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Szejko N, Schlarmann HG, Pisarenko A, Haas M, Brandt V, Jakubovski E, Müller-Vahl KR. Validation and assessment of the self-injurious behavior scale for tic disorders (SIBS-T). Sci Rep 2024; 14:17727. [PMID: 39085331 PMCID: PMC11291896 DOI: 10.1038/s41598-024-66528-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 07/02/2024] [Indexed: 08/02/2024] Open
Abstract
Self-injurious behavior (SIB) is a well-known phenomenon in patients with chronic tic disorders (CTD). To investigate prospectively symptomatology of SIB in adults with CTD, we developed and validated the self-injurious behavior scale for tic disorders (SIBS-T). Patients completed the SIBS-T and a variety of assessments for tics and comorbidities. We investigated SIB frequency, internal consistency of the SIBS-T, and carried out an exploratory factor analysis (EFA). We enrolled n = 123 adult patients with CTD. SIB was reported by n = 103 patients (83.7%). The most frequently reported SIB were beating/pushing/throwing and were found in 79.6% of cases. Patients with SIB had significantly higher tic severity measured with the Adult Tic Questionnaire (ATQ) (p = 0.002) as well as higher severity of psychiatric comorbidities such as obsessive-compulsive symptoms (OCS) (p < 0.001,), attention deficit/hyperactivity disorder (ADHD) (p < 0.001,), and anxiety (p = 0.001). In addition, patients with SIB had significantly lower quality of life (p = 0.002). Pearson correlations demonstrated significant associations between SIB and severity of tics (p < 0.001), depression (p = 0.005), ADHD (p = 0.008), and borderline personality traits (p = 0.014). Consequently, higher SIBS-T also correlated with greater impairment of quality of life (p < 0.001). The internal consistency of the SIBS-T was good (α = 0.88). The EFA confirmed a single factor underlying the SIBS-T.
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Affiliation(s)
- Natalia Szejko
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
- Department of Bioethics, Medical University of Warsaw, Warsaw, Poland
| | - Heike Große Schlarmann
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Anna Pisarenko
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Martina Haas
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Valerie Brandt
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
- Centre for Innovation in Mental Health, University of Southampton, Southampton, UK
| | - Ewgeni Jakubovski
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Kirsten R Müller-Vahl
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
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Tempia Valenta S, Campanile G, Albert U, Marcolini F, Faedi G, De Ronchi D, Atti AR. Beyond the surface: Understanding obsessive symptoms and body perceptions, from shape concerns to fear of blushing. Compr Psychiatry 2024; 132:152481. [PMID: 38552348 DOI: 10.1016/j.comppsych.2024.152481] [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: 11/30/2023] [Revised: 03/16/2024] [Accepted: 03/25/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION Recent reclassifications have expanded the understanding of Obsessive-Compulsive Disorders (OCDs), now incorporated into a broader category known as Obsessive-Compulsive Disorder and Related Disorders (OCRDs). This study sought to assess obsessive-compulsive symptoms and body uneasiness among outpatients seeking treatment for Eating Disorders (ED). Additionally, we aimed to explore associations and potential mediation effects between obsessive-compulsive symptoms and body uneasiness. This investigation extended beyond concerns related solely to body shape and weight, encompassing fears associated with specific body components (such as facial features, abdominal region, and limbs) or functions (including sweating, blushing, emitting noises, and releasing odors). METHODS Psychometric assessments included the Obsessive-Compulsive Inventory-Revised (OCI-R) and the Body Uneasiness Test (BUT). Statistical analyses involved bivariate correlations, linear regression, and mediation analysis to explore the associations and potential mediation effects between obsessive-compulsive symptoms and different manifestations of body uneasiness. RESULTS The sample (N = 210) demonstrated substantial obsessive-compulsive symptoms and notable body discomfort. OCI-R scores positively correlated with various dimensions of body dissatisfaction, including shape, weight, and specific body components or functions. Linear regression revealed significant associations between OCI-R scores and overall body uneasiness (BUT-A) as well as concerns about body components or functions (BUTB). Mediation analysis indicated that BUT-A mediated the relationship between obsessive-compulsive symptoms and BUTB. CONCLUSION This study offers new insights into the comprehensive landscape of OCRDs. It specifically emphasizes the association between obsessive-compulsive symptoms and body uneasiness, embracing not only concerns about body shape and weight but also extending to body components and functions.
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Affiliation(s)
- S Tempia Valenta
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - G Campanile
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - U Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - F Marcolini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - G Faedi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - D De Ronchi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - A R Atti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Wang J, Becker B, Wang Y, Ming X, Lei Y, Wikgren J. Conceptual-level disgust conditioning in contamination-based obsessive-compulsive disorder. Psychophysiology 2024:e14637. [PMID: 38923525 DOI: 10.1111/psyp.14637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 05/13/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
Pavlovian fear conditioning and extinction represent learning mechanisms underlying exposure-based interventions. While increasing evidence indicates a pivotal role of disgust in the development of contamination-based obsessive-compulsive disorder (C-OCD), dysregulations in conditioned disgust acquisition and maintenance, in particular driven by higher-order conceptual processes, have not been examined. Here, we address this gap by exposing individuals with high (HCC, n = 41) or low (LCC, n = 41) contamination concern to a conceptual-level disgust conditioning and extinction paradigm. Conditioned stimuli (CS+) were images from one conceptual category partially reinforced by unconditioned disgust-eliciting stimuli (US), while images from another category served as non-reinforced conditioned stimuli (CS-). Skin conductance responses (SCRs), US expectancy and CS valence ratings served as primary outcomes to quantify conditioned disgust responses. Relative to LCC, HCC individuals exhibited increased US expectancy and CS+ disgust experience, but comparable SCR levels following disgust acquisition. Despite a decrease in conditioned responses from the acquisition phase to the extinction phase, both groups did not fully extinguish the learned disgust. Importantly, the extinction resilience of acquired disgust was more pronounced in HCC individuals. Together, our findings suggest that individuals with high self-reported contamination concern exhibit increased disgust acquisition and resistance to extinction. The findings provide preliminary evidence on how dysregulated disgust learning mechanism across semantically related concepts may contribute to C-OCD.
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Affiliation(s)
- Jinxia Wang
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
- Department of Psychology, Centre for Interdisciplinary Brain Research, University of Jyvaskyla, Jyvaskyla, Finland
| | - Benjamin Becker
- State Key Laboratory of Brain and Cognitive Sciences, Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Yizhen Wang
- School of Psychology, South China Normal University, Guangzhou, China
| | - Xianchao Ming
- School of Psychology, South China Normal University, Guangzhou, China
| | - Yi Lei
- Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | - Jan Wikgren
- Department of Psychology, Centre for Interdisciplinary Brain Research, University of Jyvaskyla, Jyvaskyla, Finland
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Liao Z, Birgegård A, Monell E, Borg S, Bulik CM, Mantilla EF. Maladaptive exercise in eating disorders: lifetime and current impact on mental health and treatment seeking. J Eat Disord 2024; 12:86. [PMID: 38915052 PMCID: PMC11194861 DOI: 10.1186/s40337-024-01048-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Many patients with eating disorders report exercise as a central symptom of their illness-as a way to compensate for food intake, prevent weight-gain, and/or reduce negative affect. Previous findings show associations between maladaptive exercise and more severe eating disorder pathology, higher risk for relapse, other co-morbid symptoms, and worse treatment outcome. METHODS In this study, we included 8252 participants with eating disorders and investigated associations between maladaptive exercise (both lifetime and current) and ED pathology, illness duration, depression, anxiety, self-harm and suicidal ideation, and treatment seeking patterns in individuals with lifetime maladaptive exercise. Participants were included via the Swedish site of the large global study The Eating Disorders Genetics Initiative (EDGI) and completed measures of both lifetime and current symptomatology. RESULTS Results indicate that lifetime maladaptive exercise is associated with higher prevalence of lifetime depression and anxiety and with patients more often receiving treatment, although these results need to be investigated in future studies. Current maladaptive exercise was associated with more severe ED symptoms, and higher levels of depression, anxiety, obsessive-compulsive traits, and suicidal ideation. CONCLUSIONS Our findings point to the complexities of exercise as an eating disorder symptom and the need for clearly assessing and acknowledging this, as well as tailoring interventions to treat this symptom to achieve sustainable recovery.
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Affiliation(s)
- Zhenxin Liao
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels väg 12a, Stockholm, 171 77, Sweden.
| | - Andreas Birgegård
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels väg 12a, Stockholm, 171 77, Sweden
| | - Elin Monell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels väg 12a, Stockholm, 171 77, Sweden
- Stockholm County Council, Stockholms Centrum för ätstörningar, Wollmar Yxkullsgatan 27, Stockholm, 118 50, Sweden
| | - Stina Borg
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels väg 12a, Stockholm, 171 77, Sweden
| | - Cynthia M Bulik
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels väg 12a, Stockholm, 171 77, Sweden
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB #7160, 101 Manning Drive, Chapel Hill, NC, 27599-716, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-716, USA
| | - Emma Forsén Mantilla
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Nobels väg 12a, Stockholm, 171 77, Sweden
- The Swedish School of Sport and Health Sciences, GIH, Lidingövägen 1, Box 5626, Stockholm, 114 86, Sweden
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Gehlenborg J, Miegel F, Moritz S, Scheunemann J, Yassari AH, Jelinek L. Implicit aggressive self-concept in patients with obsessive-compulsive disorder: Results from an approach-avoidance task. J Behav Ther Exp Psychiatry 2024; 83:101927. [PMID: 38064875 DOI: 10.1016/j.jbtep.2023.101927] [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: 03/29/2023] [Revised: 11/13/2023] [Accepted: 11/21/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND AND OBJECTIVES Patients with obsessive-compulsive disorder (OCD) have reported higher anger and aggression than healthy individuals in previous studies using explicit measures. However, studies using implicit measures have demonstrated mixed results. The aim of the present study was to investigate implicit aggressiveness in OCD using an approach-avoidance task (AAT). METHODS Seventy-eight patients with OCD and 37 healthy controls underwent structured clinical interviews and measures of anger, OCD, and depressive symptoms as well as a computerized AAT that included aggressive, peaceful, negative, and positive stimuli. RESULTS In line with previous studies, patients with OCD reported higher scores on explicit anger. With respect to the implicit measure, repeated measures ANOVAs did not show any differences in mean reaction times for pushing compared to pulling aggressive versus peaceful and negative versus positive words. However, analyses of specific OCD symptom dimensions demonstrated significantly faster reaction times for pulling compared to pushing aggressive words for patients with high scores in the OCD symptom dimensions obsessing and hoarding. LIMITATIONS Eighty percent of patients with OCD showed psychiatric comorbidities and all were seeking treatment. CONCLUSION The present study supports previous studies reporting the absence of higher aggressiveness in patients with OCD compared to healthy controls using implicit measures. However, in contrast to previous studies, we found an implicit approach bias towards aggressive self-statements for OCD patients scoring high in the symptom dimensions obsessing and hoarding compared to healthy controls. Future studies should further elucidate putative functional relationships between different OCD symptom dimensions and implicit aggressiveness.
