Compulsive Symptomatology Research Articles

A Prospective Study of Paediatric Obsessive–Compulsive Symptomatology in a Spanish Community Sample

The obsessive-compulsive manifestations course was assessed with the Leyton obsessional inventory-child version survey (LOI-CV) in a 3-year prospective study, using a non-clinical sample. From an initial sample of 1,514 school-age children who underwent symptoms screening for obsessive-compulsive, anxiety and depression, 562 subjects (risk group/without risk group) were re-assessed in the 2nd phase and 242 subjects were monitored after 3 years. LOI-CV scores significantly decreased over time independently of age and gender. The prevalence, persistence and incidence for two levels of severity of obsessive–compulsive manifestations ranged between 4.8-30.4%, 9.3-28.4% and 1.1-14.4%, respectively. 34.6-64.5% of obsessive-compulsive symptomatology was predicted by anxiety, depressive and obsessive-compulsive symptoms. For the obsessiveness (less severe form of obsessive-compulsive manifestations), the depressive symptoms were not predictors. Gender and socioeconomic status were not related with obsessive-compulsive manifestations. These data support a substantial continuity of the obsessive-compulsive manifestations and the existence of different levels of severity within the obsessive-compulsive spectrum.

Perceived Parental Rearing Behaviours, Responsibility Attitudes and Life Events as Predictors of Obsessive Compulsive Symptomatology: Test of a Cognitive Model

It is important to investigate the role of cognitive, developmental and environmental factors in the development and maintenance of Obsessive Compulsive Symptomatology (OCS). The main objective of this study was to examine the vulnerability factors of OCS in a non-clinical sample. On the basis of Salkovskis' cognitive model of OCD, the study aimed to investigate the role of perceived parental rearing behaviours, responsibility attitudes, and life events in predicting OCS. Furthermore, the mediator role of responsibility attitudes in the relationship between perceived parental rearing behaviours and OCS was examined. Finally, the specificity of these variables to OCS was evaluated by examining the relationship of the same variables with depression and trait anxiety. A total of 300 university students (M = 19.55±1.79) were administered the Padua Inventory-Washington State University Revision, Responsibility Attitudes Scale, s-EMBU (My memories of upbringing), Life Events Inventory for University Students, Beck Depression Inventory, and State-Trait Anxiety Inventory-Trait Form. Regression analysis revealed that perceived mother overprotection, responsibility attitudes and life events significantly predicted OCS. Furthermore, responsibility attitudes mediated the relationship between perceived mother overprotection and OCS. The predictive role of perceived mother overprotection and the mediator role responsibility attitudes were OCS specific. The findings of the present study supported that perceived mother over-protection as a developmental vulnerability factor significantly contributed to the explanation of a cognitive vulnerability factor (namely responsibility attitudes), and perceived maternal overprotection had its predictive role for OCS through responsibility attitudes.

A Discordant Monozygotic Twin Approach to Testing Environmental Influences on Sexual Dysfunction in Women

The present study explored the causal role played by putative environmental factors on variation in female sexual dysfunction (FSD) by investigating FSD discordant monozygotic (MZ) twins, which permits a control over genetic confounders. In a population-based sample of female twins aged 25-69 years (M = 55 years), MZ twins discordant for recent and lifelong FSD were selected. Sample sizes varied depending on the specific sexual problem (N = 33-90 pairs). The Female Sexual Function Index (FSFI) score was used to discriminate cases from controls. Once genetic factors were controlled for, relationship satisfaction emerged as the strongest independent predictor for recent and lifelong FSD, being associated with FSFI dimensions measuring desire, arousal, and lubrication problems. The association with orgasm problems was especially strong (OR 7.1, 95% CI: 1.9-25.3) as was the association with sexual dissatisfaction (OR 5.1, 95% CI: 2.1-12.1). Furthermore, obsessive-compulsive symptomatology was weakly associated with desire problems (OR 1.5, 95% CI: 1.4-1.8) and anxiety-sensitivity with orgasm problems (OR 1.1, 95% CI: 0.9-1.3). Negligible effects were found for personality factors and small effects for self-reported abusive experiences. These data indicate, for the first time, that in women at identical genetic risk, relationship factors play a key role in the development of sexual problems. These findings require replication in prospective designs which can provide additional powerful tests of the direction of causality between interpersonal factors and later sexual dysfunction.

