Obsessive-compulsive Disorder Symptom Dimensions Research Articles

Are There Familial Patterns of Symptom Dimensions in Obsessive-Compulsive Disorder?

Background: Obsessive-compulsive disorder (OCD) is a heterogeneous illness, and emerging evidence suggests that different symptom dimensions may have distinct underlying neurobiological mechanisms. We aimed to look for familial patterns in the occurrence of these symptom dimensions in a sample of families with at least two individuals affected with OCD.Methods: Data from 153 families (total number of individuals diagnosed with DSM-5 OCD = 330) recruited as part of the Accelerator Program for Discovery in Brain Disorders using Stem Cells (ADBS) was used for the current analysis. Multidimensional Item Response Theory (IRT) was used to extract dimensional scores from the Yale-Brown Obsessive-Compulsive Scale (YBOCS) checklist data. Using linear mixed-effects regression models, intra-class correlation coefficients (ICC), for each symptom dimension, and within each relationship type were estimated.Results: IRT yielded a four-factor solution with Factor 1 (Sexual/Religious/Aggressive), Factor 2 (Doubts/Checking), Factor 3 (Symmetry/Arranging), and Factor 4 (Contamination/Washing). All except for Factor 1 were found to have significant ICCs, highest for Factor 3 (0.41) followed by Factor 4 (0.29) and then Factor 2 (0.27). Sex-concordant dyads were found to have higher ICC values than discordant ones, for all the symptom dimensions. No major differences in the ICC values between parent-offspring and sib-pairs were seen.Conclusions: Our findings indicate that there is a high concordance of OCD symptom dimensions within multiplex families. Symptom dimensions of OCD might thus have significant heritability. In view of this, future genetic and neurobiological studies in OCD should include symptom dimensions as a key parameter in their analyses.

Severity related neuroanatomical alteration across symptom dimensions in obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is a symptomatically heterogeneous disease. Symptoms of OCD can be grouped into a six-factor structure including washing, checking, neutralizing, obsessing, ordering and hoarding. These different symptom profiles might be one of the critical factors contributing to the inconsistent neuroanatomical findings in OCD according to the literature. In this study, whole-brain voxel-based morphometry was used to examine neuroanatomical alterations in gray matter (GM) for OCD compared to healthy controls, and the variations associated with differing symptoms of OCD. The high-quality structural imaging data from 39 OCD individuals and 42 age-matched healthy controls were recruited. First, we found increased cortical GM volume in the left postcentral gyrus in OCD participants compared to healthy controls. Next, six independent regression analyses were conducted to examine the correlation between OCD symptom dimensions and inter-individual variation in neuroanatomy. After a rigorous multiple comparison correction, greater hoarding symptom was robustly found associated with greater GM volumes at various frontotemporal regions (including orbitofrontal, middle frontal and superior temporal GMs). Additionally, greater washing symptoms were associated with increased GM volume at the superior temporal cortex. The symptom-specific GM alterations observed here support the notion that OCD is an etiologically heterogeneous disorder, with both overlapping and distinct neuroanatomical structure across symptom dimensions.

Association of insight, avoidance behavior, indecisiveness, and inflated responsibility with other clinical characteristics in children and adolescents with obsessive-compulsive disorder.

Objectives:Although the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) includes ancillary symptom dimensions – insight, avoidance, degree of indecisiveness, inflated sense of responsibility, pervasive slowness/disturbance of inertia, and pathological doubting –, we know little about their clinical/scientific utility. We examined these ancillary dimensions in childhood obsessive-compulsive disorder (OCD), and tested their associations with clinical characteristics.Methods:Treatment-seeking children and adolescents (n=173) with a DSM-5 OCD diagnosis were recruited from six centers in India and evaluated with a semi-structured proforma for sociodemographic/clinical details, the Structured Clinical Interview for DSM-5, the CY-BOCS, the Children’s Depression Rating Scale, and the Family Interview for Genetic Studies. Regression analysis was used to study the associations between ancillary dimensions (independent variables) and clinical variables (dependent variables).Results:87.9% of the sample reported at least a mild-moderate severity of ancillary dimensions, which were highly intercorrelated. Multiple ancillary dimensions were correlated with illness severity on the CY-BOCS. On regression analysis, only insight and avoidance retained significance. There were few differential associations between OCD symptom and ancillary dimensions.Conclusion:Ancillary dimensions are more a feature of illness severity than differentially associated with individual symptom dimensions in childhood OCD. Insight and avoidance should be considered for inclusion in the assessment of illness severity in childhood OCD.

