Obsessive-compulsive Research Articles

Moderating Effect of Family Accommodation on the Relation between Obsessive-Compulsive Disorder Severity and Relationship Satisfaction

Moderating Effect of Family Accommodation on the Relation between Obsessive-Compulsive Disorder Severity and Relationship Satisfaction

Advancing Obsessive-Compulsive Disorder Research: Insights from Transgenic Animal Models and Innovative Therapies.

Obsessive-compulsive disorder (OCD) is a prevalent, chronic, and severe neuropsychiatric disorder that leads to illness-related disability. Despite the availability of several treatments, many OCD patients respond inadequately, because the underlying neural mechanisms remain unclear, necessitating the establishment of many animal models, particularly mouse models, to elucidate disease mechanisms and therapeutic strategies better. Although the development of animal models is ongoing, there remain many comprehensive summaries and updates in recent research, hampering efforts to develop novel treatments and enhance existing interventions. This review summarizes the phenotypes of several commonly used models and mechanistic insights from transgenic models of OCD, such as knockout mouse models. In addition, we present the advantages and limitations of these models and discuss their future in helping further understand the pathophysiology and advanced treatment. Here, we highlight current frontline treatment approaches for OCD, including neuromodulation and surgical interventions, and propose potential future directions. By studying gene mutations and observing phenotypes from available OCD animal models, researchers have classified the molecular signatures of each model reminiscent of changes in brain areas and neural pathways, with the hope of guiding the future selection of the most appropriate models for specific research in the OCD field.

Causal Structural Modeling of Survey Questionnaires via a Bootstrapped Ordinal Bayesian Network Approach

Abstract Survey questionnaires are commonly used by psychologists and social scientists to measure various latent traits of study subjects. Various causal inference methods such as the potential outcome framework and structural equation models have been used to infer causal effects. However, the majority of these methods assume the knowledge of true causal structure, which is unknown for many applications in psychological and social sciences. This calls for alternative causal approaches for analyzing such questionnaire data. Bayesian networks are a promising option as they do not require causal structure to be known a priori but learn it objectively from data. Although we have seen some recent successes of using Bayesian networks to discover causality for psychological questionnaire data, their techniques tend to suffer from causal non-identifiability with observational data. In this paper, we propose the use of a state-of-the-art Bayesian network that is proven to be fully identifiable for observational ordinal data. We develop a causal structure learning algorithm based on an asymptotically justified BIC score function, a hill-climbing search strategy, and the bootstrapping technique, which is able to not only identify a unique causal structure but also quantify the associated uncertainty. Using simulation studies, we demonstrate the power of the proposed learning algorithm by comparing it with alternative Bayesian network methods. For illustration, we consider a dataset from a psychological study of the functional relationships among the symptoms of obsessive-compulsive disorder and depression. Without any prior knowledge, the proposed algorithm reveals some plausible causal relationships. This paper is accompanied by a user-friendly open-source R package OrdCD on CRAN.

Comparison of the Effectiveness of Cognitive-Behavioral Therapy and Short-Term Psychodynamic Therapy on Cognitive Fusion and Obsessive-Compulsive Symptoms in Individuals with Obsessive-Compulsive Disorder

