOI: 10.1002/jclp.23060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 09/05/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Some cognitive models of obsessive-compulsive disorder (OCD) posit that intrusions exist on a continuum with obsessions; others consider that they may be unrelated phenomena that differ in the context where they occur. We aimed to examine and compare, at two different moments, the context of the occurrence of intrusions and obsessions. METHOD Sixty-eight patients with OCD completed an interview appraising their most upsetting obsession and intrusion. RESULTS At their onset, the obsessions/intrusions were associated with experiencing negative emotional states and life events, and they were more likely to appear in "inappropriate" contexts. The context of the obsessions/intrusions differed the last time they were experienced. Autogenous obsessions/intrusions occurred more frequently in contexts with an indirect link. CONCLUSIONS The context distinguishes between intrusions and obsessions, not when they emerge, but when the obsession is already established. The results support that there is a continuum or progression from intrusions to obsessions.
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Affiliation(s)
- Sara Llorens-Aguilar
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Gemma García-Soriano
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Sandra Arnáez
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Valencia, Spain
| | - Frederick Aardema
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Quebec, Canada
| | - Kieron O'Connor
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología, Universitat de València, Valencia, Spain.,Department of Psychiatry and Addictology, University of Montreal, Montreal, Quebec, Canada
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26
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S Chasson G, R Guillot C, J Zvolensky M, M Liautaud M, B Schmidt N, M Leventhal A. Obsessive-compulsive symptoms and cigarette smoking: an initial cross-sectional test of mechanisms of co-occurrence. Cogn Behav Ther 2020; 49:385-397. [PMID: 32324104 DOI: 10.1080/16506073.2020.1745878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Tobacco addiction and obsessive-compulsive symptoms (OCS; intrusive thoughts or impulses that cause distress and rituals) are both mediated by compulsivity and negative reinforcement. Little evidence exists to guide theory, research, treatment, and population-based prevention of this co-occurrence. We propose a conceptual model of OCS-smoking co-occurrence in which smokers with elevated OCS capitalize on smoking to assuage OCS. This secondary analysis examined associations between OCS levels and self-reported smoking motives that are model-concordant: i) negative reinforcement-smoking for relief; ii) sensorimotor-benefits of behaviors and sensations of the tobacco self-administration ritual; and iii) habitual-smoking without conscious control. A community sample of cigarette smokers enrolled in a cessation trial (N = 458; 47.2% female; M age = 36.9; SD = 13.6) completed pre-quit self-report measures of OCS levels and smoking motives. Regression models adjusted for sociodemographic covariates and non-OCS psychopathologies indicated that OCS level was positively associated with each model-concordant motive. OCS level was also correlated with tobacco dependence severity and greater withdrawal symptom severity experienced during previous quit attempts. Those with higher OCS report greater motivation to smoke for negative reinforcement, sensorimotor behavioral-ritualistic, habit/automaticity, and stimulation reasons. Further examination of the proposed model of OCS-smoking co-occurrence is warranted to guide theory and intervention for this population.
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Affiliation(s)
- Gregory S Chasson
- Department of Psychology, Illinois Institute of Technology , Chicago, IL, USA
| | - Casey R Guillot
- Department of Psychology, University of North Texas , Denton, TX, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston , Houston, TX, USA.,University of Texas, M. D. Anderson Cancer Center , Houston, TX, USA.,Health Institute, University of Houston , Houston, TX, USA
| | - Madalyn M Liautaud
- Department of Preventative Medicine, University of Southern California Keck School of Medicine , Los Angeles, CA, USA
| | - Norman B Schmidt
- Department of Psychology, Florida State University , Tallahassee, FL, USA
| | - Adam M Leventhal
- Department of Preventative Medicine, University of Southern California Keck School of Medicine , Los Angeles, CA, USA.,USC Norris Comprehensive Cancer Center , Los Angeles, CA, USA.,Department of Psychology, University of Southern California , Los Angeles, CA, USA
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27
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Xia J, Fan J, Liu W, Du H, Zhu J, Yi J, Tan C, Zhu X. Functional connectivity within the salience network differentiates autogenous- from reactive-type obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2020; 98:109813. [PMID: 31785320 DOI: 10.1016/j.pnpbp.2019.109813] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a clinically heterogeneous condition. To better understand and treat patients, symptomatology of OCD has been categorized into more homogenous symptom dimensions. The autogenous-reactive classification model has proven helpful in the elucidation of the neurobiological substrates for clinical heterogeneity in OCD. The purpose of the current study was to systematically compare regional and network functional alterations between OCD subtypes based on the autogenous-reactive model. METHODS Autogenous-type OCD patients (OCD-AO, n = 40), reactive-type patients (OCD-RO, n = 42), and healthy controls (HC, n = 70) underwent functional magnetic resonance imaging (fMRI) scans. The amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) were compared among subjects. Areas of abnormal local spontaneous brain activity that differentiated OCD-AO and OCD-RO patients were identified and entered as seeds in functional connectivity (FC) analysis. RESULTS Compared to OCD-RO patients and HC participants, OCD-AO patients showed increased ALFF in the left anterior insula (AI), increased ReHo in the right AI, and hyperconnectivity between bilateral AI and anterior cingulate cortex (ACC). Both OCD-AO and OCD-RO patients shared regional function deficits in several areas within the prefrontal cortex, and stronger FC between bilateral AI and major nodes of the default mode network (DMN) compared to healthy controls. CONCLUSION The current results suggest that aberrant functional interaction between the salience network (SN) and the DMN may represent a common substrate in the pathophysiology of OCD, while impaired functional coupling within the SN is distinct to autogenous-type OCD patients. These findings provide further neurobiological evidence to support the autogenous-reactive classification model and contribute to the understanding of the neurobiological basis for clinical heterogeneity in OCD.