Obsessive–Compulsive Symptoms and Related Sex Differences in Brain Structure: An MRI Study in Dutch Twins

Neuroimaging studies have indicated abnormalities in cortico-striato-thalamo-cortical circuits in obsessive-compulsive disorder patients, but results have not been consistent. Since there are significant sex differences in human brain anatomy and obsessive-compulsive symptomatology and its developmental trajectories tend to be distinct in males and females, we investigated whether sex is a potential source of heterogeneity in neuroimaging studies on obsessive-compulsive symptoms. We selected male and female twin pairs who were concordant for scoring either high or low for obsessive-compulsive symptoms and a group of discordant pairs where one twin scored high and the co-twin scored low. The design included 24 opposite-sex twin pairs. Magnetic resonance imaging scans of 31 males scoring high for obsessive-compulsive symptoms, 41 low-scoring males, 58 high-scoring females, and 73 low-scoring females were analyzed and the interaction of obsessive-compulsive symptoms by sex on gray matter volume was assessed using voxel-based morphometry. An obsessive-compulsive symptom by sex interaction was observed for the left middle temporal gyrus, the right middle temporal gyrus, and the right precuneus. These interactions acted to reduce or hide a main effect in our study and illustrate the importance of taking sex into account when investigating the neurobiology of obsessive-compulsive symptoms.

Performance monitoring among non-patients with obsessive–compulsive symptoms: ERP evidence of aberrant feedback monitoring

Electrophysiological studies have shown that obsessive–compulsive disorder (OCD) is associated with hyperactive performance monitoring, as indexed by the error-related negativity (ERN). The aim of the present study was to determine whether feedback monitoring is enhanced in addition to error monitoring among young adults with obsessive–compulsive symptomatology during performance of a learning task. The ERN was equivalent in amplitude for low and high OC groups. The feedback-related negativity (FRN) was more negative following presentation of incorrect feedback relative to correct feedback for the low OC group. For the high OC group, the FRN was equivalent in amplitude for correct and incorrect feedback. Young adults with high levels of obsessive–compulsive symptoms demonstrate aberrant feedback monitoring characterised by a lack of differentiation to the valence of feedback. This pattern of results may be indicative of a cognitive bias in outcome prediction associated with obsessive–compulsive symptomatology.

Magical thinking and obsessive–compulsive symptoms in Australia and Iceland: A cross-cultural comparison

A unique relationship between obsessive–compulsive symptoms and magical thinking has previously been discovered in both Australian undergraduate samples and a clinical sample. The aim of this paper is to explore the cultural dependency of this relationship. Icelandic culture was selected due to evidence of an elevated belief in telepathy and the paranormal. An Icelandic undergraduate sample was gender and age matched to an Australian sample from the Einstein and Menzies study (2004b). Results indicate that the Icelandic sample had significantly higher magical thinking, superstitious thinking, obsessive–compulsive symptoms, but was not significantly different for superstitious behaviour and the TAF-Likelihood questionnaires. In a forced simultaneous regression with obsessive–compulsive symptoms as the dependent variable, only two subscales of the DASS, stress and anxiety, as well as magical thinking continued to be correlated with obsessive–compulsive symptoms. In conclusion, magical thinking is a core construct in obsessive–compulsive symptomatology, and this relationship appears to cross cultural boundaries. In particular, a sample of Icelanders with higher levels of magical thinking also demonstrated higher levels of obsessive–compulsive symptoms.

