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Zhang L, Takahashi Y. Relationships between obsessive-compulsive disorder and the big five personality traits: A meta-analysis. J Psychiatr Res 2024; 177:11-23. [PMID: 38964090 DOI: 10.1016/j.jpsychires.2024.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 05/31/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024]
Abstract
Although several studies have examined the relationships between obsessive-compulsive disorder (OCD) and the Big Five personality traits (i.e., neuroticism, extraversion, openness, agreeableness, and conscientiousness), the results have been inconsistent. Therefore, this meta-analysis comprehensively examined the relationships between OCD and these traits. In total, 23 studies (29 independent datasets) with 30,138 participants were analyzed. The pooled effect size was 0.34 (95% confidence interval [CI]: 0.28, 0.40) for neuroticism, -0.14 (95% CI: -0.18, -0.10) for extraversion, -0.04 (95% CI: -0.09, 0.02) for openness, -0.10 (95% CI: -0.16, -0.04) for agreeableness, and -0.03 (95% CI: -0.11, 0.05) for conscientiousness, indicating that OCD was associated with higher scores for neuroticism and lower scores for extraversion and agreeableness. Meta-regression and subgroup analyses indicated that heterogeneity was mainly due to differences in sample types and OCD measurement instruments. Sensitivity analysis showed that the results of the meta-analysis were robust. Overall, neuroticism was a maladaptive trait, whereas extraversion and agreeableness were adaptive traits for OCD. Although the results could be sample- and instrument-specific, our findings may inform preventions and interventions for OCD symptoms.
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Affiliation(s)
- Lei Zhang
- Graduate School of Education, Kyoto University, Kyoto, Japan
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Reis A, Westhoff M, Quintarelli H, Hofmann SG. Mindfulness as a therapeutic option for obsessive-compulsive disorder. Expert Rev Neurother 2024:1-7. [PMID: 38889066 DOI: 10.1080/14737175.2024.2365945] [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: 10/17/2023] [Accepted: 06/05/2024] [Indexed: 06/20/2024]
Abstract
INTRODUCTION Obsessive-compulsive disorder (OCD) is a prevalent mental health issue characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) that can cause significant life impairment. Despite cognitive-behavioral therapy (CBT) being the most effective treatment, some individuals experience insufficient symptom reduction or relapse. AREAS COVERED This special report explores the potential of mindfulness-based interventions as complementary treatments for OCD, examining the specific techniques used and their practical application. In the initial section, the authors examine ten randomized control trial studies included in the meta-analysis conducted by Chien et al. (2022), demonstrating the effectiveness of mindfulness interventions. The authors focus on elucidating the specific mindfulness techniques used in these studies. Then, the authors discuss the integration of these mindfulness strategies into CBT, focusing on enhancing emotional regulation, cognitive flexibility, and acceptance of intrusive thoughts. EXPERT OPINION While mindful based interventions (MBIs) show promise as adjunctive treatments for OCD, variability in OCD symptoms and treatment responses necessitate individualized therapeutic approaches. Further research is required to refine mindfulness-based techniques and optimize their effectiveness. Incorporating MBIs into standard CBT protocols may improve outcomes for patients with persistent OCD symptoms.
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Affiliation(s)
- Andreas Reis
- Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Marlon Westhoff
- Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Hicham Quintarelli
- Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
| | - Stefan G Hofmann
- Department of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany
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Ouellet-Courtois C, Audet JS, Aardema F. The COGINS: A New Measure of Cognitive Insight in Obsessive-Compulsive and Related Disorders. J Cogn Psychother 2024; 38:133-156. [PMID: 38631718 DOI: 10.1891/jcp-2023-0011] [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: 04/19/2024]
Abstract
Research suggests that individuals with obsessive-compulsive and related disorders (OCRDs) with lower insight show a poorer response to cognitive behavioral therapy and might benefit from alternative treatments. However, there are inconsistencies in the literature regarding the definition and measurement of insight. This study endeavored to evaluate the psychometric properties of the Cognitive Obsessional Insight Scale (COGINS), a novel self-report measure of cognitive insight in OCRDs. The sample comprised 166 participants with a diagnosis of obsessive-compulsive disorder or body dysmorphic disorder enrolled in clinical trials. Participants completed the COGINS and a questionnaire battery at baseline and posttreatment. The COGINS demonstrated good internal consistency, test-rest reliability, convergent validity with other OCRD-specific measures of insight, positive associations with OCRD symptomatology, and had a moderating effect on treatment response. The COGINS is a valid and reliable practical tool to measure cognitive insight in OCRDs and might help toward clarifying the role of cognitive insight in this population.
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Affiliation(s)
| | - Jean-Sébastien Audet
- Montreal Mental Health University Institute Research Center, Montreal, QC, Canada
| | - Frederick Aardema
- Montreal Mental Health University Institute Research Center, Montreal, QC, Canada
- Department of Psychiatry and Addiction, University of Montreal, Montreal, QC, Canada
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Pankratz B, Feige B, Runge K, Bechter K, Schiele MA, Domschke K, Prüss H, Tebartz van Elst L, Nickel K, Endres D. Cerebrospinal fluid findings in patients with obsessive-compulsive disorder, Tourette syndrome, and PANDAS: A systematic literature review. Brain Behav Immun 2024; 115:319-332. [PMID: 37748568 DOI: 10.1016/j.bbi.2023.09.016] [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: 04/02/2023] [Revised: 07/12/2023] [Accepted: 09/22/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) are related mental disorders that share genetic, neurobiological, and phenomenological features. Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) is a neuropsychiatric autoimmune disorder with symptoms of OCD and/or TS associated with streptococcal infections. Therefore, PANDAS represents a strong link between OCD, TS, and autoimmunity. Notably, cerebrospinal fluid (CSF) analyses can provide insight into the central nervous processes in OCD, TS, and PANDAS. METHODS A systematic literature search according to the PRISMA criteria was conducted to collect all CSF studies in patients with OCD, TS, and PANDAS. The total number of cases and the heterogeneity of the low number of studies were not sufficient for a meta-analysis to provide a high level of evidence. Nevertheless, meta-analytical statistics could be performed for glutamate, 5-hydroxyindoleacetic acid (degradation product of serotonin), homovanillic acid (degradation product of dopamine), 3-methoxy-4-hydroxyphenylglycol (major metabolite of noradrenaline), and corticotropin-releasing hormone (CRH) in OCD. A risk-of-bias assessment was implemented using the Cochrane ROBINS-E tool. RESULTS Meta-analytical testing identified elevated glutamate levels in the CSF of OCD patients compared with healthy controls, while no significant differences were found in other neurotransmitters or CRH. Single studies detected novel neuronal antibodies in OCD patients and elevated oligoclonal bands in TS patients. For TS and PANDAS groups, there was a dearth of data. Risk of bias assessment indicated a substantial risk of bias in most of the included studies. CONCLUSIONS This systematic review of available CSF data shows that too few studies are currently available for conclusions with good evidence. The existing data indicates glutamate alterations in OCD and possible immunological abnormalities in OCD and TS. More CSF studies avoiding sources of bias are needed.
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Affiliation(s)
- Benjamin Pankratz
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kimon Runge
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Karl Bechter
- Department for Psychiatry and Psychotherapy II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Harald Prüss
- Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany; German Center for Neurodegenerative Diseases (DZNE) Berlin, Berlin, Germany
| | - Ludger Tebartz van Elst
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kathrin Nickel
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dominique Endres
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Huang Y, Weng Y, Lan L, Zhu C, Shen T, Tang W, Lai HY. Insight in obsessive-compulsive disorder: conception, clinical characteristics, neuroimaging, and treatment. PSYCHORADIOLOGY 2023; 3:kkad025. [PMID: 38666121 PMCID: PMC10917385 DOI: 10.1093/psyrad/kkad025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/27/2023] [Accepted: 11/07/2023] [Indexed: 04/28/2024]
Abstract
Obsessive-compulsive disorder (OCD) is a chronic disabling disease with often unsatisfactory therapeutic outcomes. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has broadened the diagnostic criteria for OCD, acknowledging that some OCD patients may lack insight into their symptoms. Previous studies have demonstrated that insight can impact therapeutic efficacy and prognosis, underscoring its importance in the treatment of mental disorders, including OCD. In recent years, there has been a growing interest in understanding the influence of insight on mental disorders, leading to advancements in related research. However, to the best of our knowledge, there is dearth of comprehensive reviews on the topic of insight in OCD. In this review article, we aim to fill this gap by providing a concise overview of the concept of insight and its multifaceted role in clinical characteristics, neuroimaging mechanisms, and treatment for OCD.
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Affiliation(s)
- Yueqi Huang
- Department of Psychiatry, Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310007, China
| | - Yazhu Weng
- Fourth Clinical School of Zhejiang Chinese Medical University, Hangzhou 310053, China
| | - Lan Lan
- Department of Psychology and Behavior Science, Zhejiang University, Hangzhou 310058, China
| | - Cheng Zhu
- Department of Psychiatry, Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310007, China
| | - Ting Shen
- Frontotemporal Degeneration Center, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia 19104, PA, USA
| | - Wenxin Tang
- Department of Psychiatry, Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310007, China
| | - Hsin-Yi Lai
- Department of Psychiatry, Affiliated Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou 310007, China
- Department of Neurology of the Second Affiliated Hospital, Interdisciplinary Institute of Neuroscience and Technology, Key Laboratory of Medical Neurobiology of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310029, China
- MOE Frontier Science Center for Brain Science and Brain-Machine Integration, State Key Laboratory of Brain-machine Intelligence, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou 311121, China
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China
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van der Westhuizen C, Botha TL, Finger-Baier K, Brouwer GD, Wolmarans DW. Contingency learning in zebrafish exposed to apomorphine- and levetiracetam. Behav Pharmacol 2023; 34:424-436. [PMID: 37578419 DOI: 10.1097/fbp.0000000000000750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Cognitive rigidity (CR) refers to inadequate executive adaptation in the face of changing circumstances. Increased CR is associated with a number of psychiatric disorders, for example, obsessive-compulsive disorder, and improving cognitive functioning by targeting CR in these conditions, may be fruitful. Levetiracetam (LEV), clinically used to treat epilepsy, may have pro-cognitive effects by restoring balance to neuronal signalling. To explore this possibility, we applied apomorphine (APO) exposure in an attempt to induce rigid cue-directed responses following a cue (visual pattern)-reward (social conspecifics) contingency learning phase and to assess the effects of LEV on such behaviours. Briefly, zebrafish were divided into four different 39-day-long exposure groups ( n = 9-10) as follows: control (CTRL), APO (100 µg/L), LEV (750 µg/L) and APO + LEV (100 µg/L + 750 µg/L). The main findings of this experiment were that 1) all four exposure groups performed similarly with respect to reward- and cue-directed learning over the first two study phases, 2) compared to the CTRL group, all drug interventions, but notably the APO + LEV combination, lowered the degree of reward-directed behaviour during a dissociated presentation of the cue and reward, and 3) temporal and spatial factors influenced the manner in which zebrafish responded to the presentation of the reward. Future studies are needed to explore the relevance of these findings for our understanding of the potential cognitive effects of LEV.