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Affiliation(s)
- Jie Xia
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China
| | - Jie Fan
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Wanting Liu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Hongyu Du
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Jiang Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Jinyao Yi
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Changlian Tan
- Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
| | - Xiongzhao Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Medical Psychological Institute of Central South University, Changsha, Hunan 410011, China.
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Gibby B, Jagannathan N, Chasson GS, Mathes B, Hollern E. What's Sex Got to Do With It? Associations Between Sexual Intrusive Thoughts, Gender, and Metacognition. J Cogn Psychother 2020. [DOI: 10.1891/jcpsy-d-19-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although sexual intrusive thoughts (SITs) are often studied in combination with other intrusions, little is known about the metacognitive processes that are specific to SITs. The present study evaluated sexual versus non-SIT frequency in relation to two main factors: gender and general negative beliefs (GNB), a component of metacognition involving beliefs about the consequences of failing to control thoughts. A nonclinical sample of 286 undergraduate students completed the Revised Obsessional Intrusions Inventory-Sex Version and the Meta-Cognitions Questionnaire. Results indicated main effects for GNB and a significant interaction between gender and GNB for SITs. More specifically, frequency of SITs was significantly higher for males, as well as for participants with higher GNB. In contrast, analyses for non-SITs revealed a main effect for GNB, but no main effects for gender or a significant interaction. These findings suggest a link between high GNB and increased SIT and non-SIT frequency. Moreover, gender may function as a moderator between GNB and SIT frequency. Further characterizing the effects of gender and GNB may help in form treatments for disorders involving clinically significant SITs.
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Del Casale A, Sorice S, Padovano A, Simmaco M, Ferracuti S, Lamis DA, Rapinesi C, Sani G, Girardi P, Kotzalidis GD, Pompili M. Psychopharmacological Treatment of Obsessive-Compulsive Disorder (OCD). Curr Neuropharmacol 2020; 17:710-736. [PMID: 30101713 PMCID: PMC7059159 DOI: 10.2174/1570159x16666180813155017] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 07/06/2018] [Accepted: 08/12/2018] [Indexed: 02/07/2023] Open
Abstract
Background: Obsessive-compulsive disorder (OCD) is associated with affective and cognitive symptoms causing personal distress and reduced global functioning. These have considerable societal costs due to healthcare service utilization. Objective: Our aim was to assess the efficacy of pharmacological interventions in OCD and clinical guidelines, providing a comprehensive overview of this field. Methods: We searched the PubMed database for papers dealing with drug treatment of OCD, with a specific focus on clinical guidelines, treatments with antidepressants, antipsychotics, mood stabilizers, off-label medications, and pharmacogenomics. Results: Prolonged administration of selective serotonin reuptake inhibitors (SSRIs) is most effective. Better results can be obtained with a SSRI combined with cognitive behavioral therapy (CBT) or the similarly oriented exposure and response prevention (ERP). Refractory OCD could be treated with different strategies, including a switch to another SSRI or clomipramine, or augmentation with an atypical antipsychotic. The addition of medications other than antipsychotics or intravenous antidepressant administration needs further investigation, as the evidence is inconsistent. Pharmacogenomics and personalization of therapy could reduce treatment resistance. Conclusions: SSRI/clomipramine in combination with CBT/ERP is associated with the optimal response compared to each treatment alone or to other treatments. New strategies for refractory OCD are needed. The role of pharmacogenomics could become preponderant in the coming years.
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Affiliation(s)
- Antonio Del Casale
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Serena Sorice
- Residency School in Psychiatry, Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Alessio Padovano
- Residency School in Psychiatry, Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Maurizio Simmaco
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | | | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Chiara Rapinesi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Paolo Girardi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Georgios D Kotzalidis
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, Sant'Andrea University Hospital, Rome, Italy
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Berman NC. Treating Taboo or Forbidden Thoughts: Integrating Mindfulness, Acceptance, and Emotion Regulation Into an Exposure-Based Intervention. J Cogn Psychother 2019; 33:196-212. [PMID: 32746427 DOI: 10.1891/0889-8391.33.3.196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Individuals with obsessive compulsive disorder (OCD) who struggle with taboo or unacceptable obsessions (i.e., aggressive, sexual, or religious intrusions) tend to rely upon mental rituals to regulate their distress and possess difficulties labeling and regulating their affective state. Moreover, these individuals respond poorly to exposure with response prevention when the treatment is grounded in emotional processing theory. To improve patients' therapeutic outcomes, clinicians can consider integrating mindfulness- and acceptance-based skills into an exposure-based treatment to: facilitate the identification and acceptance of covert ritualistic urges, improve the accuracy of emotion labeling, and increase the efficiency of emotion regulation efforts. Additionally, in line with inhibitory learning theory, clinicians can design exposures to violate expectancies to promote the maintenance of long-term gains. Through a case vignette, the current article will demonstrate how to integrate these strategies into a standard exposure with response prevention intervention to meet the needs of a patient with taboo thoughts.