Brain Activation During Response Interference in Twins Discordant or Concordant for Obsessive Compulsive Symptoms

One of the core behavioral features associated with obsessive compulsive symptomatology is the inability to inhibit thoughts and/or behaviors. Neuroimaging studies have indicated abnormalities in frontostriatal and dorsolateral prefrontal - anterior cingulate circuits during inhibitory control in patients with obsessive compulsive disorder compared with controls. In the present study, task performance and brain activation during Stroop color-word and Flanker interference were compared within monozygotic twin pairs discordant for obsessive compulsive symptoms and between groups of pairs scoring very low or very high on obsessive compulsive symptoms, in order to examine the differential impact of non-shared environmental versus genetic risk factors for obsessive compulsive symptomatology on inhibitory control related functional brain activation. Although performance was intact, brain activation during inhibition of distracting information differed between obsessive compulsive symptom high-scoring compared to low-scoring subjects. Regions affected in the discordant group (e.g., temporal and anterior cingulate gyrus) were partly different from those observed to be affected in the concordant groups (e.g., parietal gyrus and thalamus). A robust increase in dorsolateral prefrontal activity during response interference was observed in both the high-scoring twins of the discordant sample and the high-scoring twins of the concordant sample, marking this structure as a possible key region for disturbances in inhibitory control in obsessive compulsive disorder.

A Five-Factor Measure of Obsessive–Compulsive Personality Traits

This study provides convergent, discriminant, and incremental validity data for the Five-Factor Obsessive–Compulsive Inventory (FFOCI), a newly developed measure of traits relevant to obsessive–compulsive personality disorder (OCPD) from the perspective of the Five-factor model (FFM). Twelve scales were constructed as maladaptive variants of specific FFM facets (e.g., Perfectionism as a maladaptive variant of FFM competence). On the basis of data from 407 undergraduates (oversampled for OCPD symptoms) these 12 scales demonstrated convergent correlations with established measures of OCPD and the FFM. Further, they obtained strong discriminant validity with respect to facets from other FFM domains. Most important, the individual scales and total score of the FFOCI obtained incremental validity beyond existing measures of the FFM and OCPD for predicting a composite measure of obsessive–compulsive symptomatology. The findings support the validity of the FFOCI as a measure of obsessive–compulsive personality traits, as well as of maladaptive variants of the FFM.

Stressful life events and obsessive–compulsive disorder: clinical features and symptom dimensions

The potential role of stressful life events (SLEs) in the genesis of obsessive–compulsive disorder (OCD) has been suggested by several authors, but whether the number or the severity or the type of SLEs preceding the onset of OCD has a triggering effect is unclear. Further, sociodemographic and clinical features of OCD preceded by SLEs, and the relationship between type of SLEs and type of obsessive–compulsive symptomatology remain mainly unexplored. The aims of this study were to compare the clinical features of OCD with and without SLEs preceding it and to examine the relationship between type of SLEs and OCD symptom dimensions. The number and type of SLEs which occurred before the onset of OCD were determined in 329 patients: the raters had to decide whether an occurrence 12months before the onset of OCD would fit any of the 61 items on Paykel's list, and each event reported was carefully investigated in order to determine the exact time of occurrence. At least one event preceded the onset of OCD in 200 patients (60.8%), and this was significantly associated with female gender, abrupt onset of the disorder and somatic obsessions. Moreover, LogReg Analysis identified three specific traumatic events (“hospitalization of a family member”, “major personal physical illness”, “loss of personally valuable object”) significantly associated with a symptom dimension (symmetry obsessions, repeating, ordering/arranging, counting, and checking compulsions). Additional evidence regarding the association among SLE-preceded OCD, female gender, somatic obsessions and symmetry/ordering symptoms should be obtained to advance the understanding of OCD.