The aim of this study was to compare the effectiveness of cognitive-behavioral therapy (CBT) and short-term psychodynamic therapy (STPP) in reducing cognitive fusion and obsessive-compulsive symptoms in individuals with obsessive-compulsive disorder (OCD). This semi-experimental study employed a pretest-posttest design with a follow-up phase. The statistical population included individuals with OCD who sought treatment at all counseling and psychological service centers in Birjand from April to December 2023. Sixty participants were purposively selected based on Cohen’s table and were randomly assigned to two experimental groups and one control group. The first experimental group received 10 sessions of cognitive-behavioral therapy, while the second experimental group received 11 sessions of short-term psychodynamic therapy. The control group did not receive any intervention during this period. Data were collected using the Cognitive Fusion Questionnaire by Gillanders et al. (2010) and the Obsessive-Compulsive Scale by Hodgson and Rachman (1977) at three stages: pretest, posttest, and follow-up. Repeated measures ANOVA was used for data analysis. The results indicated that both cognitive-behavioral therapy and short-term psychodynamic therapy significantly reduced cognitive fusion and obsessive-compulsive symptoms at the posttest stage (p < .05), and the therapeutic effects were maintained after three months. However, no significant difference was observed between the effectiveness of cognitive-behavioral therapy and short-term psychodynamic therapy in reducing cognitive fusion and obsessive-compulsive symptoms in individuals with OCD (p > .05). Based on the findings, there is no difference in the effectiveness of cognitive-behavioral therapy and short-term psychodynamic therapy in addressing cognitive fusion and obsessive-compulsive symptoms in individuals with OCD. Both approaches can be used to reduce and manage cognitive fusion and obsessive-compulsive symptoms in affected individuals.

Avoidance of negative emotional contrasts as a diagnostic feature of OCD: A receiver-operator characteristic curve analysis of the contrast avoidance questionnaires

BackgroundModels focusing on transdiagnostic mechanisms, such as repetitive negative thinking, may be of additive value to existing conceptualizations of obsessive-compulsive disorder (OCD). One such model is the Contrast Avoidance Model (CAM), which posits that individuals with generalized anxiety disorder (GAD) are sensitive to sharp increases in emotions, and use worry to maintain heightened states of negative arousal to avoid these emotional shifts. The current study used receiver operator characteristic (ROC) curve analyses to examine the predictive utility of two contrast avoidance questionnaires in detecting probable OCD. MethodsUndergraduate students with probable OCD (N = 431) and a non-OCD group (N = 433) completed measures of contrast avoidance (CAQ-GE and CAQW) and obsessive-compulsive symptoms. ResultsResults showed significant differences in total CAQ-GE and CAQ-W scores between the probable OCD group and the non-OCD group. Area under the curve values demonstrated excellent accuracy in predicting probable OCD on the CAQ-GE and CAQW, (0.87 and 0.88, respectively). Correlation analyses revealed that certain OC symptom dimensions (e.g., Unacceptable Thoughts; Responsibility for Harm) were more closely associated with the CAQ-GE and the CAQ-W relative to other symptom dimensions. LimitationsThe study had a cross-sectional design and relied on an undergraduate sample. ConclusionIdentifying shared mechanisms across OCD and its comorbidities is an important and novel approach to understanding the etiology and maintenance of symptoms.

Characterizing autogenous and reactive obsessions using theta and beta oscillations under inhibitory demands.

Obsessive-Compulsive Disorder (OCD) is a heterogenous mental health condition that causes significant impairment and is often associated with poor treatment outcomes. The aim of the current study was to examine the association between electroencephalographic (EEG) oscillatory power during inhibitory task performance and obsessive-compulsive symptoms (OCS). OCS was assessed using the well-established the Autogenous-Reactive Obsession (AO-RO) model as the main framework to address its heterogeneous clinical manifestations. The severity of AO and RO, as primary outcome measures, was indexed using the Revised Obsessive Intrusion Inventory (ROII). Cognitive- and behavioral inhibition (CI; BI) tasks were administered while EEG data were recorded from an analogue sample of 63 undergraduate students with OCS assessed along a dimensional spectrum. Oscillatory power was computed from frontal-central electrodes Fz and Cz for theta and beta frequency bands, using event-related spectral perturbations (ERSPs), which were entered into two hierarchical linear regression models to predict the severity of AO and RO, respectively, while controlling for covariates (i.e., sex, age, ethnicity, anxiety, depression, worry, and behavioral task performance). Theta power during CI (Theta-CI) was the only significant EEG predictor of AO severity, whereas beta power during BI (Beta-BI) was the only significant EEG predictor of RO severity. These results suggest that AO severity is primarily associated with an overactive neural correlate of cognitive control, whereas RO severity is primarily associated with an overactive neural correlate of behavioral cancellation. These results agree with previous literature suggesting overactive band power representing the dysfunction within OCD. Theta-CI and Beta-BI may serve as potential biomarkers differentially associated with AO and RO among undiagnosed individuals displaying varying levels of OCS, which warrants further investigation.

