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Comparison of obsessions and compulsions in patients with anorexia nervosa and obsessive compulsive disorder.

Patients with anorexia nervosa (n = 18) and patients with obsessive-compulsive disorder (OCD) (n = 16) had similar scores on the Yale-Brown Obsessive Compulsive Scale (19 + or - 9 vs. 22 + or - 6). This suggests that these disorders have similar magnitude of impairment from obsessions and compulsions; however, OCD patients endorsed a wide variety of obsessions and compulsions, whereas anorexics tended to endorse symptoms that were related to symmetry and order.

Adolescent↗

A comparison of autogenous/reactive obsessions and worry in a nonclinical population: a test of the continuum hypothesis.

Employing the autogenous-reactive model of obsessions (Behaviour Research and Therapy 41 (2003) 11-29), this study sought to test a hypothesized continuum where reactive obsessions fall in between autogenous obsessions and worry with respect to several thought characteristics concerning content appraisal, perceived form, and thought triggers. Nonclinical undergraduate students (n=435) were administered an online packet of questionnaires designed to examine the three different types of thoughts. Main data analyses included only those displaying moderate levels of obsessions or worries (n=252). According to the most distressing thought, three different groups were formed and compared: autogenous obsession (n=34), reactive obsession (n=76), and worry (n=142). Results revealed that (a) relative to worry, autogenous obsessions were perceived as more bizarre, more unacceptable, more unrealistic, and less likely to occur; (b) autogenous obsessions were more likely to take the form of impulses, urges, or images, whereas worry was more likely to take the form of doubts, apprehensions, or thoughts; and (c) worry was more characterized by awareness and identifiability of thought triggers, with reactive obsessions through these comparisons falling in between. Moreover, reactive obsessions, relative to autogenous obsessions, were more strongly associated with both severity of worry and use of worrying as a thought control strategy. Our data suggest that the reactive subtype represents more worry-like obsessions compared to the autogenous subtype.

Adolescent↗

An investigation of traumatic life events and obsessive-compulsive disorder.

Obsessive-compulsive disorder (OCD), like most other psychiatric disorders, is suspected of being influenced by an interaction between life events and genes, both with regard to onset and course of illness. To date, no specific genes have been identified as playing a frequent role, and only a relatively few empirical studies have assessed the association between stressful life events (SLEs) and OCD. The present study builds on past research by examining the potential contributions from traumatic life events (TLEs) on the severity and symptom features in 265 individuals with Structured Clinical Interview for DSM-IV (SCID)-diagnosed OCD. Of these participants 54% endorsed having experienced at least one TLE in their life time. The presence of one or more TLEs was associated with increased OCD symptom severity. This relationship remained significant despite controlling for key variables including age, OCD age-of-onset, comorbidity, and depressive symptoms. In addition, obsessions/checking and symmetry/ordering were two of four symptom factors that were specifically associated with the occurrence of TLEs. These results are generally supportive of a pathoplastic relationship between TLEs and OCD symptomatology and thus suggest the need for greater systematic consideration of life stresses in research focused on the nature and treatment of OCD.

Adult↗

Obsessive-compulsive behaviours in specific situations: the relative influence of appraisals of control, responsibility and threat.

Obsessive-compulsive disorder (OCD) is characterized by repeated and persistent attempts by the individual to control their thoughts and by taking action through rituals in order to prevent feared or personally distressing outcomes. While cognitive theories of OCD have generated supportive research findings and effective treatments, they have not considered broader control beliefs that may motivate aspects of OC-phenomenology. We have previously proposed that broader control beliefs, specifically desire for control and sense of control, may play a role in OC-symptoms (Moulding & Kyrios, 2006). In the present study, non-clinical participants (N=219) were presented with four hypothetical scenarios relevant to an OCD-checking concern, and using a manipulation paradigm, the relationship between control constructs and appraisals hypothesized to be relevant to OCD (threat, responsibility) was examined. Desire for control was moderately affected to responsibility and threat appraisals, while sense of control did not relate to these constructs. The relationship between aspects of OC-phenomenology and appraisals of control, responsibility and threat were also investigated. Higher desire for control predicted both affect and action, while a lower sense of control predicted higher distress and action, over-and-above appraisals of threat and responsibility. Control appraisals were particularly relevant to use of action, and to affect in the low responsibility situations. A possible interactive model of desire for control, threat and responsibility is discussed.