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Affiliation(s)
| | - Tarryn L Botha
- Water Research Group, Unit for Environmental Sciences and Management, North-West University, Potchefstroom
- Department of Zoology, University of Johannesburg, Johannesburg, South Africa
| | - Karin Finger-Baier
- Max Planck Institute of Neurobiology, now: Max Planck Institute for Biological Intelligence, Martinsried, Germany
| | - Geoffrey de Brouwer
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health, North-West University
| | - De Wet Wolmarans
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health, North-West University
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Chiang B, Purdon C. A study of doubt in obsessive-compulsive disorder. J Behav Ther Exp Psychiatry 2023; 80:101753. [PMID: 37247970 DOI: 10.1016/j.jbtep.2022.101753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/19/2022] [Accepted: 05/19/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND AND OBJECTIVES Obsessive-compulsive disorder (OCD) has been referred to as the "doubting disease," yet there has been little foundational research on its phenomenology and characteristics. Studies of doubt have relied on researchers' idiosyncratic conceptualizations of the construct, resulting in varied assessment methods and different prevalence rates (11-75%). We examined the nature and characteristics of doubt in people with clinical and subclinical OCD so as to identify its nature and characteristics, and factors that may be unique to OCD. METHODS A semi-structured interview about doubt was administered to people with OCD (N = 44) and with subclinical OCD (N = 21). RESULTS Doubt was highly prevalent and manifested as a form of obsession, uncertainty about whether a task was done properly, and/or lack of confidence in memory and perceptions. All participants took action to resolve doubt and/or proactively pre-empt or reduce future doubt. Doubt was deeply connected to negative core beliefs about the self. The groups did not differ on their experience of doubt, except that greater symptom severity was associated with greater interference from doubt, less ability to resist it, and less success of proactive, but not reactive, strategies to manage it. LIMITATIONS We relied on retrospective report, and the subclinical group was relatively small. CONCLUSIONS In subclinical and clinical OCD, doubt is pervasive, manifests in three domains, is connected to negative core beliefs, and is highly aversive. Continued empirical study of doubt is essential to proper assessment and to development of theories and treatment of OCD.
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Affiliation(s)
- Brenda Chiang
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada; Parkwood Institute, Operational Stress Injury Clinic - GTA Site, Toronto, ON, Canada.
| | - Christine Purdon
- Department of Psychology, University of Waterloo, Waterloo, ON, Canada.
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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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9
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Guzick AG, Schneider SC, Perozo Garcia AB, Kook M, Greenberg RL, Riddle D, McNeel M, Rodriguez-Barajas S, Yang M, Upshaw B, Storch EA. Development and pilot testing of internet-delivered, family-based cognitive behavioral therapy for anxiety and obsessive-compulsive disorders in autistic youth. J Obsessive Compuls Relat Disord 2023; 37:100789. [PMID: 36908861 PMCID: PMC9997671 DOI: 10.1016/j.jocrd.2023.100789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Cognitive behavioral therapy adapted for autistic youth with anxiety and/or OCD has a strong evidence base, but few have access. A 12-week family-based, Internet-delivered cognitive behavioral therapy (iCBT) program for 7-15 year-old autistic youth with anxiety and/or OCD was developed as a potential method to address this problem. Quantitative and qualitative feedback from stakeholders (parents, youth, clinicians) was gathered on an initial draft of content before conducting a pilot trial. This feedback suggested high quality, engagement, usability, and informativeness of the material. Suggestions were incorporated into the treatment program that was tested in a pilot trial. Eight families were randomized to the iCBT program with either 1) weekly email support or 2) weekly email support plus biweekly telehealth check-ins, and seven of these families completed pre- and post-treatment assessments. An average reduction of 39% in anxiety severity was found, with six of the seven being classified as responders. Preliminary evidence suggests that family-based iCBT is an acceptable and promising treatment for autistic youth with anxiety and/or obsessive-compulsive disorders that should be further modified and tested in future work.
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Affiliation(s)
- Andrew G Guzick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Sophie C Schneider
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Amanda B Perozo Garcia
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Minjee Kook
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Rebecca L Greenberg
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - David Riddle
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Morgan McNeel
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, Texas, USA
| | | | - Michelle Yang
- Department of Psychological Sciences, Rice University, Houston, TX, USA
| | - Blake Upshaw
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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10
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Rahman SM, Abduelmula A, Jafferany M. Psychopathological symptoms in dermatology: A basic approach toward psychocutaneous disorders. Int J Dermatol 2023; 62:346-356. [PMID: 35816285 DOI: 10.1111/ijd.16344] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/01/2022] [Accepted: 06/17/2022] [Indexed: 11/28/2022]
Abstract
Dermatological conditions impact not only an individual's physical body but also their psychological health. Similar to how cutaneous conditions can affect one's psychological health, worsening psychological conditions can exacerbate or even induce dermatological conditions. There are four common psychiatric pathologies typically found in dermatology practices: depressive symptoms, anxiety symptoms, obsessive-compulsive disorder behaviors, and psychosis. Common cutaneous disorders associated with these psychopathological symptoms include, but are not limited to, psoriasis, acne vulgaris, atopic dermatitis, urticaria, trichotillomania, excoriation disorder, and delusions of parasitosis. The goal of this review is to examine the relationship between these four psychopathological symptoms with common psychodermatological conditions and to help providers better diagnose and implement appropriate psychological support to treat their patients.
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Affiliation(s)
- Syed Minhaj Rahman
- College of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Abrahim Abduelmula
- Faculty of Medicine, University of Western Ontario, London, Ontario, Canada
| | - Mohammad Jafferany
- Department of Psychiatry, Central Michigan University, Saginaw, Michigan, USA
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Moreno-Amador B, Piqueras JA, Rodríguez-Jiménez T, Martínez-González AE, Cervin M. Measuring symptoms of obsessive-compulsive and related disorders using a single dimensional self-report scale. Front Psychiatry 2023; 14:958015. [PMID: 36865079 PMCID: PMC9971505 DOI: 10.3389/fpsyt.2023.958015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 01/17/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Obsessions and compulsions are heterogenous but can be classified into obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder (HD), hair-pulling disorder (HPD), and skin-picking disorder (SPD). OCD is in itself heterogenous, with symptoms clustering around four major symptom dimensions: contamination/cleaning, symmetry/ordering, taboo obsessions, and harm/checking. No single self-report scale captures the full heterogeneity of OCD and related disorders, limiting assessment in clinical practice and research on nosological relations among the disorders. METHODS To provide a single self-report scale of OCD and related disorders that respects the heterogeneity of OCD, we expanded the DSM-5-based Obsessive-Compulsive and Related Disorders-Dimensional Scales (OCRD-D) so that is also includes the four major symptom dimensions of OCD. A psychometric evaluation and an exploration of the overarching relations among the dimensions were conducted using an online survey which was completed by 1,454 Spanish adolescents and adults (age span = 15-74 years). Approximately 8 months after the initial survey, 416 participants completed the scale again. RESULTS The expanded scale showed excellent internal psychometric properties, adequate test-retest correlations, known groups validity, and correlations in the expected directions with well-being, depression/anxiety symptoms, and satisfaction with life. The higher-order structure of the measure indicated that harm/checking and taboo obsessions formed a common disturbing thoughts factor and that HPD and SPD formed a common body-focused repetitive behaviors factor. CONCLUSION The expanded OCRD-D (OCRD-D-E) shows promise as a unified way to assess symptoms across the major symptom dimensions of OCD and related disorders. The measure may be useful in clinical practice (e.g., screening) and research, but more research on construct validity, incremental validity, and clinical utility is needed.
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Affiliation(s)
| | - José A Piqueras
- Health Psychology Department, Miguel Hernández University, Elche, Spain
| | | | | | - Matti Cervin
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Child and Adolescent Psychiatry, Lund, Sweden
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12
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Ribeiro AP, Piquet-Pessôa M, Félix-da-Silva C, Mühlbauer JFE, de-Salles-Andrade JB, Fontenelle LF. Subjective assessments of research domain criteria constructs in addiction and compulsive disorders: a scoping review protocol. BMJ Open 2022; 12:e059232. [PMID: 36028270 PMCID: PMC9422856 DOI: 10.1136/bmjopen-2021-059232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Obsessive-compulsive and related disorders (OCRDs) and disorders due to addictive behaviours (DABs) are prevalent conditions that share behavioural and neurobiological characteristics. The Research Domain Criteria lists a series of constructs whose dysfunctions may be present in both groups of disorders. The present study will describe the research protocol of a scoping review of the literature on self-report scales and questionnaires that tap dysfunctional constructs that underlie OCRDs and DABs. METHODS AND ANALYSIS This protocol outlines a scoping review on self-report tools and questionnaires that assess OCRDs and DABs-related constructs. The scoping review will select sources in MEDLINE, EMBASE, PsychINFO and Web of Science databases. Inclusion and exclusion criteria will be designed according to the Population, Concept, Context, Types of source framework. Two reviewers will screen independently titles, abstracts and full texts to determine the eligibility of articles. A methodological framework including six stages steps ((1) identifying a research question; (2) identifying relevant studies; (3) study selection; (4) charting the data; (5) collating, summarising and reporting the result) will be used, and the findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Information extracted will be collated, and quantitative results will be presented using descriptive statistics such as percentages, tables, charts and flow diagrams as appropriate. ETHICS AND DISSEMINATION Ethical approval for conducting this scoping review is not required, as this study will involve secondary analysis of existing literature. The researchers will disseminate the study results via conference presentations and publication in a peer-reviewed journal. SCOPING REVIEW PROTOCOL REGISTRATION DOI 10.17605/OSF.IO/UJ7G5.
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Affiliation(s)
- Ana Paula Ribeiro
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ) and D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Marcelo Piquet-Pessôa
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ) and D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Carina Félix-da-Silva
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ) and D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Julia Fernandes Eigenheer Mühlbauer
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ) and D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Juliana B de-Salles-Andrade
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ) and D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Leonardo F Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ) and D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
- Department of Psychiatry, Monash University School of Clinical Sciences at Monash Health, Clayton, Victoria, Australia
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13
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Krause S, Ouellet-Courtois C, Sandstrom A, Radomsky AS. Thinking About Disgust: Cognitive Processes Mediate the Associations Between Disgust Proneness and OCD Symptom Domains. Int J Cogn Ther 2022. [DOI: 10.1007/s41811-022-00138-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Miller ML, Roche AI, Lemon E, O'Hara MW. Obsessive-compulsive and related disorder symptoms in the perinatal period: prevalence and associations with postpartum functioning. Arch Womens Ment Health 2022; 25:771-780. [PMID: 35614279 PMCID: PMC11131363 DOI: 10.1007/s00737-022-01239-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/16/2022] [Indexed: 11/02/2022]
Abstract
Obsessive-compulsive disorder (OCD) symptoms are more likely to develop or be exacerbated during pregnancy and the postpartum period, which can cause significant distress and impairment. However, the disorders grouped with OCD in the DSM-5, obsessive-compulsive and related disorders (OCRD; e.g., hoarding disorder (HD), body dysmorphic disorder (BDD), trichotillomania (TTM), excoriation disorder (ED)), have rarely been examined in the perinatal period. This study aimed to explore (1) the prevalence of all clinically significant OCRD symptoms in pregnancy and the postpartum period and (2) the correlations between OCRD psychopathology and postpartum functioning. Participants were recruited during their second trimester of pregnancy from a Midwestern medical center. Participants completed an online questionnaire and a semi-structured clinical interview during pregnancy (28-32 weeks' gestation, N = 276) and the postpartum period (6-8 weeks, N = 221). BDD and OCD symptoms were the most prevalent. In pregnancy, 14.9% (N = 41) of participants endorsed clinically significant BDD symptoms and 6.2% (N = 17) endorsed clinically significant OCD symptoms. In the postpartum period, 11.8% (N = 26) endorsed clinically significant BDD symptoms and 14% (N = 31) endorsed clinically significant OCD symptoms. Poorer postpartum functioning was associated with elevated OCRD symptoms in pregnancy and postpartum. OCRD symptoms occur during pregnancy and the postpartum period at rates similar or higher than other life periods. Elevated OCRD symptoms are associated with poorer postpartum functioning across domains. Future research should explore how all OCRD symptoms may affect functioning in the perinatal period, not only OCD symptoms.