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Ozcanli F, Ceulemans E, Hermans D, Claes L, Mesquita B. Obsessions Across Two Cultures: A Comparison of Belgian and Turkish Non-clinical Samples. Front Psychol 2019; 10:657. [PMID: 30971988 PMCID: PMC6443853 DOI: 10.3389/fpsyg.2019.00657] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 03/08/2019] [Indexed: 11/13/2022] Open
Abstract
There is a growing interest in the role of culture in Obsessive-Compulsive Disorder, yet cultural studies to date have suffered from methodological limitations and lack a clear theoretical framework. In the current study, we adopted a rigorous methodological approach, and a clear cultural psychological framework. We compared the structure and frequency of obsessions in non-clinical samples (N = 706) from Belgium, a Western culture, and Turkey, a non-Western cultural context. Obsessions were measured by a newly compiled instrument that included a broad range of obsessions. Cross-cultural equivalence of the structure of obsessions was assessed both in the pooled data, and in each culture separately. At an abstract level, we found a two-factor structure that was cross-culturally invariant, and that fit both cultures equally well. These two types of obsessions each corresponded with a different model of agency. Compared to the Turkish sample, the Belgian sample reported more obsessions that can be understood from a disjoint (independent) model of agency as frequently found in Western cultures, whereas the Turkish sample, compared to their Belgian counterparts, reported more obsessions that can be tied to a conjoint (shared) model of agency as frequently found in non-Western cultural contexts. Differences in the prevalent types of obsessions were systematic and interpretable, therefore. In addition to the cross-culturally equivalent two-factor structure, we found culture-specific factor solutions; these solutions point to cultural differences in the experience of obsessions that have yet to be fully understood. In the Discussion, we outline future directions of the research on culture and obsessions.
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Affiliation(s)
- Fulya Ozcanli
- Center for Social and Cultural Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Eva Ceulemans
- Research Group of Quantitative Psychology and Individual Differences, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Dirk Hermans
- Centre for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Laurence Claes
- Research Group of Clinical Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Batja Mesquita
- Center for Social and Cultural Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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Karagüzel EÖ, Arslan FC, Uysal EK, Demir S, Aykut DS, Tat M, Karahan SC. Blood levels of interleukin-1 beta, interleukin-6 and tumor necrosis factor-alpha and cognitive functions in patients with obsessive compulsive disorder. Compr Psychiatry 2019; 89:61-66. [PMID: 30594753 DOI: 10.1016/j.comppsych.2018.11.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/30/2018] [Accepted: 11/24/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Cognitive dysfunction and immune system disorders are two actual issues for the patients with Obsessive Compulsive Disorder (OCD). The cognitive dysfunctions have been considered to substantial part of clinical phenomenon of OCD but exploration of various etiopathogenesis of cognitive dysfunction is needed. Immune dysfuncion has been implicated to be important part of pathopysiology of OCD and different lines of evidence suggests immune abnormalities in OCD. But whether these immune changes are traits of disease or secondary to clinical burden of the disease such as cognitive dysfunctions has not been determined. Data regarding relation between the cognitive dysfunctions and immune system disorders in OCD is unsatisfied. In this study we aimed to investigate the relation of blood levels of interleukin 1-beta (IL-1ß), interleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α) with various neurocognitive functions in patients with OCD in comparison with its autogenous/reactive subtypes and healthy controls. Further exploration of the effects of various clinical variables on cognitive functioning in patients with OCD and additional investigation of whether the cognitive dysfunction associated with this disorder differs from or overlap with that in other anxiety disorders are needed. METHODS Forty-two patient with OCD and 45 age, sex and educational level matched healthy control were enrolled in the study. The diagnosis of OCD was made with Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Yale- Brown Obsessive-Compulsive Scale, Beck Anxiety and Depression Inventory Scales were administered. Neuropsychological test battery including Wisconsin Card Sorting Test (WCST), Trail Making Test A and B (TMT-A, TMT-B) were used for evaluation of the patients and healthy control. The plasma of interleukin-1beta (IL-1ß), interleukin-6 (IL-6), Tumor Necrosis Factor-Alpha (TNF-α) of both groups were measured with ELISA kits. RESULTS Blood levels of IL-1ß, IL-6 and TNF-α were significantly higher in patients with OCD than the healthy control. There was significant difference in IL-1ß, IL-6 but not in TNF-α between autogenous/reactive subtypes and healthy controls. TNF-α is positively correlated with TMT-A, TMT-B and Stroop Test Part 5, negatively correlated with immediate memory, verbal learning, interference effect, immediate recall, delayed recall and recognition in RAVLT. IL-1ß was positively correlated with TMT-A score. IL-6 was positively correlated with scores of TMT-A, TMT-B. IL-6 was negatively correlated with immediate memory, verbal learning, interference effect, immediate recall and delayed recall in RAVLT, positively correlated with number of perseverative error and negatively correlated with the number of categories completed in WCST. CONCLUSION This is the first study that investigates the relation of IL- 1ß, IL-6 and TNF-α levels with cognitive functions in OCD. There may be a contribution to pathogenesis of OCD and subtypes then new choices for treatment might be developed. Moreover, uncovering the effect of cytokine blood levels on cognitive function of OCD, new data concerning etiopathogenesis and further treatment choices can be gained.
