Nonclinical populations in research on obsessive-compulsive disorder: A critical review

Abstract

This article provides a review of the literature on nonclinical obsessive-compulsives (NCOCs). The main areas of focus include: (a) prevalence of obsessive-compulsive symptoms in nonclinical populations, (b) symptom profile, (c) associated psychopathology, (d) personality and psychological characteristics, (e) cognitive dysfunction, and (f) coping styles. For all six areas, findings on NCOCs are compared with research on clinical samples. Results suggest that: (a) lowlevel obsessive compulsive symptoms, as well as OCD, occur frequently in the general population; (b) a comparison of the symptom profile of NCOCs and OCD patients reveals both similarities and differences; (c) levels of associated anxiety, depression, and personality traits are consistent across studies and indicate that the scores of NCOCs fall between those of normal controls and OCD patients; (d) basic research on personality and psychological aspects of NCOCs has identified potential etiological factors in the development of OCD, including inflated responsibility and guilt, obsessive-compulsive personality traits, excessive need for control over the environment, and exaggerated responsiveness to emotional provocation; (e) NCOCs perform significantly worse on measures of executive functioning, memory, and information processing in comparison to control subjects, but unlike their OCD counterparts, their scores lie within the normal range; (f) the most common types of strategies employed by NCOCs and OCD patients in an effort to cope with obsessive-compulsive symptoms are qualitatively similar but less effective for OCD patients. The nature of the relationship between nonclinical obsessive-compulsive symptomatology and OCD is discussed with these findings in mind. In addition, critical commentary regarding methodological issues, as well as unanswered research questions which await empirical research, are addressed.