Obsessive belief and emotional appraisal correlates of symptom dimensions and impairment in obsessive-compulsive disorder.

Background:Obsessive–compulsive disorder (OCD) is a heterogeneous and debilitating illness. Symptom dimensions of OCD lend homogeneous avenues for research. Variations in one's appraisal of thoughts and emotions can influence symptom dimensions and impairment. However, little is known about the combined influence of these appraisals in OCD. A clear understanding of these relationships has putative treatment implications.Aim:The aim of the study is to examine the associations among obsessive beliefs, emotional appraisals, and OCD symptom dimensions in adults.Materials and Methods:We examined 50 drug-naïve/drug-free adults with active OCD. Symptom dimensions and impairment were assessed using the Dimensional Yale–Brown Obsessive–Compulsive Severity Scale. Obsessive beliefs and emotional appraisals were studied using the Obsessive Beliefs Questionnaire-44 and Perception of Threat from Emotion Questionnaire.Results:Tobit regression analysis showed the differential association of obsessive beliefs and symptom dimensions – perfectionism/certainty associated with contamination and responsibility/threat estimation associated with aggressive obsessions. Impairment was associated with dimensional symptom severities and with the perception of threat from anger. This association remained even after controlling for depression severity and obsessive beliefs.Conclusions:OCD symptom dimensions are heterogeneous in underlying obsessive beliefs. Emotional appraisals contribute significantly to impairment alongside symptom severity. Emotion-focused interventions must be included in the psychotherapeutic interventions for OCD.

Sex differences in the association between obsessive-compulsive symptom dimensions and diurnal cortisol patterns

Previous studies in non-clinical populations suggest that obsessive-compulsive symptoms are associated with hypothalamic-pituitary-adrenal (HPA) axis measures and that there are sex differences in these associations. We aimed to replicate these findings in a sample of 57 patients with obsessive-compulsive disorder (OCD) and 98 healthy subjects. Current and lifetime OCD symptom dimensions were assessed with the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS). Depressive symptoms and state and trait anxiety were also assessed. The following HPA axis measures were analysed in saliva: the diurnal cortisol slope (calculated using two formulas: [1] awakening to 11 p.m. [AWE diurnal slope] and [2] considering fixed time points [FTP diurnal slope] from 10 a.m. to 11 p.m.) and the dexamethasone suppression test ratio (DSTR) after 0.25 mg of dexamethasone. Multiple linear regression analyses were conducted to explore the contribution of OCD symptom dimensions to each HPA axis measure while adjusting for age, sex, BMI, smoking, trait anxiety and depressive symptoms. A sex-specific association between current ordering/symmetry symptoms and AWE diurnal cortisol slope (positive association [flattened slope] in men, inverse association [stepper slope] in women) was found. Two similar sex by OCD dimensions interactions were found for lifetime aggressive and ordering/symmetry symptoms and both (FTP, AWE) diurnal cortisol slopes. Current and lifetime hoarding symptoms were associated to a more flattened FTP diurnal cortisol slope in women. The DSTR was not associated with OCD symptoms. The lifetime interference in functionality was associated with a more flattened AWE diurnal cortisol slope. In conclusion, our study suggests that there are sex differences in the association between OCD subtypes and specific HPA axis measures.

Association of SLC1A1 gene polymorphism with obsessive compulsive disorder in a sample from southern India.

The glutamate transporter gene SLC1A1 has been shown to have an association with obsessive-compulsive disorder (OCD), and serotonin reuptake inhibitor (SRI) treatment response. One polymorphism (rs3056) in SLC1A1 has been associated with altered brain volumes in OCD. We investigated the association of this polymorphism with OCD and its relationship with various clinical parameters, including age of onset, disease severity, insight, factor analyzed symptom dimensions of OCD, and SRI treatment response. Three hundred seventy seven OCD patients (DSM-IV) aged between 18 to 60 years were recruited from a specialty OCD clinic. To study the association with SRI treatment response, we analyzed full responders (≥35% reduction in the Yale Brown Obsessive Compulsive Scale [YBOCS] and the Clinical Global Impression-Improvement [CGI-I] score of 1 or 2) to any SRI (n = 187) and nonresponders (<25% reduction in the YBOCS and the CGI-I score >4) to adequate trials of at least two SRIs for a duration of 12 weeks (n = 91). Healthy controls (n = 333) were recruited and evaluated using the Mini-International Neuropsychiatric Interview-Plus (MINI-Plus). All subjects were from southern India, and were genotyped for the SLC1A1 polymorphism (rs3056). Genotype frequencies did not deviate significantly from the Hardy-Weinberg equilibrium. Case-control association analysis revealed that the "GG" genotype was significantly more frequent in OCD cases than the controls (p = .04). No association was found with the age of onset, symptom severity, insight, and symptom dimensions. No significant association was found between genotype/allele frequencies with treatment response. To conclude, although there was a significant association between the SLC1A1 rs3056 polymorphism and OCD, there were no significant associations with other clinical parameters or treatment response. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The Emotional Schemas and Obsessive-Compulsive Symptom Dimensions in People with Obsessive-Compulsive Disorder