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Affiliation(s)
| | - Filiz Civil Arslan
- Karadeniz Technical Univercity Medical Faculty, Psychiatry Department, Trabzon, Turkey
| | | | - Selim Demir
- Karadeniz Technical Univercity Faculty of Health Sciences, Department of Nutrition and Dietetics, Trabzon, Turkey
| | - Demet Sağlam Aykut
- Karadeniz Technical Univercity Medical Faculty, Psychiatry Department, Trabzon, Turkey; Karadeniz Technical Univercity Medical Faculty, Department Medical Biochemistry, Trabzon, Turkey
| | - Mustafa Tat
- Karadeniz Technical Univercity Medical Faculty, Department Medical Biochemistry, Trabzon, Turkey
| | - Süleyman Caner Karahan
- Karadeniz Technical Univercity Medical Faculty, Department Medical Biochemistry, Trabzon, Turkey
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33
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Scrupulosity, Religious Affiliation and Symptom Presentation in Obsessive Compulsive Disorder. Behav Cogn Psychother 2019; 47:478-492. [PMID: 30642412 DOI: 10.1017/s1352465818000711] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Scrupulosity is a common yet understudied presentation of obsessive compulsive disorder (OCD) that is characterized by obsessions and compulsions focused on religion. Despite the clinical relevance of scrupulosity to some presentations of OCD, little is known about the association between scrupulosity and symptom severity across religious groups. AIMS The present study examined the relationship between (a) religious affiliation and OCD symptoms, (b) religious affiliation and scrupulosity, and (c) scrupulosity and OCD symptoms across religious affiliations. METHOD One-way ANOVAs, Pearson correlations and regression-based moderation analyses were conducted to evaluate these relationships in 180 treatment-seeking adults with OCD who completed measures of scrupulosity and OCD symptom severity. RESULTS Scrupulosity, but not OCD symptoms in general, differed across religious affiliations. Individuals who identified as Catholic reported the highest level of scrupulosity relative to individuals who identified as Protestant, Jewish or having no religion. Scrupulosity was associated with OCD symptom severity globally and across symptom dimensions, and the magnitude of these relationships differed by religious affiliation. CONCLUSIONS Findings are discussed in terms of the dimensionality of scrupulosity, need for further assessment instruments, implications for assessment and intervention, and the consideration of religious identity in treatment.
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34
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Kohler KC, Coetzee BJ, Lochner C. Living with obsessive-compulsive disorder (OCD): a South African narrative. Int J Ment Health Syst 2018; 12:73. [PMID: 30519281 PMCID: PMC6271582 DOI: 10.1186/s13033-018-0253-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 11/24/2018] [Indexed: 12/03/2022] Open
Abstract
Background Obsessive–compulsive disorder (OCD) is a highly prevalent and debilitating psychiatric disorder known to interfere with several life domains. Yet little is known about the subjective experiences of living with OCD amongst South Africans and more so, the ways in which it impacts daily functioning and quality of life (QOL). Methods The aim of this study was to explore daily functioning and QOL among South African adults living with OCD. Qualitative semi-structured interviews were conducted with 20 adults with a primary diagnosis of OCD. We used ATLAS.ti v7 to analyse the data, thematically. The study was conducted at the SU/UCT MRC Unit on Risk and Resilience in Mental Disorders in South Africa. Results Three key themes were identified namely, (1) realisation of OCD, (2) disruptions to daily life and (3) managing the disruptions to daily life. Participants recounted their earliest recollections of OCD, the instances when they recognised something was wrong and ways in which they came to terms with their OCD. Disruptions to daily life included poor sleep quality, inability to enjoy leisure activities which impacted on socialisation and impairment in school/work performance. Perceived social support from family members, friends and colleagues were invaluable to helping participants manage these disruptions. Further, strategies such as self-talk, diary-keeping and humour helped them cope. Conclusion While some individuals with OCD have found ways to cope with and accept having OCD, all participants perceived their QOL to be significantly reduced and their functioning impaired due to the condition, on multiple levels. The importance of acceptance in OCD ties in with research on the potential value of Acceptance and Commitment Therapy, which could form an adjunct to more conventional techniques such as Cognitive-Behavioural Therapy. The themes emanating from this study can be used to help clinicians better understand what treatment works best for patients with OCD—and whether this treatment be focused on the individual or together with close members of their microsystem, such as spouses/partners. Further these findings may potentially help to improve access, affordability and the quality of life of South Africans living with OCD from various income backgrounds.
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Affiliation(s)
| | | | - Christine Lochner
- 2SU/UCT MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
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35
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Knapton O. The linguistic construction of the self in narratives of obsessive-compulsive disorder. QUALITATIVE RESEARCH IN PSYCHOLOGY 2018. [DOI: 10.1080/14780887.2018.1499834] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Olivia Knapton
- King’s College London, Centre for Language, Discourse and Communication, School of Education, Communication and Society, Waterloo Bridge Wing, Franklin-Wilkins Building, Waterloo Campus, London, UK
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36
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Berman NC, Shaw AM, Wilhelm S. Emotion Regulation in Patients with Obsessive Compulsive Disorder: Unique Effects for Those with “Taboo Thoughts”. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9911-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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37
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Lee E, Sherwood JA, Crosby JM, Twohig MP. Can Distressing Sexual Thoughts Be Regulated? Experiential Willingness Versus Distraction. J Cogn Psychother 2018; 32:49-66. [PMID: 32746413 DOI: 10.1891/0889-8391.32.1.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study examines the effects of different techniques on the management of unwanted sexual thoughts. Participants (N = 150; 67 who found sexual thoughts distressing, 83 participants who did not) were randomly placed into one of three experimental conditions: experiential willingness, distraction, or no strategies for dealing with unwanted sexual thoughts. Participants answered questions assessing attitudes about their sexual thoughts and recorded sexual thought frequency for a 3-minute period pre- and post-intervention. Thought frequencies decreased for all groups post intervention for both the distressed and nondistressed samples. Acceptability of thoughts increased for the experiential willingness group, remained similar for the distraction group, and decreased for the control group. The findings indicate that distraction was more easily implemented, more commonly used, and equally effective to experiential willingness at reducing sexual thoughts in the short term. However, the short experiential willingness intervention increased acceptability of sexual thoughts, which could have an impact on longer-term results.