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Affiliation(s)
- Josefine Gehlenborg
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, D-20246, Hamburg, Germany.
| | - Franziska Miegel
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, D-20246, Hamburg, Germany
| | - Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, D-20246, Hamburg, Germany
| | - Jakob Scheunemann
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, D-20246, Hamburg, Germany
| | - Amir-Hosseyn Yassari
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, D-20246, Hamburg, Germany
| | - Lena Jelinek
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistraße 52, D-20246, Hamburg, Germany
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Worden BL, Tolin DF, Stevens MC. An exploration of neural predictors of treatment compliance in cognitive-behavioral group therapy for hoarding disorder. J Affect Disord 2024; 345:410-418. [PMID: 38706461 PMCID: PMC11068362 DOI: 10.1016/j.jad.2023.10.148] [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] [Indexed: 05/07/2024]
Abstract
A persistent and influential barrier to effective cognitive-behavioral therapy (CBT) for patients with hoarding disorder (HD) is treatment retention and compliance. Recent research has suggested that HD patients have abnormal brain activity identified by functional magnetic resonance (fMRI) in regions often engaged for executive functioning (e.g., right superior frontal gyrus, anterior insula, and anterior cingulate), which raises questions about whether these abnormalities could relate to patients' ability to attend, understand, and engage in HD treatment. We examined data from 74 HD-diagnosed adults who completed fMRI-measured brain activity during a discarding task designed to elicit symptom-related brain dysfunction, exploring which regions' activity might predict treatment compliance variables, including treatment engagement (within-session compliance), homework completion (between-session compliance), and treatment attendance. Brain activity that was significantly related to within- and between-session compliance was found largely in insula, parietal, and premotor areas. No brain regions were associated with treatment attendance. The results add to findings from prior research that have found prefrontal, cingulate, and insula activity abnormalities in HD by suggesting that some aspects of HD brain dysfunction might play a role in preventing the engagement needed for therapeutic benefit.
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Affiliation(s)
| | - David F Tolin
- Institute of Living/ Hartford Hospital, Hartford, CT
- Yale University School of Medicine, New Haven, CT
| | - Michael C Stevens
- Institute of Living/ Hartford Hospital, Hartford, CT
- Yale University School of Medicine, New Haven, CT
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Cosh SM, Olson J, Tully PJ. Exploration of orthorexia nervosa and diagnostic overlap with eating disorders, anorexia nervosa and obsessive-compulsive disorder. Int J Eat Disord 2023; 56:2155-2161. [PMID: 37615059 DOI: 10.1002/eat.24051] [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: 04/21/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVE Orthorexia nervosa (ON) is characterized as obsessional healthy eating that results in malnutrition and/or psychosocial impairment. Yet, ON shares theoretical overlap with eating disorders (EDs), especially anorexia nervosa (AN), as well as obsessive-compulsive disorder (OCD). This study aimed to further understand ON and its overlap with related disorders by assessing the ability of ON for detecting the presence/absence of threshold ED, AN, and OCD symptoms. METHOD An observational survey was completed by 197 participants recruited through eating disorder, dieting, and mental health support groups. Receiver operating characteristic (ROC) curve analyses determined the predictive ability of ON symptoms (assessed by Eating Habits Questionnaire [EHQ] orthorexia nervosa [OrNe] and healthy orthorexia [HeOr] subscales, and the Orthorexia Nervosa Inventory [ONI]) for detecting disordered eating symptoms (determined by Eating Disorder Examination Questionnaire [EDE-Q] global cut-scores), probable AN (determined by EDE-Q cut-scores and body mass index [BMI] <18.5), and OCD symptoms and obsessional thinking (assessed by the Revised Obsessive-Compulsive Inventory [OCI-R]). RESULTS Results showed both the ONI and EHQ OrNe measures are able to adequately predict ED symptoms and AN; however, both were poor to moderate at detecting OCD symptoms and obsessional thinking. Healthy orthorexia was poor to moderate at detecting outcomes. DISCUSSION These results suggest that ON, as it is currently operationalized, may be more closely related to EDs than OCD, and that ON may represent a subtype of AN. Results also support healthy orthorexia as a distinct construct to ON. While results are limited by the lack of definitive ON diagnostic criteria, findings suggest that treatments developed for EDs might be most suited to ON. PUBLIC SIGNIFICANCE ON has been proposed as a psychiatric disorder, and it shares theoretical overlap with several existing disorders. This study adopts a novel approach to assessing and exploring the overlap of ON with EDs, AN and OCD. Results suggest that ON shares more overlap with EDs and might best be understood as a subtype of EDs or AN.
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Affiliation(s)
- Suzanne M Cosh
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Jemma Olson
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Phillip J Tully
- School of Psychology, University of New England, Armidale, New South Wales, Australia
- Freemasons Centre for Male Health and Wellbeing, Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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Cosh SM, Eshkevari E, McNeil DG, Tully PJ. Classifying excessive exercise: Examining the relationship between compulsive exercise with obsessive-compulsive disorder symptoms and disordered eating symptoms. EUROPEAN EATING DISORDERS REVIEW 2023; 31:769-780. [PMID: 37353901 DOI: 10.1002/erv.3002] [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: 04/27/2023] [Revised: 05/11/2023] [Accepted: 06/10/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE There remains a lack of consensus around nosology for compulsive exercise (CE). Although widely observed in eating disorders (ED), CE shares theoretical overlap with obsessive-compulsive disorder (OCD), where exercise compulsions occur in response to obsessions. Yet, there is limited and mixed evidence of a relationship between CE with OCD. This study aims to explore the appropriate diagnostic classification of CE through examination of CE in relation to OCD, obsessional thinking, and ED symptoms. METHOD Two hundred and eighty one adults with mental health symptoms, dieting, and exercise behaviour completed measures of OCD, CE, and disordered eating symptoms. Regression and Receiver Operating Characteristic analyses examined relationships between dimensions of CE with OCD and ED symptoms, and the predictive ability of CE assessment for detecting threshold OCD and ED symptoms. RESULTS CE assessment was poor at predicting threshold OCD symptoms, probable Anorexia Nervosa, and Binge Eating Disorder and moderate at detecting probable disordered eating and Bulimia Nervosa. Associations between CE and OCD symptoms were not significant after adjustment for ED symptoms. Obsessional thinking was associated only with lack of exercise enjoyment. CONCLUSIONS Results indicate that excessive exercise might represent a distinct disorder, with some shared traits across CE, OCD and ED symptoms. Findings question the utility of adaptation of OCD diagnostic criteria for CE. Assessment and treatment implications are considered.
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Affiliation(s)
- Suzanne M Cosh
- School of Psychology, University of New England, Armidale, New South Wales, Australia
| | - Ertimiss Eshkevari
- Statewide Eating Disorder Service, South Australian Department of Health and Wellbeing, Government of South Australia, Adelaide, South Australia, Australia
| | - Dominic G McNeil
- Institute for Health and Wellbeing, Federation University, Ballarat, Victoria, Australia
| | - Phillip J Tully
- School of Psychology, University of New England, Armidale, New South Wales, Australia
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Garea SS, Sauer JD, Hall LC, Williams MN, Drummond A. The potential relationship between loot box spending, problem gambling, and obsessive-compulsive gamers. J Behav Addict 2023; 12:733-743. [PMID: 37594878 PMCID: PMC10562816 DOI: 10.1556/2006.2023.00038] [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: 01/31/2023] [Revised: 06/28/2023] [Accepted: 07/08/2023] [Indexed: 08/20/2023] Open
Abstract
Background and Aims Loot boxes are digital containers of randomised rewards available in many video games. Individuals with problem gambling symptomatology spend more on loot boxes than individuals without such symptoms. This study investigated whether other psychopathological symptomatology, specifically symptoms of obsessive-compulsive behaviour and hoarding may also be associated with increased loot box spending. Methods In a large cross-sectional, cross-national survey (N = 1,049 after exclusions), participants recruited from Prolific, living in Aotearoa New Zealand, Australia, and the United States, provided self-reported loot box spending, obsessive-compulsive and hoarding symptomatology, problem gambling symptomatology, and consumer regret levels. Results There was a moderate positive relationship between loot box spending and obsessive-compulsive symptoms and hoarding. Additionally, greater purchasing of loot boxes was associated with increased consumer regret. Discussion and Conclusion Results identified that those with OCD and hoarding symptomatology may spend more on loot boxes than individuals without OCD and hoarding symptomatology. This information helps identify disproportionate spending to more groups of vulnerable players and may assist in helping consumers make informed choices and also aid policy discussions around the potentialities of harm.
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Affiliation(s)
- Shaun S. Garea
- School of Psychology, Massey University, Palmerston North 4424, Manawatu, New Zealand
| | - James D. Sauer
- School of Psychological Sciences, University of Tasmania, Australia
| | - Lauren C. Hall
- School of Psychology, Massey University, Palmerston North 4424, Manawatu, New Zealand
| | - Matt N. Williams
- School of Psychology, Massey University, Palmerston North 4424, Manawatu, New Zealand
| | - Aaron Drummond
- School of Psychology, Massey University, Palmerston North 4424, Manawatu, New Zealand
- School of Psychological Sciences, University of Tasmania, Australia
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Miegel F, Daubmann A, Moritz S, Balzar A, Yassari AH, Jelinek L. Obsessive-Compulsive Symptom Dimensions and Their Relationships with Obsessive Beliefs: A Structural Equation Modeling Analysis. Psychiatr Q 2023; 94:345-360. [PMID: 37410191 DOI: 10.1007/s11126-023-10037-8] [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] [Accepted: 06/13/2023] [Indexed: 07/07/2023]
Abstract
Dysfunctional beliefs are central in the development and maintenance of obsessive-compulsive disorder (OCD) as well as its treatment. Yet, research suggests that not all dysfunctional beliefs are equally important for each of the symptom dimensions of OCD. However, results are inconsistent in that studies contradict each other regarding the associations between specific symptom dimensions and belief domains. The aim of the present study was to clarify which belief domain is specifically associated with which OCD symptom dimension. Results could help to tailor treatments more specifically to the patient's OCD symptom dimension. In- and outpatients with OCD (N = 328; 43.6% male and 56.4% female) filled out questionnaires on symptom dimensions of OCD (Obsessive-Compulsive Inventory Revised) and dysfunctional beliefs (Obsessive Beliefs Questionnaire). A structural equation model analysis was conducted to identify the associations between dysfunctional beliefs and symptom dimensions. Our results showed that perfectionism/intolerance of uncertainty was associated with hoarding and symmetry/ordering, (2) overestimation of threat/inflated responsibility was associated with checking compulsions, and (3) importance of thoughts/control of thoughts was associated with obsessing. These results were largely supported by a backward selection. Our results demonstrated associations of specific dysfunctional beliefs and specific OCD symptom dimensions. However, future studies are necessary to replicate these findings with other measures (e.g., clinician ratings).