Growing research shows an association between emotional schemas and psychopathology. Therefore, the study of emotional schemas in psychiatric disorders is an important issue regarding psychopathology. Also, emotional processes are important factors in relation to obsessive-compulsive disorder (OCD), but experimentally no study has examined the relations of emotional schemas to obsessive-compulsive (OC) symptom dimensions in people with OCD. The aims of this study were to compare emotional schemas between people with OCD and non-clinical control participants and to investigate the relationships between emotional schemas and OC symptom dimensions in OCD. Eighty individuals with OCD completed the Leahy Emotional Schema Scale (LESS) and measures of clinical characteristics. Results showed that people with OCD had higher scores on the maladaptive emotional schemas of guilt and uncontrollability than non-clinical control group. Non-clinical control participants had higher scores on the adaptive emotional schema of higher values than people with OCD. Guilt significantly predicted the OC symptom dimensions of responsibility for harm and symmetry after controlling for clinical characteristics. Uncontrollability was a significant predictor of the OC dimensions of unacceptable thoughts. These findings indicate that specific dimensions of maladaptive emotional schemas such as guilt and uncontrollability may be associated with some specific OC symptom dimensions in people with OCD. This study provided more evidence for Leahy’s emotional schema model in people with OCD.

Obsessive-compulsive symptoms and their links to depression and anxiety in clinic- and community-based pediatric samples: A network analysis

BackgroundSymptoms of depression and anxiety are common in children with obsessive-compulsive disorder (OCD) and associated with more severe OCD, greater impairment, and worse treatment outcome. Beyond twin studies showing that genetic factors contribute to the high co-occurrence, few studies have examined how OCD, depression, and anxiety are linked in youth, and current studies often fail to account for OCD and anxiety heterogeneity. MethodsNetwork analysis was used to investigate how OCD were linked to depression and anxiety in multinational youth diagnosed with OCD (total n = 419) and in school-recruited, community-based samples of youth (total n = 2 991). ResultsInitial results aligned with earlier work showing that severity of obsession-related symptoms are important in linking OCD to depression in youth with OCD. However, when symptom content of OCD (e.g., washing, ordering) was fully taken into account and when measures of anxiety were included, specific OCD symptom dimensions (primarily obsessing and doubting/checking) were linked to specific anxiety dimensions (primarily panic and generalized anxiety) which in turn were linked to depression. These results were replicated in three separate community-based samples from Chile, Italy, and Spain using different measures of anxiety and depression. LimitationsCross-sectional data were analyzed which precludes causal inference. Self-report measures were used. ConclusionsYouth with OCD with symptoms related to doubting/checking and obsessing should be carefully assessed for symptoms of panic and generalized anxiety. Non-responders to standard OCD treatment may benefit from interventions targeting panic and generalized anxiety, but more research is needed to test this hypothesis.

Obsessive compulsive disorder and thought action fusion: Relationships with eating disorder outcomes

Obsessive Compulsive Disorder (OCD) is among the most common psychiatric comorbidities with eating disorders (EDs) and most studies have only examined this relationship at a diagnostic level. More research is needed to determine whether specific symptom domains and cognitive patterns commonly observed in OCD are most salient among individuals with clinically significant EDs, and whether these symptoms appear to change and/or influence treatment outcomes. Thought Action Fusion (TAF) is one cognitive pattern that may underlie OCD-ED comorbidity. The current study assessed 112 adolescent and adult female patients at a residential ED treatment facility on levels of ED severity, OCD symptom severity, and TAF at pre- and post-treatment. All OCD symptom dimensions were positively correlated with ED severity at pretreatment, with Obsessing, Neutralizing and Ordering OCD symptoms being most elevated. TAF was also positively correlated with ED severity at pre-treatment, and higher levels of TAF at pretreatment significantly predicted greater ED severity at post-treatment after controlling for all other OCD symptoms. Improvements in TAF specific to thoughts about others also predicted improvements in ED severity after controlling for changes in OCD symptoms. Clinically, these results indicate that efforts targeting specific OCD symptom dimensions and TAF in addition to ED-focused treatment as usual may be beneficial for enhancing overall treatment outcomes.