Réflexions sur la notion de workaholisme : pour une approche transactionnelle

The workaholism is a term created starting from the word alcoholism. This is why the workaholism is often associated as an addiction at work, i.e. an individual problem. Other authors describe the workaholism using various clinical diagnostics evoking a compulsive obsessive symptomatology, bulimic or anorexic problematic, ergomany, some traits of personality (compulsive obsessive, nevrosism, etc) or troubles of personality (obsessive compulsive). These descriptions of the workaholism privilege an individual psychopathological approach which forgets the professional context contrary at the notion of professional hyperactivity and professional activism suggested by Dejours. The workaholism appears as a notion as polysemic as that of stress with which it shares many common points of which the organizational framework, the occupational context, the multidimensionality of the process, etc. Consequently, the study of the workaholism raises more of the models of stress at work than that of an individual psychopathological approach. Indeed, the transactional and multidimensional models of the stress make it possible to integrate the data of the current literature on the workaholism while differentiating clearly the organizational antecedents, the individual psychological characteristics, theirs complex interactions and the negative or positive consequences on the professional performance, physical or psychological health and the professional or extraprofessional relationships.

Effects of isotretinoin on obsessive compulsive symptoms, depression, and anxiety in patients with acne vulgaris

Background: Depression, anxiety, and obsessive compulsive symptoms are known to be common among patients with acne vulgaris. In contrast to earlier reports, a number of recent studies suggested isotretinoin to be beneficial for depression and anxiety symptoms in acne patients. Moreover, its effects on obsessive compulsive symptomatology are still widely unknown. Objectives:To examine the effects of isotretinoin treatment on obsessive compulsive symptoms, depression, and anxiety in acne vulgaris patients. Methods: The Hospital Anxiety and Depression Scale, Maudsley Obsessive Compulsive Questionnaire, and Sheehan Disability Scale were administered to 43 patients with acne vulgaris who accepted isotretinoin treatment and agreed to participate in the study. Severity of acne was evaluated with Global Acne Grading System. Thirty-three patients completed 6 months treatment with oral isotretinoin at 0.5–1.0 mg/kg daily doses. Measurements were repeated at the end of 6 months. Results:Depression, anxiety, and obsessive rumination symptoms were significantly improved after isotretinoin treatment. On the other hand, obsessive doubting of acne patients was worse at the end of the treatment. There was no significant change in disease related disability of patients. Conclusion:Besides worsening of obsessive doubting, successful treatment with oral isotretinoin seems to be related with improvement in depression, anxiety, and obsessive rumination symptoms in acne vulgaris patients. These changes were not reflected in the disability level that acne patients have reported.

Genetic and environmental risk factors for sexual distress and its association with female sexual dysfunction

The DSM-V Working Group is currently re-evaluating distress as a primary diagnostic criterion for female sexual dysfunction (FSD). Here, for the first time, we explored the epidemiology of sexual distress and its putative aetiological relationship to FSD by estimating the influence of genetic and environmental risk factors. Questionnaire data on a representative sample of 930 British female twins using validated scales of FSD and sexual distress were subject to variance components analyses to quantify latent genetic and environmental factors influencing phenotypic variation and covariation. Multiple regression analyses were used to identify other potential risk factors of sexual distress. Of 319 women with any sexual problems, only 36.5% reported distress. Of women classified as functional, 16.5% felt sexual distress. Sexual distress had a heritability of 44% [95% confidence interval (CI) 0.33-0.54]. Bivariate analysis suggested that the majority (91% CI 86-99%) of the covariance between sexual distress and FSD was due to unique environmental effects common to both traits. Associations were found between sexual distress and other risk variables, including relationship dissatisfaction [odds ratio (OR) 1.6, p<0.001], anxiety sensitivity and obsessive-compulsive symptomatology (OR 1.2, p<0.01, for both). There seems to be a weak phenotypic and genetic basis for including sexual distress as a diagnostic indicator of FSD. Instead, the data indicate that unrelated psychological factors play an important role in sexual distress and tentatively suggest that sexual distress is less a consequence of FSD and more related to general anxiety among women.