Adolescent↗

Impulsivity and compulsivity in patients with trichotillomania or skin picking compared with patients with obsessive-compulsive disorder.

To compare impulsivity and compulsivity, we performed a case control study comparing a group of 20 patients with obsessive-compulsive disorder with a group of 20 patients with skin picking and/or trichotillomania (SP/T). The instruments used were Structured Clinical Interview for DSM-IV Axis I Diagnosis, Yale-Brown Obsessive-Compulsive Scale, Schalling Impulsivity Scale, and Hamilton Anxiety and Depression Inventories. A Multidimensional Impulsive-Compulsive Spectrum Assessment Instrument was designed for this particular study. The Yale-Brown Obsessive-Compulsive Scale scores were significantly higher in patients with obsessive-compulsive disorder, compared with patients with SP/T (F = 90.29; P < .001). The Hamilton Inventories and Schalling Impulsivity Scale revealed no significant intergroup differences. The Multidimensional Impulsive-Compulsive Spectrum Assessment Instrument allowed us to find 6 statistically significant differences between groups: the ability or inability to delay an impulse, quick response or action planning, feelings of pleasure or guilt during or after an act, ritualization, and whether the patient believes he/she has losses or benefits if prevented from acting. In conclusion, SP/T should deserve further attention about their classification in future versions of diagnostic manuals because, as in International Classification of Diseases, Tenth Revision, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition includes these disorders in the same chapter as pathological gambling, kleptomania, pyromania and others. Despite their resemblance to compulsions, their classification under the Obsessive-Compulsive Spectrum needs particular phenomenological and neurobiologic investigation.

Adolescent↗

The Yale-Brown Obsessive Compulsive Scale: factor analysis, construct validity, and suggestions for refinement.

The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is widely acknowledged as the gold standard measure of obsessive-compulsive disorder (OCD) symptom severity. Despite its popularity, a number of questions remain regarding the Y-BOCS' psychometric properties including: (a) whether obsessional and compulsive symptoms contribute independently to global OCD severity and (b) whether the Y-BOCS subscales are valid with respect to other measures of OCD. We examined these issues in a sample of 100 patients with a diagnosis of OCD. While our confirmatory factor analyses failed to reproduce any previously reported models of the Y-BOCS factor structure, exploratory factor analysis indicated a two-factor solution that assessed symptom severity (i.e., time, distress, and interference from obsessions and compulsions) as separate from resistance and control of obsessions and compulsions. In contrast to the Resistance/Control Subscale, the Severity Subscale demonstrated good psychometric properties and construct validity. Based on our findings we recommend revisions to scoring the Y-BOCS.

Adult↗

A review of behavioral and pharmacological treatments for habit disorders in individuals with mental retardation.

This paper reviews the prevalence and behavioral and pharmacological treatment-outcome studies for habit disorders exhibited by individuals with mental retardation. The treatment-outcome studies target the habit disorders identified previously by researchers including nervous habits (nail biting, bruxism, and trichotillomania), motor and vocal tics, and Tourette's disorder. The paucity of behavioral treatments and the lack of controlled pharmacological research warrants further experimental evaluation of treatments for habit disorders affecting individuals with mental retardation. Conclusions and recommendations for future research are made.

Behavior Therapy↗

Religious obsessions and compulsions in a non-clinical sample: the Penn Inventory of Scrupulosity (PIOS).

The present investigation reports on the development and psychometric evaluation of the Penn Inventory of Scrupulosity (PIOS), a 19-item self-report scale measuring religious obsessive-compulsive symptoms. Factor analysis yielded a two factor solution with the first subscale measuring fears about having committed sin, and the second measuring fears concerning punishment from God. Using a sample of college students, the PIOS was shown to be internally consistent and possess good convergent and discriminant validity. Highly devout participants evidenced higher scores on both PIOS subscales, but devout Jews evidenced fewer fears of sin and punishment from God compared to devout Protestants or Catholics. The PIOS has utility both as a research and clinical tool.