Involvement of fear, incompleteness, and disgust during symptoms of pediatric obsessive\u2013compulsive disorder

Fear has been assigned a central role in models of obsessive–compulsive disorder (OCD), but empirical investigations into the emotions that underpin OCD symptoms are few, especially in pediatric samples. Using validated, clinician-led structured interviews, 124 youth with OCD reported on the presence and severity of symptoms across the main symptom dimensions of OCD (aggressive, symmetry, contamination) and the degree to which fear, incompleteness, and disgust accompanied these symptoms. For comparison purposes, the degree of fear, incompleteness, and disgust during symptoms was obtained also from youth with social anxiety disorder (SAD; n = 27) and generalized anxiety disorder (GAD; n = 28). Participants with OCD reported that all three emotions were involved in their symptoms; however, fear was most strongly linked to aggressive symptoms, incompleteness to symmetry symptoms, and disgust to contamination symptoms. Incompleteness differentiated youth with OCD from those with SAD and GAD. No differences for these emotions were found for youth with OCD with versus without the tic-disorder subtype or comorbid autism. A positive association between incompleteness and self-reported hoarding emerged among youth with OCD. Further studies of the emotional architecture of pediatric OCD, and its relationship to etiology and treatment, are warranted.

Adherence to exposure and response prevention as a predictor of improvement in obsessive-compulsive symptom dimensions

Exposure and response prevention (ERP) is an effective treatment for obsessive compulsive disorder (OCD); yet, improvement rates vary and it is therefore important to examine potential predictors of outcome. The present study examined adherence with ERP homework as a predictor of (a) treatment response across OCD symptom dimensions and (b) reductions in psychological factors implicated in the maintenance of OCD. Fifty adults with OCD received manualized twice-weekly ERP as part of a treatment trial. Results indicated that treatment was effective for all OCD symptom dimensions and that greater adherence with ERP homework predicted post-treatment (but not follow-up) improvements in OCD symptoms pertaining to responsibility for harm, unacceptable obsessional thoughts, and symmetry. Adherence did not predict outcomes for contamination symptoms, however. Adherence also predicted improvement in psychological maintenance factors such as obsessive beliefs and experiential avoidance. Implications of the findings include the importance of emphasizing adherence to homework instructions, as well as the importance of considering OCD symptoms dimensionally as opposed to globally in examining predictors of treatment response.

A comparative study of psychopathology and functioning in patients of obsessive–compulsive disorder with good and poor insight from a tertiary care center in North India

BACKGROUND: Degree of insight in Obsessive Compulsive Disorder (OCD) varies with different symptom dimensions of OCD and not much of studies are done in this area. There is need to study insight in more detail in patients of OCD along with psychopathology and functioning. AIMS: To study and compare Psychopathology and Functioning in Patients of Obsessive Compulsive Disorder with Good and Poor Insight. METHOD: This is a cross sectional study and 94 patients fulfilling diagnostic criteria for OCD on the basis of the ICD10-DCR were assessed on Yale- Brown obsessive compulsive scale (Y-BOCS), Dimensional Yale- Brown obsessive compulsive scale (DY-BOCS), Brown Assessment of Belief Scale (BABS) and Social and Occupational Functioning Assessment Scale (SOFAS). RESULTS: A total of 94 patients of OCD were assessed and 76 (81 %) patient had good insight (BABS CONCLUSION: Majority of patient with predominant symptoms as aggression, sexual and religious obsessions belonged to good insight group. Patients with poor insight had higher severity of illness, longer duration of illness and duration of untreated illness.