Systematic Review and Meta-analysis of Individual Participant Data: Randomized, Placebo-Controlled Trials of Selective Serotonin Reuptake Inhibitors for Pediatric Obsessive-Compulsive Disorder.

Selective serotonin reuptake inhibitors (SSRIs) are the first choice in pharmacotherapy for children and adolescents with obsessive-compulsive disorder (OCD). SSRI trials for pediatric OCD have not been investigated using individual participant data (IPD), which is crucial for detecting patient-level effect modifiers. This study performed an IPD meta-analysis of efficacy of SSRIs compared with placebo and a meta-regression on baseline patient characteristics that might modify efficacy. Crude participant data from short-term, randomized, placebo-controlled SSRI trials for pediatric OCD were obtained from the registry of the Dutch regulatory authority. A systematic literature search was also performed, and authors were approached to provide IPD. A 1- and 2-stage analysis was conducted, with change on Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) as the primary outcome. Odds ratio (OR) with≥35% CY-BOCS reduction was used as the responder outcome measure. Modifying effect of age, sex, weight, duration of illness, family history, and baseline symptom severity was examined. The Cochrane RoB 2.0 tool was used to examine methodological rigor, and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to examine certainty of evidence. Data were obtained from 4 studies comprising 614 patients. The sample represented 86% of all participants ever included in double-blind placebo-controlled SSRI trials for pediatric OCD. Meta-analysis showed reduction of 3.0 CY-BOCS points compared with placebo (95% CI 2.5-3.5), corresponding to a small effect size (0.38 Hedges' g). Analysis of response showed an odds ratio of 1.89 (95% CI 1.45-2.45). Of all possible modifiers, severity was correlated negatively with odds ratio for response (β=-0.92, p= .0074). Risk of bias was generally low. All studies were performed in North America with an overrepresentation of White participants. Findings were limited by inability to include data on additional variables such as socioeconomic status and comorbidities. This IPD meta-analysis showed a small effect size of SSRIs in pediatric OCD, with baseline severity as a negative modifier of response. Generalizability of findings might be limited by selective inclusion of White, North American participants. Patient Characteristics and Efficacy of SSRI Treatment in Children and Adolescents With Obsessive Compulsive Disorder: An Individual Participant Data Meta-analysis of Randomized, Placebo-Controlled Trials; https://www.crd.york.ac.uk; CRD42023486079.

Concentrated Cognitive-Behavior Therapy for Unmedicated Children and Adolescents with Obsessive-Compulsive Disorder in Routine Clinical Care: A Randomized Controlled Trial with a 6-month Naturalistic Follow-up

Concentrated Cognitive-Behavior Therapy for Unmedicated Children and Adolescents with Obsessive-Compulsive Disorder in Routine Clinical Care: A Randomized Controlled Trial with a 6-month Naturalistic Follow-up

Phenomenology of incompleteness and harm avoidance in obsessive-compulsive disorder: An experience sampling study

Phenomenology of incompleteness and harm avoidance in obsessive-compulsive disorder: An experience sampling study

Neurotrophin-3 as a mediator in the link between PM2.5 exposure and psychiatric disorders: A Mendelian randomization study.

