Compulsive Actions Research Articles

Inhibition is impaired in children with obsessive-compulsive symptoms but not in those with tics.

Impaired inhibitory control is thought to be a core deficit in psychiatric disorders where patients exhibit problems with controlling urges. These problems include the urge to perform movements typical of Tourette syndrome and the urge to execute compulsive actions typical of obsessive-compulsive disorder. However, the picture emerging from studies that address this issue is controversial. Furthermore, most studies have only focused on reactive control (the ability of subjects to react to a stop signal), but not on proactive control (the ability of patients to shape their response strategies in anticipation of known task demands). We assessed reactive and proactive inhibitory control in drug naïve children/adolescents affected by Tourette syndrome, obsessive-compulsive disorder, and in those in which the 2 disorders co-occur. Reaching version of the stop signal task and of a simple reaction time task were given to 37 unmedicated patients (mean age ± SD, 11.0 ± 2.3) and to 37 healthy age- and gender-matched controls (mean age ± SD, 10.8 ± 1.6). Both reactive and proactive inhibition scaled with the severity of obsessive-compulsive symptoms, but not with those of tic symptoms (ie, inhibitory control in uncomplicated Tourette patients was comparable with that of healthy controls). We suggest that the cognitive mechanisms underlying tics and compulsions controls are likely to be different. Possibly the preserved ability to suppress actions in uncomplicated Tourette patients allows them to experience a greater feeling of self-control, and this fact might play a key role in evolution of the disorder beyond adolescence. © 2018 International Parkinson and Movement Disorder Society.

Sertraline induced psychosis in a patient with obsessive compulsive disorder (OCD) and anxiety disorder

Introduction. Selective serotonin reuptake inhibitors are the most commonly used antidepressants in the world. Sertraline is widely used in major depressive disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder and posttraumatic-stress disorder. Among the rarest side effects are psychosis and mania induced by sertraline. Case presentation. A ten-year-old male patient was admitted for auditive and visual hallucinations, anxiety, motor tics (blinking) and compulsive actions. The patient had been under treatment with sertraline and alprazolam for six months. He had been the victim of bullying for months, reporting being hit, teased and insulted by some classmates. Considering the neurotic symptoms, the dose of sertraline was increased. After a short period the auditive and visual hallucinations were exacerbated. Discussion. The debut of the case was dominated by affective symptoms. Under treatment with sertraline the patient developed a psychotic disorder which gradually diminished after stopping sertraline and introducing risperidone. Particularities. Because the patient is a Hungarian native speaker, the parents acted as translators during the psychiatric interview, making it difficult to distinguish between intrusive images, flashbacks and hallucinations.

Braun «Iphigenia in Freedom»: destroyed dialogue

The article deals with the perception of Iphigenia’s myth by German playwright Volkner Braun. Solving the problem of freedom and the possibility of personality’s self-determination, outstanding writer in his dramatic fragment of verse «Iphigenia in Freedom» (1991) presented his interpretation of the classical plot, where bloody story of the Atrides is closely interwoven with historical events of German’s consolidation. Rejection of holistic plot in favor of fragmentariness of the narration allowed the author to represent his discrepant present-day reality. The liberation of the heroine is happening as a result of the exchange without her participating in the process at all (even with her internal resistance), as she is considered to be dumb. The main part of the work is written in form of stream of consciousness, which is built on delusive inner associations, literary allusions (first of all to Goethe) and ironically reconsidered political slogans. The playwright represents Iphigenia’s liberty between the liberation and the sacrifice, whose destiny is closely connected with world’s history. Thanks to intertextual plays with prototexts, Braun keeps current the problem of legitimacy of compulsive actions in different historical contexts. The author tried to reproduce contemporary perception, his reaction to actual social changes and at the same time reflection on the historical process as a whole. If at the beginning of the work the writer combined the detailed myth's problems with the previous history, which was determined by fate, then further reflected the current development of history, which was close to the requirements of the myth.

Compulsivity Reveals a Novel Dissociation between Action and Confidence

SummaryConfidence and actions are normally tightly interwoven—if I am sure that it is going to rain, I will take an umbrella—therefore, it is difficult to understand their interplay. Stimulated by the ego-dystonic nature of obsessive-compulsive disorder (OCD), where compulsive actions are recognized as disproportionate, we hypothesized that action and confidence might be independently updated during learning. Participants completed a predictive-inference task designed to identify how action and confidence evolve in response to surprising changes in the environment. While OCD patients (like controls) correctly updated their confidence according to changes in the environment, their actions (unlike those of controls) mostly disregarded this knowledge. Therefore, OCD patients develop an accurate, internal model of the environment but fail to use it to guide behavior. Results demonstrated a novel dissociation between confidence and action, suggesting a cognitive architecture whereby confidence estimates can accurately track the statistic of the environment independently from performance.