Incompleteness, harm avoidance, and disgust: A comparison of youth with OCD, anxiety disorders, and no psychiatric disorder

Psychological models of pediatric obsessive-compulsive disorder (OCD) place a heavy emphasis on harm avoidance as a maintaining factor and target for treatment. Incompleteness and disgust may also play a role in pediatric OCD but remain understudied. Youth with OCD (n = 100), anxiety disorders (n = 96), and no impairing psychiatric symptoms (n = 25) completed self-report measures of trait-level incompleteness, harm avoidance, and disgust and current symptoms of OCD, anxiety, and depression. Group differences and associations between emotions, symptoms, and pre- to post-treatment change in overall OCD severity were examined. Youth with OCD and anxiety disorders scored higher on harm avoidance and disgust than youth with no psychiatric disorder. Youth with OCD scored higher on incompleteness than youth with anxiety disorders and youth with no psychiatric disorder. Harm avoidance showed unique associations to self-reported symptoms of OCD, anxiety, and depression while incompleteness was uniquely related to OCD and disgust to anxiety. Within the OCD sample, incompleteness and harm avoidance were differentially related to the major OCD symptom dimensions, and change in incompleteness was uniquely related to pre- to post-treatment change in OCD severity. Trait-level incompleteness appears to play a central role in pediatric OCD and studies investigating its direct involvement in symptoms and associations with treatment outcome are needed. The role of disgust in relation to pediatric OCD remains unclear.

Not just thinking, but believing: Obsessive beliefs and domains of cognitive fusion in the prediction of OCD symptom dimensions.

Cognitive fusion (CF) involves the tendency to "buy in" to thoughts and feelings and consists of three empirically established domains: somatic concerns, emotion regulation, and negative evaluation. CF is hypothesized to play a role in obsessive-compulsive disorder (OCD). The present study examined how well the CF domains, relative to traditional cognitive-behavioural constructs (i.e., obsessive beliefs such as inflated responsibility), predict OCD symptoms. Fifty-two treatment-seeking adults with OCD completed self-report measures of CF, obsessive beliefs, OCD symptoms, and general distress. Domains of CF were differentially associated with the responsibility for harm, symmetry, and unacceptable thoughts of OCD dimensions; yet after accounting for obsessive beliefs, only the negative evaluation domain of CF significantly predicted symmetry OCD symptoms. Obsessive beliefs significantly predicted all OCD dimensions except for contamination. These findings provide additional support for existing cognitive-behavioural models of OCD across symptom dimensions, with the exception of contamination symptoms, and suggest that the believability of thoughts and feelings about negative evaluation adds to the explanation of symmetry symptoms. Conceptual and treatment implications, study limitations, and future directions are discussed.

Enhancing Exposure and Response Prevention Treatment in an Individual With Relationship Obsessive-Compulsive Disorder: A Case Report.

Obsessive-compulsive disorder (OCD), characterized by repetitive thoughts (obsessions) and behaviors (compulsions), is a leading cause of health-related disability in the world. Various kinds of obsessions and compulsions exist and tend to co-occur in dimensions (e.g., doubting/checking, symmetry/ordering, contamination/cleaning). Cognitive-behavioral therapy (CBT) consisting of exposure and response (ritual) prevention (ERP) is arguably the safest and most efficacious treatment for OCD. ERP involves exposing OCD patients to stimuli that provoke obsessions while coaching them to not ritualize. There is increasing evidence to suggest that the specific symptom dimensions of OCD have unique correlates and different responsiveness to ERP. Although many patients respond to ERP, only a subset achieve minimal symptoms. Given the challenges that may arise in ERP treatment of specific OCD dimensions, there has been increasing interest in examining OCD with relationship-related themes that focus on the romantic relationship or partner. In this case report, we present a case of an adult with OCD containing relationship themes and highlight ERP adaptations we utilized to improve his treatment course.

The Mediating Role of Emotion Regulation Difficulties in the Relationship Between Self-Compassion and OCD Severity in a Non-Referred Sample.

Self-compassion involves extending kindness and understanding to one's self. Research has demonstrated inverse relationships between self-compassion and maladaptive constructs associated with obsessive-compulsive disorder (OCD), including emotion regulation (ER) difficulties. The current study sought to explore associations between self-compassion, ER difficulties, and OCD severity. Data were collected at the International Obsessive-Compulsive Disorder Foundation convention from 62 attendees who reported having a diagnosis of OCD (51% male, mean age 35.9 years). Findings demonstrated that self-compassion and ER difficulties were associated with overall OCD severity. Results also indicated that ER difficulties mediated relationships between self-compassion and overall OCD severity, as well as the severity of two OCD symptom dimensions, responsibility for harm and unacceptable thoughts. These findings suggest that self-compassion and ER difficulties may be involved in the maintenance and severity of OCD.