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Affiliation(s)
- Michelle L Miller
- University of Iowa, Iowa City, USA.
- Indiana University School of Medicine/IU Health Physicians, Goodman Hall/IU Health Neuroscience Center, Suite 2800, 355 W. 16th St, Indianapolis, IN, 46202, USA.
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15
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Tomiyama H, Murayama K, Nemoto K, Hasuzawa S, Mizobe T, Kato K, Matsuo A, Ohno A, Kang M, Togao O, Hiwatashi A, Ishigami K, Nakao T. Alterations of default mode and cingulo-opercular salience network and frontostriatal circuit: A candidate endophenotype of obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2022; 116:110516. [PMID: 35108587 DOI: 10.1016/j.pnpbp.2022.110516] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/04/2022] [Accepted: 01/20/2022] [Indexed: 12/12/2022]
Abstract
Background It is gradually becoming clear that obsessive-compulsive disorder (OCD) patients have aberrant resting-state large-scale intrinsic networks of cingulo-opercular salience (SN), default mode (DMN), and front-parietal network (FPN). However, it remains unknown whether unaffected first-degree relatives of OCD patients have these alterations as a vulnerability marker to the disorder. Methods We performed resting-state functional magnetic resonance imaging (rsfMRI) scans of 47 medication-free OCD patients, 21 unaffected healthy first-degree relatives of OCD patients, and 62 healthy control (HC) participants. We explored differences between the three groups in the functional connectivity from SN (seeds: anterior-insula (AI) and dorsal anterior cingulate cortex (dACC)), DMN (seeds: medial prefrontal cortex (MPFC) and posterior parietal cortex (PCC)), and FPN (seeds: dorsolateral prefrontal cortex (DLPFC)). Results Compared to HC, both OCD patients and first-degree relatives showed significantly greater functional connectivity between AI and PCC and between DLPFC and the thalamus. Compared to first-degree relatives and HC, OCD patients showed reduced functional connectivity between PCC and DLPFC, and this altered functional connectivity was negatively correlated with anxiety and depressive symptom within OCD group. Conclusions OCD patients and unaffected first-degree relatives of OCD patients showed overlapping alterations in resting state functional connectivity between the regions of SN and DMN and between DLPFC and the thalamus. Our results suggested that alterations between large-scale intrinsic networks and within the dorsal cognitive cortico-striato-thalamo-cortical (CSTC) circuit could represent endophenotype markers of OCD.
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Affiliation(s)
- Hirofumi Tomiyama
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Keitaro Murayama
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Faculty of Medicine, University of Tsukuba, Japan
| | - Suguru Hasuzawa
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Taro Mizobe
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Kenta Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Akira Matsuo
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Aikana Ohno
- Department of Psychology, Kyushu University, Japan
| | - Mingi Kang
- Department of Psychology, Kyushu University, Japan
| | - Osamu Togao
- Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Akio Hiwatashi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Japan.
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16
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Champion SM, Grisham JR. Excessive reassurance seeking versus compulsive checking in OCD: Comparing implicit motivators and mechanisms. J Behav Ther Exp Psychiatry 2022; 75:101720. [PMID: 34922212 DOI: 10.1016/j.jbtep.2021.101720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/29/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Excessive reassurance seeking (ERS) in OCD increases following scenarios with high threat and personal responsibility, but the mechanism via which ERS addresses these concerns is unclear. We investigated whether reassurance following OCD-related threats facilitated temporary threat re-appraisal and/or transferred responsibility to others. We also examined the 'checking by proxy' theory of OCD ERS by comparing the functional mechanisms of reassurance and checking behaviour. METHODS Community participants (N = 398) were recruited through MTurk and randomised to one of four conditions: ambiguous object-derived (checking) information, ambiguous person-derived (reassurance) information, unambiguous object-derived information and unambiguous person-derived information. Participants read scenarios that conveyed a risk of harm or contamination before imagining receiving reassurance or checking information as per their condition. Ratings of personal and external responsibility, threat likelihood and uncertainty were made before and after receiving the information. RESULTS In support of a checking by proxy hypothesis of ERS, participants in the unambiguous information conditions reported decreased uncertainty, decreased estimated threat likelihood and increased responsibility of others, regardless of whether they imagined checking or receiving reassurance. Those in the ambiguous conditions reported no changes in threat estimation or responsibility beliefs. OCD symptom level moderated responses to ambiguity: unlike low OCD, high OCD participants did not respond differentially to ambiguous versus unambiguous reassurance. LIMITATIONS The study was performed online due to Covid-19 restrictions and utilised non-clinical participants. CONCLUSIONS Like checking, reassurance facilitates short-term threat re-appraisal and diffuses responsibility following obsessive threats. Differentiated responses to reassurance ambiguity disappear as OC symptoms increase.
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17
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Understanding why people with OCD do what they do, and why other people get involved: supporting people with OCD and loved ones to move from safety-seeking behaviours to approach-supporting behaviours. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000186] [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 distress inherent in obsessive compulsive disorder (OCD) can often lead to partners, family members and friends becoming entangled with the OCD in terms of being drawn into performing certain behaviours to try and reduce the distress of their loved one. In the past this has often been referred to somewhat pejoratively as collusion, or more neutrally as accommodation. In this paper we emphasise that this is usually a natural human response to seeing a loved one in distress and wanting to help. This paper provides detailed clinical guidance on how to understand this involvement and how to include others in the treatment of OCD along with practical tips and hints around potential blocks that may require troubleshooting. It also details the relatively recently introduced concept of approach-supporting behaviours, and provides guidance on how to distinguish these from safety-seeking behaviours. The ‘special case’ of reassurance seeking is also discussed.
Key learning aims
(1)
To illustrate the importance of understanding the person’s OCD beliefs ‘from the inside’ including the internal logic that leads to specific behaviours.
(2)
To understand the ways that key individuals in the lives of people with OCD can become entangled with the OCD (through the best of intentions) and to provide practical clinical guidance for CBT therapists around how to engage and work with these individuals in the lives of people with OCD.
(3)
To explain and delineate the idea of approach-supporting behaviours, distinguishing these from safety-seeking behaviours.
(4)
To distinguish the interpersonal component of reassurance from the neutralisation component and provide guidance on how we can help family members to replace reassurance with something that is equally or more supportive whilst not maintaining the OCD.
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18
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Yaden DB, Earp D, Graziosi M, Friedman-Wheeler D, Luoma JB, Johnson MW. Psychedelics and Psychotherapy: Cognitive-Behavioral Approaches as Default. Front Psychol 2022; 13:873279. [PMID: 35677124 PMCID: PMC9169963 DOI: 10.3389/fpsyg.2022.873279] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
The acute subjective effects of psychedelics are responsive to users' expectations and surroundings (i.e., "set and setting"). Accordingly, a great deal of thought has gone into designing the psychosocial context of psychedelic administration in clinical settings. But what theoretical paradigms inform these considerations about set and setting? Here, we describe several historical, sociological influences on current psychedelic administration in mainstream European and American clinical research settings, including: indigenous practices, new age spirituality from the 1960s, psychodynamic/psychoanalytic approaches, and cognitive-behavioral approaches. We consider each of these paradigms and determine that cognitive-behavioral therapies, including newer branches such as acceptance and commitment therapy (ACT), have the strongest rationale for psychedelic-assisted psychotherapy going forward. Our primary reasons for advocating for cognitive-behavioral approaches include, (1) they avoid issues of cultural insensitivity, (2) they make minimal speculative assumptions about the nature of the mind and reality, (3) they have the largest base of empirical support for their safety and effectiveness outside of psychedelic therapy. We then propose several concepts from cognitive-behavioral therapies such as CBT, DBT, and ACT that can usefully inform the preparation, session, and integration phases of psychedelic psychotherapy. Overall, while there are many sources from which psychedelic psychotherapy could draw, we argue that current gold-standard, evidence-based psychotherapeutic paradigms provide the best starting point in terms of safety and efficacy.
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Affiliation(s)
- David B. Yaden
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Dylan Earp
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Marianna Graziosi
- Department of Clinical Psychology, Hofstra University, Hempstead, NY, United States
| | - Dara Friedman-Wheeler
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jason B. Luoma
- Portland Psychotherapy Clinic, Research, and Training Center, Portland, OR, United States
| | - Matthew W. Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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19
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Thompson BL. Is ACT-Informed Exposure a Viable Treatment for Excoriation Disorder? A Multiple Baseline Study. Behav Modif 2022; 47:71-92. [PMID: 35485352 DOI: 10.1177/01454455221091778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study piloted the use of ACT-informed exposure as an adjunct to habit reversal training (HRT) for excoriation disorder (ExD). Using a nonconcurrent multiple baseline single case design, four participants completed sessions of exposure and HRT. Repeated measures and self-report data were collected on skin picking and psychological flexibility. Two participants completed HRT followed by exposure, and two participants completed exposure followed by HRT. Results support the effectiveness of HRT in reducing picking. Results suggest exposure may have some impact in reducing picking, but effects were weaker compared to HRT. Contrary to predictions, repeated measures and self-report data did not indicate consistent improvement in psychological flexibility during exposure phases. As any reduction in picking may be clinically meaningful and all participants maintained gains at follow-up, there is some indication that exposure may be a second-line treatment worth further study. Limitations and future areas of research are discussed.