The causal relationship between PM2.5 (particulate matter with an aerodynamic diameter ≤2.5 μm) and common mental disorders, along with its neuropathological mechanisms, remains unclear. We used genome-wide association study datasets from the UK Biobank and Psychiatric Genomics Consortium to systematically investigate the causal relationship between PM2.5 and nine common psychiatric disorders using two-sample Mendelian randomization (TSMR) methods. Subsequently, we used two-step MR to investigate the mediating effect of 108 potential mediators in the association between PM2.5 and mental disorders. Our findings indicated that PM2.5 was positively associated with major depressive disorder (odds ratio (OR): 1.33, 95 % confidence interval (CI): 1.11-1.55), anxiety disorder (OR: 2.96, 95 % CI: 2.13-3.79), schizophrenia (OR: 1.55, 95 % CI: 1.29-1.81), and attention deficit hyperactivity disorder (ADHD) (OR: 1.95, 95 % CI: 1.66-2.24). Unexpectedly, PM2.5 was inversely associated with bipolar disorder (OR: 0.65, 95 % CI: 0.37-0.93). Additionally, PM2.5 was not significantly associated with autism spectrum disorders (OR: 1.24, 95 % CI: 0.83-1.65), post-traumatic stress disorder (OR: 1.51, 95 % CI: 1.11-1.91), obsessive-compulsive disorder (OR: 0.81, 95 % CI: -0.07-1.69), or anorexia nervosa (OR: 1.42, 95 % CI: 0.86-1.98). Further analysis using two-step MR revealed that Neurotrophin-3 mediated 9.86 % of the PM2.5-ADHD association and 5.88 % of the PM2.5-schizophrenia association. Sensitivity analyses supported these findings. This TSMR analysis provides a comprehensive examination of the causal relationship between PM2.5 exposure and nine common psychiatric disorders, with mediation analysis offering insight into the underlying mechanisms. This study aims to raise public awareness of how air quality affects mental health through empirical evidence.

Neurocognitive performance in obsessive-compulsive disorder before and after treatment with cognitive behavioral therapy

Neurocognitive performance in obsessive-compulsive disorder before and after treatment with cognitive behavioral therapy

Associations between emotion regulation, symptom severity, and affect in obsessive-compulsive disorder

Associations between emotion regulation, symptom severity, and affect in obsessive-compulsive disorder

Involuntary autobiographical memories as a transdiagnostic factor in mental disorders.

Involuntary autobiographical memories are memories of personal events that come to mind with no preceding retrieval attempts. They have been studied broadly in autobiographical memory for decades and shown to be common and mostly positive in everyday life. Clinical literature has focused on negative intrusive memories of stressful events and tended to neglect other forms of involuntary autobiographical memories. However, recently, there has been an upsurge of research addressing involuntary memories more broadly in clinical disorders, including both stressful and mundane memories, and both real life events and simulated events. We here provide the first integrated and comprehensive review of all studied types of involuntary memories in clinical and subclinical populations. We review their frequencies and characteristics across a broad selection of memory properties. A systematic search of the PsycInfo, PubMed, and Web of Science databases yielded 79 empirical studies, with the majority focusing on depression, post-traumatic stress disorder, and psychosis, and a few addressing attention-deficit/hyperactivity disorder, bipolar disorder, eating disorders, health anxiety, obsessive-compulsive disorder, and social anxiety. Findings show that an increased frequency of involuntary memories-in all forms-is found across disorders, possibly reflecting executive deficits. Additionally, heightened negativity, greater emotional impact, and the use of maladaptive emotion regulation strategies in response to these memories are typically reported among individuals with PTSD and depression, but less consistently for psychotic disorders. Overall, the findings identify involuntary memories with distinct characteristics as a transdiagnostic phenomenon, suggesting a deeper understanding of mental health problems and more targeted treatment approaches.

Reappraising beliefs about losing control: An experimental investigation.

Beliefs about losing control over one's thoughts, emotions, behaviours, and/or bodily functions have been shown to cause obsessive-compulsive symptoms. The cognitive model of obsessive-compulsive disorder (OCD) suggests that catastrophic misappraisals of intrusions will lessen if underlying maladaptive beliefs are effectively reduced. The primary aim of this study was to experimentally investigate whether preexisting negative appraisals about losing control could be reduced by reappraising a previous perceived loss of control. A sample of (n=52) undergraduate participants underwent either a brief cognitive intervention or a control memory task. Negative appraisals about losing control and anxiety were measured before and after the manipulation. In comparison to participants in the control condition, participants in the experimental condition reported a significantly greater reduction in negative appraisals about having lost control (F(1, 50)=10.79, p=.002, ηp2=.18) and about losing control in the future (F(1, 50)=7.82, p=.007, ηp2=.14) but not anxiety F(1, 50)=.81, p=.37, ηp2=.02). The absence of an impact on anxiety may be attributed to an underpowered sample size or the lack of a more robust intervention. Results suggest that pre-existing beliefs about losing control can be reduced via a brief cognitive reappraisal-based intervention. Findings are discussed with respect to clinical and phenomenological implications.