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Affiliation(s)
- Eric Lee
- Utah State University, Logan City, Queensland, Australia .,Portland State University, Portland, Oregon .,McLean Hospital / Harvard Medical School, Boston, Massachusetts
| | - Joseph A Sherwood
- Utah State University, Logan City, Queensland, Australia.,Portland State University, Portland, Oregon.,McLean Hospital / Harvard Medical School, Boston, Massachusetts
| | - Jesse M Crosby
- Utah State University, Logan City, Queensland, Australia.,Portland State University, Portland, Oregon.,McLean Hospital / Harvard Medical School, Boston, Massachusetts
| | - Michael P Twohig
- Utah State University, Logan City, Queensland, Australia.,Portland State University, Portland, Oregon.,McLean Hospital / Harvard Medical School, Boston, Massachusetts
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38
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Kaczkurkin AN, Fitzgerald H, Tyler J, Asnaani A. The Contribution of Anxiety Sensitivity to Obsessive-Compulsive and Anxiety Symptoms in a Naturalistic Treatment Setting. COGNITIVE THERAPY AND RESEARCH 2018; 42:661-673. [PMID: 34135537 DOI: 10.1007/s10608-018-9909-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Anxiety sensitivity, a fear of arousal-related sensations, is prevalent in a number of disorders. We examined the relationship between internalizing symptoms and the anxiety sensitivity components of physical, social, and cognitive concerns in a sample of 165 patients seeking treatment in a clinic specializing in CBT for anxiety-related disorders. Social anxiety symptoms were associated with greater social concerns. Cognitive concerns were characteristic of both depression and generalized anxiety symptoms, suggesting these two classes of symptoms may share AS symptomatology. Physical concerns were specifically related to panic symptoms. Although obsessive-compulsive symptoms were related to cognitive concerns using univariate regression, these symptoms were not strongly related to any of the anxiety sensitivity components when the correlation between disorders was taken into account. Thus, within the internalizing symptoms studied here, the anxiety sensitivity domains were most relevant to panic, social anxiety, generalized anxiety, and depressive symptoms and less related to obsessive-compulsive symptoms.
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Affiliation(s)
| | - Hayley Fitzgerald
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Jeremy Tyler
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Anu Asnaani
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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Relationship between childhood trauma and suicide probability in obsessive-compulsive disorder. Psychiatry Res 2018; 261:132-136. [PMID: 29304426 DOI: 10.1016/j.psychres.2017.12.054] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 11/20/2017] [Accepted: 12/18/2017] [Indexed: 11/22/2022]
Abstract
The aim of this study is to assess the relationship between childhood trauma with the probability of suicide in obsessive compulsive disorders. Sixty-seven patients who were diagnosed with OCD were included in the study out of the patients who were admitted to Malatya Training and Research Hospital psychiatry outpatient clinic. The research data were collected using Yale Brawn Obsessive Compulsive Scale (YBOCS), Beck Depression (BDS) and Beck Anxiety Scales (BAS), Childhood Trauma Questionnaire-28 (CTQ-28), and Suicide Probability Scale (SPS). CTQ was detected as ≥ 35 in 36 of 67 patients who were included in the study. Aggression (p = 0.003), sexual (p = 0.007) and religious (p = 0.023) obsessions and rituelistic (p = 0.000) compulsions were significantly higher in the group with CTQ ≥ 35. Mild correlation was detected between the SPS score and the scores of CTQ. Correlation remained even when the effect of BAS and BDS scores were excluded. At the end of our study, childhood traumas were found to be associated with obsessive symptoms. In the group with childhood trauma, increased suicide probability was detected independently from depression and anxiety.
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40
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Jiujias M, Kelley E, Hall L. Restricted, Repetitive Behaviors in Autism Spectrum Disorder and Obsessive-Compulsive Disorder: A Comparative Review. Child Psychiatry Hum Dev 2017; 48:944-959. [PMID: 28281020 DOI: 10.1007/s10578-017-0717-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This review paper critically examines literature regarding restricted and repetitive behaviors (RRBs) in Autism Spectrum Disorder (ASD) and Obsessive-Compulsive Disorder (OCD). The similar behavioral profiles of these disorders presents the potential for confusion regarding diagnoses and intervention efforts. As such, this review highlights the similarities and differences between RRBs in ASD and OCD. The developmental trajectories of RRBs are presented, followed by an exploration of three constructs implicated in RRB manifestation: anxiety, executive functioning, and sensory phenomena. While RRBs tend to develop with some similarity in both disorders, the differing role of anxiety highlights important distinctions between ASD and OCD. We urge researchers and clinicians to think critically about the dimensions that affect RRB presentation. Future research should use this review as a starting point to further elucidate the differences between RRBs in these two populations.