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Affiliation(s)
- Franziska Miegel
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Anne Daubmann
- Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Alicia Balzar
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Amir-Hosseyn Yassari
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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Reutimann S, Hübscher N, Steiner J, Voderholzer U, Augsburger M. Assessing validity of the Klenico diagnostic software system in a large psychotherapeutic inpatient sample. Front Digit Health 2023; 5:1176130. [PMID: 37720163 PMCID: PMC10502166 DOI: 10.3389/fdgth.2023.1176130] [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: 02/28/2023] [Accepted: 07/31/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Mental disorders are often underdiagnosed in routine diagnostic procedures due to the use of unstandardized assessments; this can result in people either not receiving necessary treatment or receiving ineffective treatment for their condition. Klenico is an online diagnostic software system that facilitates diagnosis of mental disorders in adults through the use of standardized procedures. The procedure encompasses two modules, self-report and clinical validation. The current study aimed to confirm the validity of the Klenico assessment in a large clinical sample. Methods Fully anonymized data from 495 adult inpatients were used. ICD-10 diagnoses were made during an initial interview by the clinical staff. Afterwards, patients filled out self-report questionnaires (BDI-II, BSI, EDE-Q, OCI-R, PHQ-D, and Y-BOCS) and completed the Klenico self-report module, which involves selecting and rating the severity of applicable symptoms. Finally, in the clinical validation module, mental health professionals validated the symptoms endorsed in the self-report module. Six Klenico domains were tested against patient self-reports and routine ICD-10 diagnoses by following the multitrait-multimethod approach. Internal consistency was assessed by calculating Cronbach's alpha. Results The Klenico depressive disorders, OCD, and somatoform disorders domains revealed high correlations with the congruent questionnaires (i.e., those pertaining to these specific disorders) and revealed low correlations with the noncongruent questionnaires (i.e., those pertaining to other disorders), therefore evidencing construct validity. For the eating disorders and psychotic disorders domains, divergent validity was demonstrated. For the anxiety disorders domain, although analysis mostly indicated construct validity, this should be further confirmed. Discussion Overall, the results largely confirmed the construct validity of the Klenico assessment, demonstrating its use as an easy-to-use, valid, standardized, and comprehensive instrument for diagnosing mental disorders.
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Affiliation(s)
- Stefan Reutimann
- Klenico Health AG, University of Zurich Startup, Zurich, Switzerland
| | - Noah Hübscher
- Klenico Health AG, University of Zurich Startup, Zurich, Switzerland
- Department of Health Sciences and Technology, Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Jasmin Steiner
- Klenico Health AG, University of Zurich Startup, Zurich, Switzerland
| | - Ulrich Voderholzer
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
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12
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Cooper SE, Hunt C, Stasik-O'Brien SM, Berg H, Lissek S, Watson D, Krueger RF. The Placement of Obsessive-Compulsive Symptoms Within a Five-Factor Model of Maladaptive Personality. Assessment 2023; 30:891-906. [PMID: 35098736 DOI: 10.1177/10731911211070623] [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: 11/15/2022]
Abstract
Dimensional models of obsessive-compulsive (OC) symptoms, as seen in obsessive-compulsive disorder (OCD), are instrumental in explaining the heterogeneity observed in this condition and for informing cutting-edge assessments. Prior structural work in this area finds that OC symptoms cross-load under both Negative Affectivity and Psychoticism traits within the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Alternative Model of Personality Disorder (AMPD). However, tests of OC symptoms in conjunction with assessments of the full AMPD structure and its 25 lower-level facets representing narrower symptom content are lacking. We applied joint exploratory factor analysis to an AMPD measure (Personality Inventory for DSM-5; PID-5) and OC symptom data from two separate samples (total N = 1,506) to locate OC symptoms within AMPD space. OC symptoms cross-loaded on Negative Affectivity, Psychoticism, and on the low end of Disinhibition. We also report exploratory analyses of OC symptom subscales with PID-5 variables. Results are discussed in the context OC symptoms' location in PID-5 space, implications for assessment, and placement of OCD within the Hierarchical Taxonomy of Psychopathology.
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Affiliation(s)
| | | | | | - Hannah Berg
- University of Minnesota Twin Cities, MN, USA
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13
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Abstract
AIMS Current information about the prevalence of various mental health disorders in the general adult population of the Republic of Ireland is lacking. In this study, we examined the prevalence of 12 common mental disorders, the proportion of adults who screened positive for any disorder, the sociodemographic factors associated with meeting criteria for a disorder and the associations between each disorder and history of attempted suicide. METHODS A non-probability nationally representative sample (N = 1110) of adults living in Ireland completed self-report measures of 12 mental health disorders. Effect sizes were calculated using odds ratios from logistic regression models, and population attributable risk fractions (PAFs) were estimated to quantify the associations between each disorder and attempted suicide. RESULTS Prevalence rates ranged from 15.0% (insomnia disorder) to 1.7% (histrionic personality disorder). Overall, 42.5% of the sample met criteria for a mental health disorder, and 11.1% had a lifetime history of attempted suicide. Younger age, being a shift worker and trauma exposure were independently associated with a higher likelihood of having a mental health disorder, while being in university was associated with a lower likelihood of having a disorder. ICD-11 complex posttraumatic stress disorder, borderline personality disorder and insomnia disorder had the highest PAFs for attempted suicide. CONCLUSIONS Mental health disorder prevalence in Ireland is relatively high compared to international estimates. The findings are discussed in relation to important mental health policy implications.
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14
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Sashikata K, Ozawa E. Development of a scale to assess obsessive-compulsive tendencies among Japanese university students. Heliyon 2022; 8:e09646. [PMID: 35734565 PMCID: PMC9207615 DOI: 10.1016/j.heliyon.2022.e09646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 02/03/2022] [Accepted: 05/30/2022] [Indexed: 11/25/2022] Open
Abstract
Obsessive-compulsive (OC) tendencies refer to obsessions and compulsions in a nonclinical group, which are risk factors for obsessive-compulsive disorder (OCD). OC tendencies and OC symptoms are mainly assessed using five factors: ordering, obsessions, cleaning, hoarding, and checking. However, since hoarding is now classified as an independent diagnosis in the DSM-V, this factor was not included and was instead replaced by indecisiveness. Furthermore, many established scales used for measuring OC tendencies were originally created for OCD patients; thus, they cannot adequately capture OC tendencies. Therefore, this study aimed to develop a scale to assess OC tendencies among Japanese university students with a revised five-factor structure: ordering, obsessions, cleaning, indecisiveness, and checking. We examined the factor structure, reliability, criterion-related validity, and convergent validity of the OC tendencies scale by administering two surveys. In Survey 1 (N = 216), an exploratory factor analysis (EFA) was conducted to examine the criterion-related and convergent validity and reliability of the OC tendencies scale. In Survey 2 (N = 202), a confirmatory factor analysis (CFA) was conducted. EFA and CFA utilized a five-factor structure comprising checking, ordering, indecisiveness, cleaning, and obsessions. Correlations with other scales indicated that the OC tendencies scale had efficient convergent validity, criterion-related validity, internal consistency, and test-retest reliability. This study validated the five-factor structure of OC tendency in Japanese university students. However, indecisiveness was also strongly correlated with trait-anxiety. As this scale is easy to administer among large groups, it has the potential to contribute to mental health support for university students by measuring OC tendencies experienced on a daily basis, which have not been adequately measured in the past.
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Affiliation(s)
- Kenta Sashikata
- Department of Graduate School of Human-Environment Studies, Kyushu University, 744, Motooka, Nishi-ku, Fukuoka, 819-0395, Japan
| | - Eiji Ozawa
- Faculty of Human-Environment Studies, Kyushu University, 744, Motooka, Nishi-ku, Fukuoka, 819-0395, Japan
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15
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Church LD, Bounoua N, Rodriguez SN, Bredemeier K, Spielberg JM. Longitudinal relationships between COVID-19 preventative behaviors and perceived vulnerability to disease. J Anxiety Disord 2022; 88:102561. [PMID: 35378369 PMCID: PMC8959657 DOI: 10.1016/j.janxdis.2022.102561] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/19/2022] [Accepted: 03/23/2022] [Indexed: 01/12/2023]
Abstract
Engagement in infection-preventing behaviors (e.g., mask wearing) has become crucial in the context of the COVID-19 pandemic, and health-related anxiety may be an important determinant of individual compliance with recommended guidelines. However, little is known about transactional associations between health anxiety and preventative behaviors, particularly with respect to COVID-19. The present study aimed to longitudinally examine the links between preventative behaviors and both emotion-driven (Germ Aversion) and belief-based (Perceived Infectability) aspects of health anxiety during the COVID-19 pandemic. We hypothesized that greater health anxiety at Time 1 (early in the pandemic) would predict future compliance with preventative behaviors six months later. Two hundred and ninety-six adults (M/SDage= 30.9/10.9 years, 42.2% female) completed two online assessments during the COVID-19 pandemic (Time 1 =June 2020; Time 2 =December 2020). Longitudinal cross-lagged analyses revealed that initial Germ Aversion predicted greater engagement in preventative behaviors at follow-up (β = 0.16; p = <.001), over and above initial engagement in such behaviors. Similarly, initial engagement in preventative behaviors predicted increases in Germ Aversion at follow-up (β = .23; p = <.001), over and above initial Germ Aversion. The present findings indicate that affect-driven aspects of health anxiety have a complex transactional relationship with engagement in behaviors aimed at curbing the spread of the COVID-19 pandemic. Clinical and public health implications are discussed.