Phenomenology and gender characteristics of hobbyism and punding in Parkinson’s disease: A self-report study

ObjectivesDopamine replacement therapy administered to alleviate motor symptoms of Parkinson’s disease (PD) has been linked to a range of impulsive and compulsive behaviors (ICBs). The objective of the current study is to describe the phenomenology and delineate gender characteristics of hobbyism and punding in PD based on self-report. Materials and methodsWe applied two self-report questionnaires. A clinical and demographic questionnaire assessing motor symptomatology and the short-version of the Questionnaire for impulsive-compulsive behaviors in PD assessing symptoms of current and past ICBs in PD. ResultsResults suggest that hobbyism and punding are very common among Danish patients with PD with 27.5% of patients reporting symptoms hereof in the current sample. Furthermore, findings indicate that male and female patients engage differently in hobbyism and punding showing different preferences for specific compulsive activities. In addition, hobbyism and punding appear to be very time consuming with up to 10.6% of patients spending more than five hours each day on these behaviors. We found no significant gender differences in time consumption nor in the subjective experience of being pre-occupied with and feeling loss of control over the behavior. However, unlike men only very few female patients (12.1%) addressed a healthcare professional about ICB symptoms overall, and none when considering hobbyism and punding alone. Finally, findings suggest that age at PD onset and advanced motor symptomatology are significantly associated with hobbyism and punding, respectively, in both male and female patients with PD, whereas non-cardinal motor symptoms, only predict ICBs in male patients. ConclusionsFindings may have important clinical implications in early identification of ICBs in male and female patients with PD by emphasizing the need for healthcare professionals to explicitly ask patients about behavioral alterations and taking motor symptomatology into account when screening for ICBs in PD.

The comprehensive approach to the performance of forensic medical expertises of the injuries inflicted to juvenile victims of suspected compulsive actions

This article was designed to discuss the problems pertaining to the performance of forensic medical expertises of the injuries inflicted to juvenile victims of suspected compulsive actions. The importance of this problem arises from the lack of the comprehensive approach to the performance of such expertises concerning the children. The present study based on the scientific and practical analysis has revealed the drawbacks in forensic medical expertises with respect to the juvenile victims of suspected compulsive actions. The article contains recommendation for the correction of the aforementioned shortcomings.

Freedom as theme in psychotherapy and cognitive behavioral therapy

BackgroundThe problems that a client presents with to therapy may be associated with his possibility of free choice.MethodReview of psychotherapeutic and cognitive behavioral literature.ResultsFrom a psychological perspective, freedom may be either inner or outer, depending on the nature of obstacles and barriers that limit freedom. Therapy may be understood as a process through which the client is guided to actively increase his freedom. This refers to freedom from destructive habits, self-limiting attitudes, compulsive actions, symptoms etc. When creating the relationship, neither the client nor the therapist is entirely free as they bring past conscious and unconscious experiences into it. From the point of view of CBT, freedom is always relative. The idea of absolute freedom results from cognitive distortions – black and white thinking. CBT does not consider overall freedom but relatively free decision-making in particular situations that the client is in. The therapist helps the client to identify his errors in thinking and to learn a more realistic way to formulate his experiences and to use the new attitude to decide more freely. The change in attitude is realized through rehearsing freer behavior and experiments with it in one's life.ConclusionFreedom may be either inner or outer, depending on the nature of obstacles and barriers that limit freedom. Therapy may be understood as a process through which the client is guided to actively increase his freedom.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Excessive Research - Editorial

Excessive Research highlights the compulsive actions of digital culture, and how we are constantly encouraged to stay active, to make, to share and to secure. While idealised by hackers, these actions are at the same time the conveyors of new agile innovation strategies, and modes of economic and symbolic exchange. A culture of sharing, for instance, is evidently one of the most fetishised activities of the network and describes how value is now created. ‘Sharing is caring’, goes the catchphrase, but by its inclination of excess, loss and indebtedness, sharing also challenges the very logic of accumulation, and hence it must be domesticated and normalised. Articles delve into the nature of these actions and their limits, asking: What happens when research is less about exchange and more about excess?

When cognitive control shuts down

Neuroscience![Figure][1] Photos of untidy rooms were used to elicit OCD symptoms in the subjects of this study IMAGE: © PETER MAHER/ALAMY People with obsessive-compulsive disorder (OCD) cannot control their thoughts, engage in compulsive actions and perform repetitive behaviors to reduce their anxiety. To better understand the neurological basis of these symptoms, Banca et al. used individually tailored stimuli to provoke and alleviate symptoms in people with OCD while scanning their brains with functional magnetic resonance imaging. When provoked, the caudate-prefrontal brain circuits involved in cognitive control and goal-directed behavior shut down in OCD patients. This was accompanied by hyperactivation of a brain region called the putamen, which controls repetitive behavior. These insights may pave the way for novel therapeutic approaches to treating OCD. Brain 138 , 798 (2015). [1]: pending:yes

The Clinical Handbook of Biofeedback: A Step-by-Step Guide for Training and Practice with Mindfulness.