Relations between a ruminative thinking style and obsessive–compulsive symptoms in non-clinical samples

There is tremendous interest in understanding the cognitive processes behind obsessive–compulsive disorder (OCD). Whereas previous research on cognitive OCD models has focused on the dysfunctional content of obsessional thinking, processes and styles of thinking have not yet been investigated. The present study investigated the relationship between a ruminative response style and obsessive–compulsive (OC) symptomatology in two non-clinical samples. In Sample 1, 261 students completed the Ruminative Response Scale, the Padua-Inventory, Revised, and the Beck Depression Inventory. Tendency to ruminate was positively correlated with the severity of OC symptoms and particularly with obsessive rumination, even after controlling for depression. Results were replicated in Sample 2 (211 students). Data indicate that a ruminative response style and obsessive rumination share common processual features. Understanding the interaction between rumination and obsessional thinking might help to further elucidate the role of cognitive vulnerability factors in OCD and to expand cognitive and metacognitive models of OCD.

The Relationship Between Magical Thinking, Thought-Action Fusion and Obsessive-Compulsive Symptoms

Thought-Action Fusion (TAF) has been consistently identified as an important cognitive construct in Obsessive-Compulsive Disorder (OCD). However, some recent studies have highlighted other variables such as negative affect (Abramow-itz, Whiteside, Lynam, & Kalsy 2003) and magical ideation (Einstein & Menzies, 2004a) that may be important in further understanding this construct. The aim of this study was to determine the relationship between negative affect, magical thinking, thought-action fusion, and obsessive compulsive symptomatology One hundred and thirty seven participants completed four questionnaires pertaining to the variables of interest. Both TAF and magical ideation were significantly related to obsessive compulsive symptomatology, with magical ideation having the stronger relationship. Negative affect was found to be a partial mediator for the relationship between both magical ideation and TAF with OC symptomatology Results suggest that magical thinking may be an important cognitive variable i...

Suppressing the white bears interacts with anxiety sensitivity in the prediction of mood and anxiety symptoms

Suppression is a commonly used strategy to manage unwanted thoughts by attempting to actively remove them from awareness. However, research has shown that this cognitive strategy often results in the paradoxical effect of increasing the frequency of unwanted thoughts. While the association between thought suppression and mood and anxiety symptoms has been repeatedly demonstrated, relations between this cognitive strategy and other anxiety risk factors such as anxiety sensitivity (AS) are unexplored. Using a nonclinical sample of young adults ( N = 414), the current investigation sought to more thoroughly investigate the association between AS and thought suppression as well as explore their synergistic effect on anxiety symptomatology. As hypothesized, thought suppression and AS were positively associated. Moreover, AS and thought suppression interacted to predict elevated levels of panic and obsessive compulsive symptomatology.

Socioemotional deficits associated with obsessive–compulsive symptomatology

Increasing emphasis has been placed on the role of socioemotional functioning in models of obsessive-compulsive disorder (OCD). The present study investigated whether OCD symptoms were associated with capacity for theory of mind (ToM) and basic affect recognition. Non-clinical volunteers ( N = 204) completed self report measures of OCD and general psychopathology, in addition to behavioral measures of ToM and affect recognition. The results indicated that higher OCD symptoms were associated with reduced ToM, as well as reduced accuracy decoding the specific emotion of disgust. Importantly, these relationships could not be attributed to other, more general features of psychopathology. The findings of the current study therefore further our understanding of how the processing and interpretation of social and emotional information is affected in the context of OCD symptomatology, and are discussed in relation to neuropsychological models of OCD.

Suicidal ideation in patients with obsessive–compulsive disorder

The risk factors for suicidal behaviour in obsessive-compulsive disorder (OCD) have been less studied compared than in other anxiety disorders. In the present study, we examined the demographic and clinical correlates of current suicidal ideation (SI) in patients with OCD. Forty-four patients were grouped into those with ( n = 23) and without current SI ( n = 21) as assessed by the Scale for Suicidal Ideation. The Yale-Brown Obsessive–Compulsive Scale (Y-BOCS) was used to assess the obsessive–compulsive (OC) symptomatology. Following Bonferroni correction, only the severity of depression differed significantly between the two groups. The presence of major depression and aggressive obsessions, the level of hopelessness, and the severity of OC symptomatology were significant predictors of current SI in patients with OCD. The relatively low frequency of some comorbid Axis I disorders is based on small sample size and therefore may be vulnerable to type II error. We did not examine the relationship between the recent suicidal attempts and OCD. Also, we did not assess the effect of impulsivity in the occurrence of SI in patients with OCD. Associated depression, hopelessness, and aggressive obsessions might play an important role in the occurrence of SI in patients with OCD. However, future studies with a psychological autopsy design are required to systematically determine the presence for OCD among those who have completed suicide.