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Affiliation(s)
- Leah D. Church
- University of Delaware, Department of Psychological and Brain Sciences, 108 Wolf Hall, Newark, DE 19176, USA,Correspondence to: Leah D. Church, University of Delaware, Department of Psychological and Brain Sciences, 108 Wolf Hall, Newark, DE 19716, USA
| | - Nadia Bounoua
- University of Delaware, Department of Psychological and Brain Sciences, 108 Wolf Hall, Newark, DE 19176, USA
| | - Samantha N. Rodriguez
- University of New Mexico, Department of Psychology, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA
| | - Keith Bredemeier
- University of Pennsylvania, Perelman School of Medicine, 3535 Market St., Philadelphia, PA 19104, USA
| | - Jeffrey M. Spielberg
- University of Delaware, Department of Psychological and Brain Sciences, 108 Wolf Hall, Newark, DE 19176, USA
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16
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Boland EM, Kelley NJ, Chat IKY, Zinbarg R, Craske MG, Bookheimer S, Nusslock R. Poor sleep quality is significantly associated with effort but not temporal discounting of monetary rewards. MOTIVATION SCIENCE 2022; 8:70-76. [PMID: 37476692 PMCID: PMC10358359 DOI: 10.1037/mot0000258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Affiliation(s)
- Elaine M Boland
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia PA
- Mental Illness Research Education and Clinical Center (MIRECC), Cpl. Michael J. Crescenz VA Medical Center, Philadelphia PA
| | - Nicholas J Kelley
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Iris Ka-Yi Chat
- Department of Psychology, Temple University, Philadelphia PA
- Department of Psychology, Northwestern University, Evanston, IL
| | - Richard Zinbarg
- Department of Psychology, Northwestern University, Evanston, IL
- The Family Institute at Northwestern University, Evanston, IL
| | - Michelle G Craske
- Departments of Psychology and of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
| | - Susan Bookheimer
- Departments of Psychology and of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
| | - Robin Nusslock
- Department of Psychology, Northwestern University, Evanston, IL
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17
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Fairbrother N, Collardeau F, Albert A, Stoll K. Screening for Perinatal Anxiety Using the Childbirth Fear Questionnaire: A New Measure of Fear of Childbirth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042223. [PMID: 35206412 PMCID: PMC8872365 DOI: 10.3390/ijerph19042223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 12/27/2022]
Abstract
Fear of childbirth affects as many as 20% of pregnant people, and has been associated with pregnancy termination, prolonged labour, increased risk of emergency and elective caesarean delivery, poor maternal mental health, and poor maternal-infant bonding. Currently available measures of fear of childbirth fail to fully capture pregnant people’s childbirth-related fears. The purpose of this research was to develop a new measure of fear of childbirth (the Childbirth Fear Questionnaire; CFQ) that would address the limitations of existing measures. The CFQ’s psychometric properties were evaluated through two studies. Participants for Study 1 were 643 pregnant people residing in Canada, the United States, and the United Kingdom, with a mean age of 29.0 (SD = 5.1) years, and 881 pregnant people residing in Canada, with a mean age of 32.9 (SD = 4.3) years for Study 2. In both studies, participants completed a set of questionnaires, including the CFQ, via an online survey. Exploratory factor analysis in Study 1 resulted in a 40-item, 9-factor scale, which was well supported in Study 2. Both studies provided evidence of high internal consistency and convergent and discriminant validity. Study 1 also provided evidence that the CFQ detects group differences between pregnant people across mode of delivery preference and parity. Study 2 added to findings from Study 1 by providing evidence for the dimensional structure of the construct of fear of childbirth, and measurement invariance across parity groups (i.e., the measurement model of the CFQ was generalizable across parity groups). Estimates of the psychometric properties of the CFQ across the two studies provided evidence that the CFQ is psychometrically sound, and currently the most comprehensive measure of fear of childbirth available. The CFQ covers a broad range of domains of fear of childbirth and can serve to identify specific fear domains to be targeted in treatment.
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Affiliation(s)
- Nichole Fairbrother
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
- Correspondence:
| | - Fanie Collardeau
- Department of Psychology, Faculty of Social Sciences, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Arianne Albert
- Women’s Health Research Institute, Vancouver, BC V6H 2N9, Canada;
| | - Kathrin Stoll
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
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18
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Fairbrother N, Albert A, Keeney C, Tchir D, Cameron RB. Screening for Perinatal OCD: A Comparison of the DOCS and the EPDS. Assessment 2021; 30:1028-1039. [PMID: 34969305 PMCID: PMC10152558 DOI: 10.1177/10731911211063223] [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: 01/04/2023]
Abstract
Screening for perinatal-occurring obsessive-compulsive disorder (OCD) is rare. We sought to evaluate the Dimensional Obsessive-Compulsive Scale (DOCS) as a screening tool for perinatal OCD and compare the screening accuracy of the DOCS with the commonly recommended Edinburgh Postnatal Depression Scale (EPDS). English-speaking, pregnant individuals aged 19+ (N = 574) completed online questionnaires and diagnostic interviews to assess for OCD prenatally and twice postpartum. The DOCS total score demonstrated the highest level of accuracy. Neither the EPDS-Full nor the three-item Anxiety subscale of the EPDS (EPDS-3A) met the criteria of a sufficiently accurate screening tool for OCD at any of the assessment points. Findings provide support for the DOCS as a screening tool for perinatal OCD and indicate a need for disorder-specific screening for perinatal anxiety and their related disorders (AD). Generalizability of findings is limited to Canada only. Future research would benefit from comparisons with measures of perinatal OCD (e.g., the Perinatal Obsessive-Compulsive Scale).
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Affiliation(s)
| | - Arianne Albert
- Women's Health Research Institute, Vancouver, British Columbia, Canada
| | - Cora Keeney
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Devan Tchir
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Rose B Cameron
- The University of British Columbia, Vancouver, British Columbia, Canada
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19
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Morein-Zamir S, Kasese M, Chamberlain SR, Trachtenberg E. Elevated levels of hoarding in ADHD: A special link with inattention. J Psychiatr Res 2021; 145:167-174. [PMID: 34923357 PMCID: PMC7612156 DOI: 10.1016/j.jpsychires.2021.12.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/18/2021] [Accepted: 12/10/2021] [Indexed: 10/29/2022]
Abstract
Hoarding Disorder (HD) is under recognised and under-treated. Though HD develops by early adulthood, patients present only later in life, resulting in research based largely on samples of predominantly older females. Whilst formerly associated with Obsessive-Compulsive Disorder (OCD), it is now recognised that individuals with HD often have inattention symptoms reminiscent of Attention Deficit/Hyperactivity Disorder (ADHD). Here, we investigated HD in adults with ADHD. Patients in an ADHD clinic (n = 88) reported on ADHD, HD and OCD-related symptoms, and compared with age, gender and education matched controls (n = 90). Findings were assessed independently in an online UK sample to verify replication using a dimensional approach (n = 220). Clinically significant hoarding symptoms were found in ∼20% versus 2% of ADHD and control groups, respectively, with those with hoarding being on average in their thirties and with approximately half being male. Greater hoarding severity was noted even in the remaining patients compared with controls (d = 0.89). Inattention was the only significant statistical predictor of hoarding severity in patients. Similarly, inattention, alongside depression and anxiety were the greatest predictors of hoarding in the independent sample where 3.2% identified as having clinically significant hoarding. Patients with ADHD had a high frequency of hoarding symptoms, which were specifically linked to inattention. HD should be routinely assessed in individuals with ADHD, as they do not typically disclose associated difficulties, despite these potentially leading to impaired everyday functioning. Research in HD should also investigate adults with ADHD, who are younger and with a greater prevalence of males than typical HD samples.
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Affiliation(s)
- Sharon Morein-Zamir
- School of Psychology and Sports Science, Anglia Ruskin University, Cambridge, UK.
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20
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Is orthorexia nervosa a feature of obsessive-compulsive disorder? A multicentric, controlled study. Eat Weight Disord 2021; 26:2531-2544. [PMID: 33544361 DOI: 10.1007/s40519-021-01114-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/13/2021] [Indexed: 01/10/2023] Open
Abstract
PURPOSE The term orthorexia nervosa (ON) was coined to describe altered thoughts and behaviours related to healthy eating. The prevalence of ON was found to scale up to almost 90% among high-risk populations (ballet dancers, athletes, and health workers). ON seem to share psychopathological aspects with both Eating Disorders (ED) and Obsessive-Compulsive Disorder (OCD). The aim of the study was to analyse the frequency and intensity of ON symptoms among subjects diagnosed with OCD, hypothesising that they would be higher than in two control groups (subjects with anxiety-depressive disorders and general population). METHODS We conducted a multi-centre, observational, controlled study. Subjects filled in a socio-demographic questionnaire including questions related to life-style and two psychometric instruments: ORTO-15, for ON symptoms, and OCI-R, for OCD symptoms. Post hoc analysis of the dataset was performed using the revised version of ORTO-15, the ORTO-R. RESULTS In the final sample of 328 subjects, the overall prevalence of ORTO-15-ON was 59.5%, mean score 37.9 ± 4.2. The mean score at the ORTO-R was 16.6 ± 4.6. No statistically significant differences were found in the prevalence of ON or in the mean ORTO-15 score among OCD patients and the two control groups, and this was confirmed by the multiple regression analysis. At the ORTO-R re-scoring, OCD patients scored significantly lower than the two clinical subgroups (p = .0005) and a lower ORTO-R score was associated to positivity at the OCI-R, confirming the initial hypothesis of the study. CONCLUSIONS ON symptoms do seem to be more prevalent among subjects suffering from OCD. The psychometric properties of tools available to calculate ON symptoms, namely ORTO-15 vs. ORTO-R, play a relevant role in explaining such finding. ORTO-R seems to be a valid alternative able to overcome such difficulties, though further studies are needed to confirm this.
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21
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Shahar N, Hauser TU, Moran R, Moutoussis M, Bullmore ET, Dolan RJ. Assigning the right credit to the wrong action: compulsivity in the general population is associated with augmented outcome-irrelevant value-based learning. Transl Psychiatry 2021; 11:564. [PMID: 34741013 PMCID: PMC8571313 DOI: 10.1038/s41398-021-01642-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 11/08/2022] Open
Abstract
Compulsive behavior is enacted under a belief that a specific act controls the likelihood of an undesired future event. Compulsive behaviors are widespread in the general population despite having no causal relationship with events they aspire to influence. In the current study, we tested whether there is an increased tendency to assign value to aspects of a task that do not predict an outcome (i.e., outcome-irrelevant learning) among individuals with compulsive tendencies. We studied 514 healthy individuals who completed self-report compulsivity, anxiety, depression, and schizotypal measurements, and a well-established reinforcement-learning task (i.e., the two-step task). As expected, we found a positive relationship between compulsivity and outcome-irrelevant learning. Specifically, individuals who reported having stronger compulsive tendencies (e.g., washing, checking, grooming) also tended to assign value to response keys and stimuli locations that did not predict an outcome. Controlling for overall goal-directed abilities and the co-occurrence of anxious, depressive, or schizotypal tendencies did not impact these associations. These findings indicate that outcome-irrelevant learning processes may contribute to the expression of compulsivity in a general population setting. We highlight the need for future research on the formation of non-veridical action-outcome associations as a factor related to the occurrence and maintenance of compulsive behavior.
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Affiliation(s)
- Nitzan Shahar
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, WC1B 5EH, UK.
- Wellcome Centre for Human Neuroimaging, University College London, London, WC1N 3BG, UK.