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Affiliation(s)
- Brian L Thompson
- Portland Psychotherapy Clinic, Research, & Training Center, OR, USA
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20
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Laurito LD, Loureiro CP, Faro L, Dias RV, Torres B, Moreira-de-Oliveira ME, Santos-Ribeiro SD, de Menezes GB, Fontenelle LF, Davis CH, Twohig MP. Acceptance and Commitment Therapy for obsessive compulsive disorder in a Brazilian context: Treatment of three cases. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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Rajabi S, Kamran L, Joukar KamalAbadi M. Epidemiology of body dysmorphic disorder among adolescents: A study of their cognitive functions. Brain Behav 2022; 12:e01710. [PMID: 35307985 PMCID: PMC9015000 DOI: 10.1002/brb3.1710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 05/02/2020] [Accepted: 05/16/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Body dysmorphic disorder (BDD) is characterized by a preoccupation with an imagined defect in one's appearance. In case of a slight physical anomaly, the person would experience an excessive concern. This disorder causes cognitive dysfunction. PURPOSE The aim of this study was to examine epidemiology of body dysmorphic disorder among students at secondary schools of the first and second stage in Shiraz, Iran. It also compares executive functions in students with BDD to healthy students. METHODS The Body Dysmorphic Disorder Questionnaire (BDDQ), Stroop Color and Word Test (SCWT),Wisconsin Card Sorting Test (WCST), Tower of London test (ToL), and Trail Making Test (TMT) were measured in participants with BDD (N = 52; Mage = 16.20; SD = 1.03) and healthy control group (N = 52; Mage = 15.91; SD = 0.96). RESULTS The frequency of BDD was significantly higher in women than men (14.8% vs. 6.8%), and its prevalence was 10.4% in total. There was a significant difference between the two groups of students concerning attentional set-shifting, inhibition of cognitive interference, visual-spatial searching, and sequencing, but not problem-solving tasks. CONCLUSIONS Students with BDD have cognitive deficits, which need to be addressed in cognitive rehabilitation.
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Affiliation(s)
- Soran Rajabi
- General Psychology, Persian Gulf University, Bushehr, Iran
| | - Leila Kamran
- General Psychology, Persian Gulf University, Bushehr, Iran
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22
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Şimşek MK, Seçer İ. Developing and Examining the Effectiveness of a Cognitive Behavioral Therapy-Based Psychoeducation Practice for Reducing Obsessive-Compulsive Symptoms in Adolescents: A Mixed-Methods Study With a Turkish Sample. Front Psychol 2022; 13:805035. [PMID: 35330724 PMCID: PMC8940527 DOI: 10.3389/fpsyg.2022.805035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 02/04/2022] [Indexed: 11/13/2022] Open
Abstract
This study developed a cognitive behavioral therapy (CBT)-based psychoeducation practice aimed at reducing obsessive-compulsive symptom levels in adolescents in Turkey and tested its effectiveness with a mixed-methods study. After the study was constructed as a pretest-posttest control group experimental application consisting of qualitative stages. The experimental application of the study was carried out with high school students in Turkey. In the sampling process, the schools, where the study will be carried out, were determined with the cluster sampling method. The experimental and control groups were formed with 30 students with high obsessive-compulsive disorder (OCD) symptoms from these schools, and the developed CBT-based psychoeducation practice was applied to the experimental group for 12 weeks. Quantitative data were collected through the "Child Version of the Obsessive-Compulsive Inventory," and normality analysis, t-test for dependent samples, and Single Factor Analysis of Covariance were used. Qualitative data of the study were collected through document review, session evaluation forms, and semi-structured interview protocol; content and descriptive analysis techniques were used in the analysis. It was concluded that the developed CBT-based psychoeducation application was an effective approach in reducing OCD symptoms in the Turkish adolescent sample, except for the neutralizing dimension. It was also determined that the findings obtained from the analysis during the application and the interviews after the application are parallel with the findings obtained by quantitative methods, and the qualitative and quantitative findings adequately explained the quantitative documents findings.
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Affiliation(s)
| | - İsmail Seçer
- Faculty of Education, Counseling and Guidance, Atatürk University, Erzurum, Turkey
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23
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Adolescent Girls' Body Dysmorphic Symptoms: A Path Analysis of Body Dysmorphic Disorder Based on Obsessive-Compulsive Symptoms, Obsessive and Metacognitive Beliefs. PSYCHOLOGICAL STUDIES 2022. [DOI: 10.1007/s12646-021-00631-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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24
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Wang P, Yan Z, Chen T, Cao W, Yang X, Meng F, Liu Y, Li Z. Visuospatial working memory capacity moderates the relationship between anxiety and OCD related checking behaviors. Front Psychiatry 2022; 13:1039849. [PMID: 36699497 PMCID: PMC9868399 DOI: 10.3389/fpsyt.2022.1039849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Compulsive checking behavior is the most prevalent compulsive behavior in patients with obsessive-compulsive disorder (OCD). While some studies have shown that anxiety and executive function influence compulsive checking behavior, the relationship between these constructs is inconclusive. Hence, we sought to explore the interplay between executive function, anxiety and compulsive checking behavior. MATERIALS AND METHODS 47 healthy participants (HC) and 51 patients with OCD participated in the study. Symptoms and emotional states were assessed using the Yale-Brown Obsessive Compulsive Scale, the Obsessive-Compulsive Inventory-Revised, the Beck Anxiety Inventory, and the Beck Depression Inventory. Participants also completed three tests of neuropsychological functioning: the Stop Signal Task, the Spatial working memory Task, and the Wisconsin card sorting test. We analyzed the relationships between anxiety, executive function, and compulsive checking symptoms. RESULTS Patients with OCD showed significantly greater anxiety (p < 0.001) and impairments in visuospatial working memory function (p = 0.030) compared to HC participants, while inhibition and set-shifting were not significantly different between the two groups. Visuospatial working memory was negatively related to compulsive checking behavior (p = 0.016). Visuospatial working memory also played a moderating role in the positive relationship between anxiety and compulsive checking behavior (β = -0.281, p = 0.022). CONCLUSION Anxiety symptoms play an important role in explaining compulsive checking behavior in patients with OCD who have relatively weak visuospatial working memory ability. These findings provide a foundation for further research regarding the roles of emotion and cognitive inflexibility in compulsive checking behavior in patients with OCD.
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Affiliation(s)
- Pengchong Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zijun Yan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Tao Chen
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Wenwen Cao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiangyun Yang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fanqiang Meng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuqing Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhanjiang Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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25
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Horesh D, Hasson-Ohayon I, Harwood-Gross A. The Contagion of Psychopathology across Different Psychiatric Disorders: A Comparative Theoretical Analysis. Brain Sci 2021; 12:67. [PMID: 35053808 PMCID: PMC8774068 DOI: 10.3390/brainsci12010067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/09/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022] Open
Abstract
Psychopathology is often studied and treated from an individual-centered approach. However, studies have shown that psychological distress is often best understood from a contextual, environmental perspective. This paper explores the literature on emotional contagion and symptom transmission in psychopathology, i.e., the complex ways in which one person's psychological distress may yield symptoms among others in his/her close environment. We argue that emotions, cognitions, and behaviors often do not stay within the borders of the individual, but rather represent intricate dynamic experiences that are shared by individuals, as well as transmitted between them. While this claim was comprehensively studied in the context of some disorders (e.g., secondary traumatization and the "mimicking" of symptoms among those close to a trauma survivor), it was very scarcely examined in the context of others. We aim to bridge this gap in knowledge by examining the literature on symptom transmission across four distinct psychiatric disorders: PTSD, major depression, OCD, and psychosis. We first review the literature on emotional contagion in each disorder separately, and then we subsequently conduct a comparative analysis highlighting the shared and differential mechanisms underlying these processes in all four disorders. In this era of transdiagnostic conceptualizations of psychopathology, such an examination is timely, and it may carry important clinical implications.
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Affiliation(s)
- Danny Horesh
- Department of Psychology, Bar-Ilan University, Ramat Gan 5290002, Israel; (I.H.-O.); (A.H.-G.)
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Ilanit Hasson-Ohayon
- Department of Psychology, Bar-Ilan University, Ramat Gan 5290002, Israel; (I.H.-O.); (A.H.-G.)
| | - Anna Harwood-Gross
- Department of Psychology, Bar-Ilan University, Ramat Gan 5290002, Israel; (I.H.-O.); (A.H.-G.)
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26
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Sharma E, Sharma LP, Balachander S, Lin B, Manohar H, Khanna P, Lu C, Garg K, Thomas TL, Au ACL, Selles RR, Højgaard DRMA, Skarphedinsson G, Stewart SE. Comorbidities in Obsessive-Compulsive Disorder Across the Lifespan: A Systematic Review and Meta-Analysis. Front Psychiatry 2021; 12:703701. [PMID: 34858219 PMCID: PMC8631971 DOI: 10.3389/fpsyt.2021.703701] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 10/20/2021] [Indexed: 11/14/2022] Open
Abstract
Comorbidities are seen with obsessive-compulsive disorder (OCD) across the lifespan. Neurodevelopmental comorbidities are common in young children, followed by mood, anxiety, and obsessive-compulsive related disorders (OCRDs) in children, adolescents and adults, and neurological and degenerative disorders in the elderly. Understanding comorbidity prevalence and patterns has clinical and research implications. We conducted a systematic review and meta-analysis on comorbidities in OCD across the lifespan, with the objective to, first, estimate age-wise pattern and prevalence of comorbidities with OCD and, second, to examine associations of demographic (age at assessment, gender distribution) and clinical characteristics (age of onset, illness severity) with comorbidities. Four electronic databases (PubMed, EMBASE, SCOPUS, and PsycINFO) were searched using predefined search terms for articles published between 1979 and 2020. Eligible studies, across age, reported original findings on comorbidities and had an OCD sample size of ≥100. We excluded studies that did not use standardised diagnostic assessments, or that excluded patients on the basis of comorbidity. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review protocol has been registered on the International Prospective Register of Systematic Reviews. A comorbidity rate of 69% was found in a pooled sample of more than 15,000 individuals. Mood disorders (major depressive disorder), anxiety disorders (generalised anxiety disorder), neurodevelopmental disorders (NDDs) and OCRDs were the commonest comorbidities. Anxiety disorders prevailed in children, mood disorders in adults, whereas NDDs were similarly prevalent. Higher comorbidity with any psychiatric illness, NDDs, and severe mental disorders was seen in males, vs. females. Illness severity was inversely associated with rates for panic disorder, tic disorders, OCRDs, obsessive compulsive personality disorder, and anorexia nervosa. This systematic review and meta-analysis provides base rates for comorbidities in OCD across the lifespan. This has implications for comprehensive clinical evaluation and management planning. The high variability in comorbidity rates suggests the need for quality, multi-centric, large studies, using prospective designs. Systematic Review Registration: Unique Identifier: CRD42020215904.