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Affiliation(s)
- Marina Jiujias
- Psychology Department, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Elizabeth Kelley
- Psychology Department, Queen's University, Kingston, ON, K7L 3N6, Canada. .,Queen's University, Humphrey Hall Room 351, 62 Arch Street, Kingston, ON, K7L 3N6, Canada.
| | - Layla Hall
- Psychology Department, Queen's University, Kingston, ON, K7L 3N6, Canada
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41
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Saremi AA, Shariat SV, Nazari MA, Dolatshahi B. Neuropsychological Functioning in Obsessive-Compulsive Washers: Drug-Naive Without Depressive Symptoms. Basic Clin Neurosci 2017; 8:233-248. [PMID: 28781731 PMCID: PMC5535329 DOI: 10.18869/nirp.bcn.8.3.233] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Revised: 11/25/2016] [Accepted: 12/19/2016] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Obsessive-Compulsive Disorder (OCD) is a complex and heterogeneous neuropsychiatric syndrome. Contamination obsessions and washing/cleaning compulsions are the most frequent clinical OCD subtypes. The current study aimed at examining the neuropsychological impairments in drug-naive obsessive-compulsive (OC) washers without depressive symptoms and their association with the severity of symptoms. METHODS In the current causal-comparative study, 35 patients with diagnostic and statistical mental disorders class (DSM)-IV diagnosed with washing-subtype OCD and 35 healthy subjects were selected by the convenience sampling method and evaluated by computerized neuropsychology battery and clinical tests as Stroop Color-Word Test (SCWT), Wisconsin Card Sorting Test (WCST), Go/No-Go Test, Digits Forward (DF), Digits Backward (DB), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and General Health Questionnaire (GHQ)-28. The patients were matched to the comparison group with regard to age, gender, intelligence quotient (IQ), education, and handedness. All the tests were standardized in Iran. SPSS version 20.00 was used for descriptive and analytical data analysis. RESULTS There was no statistically significant different between the OCD washing and the control groups regarding socio-demographic variables or IQ. There were significant differences between the OC washer and the healthy control groups on the neuropsychological functioning. The obtained results suggested that OC washers performed significantly worse on neuropsychological measures than the controls. There was no significant association between the severity of OC symptoms and the neuropsychological functions in the OCD washing group. CONCLUSION It was concluded that executive function impairment, which is a core feature in OC washers was trait-like in nature.
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Affiliation(s)
- Ali Akbar Saremi
- Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Tehran, Iran
| | - Seyed Vahid Shariat
- Mental Health Research Center, Tehran Institute of Psychiatry, School of Behavioural Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Nazari
- Department of Psychology, Faculty of Education & Psychology, University of Tabriz, Tabriz, Iran
| | - Behrooz Dolatshahi
- Department of Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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42
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Keleş Altun İ, Uysal E, Özkorumak Karagüzel E. Differences between autogenous and reactive obsessions in terms of metacognitions and automatic thoughts. Neuropsychiatr Dis Treat 2017; 13:2977-2985. [PMID: 29263672 PMCID: PMC5732555 DOI: 10.2147/ndt.s151083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Obsessive compulsive disorder (OCD) is characterized by obsessions and compulsions. Obsessions have been classified as autogenous obsessions and reactive obsessions on the basis of the cognitive theory of Lee and Kwon. The aim of this study was to investigate the differences between autogenous groups (AG) and reactive groups (RG) in terms of metacognition and automatic thoughts, for the purpose of investigating the differences of cognitive appraisals. METHODS One hundred and thirty-three patients diagnosed with OCD were included in the study as the patient group. A control group was formed of 133 age, gender and education-matched healthy individuals. The OCD group patients were separated into subgroups according to the primary obsessions. The sociodemographic data, and the Yale-Brown Obsessive Compulsive Scale, Metacognition Questionnaire-30 (MCQ-30), Automatic Thoughts Questionnaire (ATQ), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) scores of the AG, RG, and control groups were compared. RESULTS The MCQ-30 (total) and the subscales of MCQ-30 and ATQ scale points were seen to be significantly higher in the AG than in the RG and significantly higher in the RG than in the control group. In the reactive obsession group, the predictive variables of the ATQ points were determined to be MCQ-30 (total), BDI and BAI. In the autogenous obsession group, the predictive variables of the ATQ points were determined to be BDI and BAI. CONCLUSION In the current study, differences were determined between the AG and the RG in respect of metacognitions and automatic thoughts. In light of these results, the recommended grouping can be considered useful in the identification of OCD sub-types. There is a need for further studies to identify more homogenous sub-types of OCD. Future multi-centered studies of sub-typing with larger samples using more specific instruments to sub-type and dimensional evaluation will be useful for detailed evaluation and better understanding of the subject.