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
- Psychology Department, Tel Aviv University, Tel Aviv, Israel.
| | - Tobias U Hauser
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, WC1B 5EH, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, WC1N 3BG, UK
| | - Rani Moran
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, WC1B 5EH, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, WC1N 3BG, UK
| | - Michael Moutoussis
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, WC1B 5EH, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, WC1N 3BG, UK
| | | | - Raymond J Dolan
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, WC1B 5EH, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, WC1N 3BG, UK
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22
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Ong CW, Krafft J, Levin ME, Twohig MP. A systematic review and psychometric evaluation of self-report measures for hoarding disorder. J Affect Disord 2021; 290:136-148. [PMID: 33993080 DOI: 10.1016/j.jad.2021.04.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/08/2021] [Accepted: 04/25/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Hoarding disorder (HD) affects approximately 2.5% of the general population, leads to significant distress and impairment, and is notoriously difficult to treat. The crux of developing effective treatments for HD is our ability to reliably and validly measure relevant constructs in HD to better understand its presentation and, subsequently, formulate appropriate interventions. METHODS We identified measures specific to HD and evaluated their psychometric properties using rating criteria formulated by the Consensus-based Standards for the selection of health Measurement INstruments (COSMIN) group. RESULTS The 17 included measures were developed to assess adult and pediatric hoarding severity, functional impairment, and maladaptive processes (e.g., material scrupulosity). The Saving Inventory-Revised, the most widely used measure of HD severity showed the strongest psychometric properties. However, psychometric investigations were generally of poor quality across all measures and results indicated unsatisfactory performance of measures. LIMITATIONS The current review excluded non-English measures and ratings inherently contain some element of subjectivity despite use of predetermined criteria and two independent reviewers. CONCLUSIONS We suggest that clinical researchers continue to develop and modify measures used to conceptualize and, ultimately, improve treatment for HD.
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Affiliation(s)
- Clarissa W Ong
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT 84322-2810, United States.
| | - Jennifer Krafft
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT 84322-2810, United States
| | - Michael E Levin
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT 84322-2810, United States
| | - Michael P Twohig
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT 84322-2810, United States
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23
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Predictors of trajectories of obsessive-compulsive symptoms during the COVID-19 pandemic in the general population in Germany. Transl Psychiatry 2021; 11:323. [PMID: 34045444 PMCID: PMC8155650 DOI: 10.1038/s41398-021-01419-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/19/2021] [Accepted: 03/31/2021] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic has been associated with an increase in obsessive-compulsive disorder/symptoms (OCD/OCS). However, knowledge is limited regarding the trajectories of OCS during the pandemic, as well as their predictors and mechanisms (e.g., experiential avoidance, EA). The aim of this study was to describe the trajectories of OCS and the identification of associated factors. We assessed 1207 participants of the general population in March 2020 (t1) and June 2020 (t2). Pre-pandemic data was available from March 2014 for a subsample (n = 519). To define trajectories, we determined OCS status (OCS+/-). We performed a hierarchical multinomial logistic regression to investigate predictors of trajectories. Between t1 and t2, 66% of participants had an asymptomatic trajectory (OCS-/OCS-); 18% had a continuously symptomatic trajectory (OCS+/OCS+). Ten percent had a delayed-onset trajectory (OCS-/OCS+), and the recovery trajectory group (OCS+/OCS-) was the smallest group (6%). Higher education reduced the odds of an OCS+/OCS- trajectory. OCS in 2014 was associated with increased odds of showing an OCS+/OCS+ or OCS-/OCS+ trajectory. When EA at t1 and change in EA from t1 to t2 were added to the model, higher EA at t1 was associated with increased odds of scoring above the cut score on one or more of the assessments. A higher decrease in EA from t1 to t2 reduced the probability of showing an OCS+/OCS+ and an OCS-/OCS+ trajectory. While the current data supports a slight increase in OCS during the pandemic, trajectories differed, and EA seems to represent an important predictor for an unfavorable development.
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24
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Abramovitch A, Abramowitz JS, McKay D. The OCI-12: A syndromally valid modification of the obsessive-compulsive inventory-revised. Psychiatry Res 2021; 298:113808. [PMID: 33647706 DOI: 10.1016/j.psychres.2021.113808] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 02/11/2021] [Indexed: 12/12/2022]
Abstract
The 18-item Obsessive-Compulsive Inventory-Revised (OCI-R) is a widely used self-report measure of Obsessive-Compulsive Disorder (OCD) symptoms, yet its factor structure does not converge with contemporary dimensional models of OCD symptoms. In addition to assessing the four core OCD dimensions, the OCI-R includes hoarding and neutralizing factors. However, since its publication, hoarding has been designated as a separate disorder, and there are concerns about the neutralizing factor's reliability and validity. The aim of this study was to evaluate a syndromally valid modification of the OCI-R. Adult samples of individuals diagnosed with OCD (n = 1087), anxiety related disorders (n = 1306), and unselected community volunteers (n = 423) completed the OCI-R and measures of anxiety and mood. Analyses excluded the 3 OCI-R hoarding items and suggested the removal of the 3 neutralizing items. Internal consistency, sensitivity and specificity to OCD clinical status, test-retest reliability, sensitivity to treatment, and convergent and discriminant validity were evaluated for the resultant 12-item scale (termed the OCI-12). The OCI-12 evidenced good to excellent psychometric properties. Clinical norms, severity benchmarks, and a clinical cutoff score were computed. In conclusion, the OCI-12 represents a syndromally valid update of the OCI-R with comparable psychometric properties and superior sensitivity and specificity.
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Affiliation(s)
- Amitai Abramovitch
- Department of Psychology, Texas State University, San Marcos, TX, United States.
| | - Jonathan S Abramowitz
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Dean McKay
- Department of Psychology Fordham University, Bronx, NY, United States.
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25
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Liao Z, You C, Chen Y, Zhang J, Ding L. Psychometric properties of the Chinese version of the family accommodation scale for obsessive-compulsive disorder interviewer-rated. Compr Psychiatry 2021; 105:152220. [PMID: 33348295 DOI: 10.1016/j.comppsych.2020.152220] [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: 08/06/2020] [Revised: 11/03/2020] [Accepted: 11/13/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Family accommodation (FA) in obsessive-compulsive disorder (OCD) means that the relatives of patients are involved in, help or facilitate patients' ritual behaviors and avoidance, which is a frequent occurrence and underresearched phenomenon in China. Recent studies have suggested that FA is adversely associated with treatment response, contradictory to the goal of cognitive behavior therapy, a contributor to the maintenance of symptoms and increased symptom severity, and associated with low levels of family and social functioning. There is increasing interest and focus on establishing a family-based intervention for OCD treatment based on the inclusion of relatives by decreasing FA. The present study explored the psychometric properties of the Chinese version of the Family Accommodation Scale for OCD Interviewer-Rated (FAS-IR). METHOD A total of 109 patients with OCD and 91 primary relatives were assessed in corresponding patient and family measures, and the FAS-IR was administered to relatives by trained interviewers. RESULTS More than 90% of the relatives accommodated patients' symptoms with at least one kind of FA behavior over the previous week, and the incidence of extreme or everyday routines was as high as 59.3%. Exploratory factor analysis demonstrated two-factor structure for the whole scale, including (1) modification and facilitation, and (2) participation. Cronbach's alpha was 0.798 for the whole scale, and the interrater and test-retest reliability coefficients were 0.835 (95%CI: 0.603-0.937) and 0.882 (95%CI: 0.685-0.959), respectively. Convergent validity was supported in exploring FA and was associated with symptom severity, level of functional impairment and family functioning related to OCD. The FA was not significantly correlated with depressive symptoms rated by the patients, as evidence of acceptable divergent validity. There was no significant difference in FA total score based on patient gender, patient age, or relationship with patients. CONCLUSIONS The Chinese version of the FAS-IR demonstrated excellent psychometric properties for assessing the degree of FA, suggesting that it is a useful and valuable instrument in clinical and research settings.
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Affiliation(s)
- Zhenhua Liao
- Department of Research and Education, Xiamen Xianyue Hospital, Xiamen, Fujian, China; Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Ciping You
- Department of Research and Education, Xiamen Xianyue Hospital, Xiamen, Fujian, China
| | - Ying Chen
- Department of Research and Education, Xiamen Xianyue Hospital, Xiamen, Fujian, China
| | - Jinli Zhang
- Department of Psychiatry Rehabilitation Medicine, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
| | - Lijun Ding
- Department of Research and Education, Xiamen Xianyue Hospital, Xiamen, Fujian, China.
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26
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Balachander S, Meier S, Matthiesen M, Ali F, Kannampuzha AJ, Bhattacharya M, Kumar Nadella R, Sreeraj VS, Ithal D, Holla B, Narayanaswamy JC, Arumugham SS, Jain S, Reddy YJ, Viswanath B. Are There Familial Patterns of Symptom Dimensions in Obsessive-Compulsive Disorder? Front Psychiatry 2021; 12:651196. [PMID: 33959055 PMCID: PMC8093508 DOI: 10.3389/fpsyt.2021.651196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Obsessive-compulsive disorder (OCD) is a heterogeneous illness, and emerging evidence suggests that different symptom dimensions may have distinct underlying neurobiological mechanisms. We aimed to look for familial patterns in the occurrence of these symptom dimensions in a sample of families with at least two individuals affected with OCD. Methods: Data from 153 families (total number of individuals diagnosed with DSM-5 OCD = 330) recruited as part of the Accelerator Program for Discovery in Brain Disorders using Stem Cells (ADBS) was used for the current analysis. Multidimensional Item Response Theory (IRT) was used to extract dimensional scores from the Yale-Brown Obsessive-Compulsive Scale (YBOCS) checklist data. Using linear mixed-effects regression models, intra-class correlation coefficients (ICC), for each symptom dimension, and within each relationship type were estimated. Results: IRT yielded a four-factor solution with Factor 1 (Sexual/Religious/Aggressive), Factor 2 (Doubts/Checking), Factor 3 (Symmetry/Arranging), and Factor 4 (Contamination/Washing). All except for Factor 1 were found to have significant ICCs, highest for Factor 3 (0.41) followed by Factor 4 (0.29) and then Factor 2 (0.27). Sex-concordant dyads were found to have higher ICC values than discordant ones, for all the symptom dimensions. No major differences in the ICC values between parent-offspring and sib-pairs were seen. Conclusions: Our findings indicate that there is a high concordance of OCD symptom dimensions within multiplex families. Symptom dimensions of OCD might thus have significant heritability. In view of this, future genetic and neurobiological studies in OCD should include symptom dimensions as a key parameter in their analyses.