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Affiliation(s)
- Eesha Sharma
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Lavanya P. Sharma
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Srinivas Balachander
- Obsessive-Compulsive Disorders (OCD) Clinic, Accelerator Program for Discovery in Brain Disorders Using Stem Cells (ADBS), Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Boyee Lin
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Harshini Manohar
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Puneet Khanna
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Cynthia Lu
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Kabir Garg
- Oxleas National Health Service (NHS) Foundation Trust, London, United Kingdom
| | - Tony Lazar Thomas
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Anthony Chun Lam Au
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Robert R. Selles
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Davíð R. M. A. Højgaard
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Skejby, Denmark
| | | | - S. Evelyn Stewart
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Cooper SE, Dunsmoor JE. Fear conditioning and extinction in obsessive-compulsive disorder: A systematic review. Neurosci Biobehav Rev 2021; 129:75-94. [PMID: 34314751 PMCID: PMC8429207 DOI: 10.1016/j.neubiorev.2021.07.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/04/2021] [Accepted: 07/23/2021] [Indexed: 11/29/2022]
Abstract
Laboratory experiments using fear conditioning and extinction protocols help lay the groundwork for designing, testing, and optimizing innovative treatments for anxiety-related disorders. Yet, there is limited basic research on fear conditioning and extinction in obsessive-compulsive disorder (OCD). This is surprising because exposure-based treatments based on associative learning principles are among the most popular and effective treatment options for OCD. Here, we systematically review and critically assess existing aversive conditioning and extinction studies of OCD. Across 12 studies, there was moderate evidence that OCD is associated with abnormal acquisition of conditioned responses that differ from comparison groups. There was relatively stronger evidence of OCD's association with impaired extinction processes. This included multiple studies finding elevated conditioned responses during extinction learning and poorer threat/safety discrimination during recall, although a minority of studies yielded results inconsistent with this conclusion. Overall, the conditioning model holds value for OCD research, but more work is necessary to clarify emerging patterns of results and increase clinical translational utility to the level seen in other anxiety-related disorders. We detail limitations in the literature and suggest next steps, including modeling OCD with more complex conditioning methodology (e.g., semantic/conceptual generalization, avoidance) and improving individual-differences assessment with dimensional techniques.
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Affiliation(s)
- Samuel E Cooper
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, Austin, TX, 78712, USA.
| | - Joseph E Dunsmoor
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, Austin, TX, 78712, USA.
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28
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Mathew AS, Rech MA, Lee HJ. Evaluating the role of Approach-Avoidance Training on action-tendencies in individuals with skin-picking disorder: A preliminary randomized experiment. J Behav Addict 2021; 10:827-838. [PMID: 34388110 PMCID: PMC8997211 DOI: 10.1556/2006.2021.00031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/31/2021] [Accepted: 05/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Pathological skin-picking (PSP) or excoriation disorder is a destructive behavior that affects 1-2% of the general population. The purpose of this pilot study was to evaluate the effect of a computerized behavior modification task on action-tendencies (i.e., approach or avoidance) in adults with PSP. We aimed to modify these action-tendencies by having participants with PSP complete the Approach-Avoidance Training (AAT) task, using a joystick to simulate an approach (=pull) or avoidance (=push) response. METHOD Forty-five participants diagnosed with PSP were randomized to one of three training conditions: (1) Avoidance Training (AvT; n = 15), (2) Approach Training (ApT; n = 15), or (3) Placebo Training (PT; n = 15). We hypothesized that after training, those in the AvT would have the greatest reduction in behavioral approach (i.e., their overall reaction time [RT] to approach pictures of irregular skin stimuli). RESULTS Results of the pre-training assessment task revealed a positive correlation between behavioral approach to irregular skin stimuli and skin-picking severity as assessed by the Skin Picking Scale-Revised (SPS-R). After training, a lower behavioral approach and urges to pick were found in the AvT and PT groups, while those in the ApT reported higher behavioral approach and urges to pick. At two-week follow-up, no significant changes on the SPS-R were reported between groups. DISCUSSION Our preliminary data suggest that the AAT is a promising avenue of research to develop as a cognitive intervention to address an excessive behavioral approach tendency that characterizes skin-picking problems.
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Affiliation(s)
- Abel S. Mathew
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Madeline A. Rech
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Han-Joo Lee
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA,Corresponding author. E-mail:
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29
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Snorrason I, Beard C, Peckham AD, Björgvinsson T. Transdiagnostic dimensions in obsessive-compulsive and related disorders: associations with internalizing and externalizing symptoms. Psychol Med 2021; 51:1657-1665. [PMID: 32138800 DOI: 10.1017/s0033291720000380] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Hierarchical structural models of psychopathology rarely extend to obsessive-compulsive spectrum disorders. The current study sought to examine the higher-order structure of the obsessive-compulsive and related disorders (OCRDs) in DSM-5: obsessive-compulsive disorder (OCD), hoarding disorder (HD), body dysmorphic disorder (BDD), trichotillomania (hair-pulling disorder; HPD) and excoriation (skin-picking) disorder (SPD). METHODS Adult patients in a partial hospital program (N = 532) completed a dimensional measure of the five OCRDs. We used confirmatory factor analysis to identify the optimal model of the comorbidity structure. We then examined the associations between the transdiagnostic factors and internalizing and externalizing symptoms (i.e. depression, generalized anxiety, neuroticism, and drug/alcohol cravings). RESULTS The best fitting model included two correlated higher-order factors: an obsessions-compulsions (OC) factor (OCD, BDD, and HD), and a body-focused repetitive behavior (BFRB) factor (HPD and SPD). The OC factor, not the BFRB factor, had unique associations with internalizing symptoms (standardized effects = 0.42-0.66) and the BFRB factor, not the OC factor, had small marginally significant unique association with drug/alcohol cravings (standardized effect = 0.22, p = 0.088). CONCLUSIONS The results mirror findings from twin research and indicate that OCD, BDD, and HD share liability that is significantly associated with internalizing symptoms, but this liability may be relatively less important for BFRBs. Further research is needed to better examine the associations between BFRBs and addictive disorders.
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Affiliation(s)
- Ivar Snorrason
- McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Courtney Beard
- McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Andrew D Peckham
- McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Thröstur Björgvinsson
- McLean Hospital, Belmont, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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30
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de Brouwer G, Engelbrecht J, Mograbi DC, Legoabe L, Steyn SF, Wolmarans DW. Stereotypy and spontaneous alternation in deer mice and its response to anti-adenosinergic intervention. J Neurosci Res 2021; 99:2706-2720. [PMID: 34115897 DOI: 10.1002/jnr.24867] [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] [Received: 03/14/2021] [Revised: 05/05/2021] [Accepted: 05/11/2021] [Indexed: 12/24/2022]
Abstract
Repetitive behavioral phenotypes are a trait of several neuropsychiatric disorders, including obsessive-compulsive disorder (OCD). Such behaviors are typified by complex interactions between cognitive and neurobiological processes which most likely contribute to the suboptimal treatment responses often observed. To this end, exploration of the adenosinergic system may be useful, since adenosine-receptor modulation has previously shown promise to restore control over voluntary behavior and improve cognition in patients presenting with motor repetition. Here, we employed the deer mouse (Peromyscus maniculatus bairdii) model of compulsive-like behavioral persistence, seeking to investigate possible associations between stereotypic motor behavior and cognitive flexibility as measured in the T-maze continuous alternation task (T-CAT). The effect of istradefylline, a selective adenosine A2A receptor antagonist at two doses (10 and 20 mg kg-1 day-1 ) on the expression of stereotypy and T-CAT performance in high (H) and non-(N) stereotypical animals, was investigated in comparison to a control intervention (six groups; n = 8 or 9 per group). No correlation between H behavior and T-CAT performance was found. However, H but not N animals presented with istradefylline-sensitive spontaneous alternation and stereotypy, in that istradefylline at both doses significantly improved the spontaneous alternation scores and attenuated the stereotypical expression of H animals. Thus, evidence is presented that anti-adenosinergic drug action improves repetitive behavior and spontaneous alternation in stereotypical deer mice, putatively pointing to a shared psychobiological construct underlying naturalistic stereotypy and alterations in cognitive flexibility in deer mice.
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Affiliation(s)
- Geoffrey de Brouwer
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Jaco Engelbrecht
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Daniel C Mograbi
- Department of Psychology, Pontifícia Universidade Católica - Rio (PUC-Rio), Rio de Janeiro, Brazil.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Lesetja Legoabe
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Stephan F Steyn
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - De Wet Wolmarans
- Center of Excellence for Pharmaceutical Sciences, Department of Pharmacology, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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31
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Houazene S, Leclerc J, O’Connor K, Aardema F. “Shame on you”: The impact of shame in body-focused repetitive behaviors and binge eating. Behav Res Ther 2021; 138:103804. [DOI: 10.1016/j.brat.2021.103804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/08/2020] [Accepted: 01/04/2021] [Indexed: 11/25/2022]
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32
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Stamatis CA, Batistuzzo MC, Tanamatis T, Miguel EC, Hoexter MQ, Timpano KR. Using supervised machine learning on neuropsychological data to distinguish OCD patients with and without sensory phenomena from healthy controls. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2020; 60:77-98. [PMID: 33300635 DOI: 10.1111/bjc.12272] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 11/17/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES While theoretical models link obsessive-compulsive disorder (OCD) with executive function deficits, empirical findings from the neuropsychological literature remain mixed. These inconsistencies are likely exacerbated by the challenge of high-dimensional data (i.e., many variables per subject), which is common across neuropsychological paradigms and necessitates analytical advances. More unique to OCD is the heterogeneity of symptom presentations, each of which may relate to distinct neuropsychological features. While researchers have traditionally attempted to account for this heterogeneity using a symptom-based approach, an alternative involves focusing on underlying symptom motivations. Although the most studied symptom motivation involves fear of harmful events, 60-70% of patients also experience sensory phenomena, consisting of uncomfortable sensations or perceptions that drive compulsions. Sensory phenomena have received limited attention in the neuropsychological literature, despite evidence that symptoms motivated by these experiences may relate to distinct cognitive processes. METHODS Here, we used a supervised machine learning approach to characterize neuropsychological processes in OCD, accounting for sensory phenomena. RESULTS Compared to logistic regression and other algorithms, random forest best differentiated healthy controls (n = 59; balanced accuracy = .70), patients with sensory phenomena (n = 29; balanced accuracy = .59), and patients without sensory phenomena (n = 46; balanced accuracy = .62). Decision-making best distinguished between groups based on sensory phenomena, and among the patient subsample, those without sensory phenomena uniquely displayed greater risk sensitivity compared to healthy controls (d = .07, p = .008). CONCLUSIONS Results suggest that different cognitive profiles may characterize patients motivated by distinct drives. The superior performance and generalizability of the newer algorithms highlights the utility of considering multiple analytic approaches when faced with complex data. PRACTITIONER POINTS Practitioners should be aware that sensory phenomena are common experiences among patients with OCD. OCD patients with sensory phenomena may be distinguished from those without based on neuropsychological processes.
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Affiliation(s)
- Caitlin A Stamatis
- Department of Psychology, University of Miami, Florida, USA.,Weill Cornell Medicine/NewYork-Presbyterian Hospital, USA
| | | | - Tais Tanamatis
- Department of Psychiatry, University of São Paulo, Brazil
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33
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Schaumberg K, Reilly EE, Gorrell S, Levinson CA, Farrell NR, Brown TA, Smith KM, Schaefer LM, Essayli JH, Haynos AF, Anderson LM. Conceptualizing eating disorder psychopathology using an anxiety disorders framework: Evidence and implications for exposure-based clinical research. Clin Psychol Rev 2020; 83:101952. [PMID: 33221621 DOI: 10.1016/j.cpr.2020.101952] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022]
Abstract
Eating disorders (EDs) and anxiety disorders (ADs) evidence shared risk and significant comorbidity. Recent advances in understanding of anxiety-based disorders may have direct application to research and treatment efforts for EDs. The current review presents an up-to-date, behavioral conceptualization of the overlap between anxiety-based disorders and EDs. We identify ways in which anxiety presents in EDs, consider differences between EDs and ADs relevant to treatment adaptions, discuss how exposure-based strategies may be adapted for use in ED treatment, and outline directions for future mechanistic, translational, and clinical ED research from this perspective. Important research directions include: simultaneous examination of the extent to which EDs are characterized by aberrant avoidance-, reward-, and/or habit-based neurobiological and behavioral processes; improvement in understanding of how nutritional status interacts with neurobiological characteristics of EDs; incorporation of a growing knowledge of biobehavioral signatures in ED treatment planning; development of more comprehensive exposure-based treatment approaches for EDs; testing whether certain exposure interventions for AD are appropriate for EDs; and improvement in clinician self-efficacy and ability to use exposure therapy for EDs.