Adolescent↗

Two different types of obsession: autogenous obsessions and reactive obsessions.

We propose that obsessions are categorized into two subtypes, i.e. autogenous obsessions and reactive obsessions, which are different in terms of identifiability of their evoking stimuli, subjective experiences, contents, and subsequent cognitive processes. Autogenous obsessions tend to come abruptly into consciousness without identifiable evoking stimuli, which are perceived as ego-dystonic and aversive enough to be repelled, and include sexual, aggressive, and immoral thoughts or impulses. On the other hand, reactive obsessions are evoked by identifiable external stimuli, which are perceived as relatively realistic and rational enough to do something toward the stimuli, and include thoughts about contamination, mistake, accident, asymmetry, loss, etc. Through three empirical studies, we confirmed the differences between the two types of obsessional intrusion in their frequency, subjective experiences, subsequent appraisal and control strategy. In particular, autogenous obsessions led to high appraisal on 'control over thought' and 'importance of thought' and frequent use of 'avoidant control strategies', while reactive obsessions linked with high appraisal on 'responsibility' and frequent use of 'confrontational control strategies'. These findings are expected to provide a basis for classifying and explaining the heterogeneous phenomena of obsessive-compulsive disorder.

Adolescent↗

Symptom structure in obsessive-compulsive disorder: a confirmatory factor-analytic study.

Although obsessive-compulsive disorder (OCD) has long been a unitary diagnosis, there is much recent interest in its potential heterogeneity, as manifested by symptom subgroups. This study evaluated existing models of symptom structure in a sample of 203 individuals with OCD. Using confirmatory factor analysis, we examined the ability of each model to account for two levels of data: a priori symptom groupings (second-order) and individual symptoms, identified by the Yale-Brown Obsessive Compulsive Scale symptom checklist. Four models were examined: a single-factor, a two-factor (i.e., obsessions and compulsions), and two multidimensional models, comprising three and four factors. Adequate fit was found solely for the four-factor model--specifying obsessions/checking, symmetry/ordering, contamination/cleaning, and hoarding--but only at the second-order level; it did not account for relationships among discrete symptoms. Parameter estimates showed within-factor heterogeneity, as well as overlap between factors, most notably the two representing checking and contamination-related symptoms. The implications of these findings are discussed. Results provide evidence for the multidimensionality of OCD symptoms, but suggest that a comprehensive model has yet to be identified. They also point to the inadequacy of groupings based solely upon overt behavioural similarities (e.g., 'checking'). Recommendations are made for future research.

Adult↗

Relationships between thought-action fusion, thought suppression and obsessive-compulsive symptoms: a structural equation modeling approach.

Research has shown that there are strong similarities in content between the obsessions and compulsions that characterize obsessive-compulsive disorder and nonclinical obsessions and compulsions. However, clinical and nonclinical obsessions and compulsions do differ with respect to characteristics like frequency, intensity, discomfort and elicited resistance. Two separate concepts have been invoked to explain how normal obsessions and compulsions may develop into clinical phenomena. First, it is suggested that thought-action fusion (TAF) contributes to obsessive-compulsive symptoms. Second, thought suppression may intensify obsessive-compulsive symptoms due to its paradoxical effect on intrusive thoughts. Although both phenomena have been found to contribute to obsessive-compulsive symptoms, possible interactions between these two have never been investigated. The current study explored how TAF and thought suppression interact in the development of obsessive-compulsive symptoms. Undergraduate psychology students (N = 173) completed questionnaires pertaining to TAF, thought suppression and obsessive-compulsive symptoms. Covariances between the scores on these questionnaires were analyzed by means of structural equation modeling. Results suggest that TAF triggers thought suppression, while thought suppression, in turn, promotes obsessive-compulsive symptoms.

Adolescent↗

Neuropsychological functioning in a subclinical obsessive-compulsive sample.