A Psychometric Evaluation of the Thought Control Ability Questionnaire (TCAQ) and the Prediction of Cognitive Control

Study 1 evaluated the psychometric properties of the English version of the Thought Control Ability Questionnaire (TCAQ; Luciano et al. 2005), an index of perceived control over intrusive cognitions. Confirmatory factor analysis in a sample of 720 University students revealed a clear uni-dimensional structure (after removal of items 5, 7, 8, 14, and 25) with high internal consistency (α = .87, 95% CI = [.86, .88]) and test-retest reliability after a six month interval (r = .68). Correlational analyses supported an inverse relationship with measures of depression, anxiety, maladaptive cognitive control strategies, and obsessive–compulsive symptomatology. Study 2 tested the ability of the TCAQ to predict successful cognitive control during an experimental suppression protocol. Results demonstrated that weak thought control ability was predictive of the frequency and associated levels of distress of a target thought while under instruction to suppress. Additionally, weak perceived thought control ability was predictive of increased efforts to suppress the target material. Collectively, results suggest that thought control ability is a measurable individual difference variable and that the TCAQ is a reliable index of perceived cognitive control.

Normative childhood repetitive routines and obsessive compulsive symptomatology in 6‐year‐old twins

To investigate the association between normative repetitive routines of childhood and paediatric obsessive compulsive symptom syndrome (OCSS) and the extent to which it is genetically mediated. In a two-phase design a community sample of 4,662 6-year-old twin-pairs were sampled and 854 pairs were assessed in the second phase for normative repetitive routines using the Childhood Routines Inventory (CRI) and for OCSS by maternal-informant diagnostic interview. The OCSS phenotype was defined using standard diagnostic criteria for obsessive compulsive disorder, though regardless of impairment. In the bivariate model, correlation between the CRI defined phenotype and the OCSS phenotype was estimated to be .40 (95% CI .27-.50), and this correlation was attributable wholly to additive genetic effects. The bivariate model also provided estimates of heritability of the two phenotypes separately: 55% (95% CI 80-89%) for the OCSS phenotype, with the remaining variance attributable mainly to non-shared environment, and 50% (95% CI 39-62%) for CRI assessed normative repetitive routines of childhood, with 36% of the remaining variance attributable to shared environment and 14% to non-shared. The moderate correlation between normative childhood repetitive routines and obsessive compulsive symptomatology, attributable to genetic factors, is consistent with the hypothesis that high levels of this trait in young children constitute a risk factor for the development of obsessive compulsive symptoms.

Habit Reversal Treatment of Repetitive Hand Writing in a 7-Year-Old Child with a Learning Disability

Habit reversal (HR) is a cognitive—behavioral treatment for tic disorders, Tourette syndrome, stereotypic movements, and habit disorders. This case study utilizes aspects of habit reversal, including awareness training, self-monitoring, and competing response training, as an intervention for obsessive—compulsive repetitive air handwriting in a 7-year-old girl with a significant learning disability. Therapy is provided on an outpatient basis in a private practice setting. Analysis of in-home, at-school, and in-session data collected by the parents, teacher, and therapist show decreased frequency in repetitive handwriting. Supplemental and cojoint administration of antianxiety medication extinguishes all obsessive handwriting within a 6-month period. These results support previous research demonstrating the efficacy of cojoint cognitive—behavioral and medication treatment of acute obsessive—compulsive symptomatology in children.