<i>The Clinical Handbook of Biofeedback: A Step-by-Step Guide for Training and Practice with Mindfulness.</i>

Converting a Freudian analysis into a Jungian one: obsession, addiction, and an answer from Job.

In his analyses of obsessional patients, Sigmund Freud suggested that they suffered from intrusive cognitions and compulsive activities. Early psychoanalysts delineated the phenomenology of obsessionality, but did not differentiate what is currently termed obsessive-compulsive disorder from obsessional personality. However, it was widely recognized that the success of psychoanalysis with obsessional patients was limited due to rigid characterological defences and transference resistances. The present paper examines the case of a middle-aged obsessional academic who had been treated for nearly twenty years in a 'classical' Freudian psychoanalysis prior to entering Jungian analysis. It examines how persistent focus on Oedipal conflicts undesirably reinforced the transference resistance in this obsessional man, and suggests that focusing instead on diminishing the harshness of the super-ego via the therapeutic alliance, and fostering faith in the salutary aspects of unconscious processing has led to salutary results in this case. The biblical book of Job is adopted as ancient instruction in how to address the scrupulosity and addictive mental structuring of obsessionality in analysis.

Distinguishing Obsessive-Compulsive Behavior From Stereotypy

The current project was an initial attempt to develop assessment procedures for distinguishing between obsessive-compulsive (OC) and stereotypic behavior and evaluate the impact of different treatments for these behaviors. Two individuals with autism, one with repetitive behavior characteristic of OC behavior and one with repetitive behavior not characteristic of OC behavior, participated in the study. In Experiment 1, given that individuals with Obsessive-Compulsive Disorder (OCD) report experiencing unpleasant urges that are relieved when they perform compulsive actions, an attempt was made to identify these experiences by measuring heart rate and affect when access to repetitive behavior was restricted and allowed. In Experiment 2, a multiple schedules treatment was conducted with each participant, and in Experiment 3, the participant with autism and OC behavior completed exposure and response prevention (ERP) treatment. The overall results across studies suggest that one potential way to discriminate between OC behavior and stereotypy in nonvocal children with autism is to consider the topography of repetitive behavior along with changes in physiology and affect. In addition, it may be worth considering the use of ERP, a traditional treatment for OCD, to treat repetitive behavior maintained by automatic reinforcement if treatments that provide access to repetitive behavior are not effective.

Central extrapontine myelinolysis appearing as acute parkinsonism

Central extrapontine myelinolysis appearing as acute parkinsonism

Impulse Control Disorders in Parkinson’s Disease: Crossroads between Neurology, Psychiatry and Neuroscience

Non-motor symptoms contribute significantly to Parkinson’s disease (PD) related disability. Impulse control disorders (ICDs) have been recently added to the behavioural spectrum of PD-related non-motor symptoms. Such behaviours are characterized by an inappropriate drive to conduct repetitive behaviours that are usually socially inadequate or result in harmful consequences. Parkinson disease impulse control disorders (PD-ICDs) have raised significant interest in the scientific and medical community, not only because of their incapacitating nature, but also because they may represent a valid model of ICDs beyond PD and a means to study the physiology of drive, impulse control and compulsive actions in the normal brain. In this review, we discuss some unresolved issues regarding PD-ICDs, including the association with psychiatric co-morbidities such as obsessive-compulsive disorder and with dopamine related side effects, such as hallucinations and dyskinesias; the relationship with executive cognitive dysfunction; and the neural underpinnings of ICDs in PD. We also discuss the contribution of neuroscience studies based on animal-models towards a mechanistic explanation of the development of PD-ICDs, specifically regarding corticostriatal control of goal directed and habitual actions.

Impulse control disorders in Parkinson's disease: crossroads between neurology, psychiatry and neuroscience.

Non-motor symptoms contribute significantly to Parkinson’s disease (PD) related disability. Impulse control disorders (ICDs) have been recently added to the behavioural spectrum of PD-related non-motor symptoms. Such behaviours are characterized by an inappropriate drive to conduct repetitive behaviours that are usually socially inadequate or result in harmful consequences. Parkinson disease impulse control disorders (PD-ICDs) have raised significant interest in the scientific and medical community, not only because of their incapacitating nature, but also because they may represent a valid model of ICDs beyond PD and a means to study the physiology of drive, impulse control and compulsive actions in the normal brain. In this review, we discuss some unresolved issues regarding PD-ICDs, including the association with psychiatric co-morbidities such as obsessive-compulsive disorder and with dopamine related side effects, such as hallucinations and dyskinesias; the relationship with executive cognitive dysfunction; and the neural underpinnings of ICDs in PD. We also discuss the contribution of neuroscience studies based on animal-models towards a mechanistic explanation of the development of PD-ICDs, specifically regarding corticostriatal control of goal directed and habitual actions.