BACKGROUND: Previous neuropsychological research has suggested that the study of psychometrically defined subclinical samples might be a valid approach to understand the underlying pathophysiology of obsessive-compulsive disorder (OCD). This approach has the potential benefit of overcoming some of the methodological problems linked to the use of clinical samples. METHODS: A group of subclinical obsessive-compulsive (OC) subjects (n = 35), selected on the basis of their scores on the Padua Inventory, and a control group were assessed on executive functioning tasks and other neuropsychological tests which have been demonstrated to be impaired in clinical OCD patients and/or in those with several basal ganglia disorders. RESULTS: Subclinical OC subjects needed significantly more moves than controls to reach the solution criteria on the Tower of Hanoi puzzle, and performance on this test was positively correlated with total score and the Checking factor of the Padua Inventory. There were no between-group differences on the other frontal lobe tests. CONCLUSIONS: The results suggest that deficits in manipulating spatial information might be basic in OCD, and are congruent with the involvement of the frontostriatal circuits in the disorder.

Adult↗

The contribution of perceived control of stressful life events and thought suppression to the symptoms of obsessive-compulsive disorder in both non-clinical and clinical samples.

The two studies presented in this paper investigated the impact of controllable versus uncontrollable stressful life events (SLE) and low versus high thought suppression upon symptoms of obsessive-compulsive disorder (OCD) in both a non-clinical sample (Study 1) and a clinical sample (Study 2). The sample for Study 1 consisted of 269 undergraduate university students and the sample for Study 2 consisted of 91 participants obtained from the Obsessive Compulsive and Anxiety Disorders Foundation of Victoria, Australia. Participants in both studies were given identical questionnaires measuring anxiety, depression, thought suppression, OCD, and, the control, magnitude and number of SLEs suffered during the previous 18 months. In both studies, analysis of covariance (ANCOVA) followed by post hoc tests indicated that high OCD scores were associated with high thought suppression and low perceived control over high magnitude stressful life events relative to controls. The results suggest that high thought suppression coupled with low control over stressful life events may interact with other predisposing factors, such as genetic vulnerability to produce OCD symptoms.

Adolescent↗

Regional differences in obsessionality and obsessional neurosis.

The Leyton Obsessional Inventory was administered to 69 orthopaedic patients in Glasgow, and their responses were compared with those of 77 similar subjects in London and 73 in Cork. The responses of the Scots and the English did not differ, but both of these groups were significantly less obsessional than the Irish subjects, who were particularly likely to regard cleanliness and tidiness as virtues in themselves. Obsessionality was unrelated to age, sex, social class, family size and birth order, but higher Leyton scores were found among bachelors, and among women living in the country and without outside employment. It is suggested that the common factor among these 3 subgroups is emotional or geographic isolation, and that this may enhance any tendency to obsessional ruminations and routines. This could also account for the higher Leyton scores and greater incidence of obsessional neurosis in the Irish.

Compulsive Behavior↗

[Prevalence of behavioral disorders in the Swiss horse population].

In the Swiss horse population, the prevalence of conspicuous behaviours (behavioural disorders and stable vices) was recorded with a written questionnaire in a representative survey among 1861 horse yards, and the occurrence of the stereotypic behavioural disorders crib-biting, weaving and boxwalking was analysed with emphasis on their association with horse specific (breed, age, sex) and environmental factors (e.g. housing system, nutrition, management and utilisation). 622 horse yards with a total number of 2536 horses answered to the questionnaire, and conspicuous behaviours were described for 418 horses (16.5%). Thereof, the most common stereotypic behavioural disorders with a potential negative impact on animal welfare, crib-biting, weaving, and/or boxwalking were named for 89 horses (3.5%). Stable vices (e.g. shying, bucking, aggressivity against humans) were noted for 47 horses (1.9%). For 281 horses (11.1%) conspicuous behaviours such as pawing, lip-liking, head shacking, kicking stall were given; these can be categorised as behavioural disorders or as stable vices depending on their intensity and causation. Data analysis data revealed a number of statistically significant associations between genetic factors (breed), housing, management practices, utilisation and the three stereotypies. The strongest influence on the degree of behavioural disorders had the breed as well as the extent of direct social contact with other horses, free movement on pasture, feeding pattern and regular utilisation.

Animal Husbandry↗