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Affiliation(s)
| | | | - Sasha Gorrell
- University of California, San Francisco, United States of America
| | - Cheri A Levinson
- University of Louisville, Department of Psychological & Brain Sciences, United States of America
| | | | - Tiffany A Brown
- University of California, San Diego, United States of America
| | - Kathryn M Smith
- Sanford Health, United States of America; University of Southern California, United States of America
| | | | | | - Ann F Haynos
- University of Minnesota, United States of America
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34
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Kogan CS, Stein DJ, Rebello TJ, Keeley JW, Chan KJ, Fineberg NA, Fontenelle LF, Grant JE, Matsunaga H, Simpson HB, Thomsen PH, van den Heuvel OA, Veale D, Grenier J, Kulygina M, Matsumoto C, Domínguez-Martínez T, Stona AC, Wang Z, Reed GM. Accuracy of diagnostic judgments using ICD-11 vs. ICD-10 diagnostic guidelines for obsessive-compulsive and related disorders. J Affect Disord 2020; 273:328-340. [PMID: 32560926 DOI: 10.1016/j.jad.2020.03.103] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/28/2020] [Accepted: 03/28/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND We report results of an internet-based field study evaluating the diagnostic guidelines for the newly introduced ICD-11 grouping of obsessive-compulsive and related disorders (OCRD). We examined accuracy of clinicians' diagnostic judgments applying draft ICD-11 as compared to the ICD-10 diagnostic guidelines to standardized case vignettes. METHODS 1,717 mental health professionals who are members of the World Health Organization's Global Clinical Practice Network completed the study in Chinese, English, French, Japanese, Russian or Spanish. Participants were randomly assigned to apply ICD-11 or ICD-10 guidelines to one of nine pairs of case vignettes. RESULTS Participants using ICD-11 outperformed those using ICD-10 in correctly identifying newly introduced OCRD, although results were mixed for differentiating OCRD from disorders in other groupings largely due to clinicians having difficulty differentiating challenging presentations of OCD. Clinicians had difficulty applying a three-level insight qualifier, although the 'poor to absent' level assisted with differentiating OCRD from psychotic disorders. Brief training on the rationale for an OCRD grouping did not improve diagnostic accuracy suggesting sufficient detail of the proposed guidelines. LIMITATIONS Standardized case vignettes were manipulated to include specific characteristics; the degree of accuracy of clinicians' diagnostic judgments about these vignettes may not generalize to application in routine clinical practice. CONCLUSIONS Overall, use of the ICD-11 guidelines resulted in more accurate diagnosis of case vignettes compared to the ICD-10 guidelines, particularly in differentiating OCRD presentations from one another. Specific areas in which the ICD-11 guidelines did not perform as intended provided the basis for further revisions to the guidelines.
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Affiliation(s)
- Cary S Kogan
- School of Psychology, Faculty of Social Sciences, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON K1N 6N5, Canada.
| | - Dan J Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, University of Cape Town Dept of Psychiatry & Neuroscience Institute, Groote Schuur Hospital, J-Block, Anzio Road, Observatory 7925, Cape Town, South Africa.
| | - Tahilia J Rebello
- Global Mental Health Program, Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, Mailman School of Public Health, 722 West 168th, Floor R2, R-233, New York, NY 10032, USA.
| | - Jared W Keeley
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin St, Box 842018, Richmond, VA 23284, USA.
| | - K Jacky Chan
- School of Psychology, Faculty of Social Sciences, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON K1N 6N5, Canada.
| | - Naomi A Fineberg
- Highly Specialized Obsessive Compulsive and Related Disorders Service, Hertfordshire Partnership University NHS Foundation Trust, Rosanne House, Welwyn Garden City, UK; Postgraduate Medical School, University of Hertfordshire, Hatfield, UK; University of Cambridge School of Clinical Medicine, Cambridge, UK.
| | - Leonardo F Fontenelle
- Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil; "D'Or' Institute for Research and Education, Rio de Janeiro, RJ, Brazil; School of Psychological Sciences, Monash University, Melbourne, Australia.
| | - Jon E Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA.
| | - Hisato Matsunaga
- Department of Neuropsychiatry, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya Hyogo, Japan.
| | - H Blair Simpson
- College of Physicians and Surgeons, Columbia University, New York, NY, USA; Anxiety Disorders Clinic and the Center for OCD and Related Disorders, New York State Psychiatric Institute, New York, NY, USA.
| | - Per Hove Thomsen
- Department for Child and Adolescent Psychiatry, Aarhus University Hospital, Skejby, Aarhus, Denmark.
| | - Odile A van den Heuvel
- Amsterdam University Medical Centers, Vrije Universiteit, Department of Psychiatry and Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, the Netherlands.
| | - David Veale
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Center for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, London, UK.
| | - Jean Grenier
- Institut du Savoir Montfort - Hôpital Montfort and Université d'Ottawa, Ottawa, Ontario, Canada.
| | - Mayya Kulygina
- Alekseev Mental Health Clinic, No. 1, Education Centre, Moscow, Russian Federation.
| | - Chihiro Matsumoto
- National Study Coordinator for ICD-11 Field Studies, ICD-11 Committee, Japanese Society of Psychiatry and Neurology, Hongo-Yumicho Building, 2-38-4, Hongo, Bunkyo-ku, Tokyo 113-0033. Japan.
| | - Tecelli Domínguez-Martínez
- Center for Research on Global Mental Health, Direction of Epidemiology and Psychosocial Research, National Institute of Psychiatry "Ramón de la Fuente Muñiz", Mexico City, Mexico.
| | - Anne-Claire Stona
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore.
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai 200030, PR China.
| | - Geoffrey M Reed
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA; Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.
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Yeager V, Bogoyas M, Goubran B, Gonzalez L, Ferrer GF. Olanzapine as an Adjunct in the Management of Refractory Psychogenic Excoriation With Comorbid Schizophrenia: A Case Report. Cureus 2020; 12:e8772. [PMID: 32742822 PMCID: PMC7384453 DOI: 10.7759/cureus.8772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Neurotic or psychogenic excoriation (PE) is one of the most commonly diagnosed skin disorders associated with a primary psychiatric condition. PE is characterized by excessive picking and scratching of normal-appearing skin, and is often comorbid or is an inherent manifestation of affective disturbance and psychosis itself in schizophrenia. Evidence in the literature has demonstrated the therapeutic efficacy of selective serotonin reuptake inhibitors (SSRI) in treating PE. Other pharmacological treatments that have shown therapeutic benefits in case reports include doxepin, clomipramine, naltrexone, pimozide, and olanzapine. However, using adjunct therapeutic methods or augmentation in the treatment of neurogenic excoriation in the setting of schizophrenia is still not well explored. In this study, we discuss the case of a 59-year-old medically complex paraplegic male with schizophrenia comorbid with severe refractory PE. The patient had poor adherence to psychopharmacological treatment. Consequently, the patient was repeatedly hospitalized due to acute exacerbations of schizophrenic episodes and self-mutilation due to PE. After several failed treatment approaches, olanzapine 10 mg PO BID was added as an adjunct therapy to the Haldol® Decanoate (Janssen Pharmaceutica, Beerse, Belgium) at a dosage of 100 mg/month intramuscularly to control the acute PE symptoms. This treatment modality proved successful in this case, and the patient has been free from PE relapse for over one year of close follow-up. Olanzapine along with Haldol Decanoate long-acting injectable (LAI), might, therefore, be a useful adjunct therapeutic modality for patients with refractory PE with a comorbid diagnosis of schizophrenia and warrants further research.
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Affiliation(s)
| | | | - Bishoy Goubran
- Division of Clinical and Translational Research, Larkin Community Hospital, Miami, USA
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36
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Hartmann AS, Staufenbiel T, Bielefeld L, Buhlmann U, Heinrichs N, Martin A, Ritter V, Kollei I, Grocholewski A. An empirically derived recommendation for the classification of body dysmorphic disorder: Findings from structural equation modeling. PLoS One 2020; 15:e0233153. [PMID: 32492037 PMCID: PMC7269265 DOI: 10.1371/journal.pone.0233153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 04/29/2020] [Indexed: 01/10/2023] Open
Abstract
Body dysmorphic disorder (BDD), together with its subtype muscle dysmorphia (MD), has been relocated from the Somatoform Disorders category in the DSM-IV to the newly created Obsessive-Compulsive and Related Disorders category in the DSM-5. Both categorizations have been criticized, and an empirically derived classification of BDD is lacking. A community sample of N = 736 participants completed an online survey assessing different psychopathologies. Using a structural equation modeling approach, six theoretically derived models, which differed in their allocation of BDD symptoms to various factors (i.e. general psychopathology, somatoform, obsessive-compulsive and related disorders, affective, body image, and BDD model) were tested in the full sample and in a restricted sample (n = 465) which indicated primary concerns other than shape and weight. Furthermore, measurement invariance across gender was examined. Of the six models, only the body image model showed a good fit (CFI = 0.972, RMSEA = 0.049, SRMR = 0.027, TLI = 0.959), and yielded better AIC and BIC indices than the competing models. Analyses in the restricted sample replicated these findings. Analyses of measurement invariance of the body image model showed partial metric invariance across gender. The findings suggest that a body image model provides the best fit for the classification of BDD and MD. This is in line with previous studies showing strong similarities between eating disorders and BDD, including MD. Measurement invariance across gender indicates a comparable presentation and comorbid structure of BDD in males and females, which also corresponds to the equal prevalence rates of BDD across gender.