Abnormal corticostriatal-limbic functional connectivity in obsessive–compulsive disorder during reward processing and resting-state

Compulsive behaviors in obsessive–compulsive disorder (OCD) may be related to deficits in reward processing mediated by corticostriatal circuitry, a brain network implicated in the pathophysiology of OCD. Performing compulsive actions can be perceived as a reward to OCD patients because it temporarily reduces the anxiety provoked by obsessions. Although most OCD literature provides evidence of altered regional activity in these corticostriatal circuits, very little is known about the connectivity between individual regions of the corticostriatal-limbic circuits, including the cognitive and affective neural circuitry associated with OCD. Thus, this study investigated the differences in functional connectivity (FC) patterns in this network during resting-state and incentive processing. Nineteen patients with OCD and 18 well-matched healthy controls were scanned during resting-state and a monetary incentive delay task (task state). FC was assessed using both voxel-wise and region-of-interest (ROI)-wise analyses. Voxel-wise FC analysis with the nucleus accumbens seed revealed that patients with OCD exhibited increased FC between the nucleus accumbens and the lateral orbitofrontal cortex during resting-state. Additionally, these patients showed decreased FC between the nucleus accumbens and limbic areas such as the amygdala during incentive processing. Exploratory ROI-wise FC analysis revealed that OCD patients demonstrated enhanced FC between the nucleus accumbens and the lateral orbitofrontal cortex and increased total connectivity of the lateral orbitofrontal cortex during resting-state. Additionally, patients showed alterations in FC between resting and task state. This study provides evidence that patients with OCD have altered FC in the corticostriatal-limbic network, particularly in striatal-amygdala and striatal-orbitofrontal circuitry, during incentive processing and resting-state. These findings also emphasize that functional connections in the network are modulated by affective/motivational states and further suggest that OCD patients may have abnormalities of such modulation in this network.

Effects of the active constituents of Crocus Sativus L., crocins, in an animal model of obsessive–compulsive disorder

Crocins are among the active components of the plant Crocus Sativus L. C. Sativus L. and its constituents were effective in different models of psychiatric disorders including anxiety and depression. Obsessive–compulsive disorder (OCD) is a common psychiatric disorder defined by the presence of obsessive thoughts and repetitive compulsive actions. The non selective serotonin (5-HT) receptor agonist mCPP is known to induce OCD-like behavior (excessive self-grooming) in rodents and exacerbate symptoms in patients with OCD. The present study investigated whether or not crocins were able to counteract excessive self-grooming induced by mCPP (0.6mg/kg, i.p.) in rats. Crocins (30 and 50mg/kg, i.p.) attenuated mCPP-induced excessive self-grooming. The present results also indicate that these effects of crocins on an animal model of OCD cannot be attributed to changes in locomotor activity. Our findings suggest that the active constituents of C. Sativus L. crocins might play a role in compulsive behavior and support a functional interaction between crocins and the serotonergic system.

Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is a chronic mental illness (psychiatric disorder) that is characterized by distressing intrusive obsessive thoughts and fears and/or repetitive compulsive actions (rituals) that are done to prevent or reduce anxiety or distress, not to provide pleasure or gratification. It is a lifelong mental illness and recovery from it is gradual and ongoing treatment is necessary to help prevent relapses.

113 The risk and gamble we take with our patients on dopamine agonists

IntroductionDopamine agonists are associated with impulse control disorders (ICDs) such as reward based, compulsive actions, medication use and punding. In clinical practice these are relatively common and potentially have devastating...

Behavioral Addictions: An Overview

The legitimacy of nonsubstance addictions has received increased attention from clinicians, researchers and the general population as more and more individuals report symptoms consistent with impairment of impulse control. The clinical presentation of these disorders is varied, as compulsive activities may include: gambling, eating, sex, shopping, use of the Internet or videogames or even exercising, working or falling in love. As such, there is great controversy in diagnosing, treating or even naming these conditions, as many of these behaviors are daily rituals instrumental to our ultimate survival. Historically, the phrase “impulse control disorders” described these conditions but many researchers and clinicians also use the term “behavioral addictions,” “process addictions” or “impulsive-compulsive behaviors” to report behavioral pathology. This review summarizes the data of each of these behavioral addictions from epidemiology to neurobiology to treatment options. Research suggests similarities between natural and drug reward processing but clinical evidence supports the utilization of treatment modalities for these behavioral conditions that can sometimes differ from traditional drug treatment.