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Affiliation(s)
- İlkay Keleş Altun
- Department of Psychiatry, Kanuni Research and Training Hospital, Trabzon
| | - Emel Uysal
- Department of Psychiatry, Karadeniz Technical University, Trabzon, Turkey
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Knapton O. Experiences of Obsessive-Compulsive Disorder: Activity, State, and Object Episodes. QUALITATIVE HEALTH RESEARCH 2016; 26:2009-2023. [PMID: 26329423 DOI: 10.1177/1049732315601666] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a mental health problem characterized by persistent obsessions and compulsions. This article provides insights into experiences of OCD through a qualitative, thematic analysis performed on a set of interviews with people with OCD. Four themes were found as central in the participants' descriptions of OCD episodes: (a) space, (b) the body, (c) objects, and (d) interactions. The findings also show that episodes of OCD can be grouped into three broad categories: (a) activity episodes, which revolve around everyday tasks; (b) state episodes, which are concerned with the self and identity; and (c) object episodes, which are concerned with the effects of objects on the self. The relationship of this three-way classification of OCD episodes to existing cognitive models of OCD is discussed. The study also demonstrates the value of categorizing episodes, rather than people, into subtypes of OCD so that intra-participant variation can be highlighted.
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Wu MS, Storch EA. A Case Report of Harm-Related Obsessions in Pediatric Obsessive-Compulsive Disorder. J Clin Psychol 2016; 72:1120-1128. [DOI: 10.1002/jclp.22392] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Eric A. Storch
- University of South Florida
- Rogers Behavioral Health
- All Children's Hospital-Johns Hopkins Medicine
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Olatunji BO, Ebesutani C, Abramowitz JS. Examination of a Bifactor Model of Obsessive-Compulsive Symptom Dimensions. Assessment 2016; 24:45-59. [DOI: 10.1177/1073191115601207] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although obsessive-compulsive (OC) symptoms are observed along four dimensions (contamination, responsibility for harm, order/symmetry, and unacceptable thoughts), the structure of the dimensions remains unclear. The current study evaluated a bifactor model of OC symptoms among those with and without obsessive-compulsive disorder (OCD). The goals were (a) to evaluate if OC symptoms should be conceptualized as unidimensional or whether distinct dimensions should be interpreted and (b) to use structural equation modeling to examine the convergence of the OC dimensions above and beyond a general dimension with related criteria. Results revealed that a bifactor model fit the data well and that OC symptoms were influenced by a general dimension and by four dimensions. Measurement invariance of the bifactor model was also supported among those with and without OCD. However, the general OC dimension accounted for only half of the variability in OC symptoms, with the remaining variability accounted for by distinct dimensions. Despite evidence of multidimensionality, the dimensions were unreliable after covarying for the general OC dimension. However, the four dimensions did significantly converge with a latent OC spectrum factor above and beyond the general OC dimension. The implications of these findings for conceptualizing the structure of OCD are discussed.
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Summers BJ, Sarawgi S, Fitch KE, Dillon KH, Cougle JR. Six In Vivo Assessments of Compulsive Behavior: A Validation Study Using the Obsessive-Compulsive Inventory-Revised. Assessment 2016; 25:483-497. [PMID: 27305930 DOI: 10.1177/1073191116654759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Due to the complex and heterogeneous nature of obsessive-compulsive disorder (OCD), movement toward multimodal assessment has become necessary to more precisely understand the nature of the disorder and interrelations between symptom clusters. Thus, the present study utilized large undergraduate samples (total N = 800) to test the validity of six in vivo assessments of OC symptoms (i.e., one ordering/arranging task, two contamination fear/washing tasks, and three checking tasks). Associations between task-specific variables and self-reported symptom scores (as measured by the Obsessive-Compulsive Inventory-Revised [OCI-R]) were examined. The majority of the in vivo task variables (those presented in Studies 1-4) exhibited significant relationships with the corresponding OCI-R symptom subscale (i.e., ordering, washing, checking). However, many of the task variables demonstrated relationships with other OCI-R symptom subscales, as well. Some evidence for discriminant validity was found, as task variables were generally unrelated to past-week symptoms of depression or anxiety. While continued research is necessary to further establish the validity and utility of the tasks discussed in the current article, findings have implications for improving future empirical examination of OC symptoms.
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Fan J, Liu W, Lei H, Cai L, Zhong M, Dong J, Zhou C, Zhu X. Components of inhibition in autogenous- and reactive-type obsessive-compulsive disorder: Dissociation of interference control. Biol Psychol 2016; 117:117-130. [DOI: 10.1016/j.biopsycho.2016.03.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 03/07/2016] [Accepted: 03/15/2016] [Indexed: 12/28/2022]
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Kubota Y, Sato W, Kochiyama T, Uono S, Yoshimura S, Sawada R, Sakihama M, Toichi M. Putamen volume correlates with obsessive compulsive characteristics in healthy population. Psychiatry Res Neuroimaging 2016; 249:97-104. [PMID: 26849956 DOI: 10.1016/j.pscychresns.2016.01.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 01/09/2016] [Accepted: 01/14/2016] [Indexed: 12/16/2022]
Abstract
Obsessions and compulsions (OCs) are frequent in healthy subjects; however neural backgrounds of the subclinical OCs were largely unknown. Results from recent studies suggested involvement of the putamen in the OC traits. To investigate this issue, 49 healthy subjects were assessed using structural magnetic resonance imaging (MRI) and the Maudsley Obsessive Compulsive Inventory (MOCI). Anatomical delineation on MRI yielded the global volume and local shape of the putamen. Other striatal structures (the caudate nucleus and globus pallidus) were also examined for exploratory purpose. The relationship between volume/shape of each structures and MOCI measure was analyzed, with sex, age, state anxiety, trait anxiety, and full-scale Intelligence Quotient regressed out. The volume analysis revealed a positive relationship between the MOCI total score and the bilateral putamen volumes. The shape analysis demonstrated associations between the higher MOCI total score and hypertrophy of the anterior putamen in both hemispheres. The present study firstly revealed that the volume changes of the putamen correlated with the manifestation of subclinical OC traits. The dysfunctional cortico-anterior striatum networks seemed to be one of the neuronal subsystems underlying the subclinical OC traits.
