Abstract
BackgroundThis study focused on hypotheses regarding the source of incompleteness in obsessive-compulsive disorder (OCD). For this, we had to document the behavioral manifestation of incompleteness in compulsive rituals, predicting that an exaggerated focus on acts that are appropriate for the task will support the hypothesis on heightened responsibility/perfectionism. In contrast, activity past the expected terminal act for the motor task would support the “stop signal deficiency” hypothesis.Methodology and Principal FindingsWe employed video-telemetry to analyze 39 motor OCD rituals and compared each with a similar task performed by a non-OCD individual, in order to objectively and explicitly determine the functional end of the activity. We found that 75% of OCD rituals comprised a “tail,” which is a section that follows the functional end of the task that the patients ascribed to their activity. The other 25% tailless rituals comprised a relatively high number and higher rate of repetition of non-functional acts. Thus, in rituals with tail, incompleteness was manifested by the mere presence of the tail whereas in tailless rituals, incompleteness was manifested by the reduced functionality of the task due to an inflated execution and repetition of non-functional acts.ConclusionsThe prevalence of activity after the functional end (“tail”) and the elevated non-functionality in OCD motor rituals support the “lack of stop signal” theories as the underlying mechanism in OCD. Furthermore, the presence and content of the tail might have a therapeutic potential in cognitive-behavior therapy.
Highlights
In their exposition of the conceptual issues underpinning biological psychiatry as a field of science, Berrios and Markova [1] noted that the discipline’s evidence is dependent on two types of data: psychiatric data and neurological data
The analysis of observable behavior can serve as psychiatric data [3,4], and this is obvious when the psychiatric disorder includes manifest behavior, for example, motor obsessive-compulsive disorder (OCD) rituals that serve as a source of information regarding mental symptoms
The raw material for analysis was the actual sequence of acts performed in 39 OCD rituals
Summary
In their exposition of the conceptual issues underpinning biological psychiatry as a field of science, Berrios and Markova [1] noted that the discipline’s evidence is dependent on two types of data: psychiatric data (psychopathology symptoms, signs, behaviors) and neurological data (neurology symptoms, signs, neuroimaging lesions, etc.). The analysis of observable behavior can serve as psychiatric data [3,4], and this is obvious when the psychiatric disorder includes manifest behavior, for example, motor OCD rituals that serve as a source of information regarding mental symptoms. Analysis of such motor manifestation may shed light onto the various hypotheses regarding the psychological reasons for OCD symptoms [5]. We had to document the behavioral manifestation of incompleteness in compulsive rituals, predicting that an exaggerated focus on acts that are appropriate for the task will support the hypothesis on heightened responsibility/perfectionism. Activity past the expected terminal act for the motor task would support the ‘‘stop signal deficiency’’ hypothesis
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