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Affiliation(s)
- Srinivas Balachander
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, India.,Accelerator Program for Discovery in Brain Disorders Using Stem Cells, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
| | - Sandra Meier
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Manuel Matthiesen
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.,Department of Psychiatry Psychosomatics and Psychotherapy, University of Wuerzburg, Wuerzburg, Germany.,Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Furkhan Ali
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, India.,Accelerator Program for Discovery in Brain Disorders Using Stem Cells, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
| | - Anand Jose Kannampuzha
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, India.,Accelerator Program for Discovery in Brain Disorders Using Stem Cells, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
| | - Mahashweta Bhattacharya
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, India.,Accelerator Program for Discovery in Brain Disorders Using Stem Cells, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
| | - Ravi Kumar Nadella
- Accelerator Program for Discovery in Brain Disorders Using Stem Cells, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
| | - Vanteemar S Sreeraj
- Accelerator Program for Discovery in Brain Disorders Using Stem Cells, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
| | - Dhruva Ithal
- Accelerator Program for Discovery in Brain Disorders Using Stem Cells, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
| | - Bharath Holla
- Accelerator Program for Discovery in Brain Disorders Using Stem Cells, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
| | - Janardhanan C Narayanaswamy
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, India.,Accelerator Program for Discovery in Brain Disorders Using Stem Cells, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
| | - Shyam Sundar Arumugham
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, India
| | - Sanjeev Jain
- Accelerator Program for Discovery in Brain Disorders Using Stem Cells, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
| | - Yc Janardhan Reddy
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health & Neuro Sciences, Bangalore, India.,Accelerator Program for Discovery in Brain Disorders Using Stem Cells, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
| | - Biju Viswanath
- Accelerator Program for Discovery in Brain Disorders Using Stem Cells, National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore, India
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Anger and aggressiveness in obsessive-compulsive disorder (OCD) and the mediating role of responsibility, non-acceptance of emotions, and social desirability. Eur Arch Psychiatry Clin Neurosci 2021; 271:1179-1191. [PMID: 33155153 PMCID: PMC8354876 DOI: 10.1007/s00406-020-01199-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 10/14/2020] [Indexed: 01/08/2023]
Abstract
According to psychodynamic and cognitive models of obsessive-compulsive disorder (OCD), anger and aggression play an important role in the development and maintenance of the disorder. (Sub-) clinical samples with OCD have reported higher anger and anger suppression. Patients with checking-related symptoms of OCD showed a less aggressive self-concept as assessed by an Implicit Association Test (IAT). This study assessed anger and aggressiveness self-concepts in OCD as well as possible mediators of the link between OCD and aggressiveness. A total of 48 patients with OCD and 45 healthy controls were included. Measures included the State-Trait Anger Expression Inventory-II and an aggressiveness self-concept IAT (Agg-IAT). An inflated sense of responsibility, non-acceptance of emotions, and social desirability were tested as mediators. As expected, patients with OCD reported higher trait anger and anger suppression compared to healthy controls. Contrary to hypotheses, the aggressiveness self-concept (Agg-IAT) did not differ between groups. The inflated sense of responsibility mediated the relationship between group and anger suppression. Non-acceptance of negative emotions mediated the relationship between group and trait anger, as well as anger suppression. However, comorbidities and medication may account for some effect in anger suppression. Elevated trait anger and anger suppression in OCD patients could be explained by dysfunctional beliefs or maladaptive emotion regulation strategies. Emotion regulation therapy might help to enhance awareness and acceptance of emotions and possibly improve treatment outcomes.
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28
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Nutley SK, Bertolace L, Vieira LS, Nguyen B, Ordway A, Simpson H, Zakrzewski J, Camacho MR, Eichenbaum J, Nosheny R, Weiner M, Mackin RS, Mathews CA. Internet-based hoarding assessment: The reliability and predictive validity of the internet-based Hoarding Rating Scale, Self-Report. Psychiatry Res 2020; 294:113505. [PMID: 33070108 PMCID: PMC8080473 DOI: 10.1016/j.psychres.2020.113505] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/07/2020] [Indexed: 11/19/2022]
Abstract
The Hoarding Rating Scale, Self Report (HRS-SR) is a 5-item assessment developed to ascertain the presence and severity of hoarding symptoms. This study aimed to evaluate the validity of an online adaptation of the HRS-SR in a remote, unsupervised internet sample of 23,214 members of the Brain Health Registry (BHR), an online research registry that evaluates and longitudinally monitors cognition, medical and psychiatric health status. Convergent validity was assessed among a sub-sample of 1,183 participants who completed additional, remote measures of self-reported hoarding behaviors. Structured clinical interviews conducted in-clinic and via video conferencing tools were conducted among 230 BHR participants; ROC curves were plotted to assess the diagnostic performance of the internet-based HRS-SR using best estimate hoarding disorder (HD) diagnoses as the gold standard. The area under the curve indicated near-perfect model accuracy, and was confirmed with 10-fold cross validation. Sensitivity and specificity for distinguishing clinically relevant hoarding were optimized using an HRS-SR total score cut-off of 5. Longitudinal analyses indicated stability of HRS-SR scores over time. Findings indicate that the internet-based HRS-SR is a useful and valid assessment of hoarding symptoms, though additional research using samples with more diverse hoarding behavior is needed to validate optimal cut-off values.
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Affiliation(s)
- Sara K Nutley
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
| | - Lyvia Bertolace
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Luis Sordo Vieira
- Department of Medicine, University of Florida, Gainesville, FL, United States
| | - Binh Nguyen
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Ashley Ordway
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Heather Simpson
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Jessica Zakrzewski
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Monica R Camacho
- San Francisco VA Medical Center, San Francisco, California, United States
| | - Joseph Eichenbaum
- San Francisco VA Medical Center, San Francisco, California, United States; Department of Radiology, University of California, San Francisco, San Francisco, California, United States
| | - Rachel Nosheny
- Department of Psychiatry, University of California, San Francisco, San Francisco, California, United States
| | - Michael Weiner
- Department of Radiology, University of California, San Francisco, San Francisco, California, United States; Department of Psychiatry, University of California, San Francisco, San Francisco, California, United States
| | - R Scott Mackin
- Department of Psychiatry, University of California, San Francisco, San Francisco, California, United States; Department of Mental Health, Veterans Affairs Medical Center, San Francisco, California, United States
| | - Carol A Mathews
- Department of Psychiatry, University of Florida, Gainesville, FL, United States.
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29
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Screening for Pediatric Obsessive-Compulsive Disorder Using the Obsessive-Compulsive Inventory-Child Version. Child Psychiatry Hum Dev 2020; 51:888-899. [PMID: 32030629 DOI: 10.1007/s10578-020-00966-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The study assessed the ability of the Obsessive-Compulsive Inventory-Child Version (OCI-CV) to detect pediatric obsessive-compulsive disorder (OCD) using receiver operating characteristic analyses. The sample consisted of 114 cases with current OCD, 340 cases with other psychiatric disorders (OPD), and 301 healthy controls (HC) ages 7 to 18 years. All 755 participants were assessed with two semi-structured interviews and seven rating scales. In a comparison of current OCD cases and all other participants, the optimal OCI-CV cut-score was 11 with an area under the curve (AUC) of .88. In a comparison of current OCD cases and OPD cases, the optimal OCI-CV cut-score was 11 with an AUC of .82. In a comparison of current OCD cases and HC, the optimal OCI-CV cut-score was 10 with an AUC of .94. The results indicate that the OCI-CV provides an effective screen for pediatric OCD using empirically derived cut-scores.
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30
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Bartel SJ, Sherry SB, Farthing GR, Stewart SH. Classification of Orthorexia Nervosa: Further evidence for placement within the eating disorders spectrum. Eat Behav 2020; 38:101406. [PMID: 32540715 DOI: 10.1016/j.eatbeh.2020.101406] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 02/01/2023]
Abstract
PURPOSE Orthorexia Nervosa (ON) may belong on the eating disorder (ED) or obsessive-compulsive (OC) spectrum. We sought to provide additional evidence regarding the working classification of ON as an ED. METHODS 512 individuals completed a measure of ON symptoms (rBOT), ED symptoms (Eating Disorder Examination Questionnaire), OC symptoms (Obsessive-Compulsive Inventory Revised), food choice motives (Food Choice Questionnaire), and perfectionism (Multidimensional Perfectionism Scale). RESULTS ON symptoms were more strongly linked to ED symptoms than to OC symptoms. ON symptoms were related to body weight and shape concerns, and with prioritizing weight above health with respect to food selection. Both ED and ON symptoms were moderately related to perfectionism, while OC symptoms were strongly related to perfectionism. CONCLUSION Our results support ON being classified on the ED spectrum; however, whether ON represents a precursor to an ED, an ED with added health concerns, or a disorder that evolves from an ED is not certain. Future longitudinal research is necessary to test these alternate possibilities.
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Affiliation(s)
- S J Bartel
- Department of Psychology and Neuroscience, Dalhousie University, Life Sciences Centre, 1355 Oxford St, PO Box 15000, Halifax, NS, Canada.
| | - S B Sherry
- Department of Psychology and Neuroscience, Dalhousie University, Life Sciences Centre, 1355 Oxford St, PO Box 15000, Halifax, NS, Canada
| | - G R Farthing
- Department of Psychology, St. Thomas More College, 1437 College Drive, Rm 136, Saskatoon, SK S7N 0W6, Canada
| | - S H Stewart
- Department of Psychology and Neuroscience, Dalhousie University, Life Sciences Centre, 1355 Oxford St, PO Box 15000, Halifax, NS, Canada; Department of Psychiatry, Dalhousie University, Abby J. Lane Memorial Building, 5909 Veterans' Memorial Lane, Halifax, NS B3H 2E2, Canada
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31
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Maleki S, Chye Y, Zhang X, Parkes L, Chamberlain SR, Fontenelle LF, Braganza L, Youssef G, Lorenzetti V, Harrison BJ, Yücel M, Suo C. Neural correlates of symptom severity in obsessive-compulsive disorder using magnetization transfer and diffusion tensor imaging. Psychiatry Res Neuroimaging 2020; 298:111046. [PMID: 32106018 PMCID: PMC7100004 DOI: 10.1016/j.pscychresns.2020.111046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 02/02/2020] [Accepted: 02/04/2020] [Indexed: 11/18/2022]
Abstract
Recent neuroimaging studies in OCD have reported structural alterations in the brain, not limited to frontostriatal regions. While Diffusion Tensor Imaging (DTI) is typically used to interrogate WM microstructure in OCD, additional imaging metric, such as Magnetization Transfer Imaging (MTI), allows for further identification of subtle but important structural changes across both GM and WM. In this study, both MTI and DTI were utilised to investigate the structural integrity of the brain, in OCD in relation to healthy controls. 38 adult OCD patients were recruited, along with 41 age- and gender-matched controls. Structural T1, MTI and DTI data were collected. Case-control differences in Magnetization Transfer Ratio (MTR) and DTI metrics (FA, MD) were examined, along with MTR/DTI-related associations with symptom severity in patients. No significant group differences were found across MTR, FA, and MD. However, OCD symptom severity was positively correlated with MTR in a distributed network of brain regions, including the striatum, cingulate, orbitofrontal area and insula. Within the same regions, OCD symptoms were also positively correlated with FA in WM, and negatively correlated with MD in GM. These results indicate a greater degree of myelination in certain cortical and subcortical regions in the more severe cases of OCD.