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Affiliation(s)
- Yasutaka Kubota
- Health and Medical Services Center, Shiga University, Shiga, Japan.
| | - Wataru Sato
- The Organization for Promoting Developmental Disorder Research, Kyoto, Japan; The Hakubi Project, Primate Research Institute, Kyoto University, Aichi, Japan
| | - Takanori Kochiyama
- The Hakubi Project, Primate Research Institute, Kyoto University, Aichi, Japan
| | - Shota Uono
- Faculty of Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sayaka Yoshimura
- Faculty of Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Reiko Sawada
- The Hakubi Project, Primate Research Institute, Kyoto University, Aichi, Japan
| | | | - Motomi Toichi
- The Organization for Promoting Developmental Disorder Research, Kyoto, Japan; Faculty of Human Health Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Rasmussen J, Siev J, Abramovitch A, Wilhelm S. Scrupulosity and contamination OCD are not associated with deficits in response inhibition. J Behav Ther Exp Psychiatry 2016; 50:120-6. [PMID: 26183654 DOI: 10.1016/j.jbtep.2015.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 05/02/2015] [Accepted: 06/16/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Prior research has indicated a number of neuropsychological deficits in patients with OCD consistent with the cortico-striato-thalamo-cortical model of the disorder. Response inhibition (RI), defined as the inability to inhibit a prepotent response, has been identified as a possible candidate endophenotype for OCD. However, the results from previous studies of RI in OCD patients have been mixed, suggesting the possibility that some OCD dimensions may be associated with deficits in RI while others may not. The present study aimed to examine RI using a Go/No-Go (GNG) task in two OCD symptom dimensions, one of which, scrupulosity, has never been subject to neuropsychological investigation. METHODS A total of 63 individuals, consisting of scrupulous OCD (n = 26), contamination OCD (n = 18) and non-psychiatric controls (n = 19) completed study measures. Controlling for depression symptoms, no significant performance differences were found between the groups on the GNG test, indicating no deficits in RI among contamination or scrupulous OCD. RESULTS Results are consistent with several prior studies of RI in OCD that found no differences as compared to non-psychiatric controls, especially on GNG tests, and with more recent suggestions that RI may not constitute a clinical significant impaired domain in OCD. LIMITATIONS Limitations included a primarily highly educated and Caucasian sample. CONCLUSIONS Additional conclusions include careful consideration of the RI measures selected for future studies, as well as the need for further investigation into the neuropsychological and neurobiological nature of scrupulous OCD.
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Affiliation(s)
| | | | - Amitai Abramovitch
- Massachusetts General Hospital & Harvard Medical School, USA; Texas State University, USA
| | - Sabine Wilhelm
- Massachusetts General Hospital & Harvard Medical School, USA
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Batmaz S, Yildiz M, Songur E. Psychopharmacological treatment differences in autogenous and reactive obsessions: A retrospective chart review. Nord J Psychiatry 2016; 70:31-7. [PMID: 25952115 DOI: 10.3109/08039488.2015.1041157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Identification of homogeneous subgroups of obsessive compulsive disorder (OCD) patients may have important implications for improving effective treatment options. It has been proposed that obsessive thoughts can be classified into two subtypes, i.e. autogenous and reactive obsessions. Although it has been shown that patients with autogenous obsessions may display a worse response to treatment, no studies have yet addressed whether there is a different need for the psychopharmacological treatment options in the subtypes of OCD patients. AIM To investigate the clinical characteristics and treatment differences between autogenous (A-OCD) and reactive (R-OCD) subtypes of OCD patients. METHODS Both OCD subgroups (n = 50 for A-OCD, n = 130 for R-OCD) were compared with each other in terms of their demographic and clinical parameters. Odds ratio values for gender, treatment options, co-morbidity, severity of OCD, and response to treatment were computed. Multivariate hierarchical regression analyses were performed to identify any predictors for treatment options, severity of OCD, and response to treatment. RESULTS Our results indicated that the A-OCD and R-OCD groups differed from each other on some demographic and clinical variables in addition to their psychopharmacological treatment needs. Patients in the A-OCD group were found to be prescribed an atypical antipsychotic 2.3 times more likely than the R-OCD group. The odds for a combination treatment, or the improvement of OCD symptoms from baseline levels did not differ between the two subtypes of obsession groups. CONCLUSIONS Autogenous and reactive subtypes of obsessions may need to be offered different psychopharmacological treatment options.
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Affiliation(s)
- Sedat Batmaz
- a Sedat Batmaz, Gaziosmanpasa University, School of Medicine , Department of Psychiatry , Tokat , Turkey
| | - Mesut Yildiz
- b Mesut Yildiz, Gaziosmanpasa University, School of Medicine , Department of Psychiatry , Tokat , Turkey
| | - Emrah Songur
- c Emrah Songur, Gaziosmanpasa University, School of Medicine , Department of Psychiatry , Tokat , Turkey
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