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Affiliation(s)
| | | | - Lukas Bielefeld
- Institute of Psychology, Osnabrück University, Osnabrück, Germany
| | - Ulrike Buhlmann
- Institute of Psychology, Münster University, Münster, Germany
| | - Nina Heinrichs
- Department of Psychology, University of Bremen, Bremen, Germany
| | - Alexandra Martin
- Institute of Psychology, Wuppertal University, Wuppertal, Germany
| | - Viktoria Ritter
- Institute of Psychology, Goethe University Frankfurt, Frankfurt, Germany
| | - Ines Kollei
- Institute of Psychology, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Anja Grocholewski
- Institute of Psychology, Technische Universität Braunschweig, Brunswick, Germany
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Naturalistic operant responses in deer mice (Peromyscus maniculatus bairdii) and its response to outcome manipulation and serotonergic intervention. Behav Pharmacol 2020; 31:343-358. [DOI: 10.1097/fbp.0000000000000536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abstract
Is there a clear line between normal and abnormal mood? Studies of manifest and latent structure provide strong support for a continuum that extends from asymptomatic to subsyndromal to syndromal cases of increasing severity. Subsyndromal symptoms are impairing, predict syndrome onset and relapse, and account for more doctor's visits and suicide attempts than the full syndromes, yet they are not recognized in the current classification. For most research and some clinical activities, dimensional diagnoses are recommended, and examples are offered for how such diagnoses could be made. For clinical activities requiring decisions, a multithreshold model is proposed in which both lower (e.g., mild depression, capturing subsyndromal cases) and upper (e.g., major depression, capturing clinically significant cases) diagnostic categories are used to inform clinical care. Beyond its implications for diagnosis, the dimensionality of depression and anxiety has implications for etiology and for research aimed at understanding how emotions become disrupted in psychopathology.
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Affiliation(s)
- Ayelet Meron Ruscio
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6018, USA;
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A critical inquiry into marble-burying as a preclinical screening paradigm of relevance for anxiety and obsessive-compulsive disorder: Mapping the way forward. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2020; 19:1-39. [PMID: 30361863 DOI: 10.3758/s13415-018-00653-4] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Rodent marble-burying behavior in the marble-burying test (MBT) is employed as a model or measure to study anxiety- and compulsive-like behaviors or anxiolytic and anticompulsive drug action. However, the test responds variably to a range of pharmacological interventions, and little consensus exists regarding specific methodologies for its execution. Regardless, the test is widely applied to investigate the effects of pharmacological, genetic, and behavioral manipulations on purported behaviors related to the said neuropsychiatric constructs. Therefore, in the present review we attempt to expound the collective translational significance of the MBT. We do this by (1) reviewing burying behavior as a natural behavioral phenotype, (2) highlighting key aspects of anxiety and obsessive-compulsive disorder from a translational perspective, (3) reviewing the history and proof of concept of the MBT, (4) critically appraising potential methodological confounds in execution of the MBT, and (5) dissecting responses of the MBT to various pharmacological interventions. We conclude by underlining that the collective translational value of the MBT will be strengthened by contextually valid experimental designs and objective reporting of data.
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Wilton EP, Flessner CA, Brennan E, Murphy Y, Walther M, Garcia A, Conelea C, Dickstein DP, Stewart E, Benito K, Freeman JB. A Neurocognitive Comparison of Pediatric Obsessive-Compulsive Disorder and Trichotillomania (Hair Pulling Disorder). JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:733-744. [DOI: 10.1007/s10802-020-00627-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
PURPOSE OF REVIEW Studies on the relations between shame and anxiety and obsessive-compulsive and related disorders (OCRDs) are reviewed, with a focus on recent work. RECENT FINDINGS Medium-sized positive correlations have been consistently found across anxiety disorders and OCRDs, suggesting that this relation is transdiagnostic. Most studies focused on shame-proneness and found similar relations across multiple types (e.g. internal, external) and domains (e.g. bodily, characterological, behavioural) of shame, with little variation between clinical and non-clinical populations and different age categories. However, most studies are cross-sectional and correlational and by separately studying clinical and non-clinical populations, they do not give a unitary dimensional view of the relation between shame and symptoms. Emerging findings suggest that shame may be a marker of the response to treatment in these disorders, and its relation with symptoms may be bidirectional. The consistent but medium-sized associations between shame and symptoms of anxiety and OCRDs warrant the future search for mediators and moderators.
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Affiliation(s)
- Aurora Szentágotai-Tătar
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania. .,The Institute for Research, Development and Innovation in Applied Natural Sciences, Babeş-Bolyai University, Cluj-Napoca, Romania.
| | - Diana-Mirela Nechita
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania.,International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeş-Bolyai University, Cluj-Napoca, Romania
| | - Andrei C Miu
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania.,Cognitive Neuroscience Laboratory, Babeș-Bolyai University, Cluj-Napoca, Romania
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van Staden C, de Brouwer G, Botha TL, Finger-Baier K, Brand SJ, Wolmarans D. Dopaminergic and serotonergic modulation of social reward appraisal in zebrafish (Danio rerio) under circumstances of motivational conflict: Towards a screening test for anti-compulsive drug action. Behav Brain Res 2020; 379:112393. [PMID: 31785362 DOI: 10.1016/j.bbr.2019.112393] [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] [Received: 09/26/2019] [Revised: 11/26/2019] [Accepted: 11/26/2019] [Indexed: 01/04/2023]
Abstract
Cognitive flexibility, shown to be impaired in patients presenting with compulsions, is dependent on balanced dopaminergic and serotonergic interaction. Towards the development of a zebrafish (Danio rerio) screening test for anti-compulsive drug action, we manipulated social reward appraisal under different contexts by means of dopaminergic (apomorphine) and serotonergic (escitalopram) intervention. Seven groups of zebrafish (n = 6 per group) were exposed for 24 days (1 h per day) to either control (normal tank water), apomorphine (50 or 100 μg/L), escitalopram (500 or 1000 μg/L) or a combination (A100/E500 or A100/E1000 μg/L). Contextual reward appraisal was assessed over three phases i.e. Phase 1 (contingency association), Phase 2 (dissociative testing), and Phase 3 (re-associative testing). We demonstrate that 1) sight of social conspecifics is an inadequate motivational reinforcer under circumstances of motivational conflict, 2) dopaminergic and serotonergic intervention lessens the importance of an aversive stimulus, increasing the motivational valence of social reward, 3) while serotoninergic intervention maintains reward directed behavior, high-dose dopaminergic intervention bolsters cue-directed responses and 4) high-dose escitalopram reversed apomorphine-induced behavioral inflexibility. The results reported here are supportive of current dopamine-serotonin opponency theories and confirm the zebrafish as a potentially useful species in which to investigate compulsive-like behaviors.
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Affiliation(s)
- C van Staden
- Centre of Excellence for Pharmaceutical Sciences, Department of Pharmacology, North-West University, Potchefstroom, South Africa
| | - G de Brouwer
- Centre of Excellence for Pharmaceutical Sciences, Department of Pharmacology, North-West University, Potchefstroom, South Africa
| | - T L Botha
- Water Research Group, Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| | - K Finger-Baier
- Department Genes - Circuits - Behavior, Max Planck Institute of Neurobiology, Martinsried, Germany
| | - S J Brand
- Water Research Group, Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| | - D Wolmarans
- Centre of Excellence for Pharmaceutical Sciences, Department of Pharmacology, North-West University, Potchefstroom, South Africa.
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Cervin M, Perrin S, Olsson E, Claesdotter-Knutsson E, Lindvall M. Incompleteness, harm avoidance, and disgust: A comparison of youth with OCD, anxiety disorders, and no psychiatric disorder. J Anxiety Disord 2020; 69:102175. [PMID: 31896022 DOI: 10.1016/j.janxdis.2019.102175] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 11/12/2019] [Accepted: 12/16/2019] [Indexed: 11/24/2022]
Abstract
Psychological models of pediatric obsessive-compulsive disorder (OCD) place a heavy emphasis on harm avoidance as a maintaining factor and target for treatment. Incompleteness and disgust may also play a role in pediatric OCD but remain understudied. Youth with OCD (n = 100), anxiety disorders (n = 96), and no impairing psychiatric symptoms (n = 25) completed self-report measures of trait-level incompleteness, harm avoidance, and disgust and current symptoms of OCD, anxiety, and depression. Group differences and associations between emotions, symptoms, and pre- to post-treatment change in overall OCD severity were examined. Youth with OCD and anxiety disorders scored higher on harm avoidance and disgust than youth with no psychiatric disorder. Youth with OCD scored higher on incompleteness than youth with anxiety disorders and youth with no psychiatric disorder. Harm avoidance showed unique associations to self-reported symptoms of OCD, anxiety, and depression while incompleteness was uniquely related to OCD and disgust to anxiety. Within the OCD sample, incompleteness and harm avoidance were differentially related to the major OCD symptom dimensions, and change in incompleteness was uniquely related to pre- to post-treatment change in OCD severity. Trait-level incompleteness appears to play a central role in pediatric OCD and studies investigating its direct involvement in symptoms and associations with treatment outcome are needed. The role of disgust in relation to pediatric OCD remains unclear.
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Affiliation(s)
- Matti Cervin
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund, Sweden; Skåne Child and Adolescent Psychiatry, Lund, Sweden.
| | - Sean Perrin
- Lund University, Department of Psychology, Lund, Sweden
| | - Elin Olsson
- Skåne Child and Adolescent Psychiatry, Lund, Sweden
| | - Emma Claesdotter-Knutsson
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund, Sweden; Skåne Child and Adolescent Psychiatry, Lund, Sweden
| | - Magnus Lindvall
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund, Sweden; Skåne Child and Adolescent Psychiatry, Lund, Sweden
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Scheepers IM, Cryan JF, Bastiaanssen TFS, Rea K, Clarke G, Jaspan HB, Harvey BH, Hemmings SMJ, Santana L, van der Sluis R, Malan-Müller S, Wolmarans DW. Natural compulsive-like behaviour in the deer mouse (Peromyscus maniculatus bairdii) is associated with altered gut microbiota composition. Eur J Neurosci 2019; 51:1419-1427. [PMID: 31663195 DOI: 10.1111/ejn.14610] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 10/18/2019] [Accepted: 10/22/2019] [Indexed: 12/14/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a psychiatric illness that significantly impacts affected patients and available treatments yield suboptimal therapeutic response. Recently, the role of the gut-brain axis (GBA) in psychiatric illness has emerged as a potential target for therapeutic exploration. However, studies concerning the role of the GBA in OCD are limited. To investigate whether a naturally occurring obsessive-compulsive-like phenotype in a rodent model, that is large nest building in deer mice, is associated with perturbations in the gut microbiome, we investigated and characterised the gut microbiota in specific-pathogen-free bred and housed large (LNB) and normal (NNB) nest-building deer mice of both sexes (n = 11 per group, including three males and eight females). Following baseline characterisation of nest-building behaviour, a single faecal sample was collected from each animal and the gut microbiota analysed. Our results reveal the overall microbial composition of LNB animals to be distinctly different compared to controls (PERMANOVA p < .05). While no genera were found to be significantly differentially abundant after correcting for multiple comparisons, the normal phenotype showed a higher loading of Prevotella and Anaeroplasma, while the OC phenotype demonstrated a higher loading of Desulfovermiculus, Aestuariispira, Peptococcus and Holdemanella (cut-off threshold for loading at 0.2 in either the first or second component of the PCA). These findings not only provide proof-of-concept for continued investigation of the GBA in OCD, but also highlight a potential underlying aetiological association between alterations in the gut microbiota and the natural development of obsessive-compulsive-like behaviours.