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Affiliation(s)
- Suzan Maleki
- Brain, Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Yann Chye
- Brain, Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Xiaoliu Zhang
- Brain, Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Linden Parkes
- Brain, Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia; Department of Bioengineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, USA
| | - Samuel R Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge, UK; Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Leonardo F Fontenelle
- Brain, Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia; D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Obsessive, Compulsive, and Anxiety Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Leah Braganza
- Brain, Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - George Youssef
- Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Geelong, Australia; Murdoch Children's Research Institute, Centre for Adolescent Health, Melbourne, Australia
| | - Valentina Lorenzetti
- Brain, Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia; School of Behavioural & Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Ben J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Murat Yücel
- Brain, Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Chao Suo
- Brain, Mind and Society Research Hub, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.
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Metacognitive beliefs mediate the relationship between anxiety sensitivity and traits of obsessive-compulsive symptoms. BMC Psychol 2020; 8:40. [PMID: 32336292 PMCID: PMC7184693 DOI: 10.1186/s40359-020-00412-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 04/16/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Metacognition has been shown as a key contributor to Obsessive Compulsive Disorder as well as other anxiety-related disorders, yet its role in the development and maintenance of these disorders remains unclear. This study aims to investigate whether anxiety sensitivity traits are related to obsessive-compulsive symptoms in the general population and whether the relationship between anxiety sensitivity and obsessive-compulsive symptoms is mediated by metacognition. METHODS Non-clinical volunteers (N = 156, mean age: 23.97, 121 females) completed measures related to state/trait anxiety, anxiety sensitivity, obsessive compulsive symptoms and metacognition. RESULTS A direct relationship between anxiety sensitivity and obsessive-compulsive symptoms was established. Further analysis revealed that metacognition was the strongest mediator of this relationship, even when accounting for state and trait anxiety. CONCLUSIONS Results suggest that the relationships between traits of anxiety sensitivity and obsessive-compulsive symptoms are partially attributable to the role of metacognition.
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Schirmbeck F, Konijn M, Hoetjes V, Vermeulen J, Zink M, Dekker J, de Haan L. Stressful experiences affect the course of co-occurring obsessive-compulsive and psychotic symptoms: A focus on within-subject processes. Schizophr Res 2020; 216:69-76. [PMID: 31919031 DOI: 10.1016/j.schres.2019.12.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/26/2019] [Accepted: 12/22/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Obsessive-compulsive symptoms (OCS) frequently occur in patients with psychotic disorders and are associated with higher burden and poorer prognosis. This study prospectively investigated the effect of stressful experiences on the severity of OCS and co-occurring psychotic and affective symptoms, with a focus on within-subject processes. METHOD Monthly assessments over 6 months in patients with a psychotic disorder (n = 56) and unaffected siblings (n = 49) resulted in 309 and 277 observations, respectively. Linear mixed-effects models investigated the disaggregated effects of within-subject changes and between-subject differences in stressful events on OCS, positive, negative and depressive symptoms. Subsequently, moderating effects of coping strategies and dysfunctional metacognitive beliefs were assessed. Mediation analyses investigated direct and indirect effects of stressful events on OCS four weeks later. RESULTS Stressful experiences were associated with severity in almost all symptom domains on the between- and within-subject levels. Dysfunctional coping and metacognitive beliefs moderated these associations. Patients and siblings with a tendency for passive coping showed higher within-subject increase in depressive symptoms, whereas passive coping and dysfunctional beliefs moderated the association between stressful experiences and severity of positive symptoms and OCS on the between-subject level. Effects of stressful experiences on OCS four weeks later were partially mediated by depressive and positive symptoms in patients and siblings. CONCLUSIONS Findings suggest that severity and variability of co-occurring psychopathology can partly be explained by recent stressful events and the way individuals cope with these experiences. The implementation of coping-oriented interventions could possibly help to prevent development and/or aggravation of co-occurring symptom severity.
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Affiliation(s)
- Frederike Schirmbeck
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands.
| | - Max Konijn
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Vera Hoetjes
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Jentien Vermeulen
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
| | - Mathias Zink
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; District Hospital Mittelfranken, Ansbach, Germany
| | - Jack Dekker
- Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Lieuwe de Haan
- Amsterdam University Medical Center, Location Meibergdreef, University of Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands
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Extended formulation in cognitive behavioural therapy for OCD: a single case experimental design. COGNITIVE BEHAVIOUR THERAPIST 2020. [DOI: 10.1017/s1754470x20000367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The demanding nature of exposure work that forms an essential component of exposure and response prevention (ERP) for obsessive compulsive disorder (OCD) is for some patients intolerable and leads to disengagement. The addition of cognitive therapy to ERP (CBT) with a focus on developing a shared understanding of how OCD works may aid engagement. This paper reports a case study of an individual who had not responded to two previous courses of ERP due to engagement difficulties with the treatment rationale. This study aimed to establish if CBT for OCD, incorporating an extended period of assessment and longitudinal formulation, would: (1) aid in engagement with the treatment rationale and therapy and (2) lead to an improvement in OCD symptoms, general functioning and mood. An A–B single case experimental design was used. Standardised measures were collected at weekly intervals over 15 sessions of CBT, in conjunction with pre–post idiographic behavioural measures. The extended formulation was successful in helping the individual to develop a less threatening understanding of how OCD works, enabling her to engage in therapy. This led to a reduction in the duration of the overt compulsions in her behavioural measures although on the standardised measures there was no change in self-reported OCD symptoms. The patient’s covert rituals and underlying responsibility and control beliefs largely remained intact, thus maintaining her OCD and requiring further intervention. There was a significant improvement in social functioning and consequently the patient reported being able to regain a sense of some control in her life.
Key learning aims
(1)
To describe the factors that might lead to a patient disengaging from exposure work in treatment for OCD.
(2)
To identify the advantages and disadvantages of incorporating a period of extended formulation when working with patients who have not previously been able to tolerate exposure work.
(3)
To describe ways of monitoring observable improvements in areas of functioning that matter to the patient in order to help them to celebrate their progress and boost their sense of self-efficacy.
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Leeuwerik T, Cavanagh K, Strauss C. The Association of Trait Mindfulness and Self-compassion with Obsessive-Compulsive Disorder Symptoms: Results from a Large Survey with Treatment-Seeking Adults. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10049-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Abstract
Little is known about the role of mindfulness and self-compassion in obsessive-compulsive disorder. This cross-sectional study examined associations of mindfulness and self-compassion with obsessive-compulsive disorder symptoms and with the obsessive beliefs and low distress tolerance thought to maintain them. Samples of treatment-seeking adults (N = 1871) and non-treatment-seeking adults (N = 540) completed mindfulness, self-compassion, obsessive-compulsive disorder, anxiety, depression, obsessive beliefs and distress tolerance questionnaires. Participants with clinically significant obsessive-compulsive disorder symptoms reported lower trait mindfulness and self-compassion compared to participants with clinically significant anxiety/depression and to non-clinical controls. Among the clinical sample, there were medium-large associations between mindfulness and self-compassion and obsessive-compulsive disorder symptoms, obsessive beliefs and distress tolerance. Mindfulness and self-compassion were unique predictors of obsessive-compulsive disorder symptoms, controlling for depression severity. Once effects of obsessive beliefs and distress tolerance were controlled, a small effect remained for mindfulness (facets) on obsessing symptoms and for self-compassion on washing and checking symptoms. Directions for future research and clinical implications are considered in conclusion.
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Schirmbeck F, Konijn M, Hoetjes V, Zink M, de Haan L. Obsessive-compulsive symptoms in psychotic disorders: longitudinal associations of symptom clusters on between- and within-subject levels. Eur Arch Psychiatry Clin Neurosci 2019. [PMID: 29520640 PMCID: PMC6726663 DOI: 10.1007/s00406-018-0884-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Obsessive-compulsive symptoms (OCS) are frequently reported in patients with schizophrenia and have been associated with subjective distress and higher impairment. Recent studies suggest fluctuation in co-occurring OCS and associations with the course of psychotic symptoms. Current evidence is limited by few studies with long assessments intervals and a sole focus on between-subject comparisons. The aim of this study was to specifically investigate co-variation of symptom domains over time within individuals. Patients with a psychotic disorder (n = 56) and un-affected siblings (n = 49) completed monthly assessments of clinical and subclinical symptoms over 6 months. Mixed-model multilevel analyses examined the variability and relationship between OCS and positive, negative, and depressive symptoms on the between- and within-subject level. Symptom domains were associated across subjects and assessment times, in patients and siblings, with the strongest association between OCS and (subclinical) positive symptoms. Within-subjects, substantial variability and co-variation of all symptom domains was found. Particularly, between-subject differences in positive symptoms and within-subject change in depressive symptoms predicted subsequent OCS in patients 1 months later. This is the first prospective study disaggregating between and within-subject associations between co-occurring OCS and symptom cluster of psychosis. Differences on these two levels suggest different underlying mechanisms. The association between depressive symptoms and subsequent increase/decrease of OCS within patients may have important treatment implications.
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Affiliation(s)
- Frederike Schirmbeck
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands. .,Arkin Institute for Mental Health, Amsterdam, The Netherlands.
| | - Max Konijn
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Vera Hoetjes
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands
| | - Mathias Zink
- Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, Amsterdam, The Netherlands ,Arkin Institute for Mental Health, Amsterdam, The Netherlands
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Taylor JK, Theiler S, Nedeljkovic M, Moulding R. A qualitative analysis of emotion and emotion regulation in hoarding disorder. J Clin Psychol 2018; 75:520-545. [PMID: 30431647 DOI: 10.1002/jclp.22715] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 09/04/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The role of emotion regulation (ER) has been receiving increased attention in relation to various forms of psychopathology including hoarding disorder (HD). However, questionnaire designs are limited to finding associations of ER with symptoms or symptom groups, without finding out how such constructs might be involved in the disorder. METHODS This study was a qualitative investigation of ER in a clinical HD sample (N = 11). RESULTS Prominent themes provided support for ER difficulties in hoarding. In particular, difficulties with identifying and describing feelings, unhelpful attitudes toward the emotional experience, the use of avoidance-based strategies, and a perceived lack of effective ER strategies were prominent themes. Furthermore, emotional factors were identified as being associated with the onset and/or exacerbation of hoarding behavior, and possessions and acquiring behavior appeared to serve an ER function. CONCLUSION The current paper provides a nuanced account of the role of ER in hoarding difficulties.