The clinical phenomenology of skin-picking disorder - Are there any obsessive-compulsive components?

Skin-picking disorder (SPD) is currently conceptualized as a condition related to obsessive-compulsive disorder (OCD). The present study investigated whether the emotional, cognitive, and somatic components of skin-picking episodes align with this conceptual framework. A total of 134 patients diagnosed with SPD (mean age=32years; 84% female; average symptom duration: 16years) underwent in-person clinical assessment. Patients were asked to describe what they experienced directly before, during, and after picking their skin. Patients reported a very strong urge to manipulate their skin, particularly in situations characterized by emotional and/or bodily tension. No obsession-like phenomena preceded the skin-picking episodes. Skin manipulation had an immediately rewarding effect in the majority of patients or induced 'trance-like' states. After terminating a skin-picking episode, negative self-conscious emotions were dominant. The interview findings do not align with the conceptualization of SPD as an OCD-related disorder. Patients reported no obsession-like symptoms, and their skin-picking behaviors did not serve harm prevention, which is characteristic of compulsions. Instead, the rewarding nature of skin-picking and its function in experiential avoidance suggests an addiction component to this behavior.

Exploring Inhibitory Control Processes in Highly Superior Autobiographical Memory (HSAM): A Single Case Study.

Individuals who possess a Highly Superior Autobiographical Memory (HSAM) can remember their own lives in exceptional detail, retrieving specific autobiographical events in response to dates (e.g., 15th April 1995). The phenomenon remains extremely rare, and little is known about why these individuals can remember substantially more than the general population, without being continually flooded by past memories. According to the cognitive inhibition dependency hypothesis, inhibitory processes modulate general autobiographical memory by determining which memories will (and will not) enter one's consciousness. We hypothesised that these control processes are amplified in HSAM, protecting them from being overwhelmed by their abundance of memories. To explore if cognitive inhibition is exceptional in HSAM, a single case with HSAM (DT) and 20 matched controls completed a battery of 6 tasks assessing various aspects of inhibition (e.g., memory, prepotent motor responses). Participants also completed a screening for obsessive compulsive disorder and autism. Results indicate that DT's inhibitory functioning is comparable to that of the typical population, and thus not exceptional. We conclude that inhibition is unlikely to be the best explanation for extraordinary remembering and add to the growing body of literature that HSAM can occur in the absence of clinical symptomatology. Results are discussed in relation to future directions of HSAM research.

The High Place Phenomenon: Associations With Markers of Positive and Negative Mental Health in Individuals Suffering From Specific Phobia or Agoraphobia.

The Call of the Void phenomenon describes an inexplicable urge to consider dangerous or self-destructive actions in certain situations. Previous studies have focused on the high place phenomenon (HPP), which is the sudden urge to jump from high places. One aim of this study is to replicate the previously found associations of HPP with suicidality and anxiety in a larger sample of patients suffering from flight phobia or agoraphobia. Furthermore, the influence of personality traits and protective factors, such as self-efficacy and self-esteem, will be examined to identify associations between the HPP and potential markers of both positive and negative mental health. The study sample comprised 612 patients (76% female; Mage = 43.77, SDage = 12.82) suffering from clinically relevant fear of flying. Participants filled out questionnaires on experiences with the high place phenomenon, depression, personality traits, anxiety sensitivity, suicidal ideation, insecurity in social contact, flight phobia symptoms, positive mental health, self-efficacy expectations, self-esteem and satisfaction with life. Consistent with previous findings, the high place phenomenon was known to nearly 43% of the patient sample. Multiple regression analysis showed that openness to experiences, neuroticism, suicidal ideation and insecurity in social contacts were positively related to the high place phenomenon, whereas agreeableness, self-efficacy and self-esteem were negatively related. The high place phenomenon is a common experience in individuals, whether or not they suffer from suicidal ideation. It is therefore cautioned not to interpret such experiences as an expression of a hidden death wish. Nevertheless, the occurrence of the HPP is influenced by the presence of negative and positive mental health markers. Future studies should examine the association between HPP and intrusions in the context of obsessive-compulsive disorders.