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Affiliation(s)
- Isabella M Scheepers
- Centre of Excellence for Pharmaceutical Sciences, North West-University, Potchefstroom, South Africa
| | - John F Cryan
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Thomaz F S Bastiaanssen
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
| | - Kieran Rea
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Gerard Clarke
- APC Microbiome Ireland, University College Cork, Cork, Ireland.,Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
| | - Heather B Jaspan
- Institute of Infectious Disease and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.,Seattle Children's Research Institute, University of Washington, Seattle, WA, USA
| | - Brian H Harvey
- Centre of Excellence for Pharmaceutical Sciences, North West-University, Potchefstroom, South Africa.,MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Sian M J Hemmings
- Department of Psychiatry, Stellenbosch University, Tygerberg, South Africa
| | - Leonard Santana
- Unit for Business Mathematics and Informatics, North-West University, Potchefstroom, South Africa
| | - Rencia van der Sluis
- Focus area for Human Metabolomics, North-West University, Potchefstroom, South Africa
| | | | - De Wet Wolmarans
- Centre of Excellence for Pharmaceutical Sciences, North West-University, Potchefstroom, South Africa
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46
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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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47
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Oliveirra ECB, Fitzpatrick CL, Kim HS, Gulassa DCR, Amaral RS, Cristiana NDM, Hayashiuchi AY, McGrath DS, Tavares H. Obsessive-compulsive or addiction? Categorical diagnostic analysis of excoriation disorder compared to obsessive-compulsive disorder and gambling disorder. Psychiatry Res 2019; 281:112518. [PMID: 31546148 DOI: 10.1016/j.psychres.2019.112518] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 08/04/2019] [Accepted: 08/10/2019] [Indexed: 11/25/2022]
Abstract
Excoriation disorder (ED) is currently classified in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders' Obsessive-compulsive and Related Disorders section (OCRD). However, there remain debates regarding whether ED is related to obsessive-compulsive disorder (OCD) or whether it is better conceptualized as a behavioral addiction. The present research compared the diagnostic overlap and psychiatric comorbidities of 121 individuals seeking treatment for ED (n = 40), OCD (n = 41) and gambling disorder (GD) (n = 40). ED was more likely to overlap with OCD (n = 14) than GD (n = 3). Compared to OCD, ED had similar frequencies of other body focused repetitive behaviors (BFRBs), but higher frequency of addictive behaviors (Odds Ratio - OR = 11.82). In comparison to GD, ED had similar frequencies of addictive behaviors, but higher frequency of BFRBs (OR=19.67). The results support the recent classification of ED as an OCRD. However, ED presents an association with behavioral addictions that suggests a mixed impulsive-compulsive nature. A limitation of the present research was the use of a non-validated semi-structured clinical interview to diagnose impulse control disorders. Future research should examine other characteristics (e.g., epidemiology, neurobiology, genetics, treatment response) to further investigate whether ED should remain classified as an OCRD.
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Affiliation(s)
- Elen Cristina Batista Oliveirra
- Programa Ambulatorial de Transtornos do Impulso (PRO-AMITI), Instituto de Psiquiatria (IPq), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Artur de Azevedo, 145, Cerqueira Cesar, CEP: 05404-010, Sao Paulo, SP, Brazil.
| | | | - Hyoun S Kim
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Daniel Carr Ribeiro Gulassa
- Programa Ambulatorial de Transtornos do Impulso (PRO-AMITI), Instituto de Psiquiatria (IPq), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Artur de Azevedo, 145, Cerqueira Cesar, CEP: 05404-010, Sao Paulo, SP, Brazil
| | - Roberta Souza Amaral
- Programa Ambulatorial de Transtornos do Impulso (PRO-AMITI), Instituto de Psiquiatria (IPq), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Artur de Azevedo, 145, Cerqueira Cesar, CEP: 05404-010, Sao Paulo, SP, Brazil
| | - Nicoli de Mattos Cristiana
- Programa Ambulatorial de Transtornos do Impulso (PRO-AMITI), Instituto de Psiquiatria (IPq), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Artur de Azevedo, 145, Cerqueira Cesar, CEP: 05404-010, Sao Paulo, SP, Brazil
| | - Ana Yaemi Hayashiuchi
- Programa Ambulatorial de Transtornos do Impulso (PRO-AMITI), Instituto de Psiquiatria (IPq), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Artur de Azevedo, 145, Cerqueira Cesar, CEP: 05404-010, Sao Paulo, SP, Brazil
| | - Daniel S McGrath
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Hermano Tavares
- Programa Ambulatorial de Transtornos do Impulso (PRO-AMITI), Instituto de Psiquiatria (IPq), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Rua Artur de Azevedo, 145, Cerqueira Cesar, CEP: 05404-010, Sao Paulo, SP, Brazil
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Olatunji BO, Christian C, Brosof L, Tolin DF, Levinson CA. What is at the core of OCD? A network analysis of selected obsessive-compulsive symptoms and beliefs. J Affect Disord 2019; 257:45-54. [PMID: 31299404 DOI: 10.1016/j.jad.2019.06.064] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/01/2019] [Accepted: 06/30/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a heterogeneous condition that consists of distinct subtypes, and identification of its core symptoms may inform how to best conceptualize the heterogeneity. Accordingly, we used network analysis to evaluate which symptoms (and associations between symptoms) are most central to OCD symptoms and beliefs. METHODS Participants consisted of a combined sample of adults with a primary diagnosis of OCD (N = 150), those with other primary diagnoses (N = 114), and an unselected nonclinical sample (N = 310). Network analysis was used to identify the most central symptoms (nodes) and associations between symptoms (edges) assessed by the Obsessive-Compulsive Inventory-Revised and the Obsessional Beliefs Questionnaire-44. RESULTS The most central symptoms in the network were negative appraisals of intrusive thoughts (i.e., Having intrusive thoughts means I'm out of control). Some of the strongest associations between symptoms were also observed for those pertaining to intrusive thoughts and their negative appraisal. Furthermore, central symptoms in the network predicted depression and anxiety (over and above peripheral symptoms) among those with a primary diagnosis of OCD, but not the severity of OCD symptoms. LIMITATIONS The approach was exploratory rather than experimental and relied solely on self-report measures of OCD symptoms and beliefs. CONCLUSIONS Negative appraisals of intrusive thoughts were the most central symptoms in the OCD network, and they uniquely predict co-occurring symptoms of anxiety and depression, suggesting that these symptoms should be prioritized in theoretical and treatment models of OCD.
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Affiliation(s)
- Bunmi O Olatunji
- Department of Psychology, Vanderbilt University, 301 Wilson Hall, 111 21st Avenue South, Nashville, TN 37203, USA.
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Dell'Osso B, Cremaschi L, Oldani L, Altamura AC. New Directions in the Use of Brain Stimulation Interventions in Patients with Obsessive-Compulsive Disorder. Curr Med Chem 2019; 25:5712-5721. [PMID: 28474552 DOI: 10.2174/0929867324666170505113631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 03/20/2017] [Accepted: 04/23/2017] [Indexed: 01/03/2023]
Abstract
Obsessive-Compulsive Disorder (OCD) is a highly disabling condition with early onset and chronic course in most of the affected patients. In addition, OCD may show high comorbidity and suicide attempt rates, which worsen the overall burden of the disease for patients and their caregivers. First-line treatments for OCD consist of pro-serotonergic compounds and cognitive-behavioral therapy. Nonetheless, many patients show only limited benefit from such interventions and require additional "next-step" interventions, including augmentative antipsychotics and glutamate-modulating agents. Based on the knowledge about altered neurocircuitry in OCD, brain stimulation techniques, including transcranial magnetic and electrical stimulations (TMS and tDCS) and deep brain stimulation (DBS), have been increasingly investigated over the last decade, revealing positive results for otherwise intractable and treatment-refractory patients. Available evidence in the field is in continuous evolution and professionals actively involved in the management of OCD patients, psychiatrists in particular, need to be updated about latest developments. Through the analysis of controlled studies, meta-analyses, and International treatment guidelines, the present article is aimed at providing the state of the art on the use of brain stimulation techniques for the treatment of OCD.
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Affiliation(s)
- Bernardo Dell'Osso
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.,Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, CA, United States
| | - Laura Cremaschi
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Lucio Oldani
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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50
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Gerstenblith TA, Jaramillo-Huff A, Ruutiainen T, Nestadt PS, Samuels JF, Grados MA, Cullen BA, Riddle MA, Liang KY, Greenberg BD, Rasmussen SA, Rauch SL, McCracken JT, Piacentini J, Knowles JA, Nestadt G, Bienvenu OJ. Trichotillomania comorbidity in a sample enriched for familial obsessive-compulsive disorder. Compr Psychiatry 2019; 94:152123. [PMID: 31518848 PMCID: PMC6980465 DOI: 10.1016/j.comppsych.2019.152123] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 07/24/2019] [Accepted: 08/28/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND This study addresses the strength of associations between trichotillomania (TTM) and other DSM-IV Axis I conditions in a large sample (n = 2606) enriched for familial obsessive-compulsive disorder (OCD), to inform TTM classification. METHODS We identified participants with TTM in the Johns Hopkins OCD Family Study (153 families) and the OCD Collaborative Genetics Study, a six-site genetic linkage study of OCD (487 families). We used logistic regression (with generalized estimating equations) to assess the strength of associations between TTM and other DSM-IV disorders. RESULTS TTM had excess comorbidity with a number of conditions from different DSM-IV chapters, including tic disorders, alcohol dependence, mood disorders, anxiety disorders, impulse-control disorders, and bulimia nervosa. However, association strengths (odds ratios) were highest for kleptomania (6.6), pyromania (5.8), OCD (5.6), skin picking disorder (4.4), bulimia nervosa (3.5), and pathological nail biting (3.4). CONCLUSIONS TTM is comorbid with a number of psychiatric conditions besides OCD, and it is strongly associated with other conditions involving impaired impulse control. Though DSM-5 includes TTM as an OCD-related disorder, its comorbidity pattern also emphasizes the impulsive, appetitive aspects of this condition that may be relevant to classification.
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Affiliation(s)
- Ted Avi Gerstenblith
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States of America
| | - Ashley Jaramillo-Huff
- University of New Mexico School of Medicine, Department of Obstetrics and Gynecology, United States of America
| | - Tuua Ruutiainen
- University of Pennsylvania Perelman School of Medicine, Department of Psychiatry, United States of America
| | - Paul S Nestadt
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States of America
| | - Jack F Samuels
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States of America
| | - Marco A Grados
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States of America
| | - Bernadette A Cullen
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States of America
| | - Mark A Riddle
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States of America
| | | | - Benjamin D Greenberg
- Brown Medical School, Department of Psychiatry and Human Behavior, United States of America
| | - Steven A Rasmussen
- Brown Medical School, Department of Psychiatry and Human Behavior, United States of America
| | - Scott L Rauch
- Harvard Medical School, Department of Psychiatry, United States of America
| | - James T McCracken
- University of California, Los Angeles School of Medicine, Department of Psychiatry and Biobehavioral Sciences, United States of America
| | - John Piacentini
- University of California, Los Angeles School of Medicine, Department of Psychiatry and Biobehavioral Sciences, United States of America
| | - James A Knowles
- SUNY Downstate Medical Center College of Medicine, Department of Cell Biology, United States of America
| | - Gerald Nestadt
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States of America
| | - O Joseph Bienvenu
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, United States of America.
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