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Affiliation(s)
- Jasmine K Taylor
- School of Psychology, Swinburne University of Technology; Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Stephen Theiler
- School of Psychology, Swinburne University of Technology; Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Maja Nedeljkovic
- School of Psychology, Swinburne University of Technology; Centre for Mental Health, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Richard Moulding
- School of Psychology, Deakin University, Geelong; Deakin University Centre for Drug Use, Addictive and Anti-Social Behaviour Research (CEDAAR), Geelong, Victoria, Australia
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McDermott KA, Smith HL, Cougle JR. An Examination of Perseverative Thinking and Perception of Threat from Emotion as Mechanisms Underlying the Relationship Between Distress Intolerance and Internalizing Symptoms. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9960-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Tolin DF, Gilliam CM, Davis E, Springer K, Levy HC, Frost RO, Steketee G, Stevens MC. Psychometric Properties of the Hoarding Rating Scale-Interview. J Obsessive Compuls Relat Disord 2018; 16:76-80. [PMID: 31544015 PMCID: PMC6753954 DOI: 10.1016/j.jocrd.2018.01.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The present study tested the psychometric properties of an expanded version of the Hoarding Rating Scale (HRS-I), a semistructured interview for hoarding disorder (HD). Eighty-seven adults with HD and 44 healthy control (HC) participants were assessed using the HRS-I and completed a battery of self-report measures of HD severity, negative affect, and functional impairment. All interviews were audio recorded. From the HD participants, 21 were randomly selected for inter-rater reliability (IRR) analysis and 11 for test-retest reliability (TRR) analysis. The HRS-I showed excellent internal consistency (α = 0.87). IRR and TRR in the HD sample were good (intra-class coefficients = 0.81 and 0.85, respectively). HRS-I scores correlated strongly with scores on the self-report Saving Inventory-Revised (SI-R); partial correlations indicated that the HRS-I clutter, difficulty discarding, and acquiring items correlated significantly and at least moderately with corresponding SI-R subscales, when controlling for the other SI-R subscales. The HD group scored significantly higher on all items than did the HC group, with large effect sizes (d = 1.28 to 6.58). ROC analysis showed excellent sensitivity (1.00) and specificity (1.00) for distinguishing the HD and HC groups with a cutoff score of 11. Results and limitations are discussed in light of prior research.
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Affiliation(s)
- David F. Tolin
- Institute of Living, Hartford, CT
- Yale University School of Medicine
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Eilertsen T, Hansen B, Kvale G, Abramowitz JS, Holm SEH, Solem S. The Dimensional Obsessive-Compulsive Scale: Development and Validation of a Short Form (DOCS-SF). Front Psychol 2017; 8:1503. [PMID: 28928693 PMCID: PMC5591872 DOI: 10.3389/fpsyg.2017.01503] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 08/18/2017] [Indexed: 11/13/2022] Open
Abstract
Accurately and reliably measuring the presence and severity of Obsessive-Compulsive Disorder (OCD) symptoms is essential for both routine clinical work and research. The current study investigated psychometric properties of the dimensional obsessive-compulsive scale-short form (DOCS-SF). DOCS-SF was developed and validated in Norwegian. DOCS-SF contains a checklist with four symptom categories and five severity items scored on a zero to eight scale yielding a total score of 0–40. Data were collected from adults with a current diagnosis of OCD (n = 204) and a community comparison group (n = 211). The results provided evidence of internal consistency and convergent validity, although evidence for discriminant validity was mixed. Evidence was also found for diagnostic sensitivity and specificity, and treatment sensitivity. The analyses suggested a cut-off score of 16. In summary, the data obtained proved similar to studies published on the original dimensional obsessive-compulsive scale. There is strong evidence for the reliability and validity of the DOCS-SF for assessing OCD symptoms in individuals with this condition and in non-clinical individuals.
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Affiliation(s)
- Thomas Eilertsen
- OCD-Team, Haukeland University HospitalBergen, Norway.,Department of Clinical Psychology, University of BergenBergen, Norway
| | - Bjarne Hansen
- OCD-Team, Haukeland University HospitalBergen, Norway.,Department of Clinical Psychology, University of BergenBergen, Norway
| | - Gerd Kvale
- OCD-Team, Haukeland University HospitalBergen, Norway
| | - Jonathan S Abramowitz
- Department of Psychology and Neuroscience, University of North Carolina at Chapel HillChapel Hill, NC, United States
| | - Silje E H Holm
- OCD-Team, Haukeland University HospitalBergen, Norway.,Department of Clinical Psychology, University of BergenBergen, Norway
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and TechnologyTrondheim, Norway
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Bello MS, Pang RD, Chasson GS, Ray LA, Leventhal AM. Obsessive-compulsive symptoms and negative affect during tobacco withdrawal in a non-clinical sample of African American smokers. J Anxiety Disord 2017; 48:78-86. [PMID: 27769664 PMCID: PMC5380588 DOI: 10.1016/j.janxdis.2016.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/01/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022]
Abstract
The association between obsessive-compulsive (OC) symptomatology and smoking is poorly understood, particularly in African Americans-a group subject to smoking- and OC-related health disparities. In a non-clinical sample of 253 African American smokers, we tested the negative reinforcement model of OC-smoking comorbidity, purporting that smokers with higher OC symptoms experience greater negative affect (NA) and urge to smoke for NA suppression upon acute tobacco abstinence. Following a baseline visit involving OC assessment, participants completed two counterbalanced experimental visits (non-abstinent vs. 16-h tobacco abstinence) involving affect, smoking urge, and nicotine withdrawal assessment. OC symptom severity predicted larger abstinence-provoked increases in overall NA, anger, anxiety, depression, fatigue, urge to smoke to suppress NA, and composite nicotine withdrawal symptom index. African American smokers with elevated OC symptoms appear to be vulnerable to negative reinforcement-mediated smoking motivation and may benefit from cessation treatments that diminish NA or the urge to quell NA via smoking.
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Affiliation(s)
- Mariel S Bello
- University of Southern California, Department of Psychology, Los Angeles, CA, USA
| | - Raina D Pang
- University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA
| | - Gregory S Chasson
- Illinois Institute of Technology, Department of Psychology, Chicago, IL, USA
| | - Lara A Ray
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Adam M Leventhal
- University of Southern California, Department of Psychology, Los Angeles, CA, USA; University of Southern California Keck School of Medicine, Department of Preventive Medicine, Los Angeles, CA, USA.
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Asnaani A, Kaczkurkin AN, Alpert E, McLean CP, Simpson HB, Foa EB. The effect of treatment on quality of life and functioning in OCD. Compr Psychiatry 2017; 73:7-14. [PMID: 27838572 PMCID: PMC5263110 DOI: 10.1016/j.comppsych.2016.10.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 09/20/2016] [Accepted: 10/07/2016] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Given that obsessive compulsive disorder (OCD) is associated with impaired quality of life (QoL) and functioning, it is important examine whether therapeutic recovery from OCD leads to improvements on these important secondary outcomes. Only a few studies have examined how measures of OCD symptom severity relate to QoL and functioning among patients receiving treatment for OCD. METHODS OCD severity was measured with the Obsessive-Compulsive Inventory-Revised (OCI-R), a self-report scale of OCD, and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), an interview measure of OCD. Participants were 100 adults with a primary diagnosis of OCD on serotonin reuptake inhibitors (SRIs) enrolled in a randomized clinical trial comparing SRI augmentation with either exposure and response prevention (EX/RP) therapy, risperidone, or pill placebo. At baseline, mid-treatment, and post-treatment, patients completed assessments for OCD symptoms and QoL/functioning measures. Multilevel modeling was used to assess changes in QoL/functioning over the course of treatment and to compare such changes across treatment conditions. RESULTS Improvements in QoL/functioning were significantly greater among those receiving EX/RP compared to those receiving risperidone. Compared to pill placebo, EX/RP performed better on measures of functioning but not QoL. Greater improvement in individual OCI-R scores was associated with greater improvements in QoL/functioning, regardless of condition. In addition, Y-BOCS scores appeared to moderate improvements in QoL over the course of all treatment conditions, such that those with higher Y-BOCS scores showed the greatest improvements in QoL over time. CONCLUSIONS Improvements in QoL/functioning were associated with reduction in OCD symptom severity. The implications on OCD treatment and clinical research are discussed.
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Affiliation(s)
- Anu Asnaani
- University of Pennsylvania, Philadelphia, PA.
| | | | | | | | - H. Blair Simpson
- Columbia University, NYC, NY,New York State Psychiatric Institute, NYC, NY
| | - Edna B. Foa
- University of Pennsylvania, Philadelphia, PA
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Tsuchiyagaito A, Horiuchi S, Igarashi T, Kawanori Y, Hirano Y, Yabe H, Nakagawa A. Factor structure, reliability, and validity of the Japanese version of the Hoarding Rating Scale-Self-Report (HRS-SR-J). Neuropsychiatr Dis Treat 2017; 13:1235-1243. [PMID: 28533685 PMCID: PMC5431741 DOI: 10.2147/ndt.s133471] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The Hoarding Rating Scale-Self-Report (HRS-SR) is a five-item scale that assesses the symptoms of hoarding. These symptoms include excessive acquisition, difficulty in discarding, and excessive clutter that causes distress. We conducted three studies to examine the factor structure, reliability, and validity of the Japanese version of the HRS-SR (HRS-SR-J). METHODS Study 1 examined its reliability; 193 college students and 320 adolescents and adults completed the HRS-SR-J and, of the college students, 32 took it again 2 weeks later. Study 2 aimed to confirm that its scores in a sample of 210 adolescents and adults are independent of social desirability. Study 3 aimed to validate the HRS-SR-J in the aspects of convergent and discriminant validity in a sample of 550 adults. RESULTS The HRS-SR-J showed good internal consistency and 2-week test-retest reliability. Based on the nonsignificant correlations between the HRS-SR-J and social desirability, the HRS-SR-J was not strongly affected by social desirability. In addition, it also had a good convergent validity with the Japanese version of the Saving Inventory-Revised (SI-R-J) and the hoarding subscale of the Obsessive-Compulsive Inventory, while having a significantly weaker correlation with the five subscales of the Obsessive-Compulsive Inventory, except for the hoarding subscale. In addition, the strength of the correlation between the HRS-SR-J and the Japanese version of the Patient Health Questionnaire-9 and that between the HRS-SR-J and the Generalized Anxiety Disorder-7 were significantly weaker than the correlation between the HRS-SR-J and the SI-R-J. These results demonstrate that the HRS-SR-J has good convergent and discriminant validity. CONCLUSION The HRS-SR-J is a notable self-report scale for examining the severity of hoarding symptoms.
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Affiliation(s)
- Aki Tsuchiyagaito
- Research Center for Child Mental Development, Chiba University, Chiba.,Department of Neuropsychiatry, Fukushima Medical University, Fukushima.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka
| | | | - Toko Igarashi
- Graduate School of Education, Joetsu University of Education, Niigata, Japan
| | | | - Yoshiyuki Hirano
- Research Center for Child Mental Development, Chiba University, Chiba.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University, Fukushima
| | - Akiko Nakagawa
- Research Center for Child Mental Development, Chiba University, Chiba.,United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka
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Baldwin PA, Whitford TJ, Grisham JR. The Relationship between Hoarding Symptoms, Intolerance of Uncertainty, and Error-Related Negativity. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2016. [DOI: 10.1007/s10862-016-9577-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Angelakis I, Panagioti M, Austin JL. Factor Structure and Validation of the Obsessive Compulsive Inventory-Revised (OCI-R) in a Greek Non-Clinical Sample. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2016. [DOI: 10.1007/s10862-016-9575-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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