A Disposable Pipette Extraction-UHPLC-MS/MS Method Based on Removal of Phospholipids to Determine Anandamide, 2-Arachidonoylglycerol, Cannabidiol, and Δ9-Tetrahydrocannabidiol in Plasma Samples.

Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC), the main components of Cannabis sativa plants, can interact with specific cell receptors known as cannabinoid receptors (CBs). The endogenous compounds anandamide (AEA) and 2-arachidonoylglycerol (2-AG) are CB agonists, and, alongside enzymes, they constitute the endocannabinoid system (ECS) and take part in neuromodulation. Several LC-MS/MS methods have been developed to quantify these compounds in biological matrixes, but a fast and simple method that can determine these analytes in plasma samples simultaneously is not available. Here, we propose a disposable pipette extraction technique containing a zirconia-based sorbent (DPX(Zr)) combined with UHPLC-MS/MS analysis to determine CBD, THC, AEA, and 2-AG in plasma samples, simultaneously. The method combines simple protein precipitation (PPT) with a one-step DPX procedure to remove phospholipids, one of the most common endogenous interferents in biological samples. Optimization of the combined PPT-DPX sample preparation method reduced the matrix effect and improved the sensitivity of the analytical method. The validated DPX(Zr)-UHPLC-MS/MS method reported LLOQs of 0.1ng mL-1 for AEA and 2-AG and 1ng mL-1 for CBD and THC. The method demonstrated intra- and interassay accuracy and precision of less than 20% for the LLOQ, and less than 15% for the other calibration points. Additionally, no carryover or significant matrix effect was observed. We applied this method to determine AEA, 2-AG, and CBD in plasma samples obtained from obsessive-compulsive disorder patients treated with CBD.

Clinical Insights into PTSD and OCD Comorbidity

This paper examines the complex relationship between post-traumatic stress disorder (PTSD) and obsessive- compulsive disorder (OCD), highlighting how trauma can not only exacerbate, but also trigger the onset of obsessive-compulsive symptoms, contributing to treatment resistance. Both disorders share overlapping features such as intrusive thoughts, avoidance behaviors, and abnormalities in brain regions responsible for emotional regulation, including hyperactivity in the amygdala and hypoactivity in the prefrontal cortex. Trauma-induced OCD, which often emerges after trauma, tends to be more resistant to standard treatments like exposure and response prevention (ERP) due to the heightened emotional distress linked to trauma memories. This paper also discusses the neurobiological underpinnings of these comorbid conditions, presenting evidence of disrupted cortico-striatal- thalamo-cortical (CSTC) circuits, which affect fear processing and cognitive control. By incorporating trauma- focused interventions, such as trauma-sensitive ERP, prolonged exposure therapy (PE), and mindfulness-based cognitive therapy (MBCT), clinicians can more effectively address the emotional dysregulation that drives and exacerbates OCD symptoms. A case study of a treatment-resistant OCD patient with comorbid PTSD underscores the need for tailored, multidimensional approaches to improve clinical outcomes. The findings stress the importance of early trauma identification and integrating cognitive-behavioral strategies with trauma-informed care to promote lasting recovery in patients with these dual diagnoses.

Obsessive Compulsive Disorder, its contributing factor and its relationship with depression among private medical students of Islamabad: an analytical cross-sectional study

Obsessive Compulsive Disorder, its contributing factor and its relationship with depression among private medical students of Islamabad: an analytical cross-sectional study