Feelings of incompleteness explain symptoms of OCD and OCPD beyond harm avoidance

Traditional models of Obsessive-Compulsive Disorder (OCD) suggest that neutralizing behaviors are motivated by harm avoidance. However, some individuals with OCD report an experience of discomfort, rather than anxiety per se, as motivating their behavior. Incompleteness has been proposed as another potential motivator of compulsive behaviors. We examined the relative strength of harm avoidance and incompleteness in predicting OCD symptom dimensions in a nonclinical sample (n = 238). We also examined the relationship between incompleteness and symptoms of two conditions with phenotypic similarity to OCD—Obsessive-Compulsive Personality Disorder (OCPD) and Autism Spectrum Disorder (ASD). Each involves patterns of repetitive, rigid behavior. Hierarchical regressions returned that incompleteness significantly predicted OCD and OCPD symptoms after controlling for harm avoidance; in some cases, the magnitude of association was stronger for incompleteness than for harm avoidance. We suggest that a better understanding of incompleteness may help to advance conceptualization of OCD and other symptoms.

Metacognition in obsessive-compulsive disorder symptom dimensions: Role of fusion beliefs, beliefs about rituals and stop signals

The role of OCD-specific metacognitions (thought fusion beliefs, beliefs about rituals, beliefs about stop signals) has been accentuated in Wells' (2001) Metacognitive Model. This study aimed at investigating the applicability of the model in OCD symptom dimensions. Participants completed a web-based survey comprising multiple questionnaires to assess their OCD symptom dimensions, OCD-specific metacognitions, and their general metacognitions and worries. Of the 276 total respondents who completed the survey, 227 met A- and B-self-rating-criteria of the DSM-5 (American Psychiatric Association, 2013) regarding OCD; these 227 participants made up the final sample. We analyzed the participants’ responses using regression models on each OCD symptom dimension to determine how much of the variance in each model was accounted for by the different OCD-specific and general metacognitions. Results showed that when the OCD-specific metacognitive measures were added to the model, they did not explain additional variance for each OCD symptom dimension. Additionally, in the final equations we found that different patterns of OCD-specific and general metacognitive beliefs were significant predictors for different symptom dimensions. Overall, the results show that the hypothesized role of OCD-specific metacognitive beliefs as proposed by the Metacognitive Model might not be applicable to each OCD symptom dimension.

Association between miscellaneous symptoms and primary symptom dimensions among chinese adults with obsessive-compulsive disorder

Obsessive compulsive-disorder (OCD) is a common mental illness characterized by the presence of obsessions and/or compulsions. Symptom presence and severity is typically evaluated through the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). However, miscellaneous symptoms embedded within the Y-BOCS Symptom Checklist have often been overlooked despite being associated with certain dimensions. In this study, we used exploratory factor analysis and logistic regression to explore the relationship between various miscellaneous symptoms and OCD symptom dimensions among 123 Chinese adults with OCD. A four-dimensional model was factorially derived: Obsessions, Symmetry/Ritual, Contamination/Cleaning and Contamination/Cleaning. In general, 11 out of 17 miscellaneous symptoms were associated with one or more of the symptom dimensions. Among them, the Obsessions dimension was significantly associated with seven miscellaneous symptoms: “Fear of not saying just the right thing,” “Intrusive (non-violent) images,” “Intrusive nonsense sounds, words”, etc. The Symmetry/Ritual dimension was significantly associated with “Need to tell, ask, or confess.” The Contamination/Cleaning dimension was related to “Need to know or remember”. The Hoarding/Religion dimension was related to “Fear of losing things,” and “Superstitious fears”. Results contribute to the clinical assessment, diagnosis and treatment of Chinese patients with OCD by understanding the extent to which certain miscellaneous symptoms are associated with primary symptom dimensions.

Symptom-Specific Threat Perception Mediates the Relationship Between Obsessive Beliefs and OCD Symptoms

Cognitive theories of obsessive compulsive disorder (OCD) propose that obsessive beliefs bias individuals’ perception of OC-relevant threats, which in turn maintain OCD symptoms. However, no prior research has directly tested this mediational model in a clinical sample. The current study bridges this gap in the literature. Sixty adults with OCD completed a diagnostic interview, self-report questionnaires and a threat perception task. More specifically, participants rated the perceived threat associated with (a) OC-specific stimuli (e.g., toilet) that matched their most interfering symptom dimension (e.g., contamination) and (b) generally negative terms (e.g., pain). Results supported hypotheses, in that the threat associated with OC-specific—but not generally negative—terms significantly mediated the relationship between obsessive beliefs and the severity of participants’ most interfering OCD symptom dimension. Findings underscore the importance of targeting inflated perceptions of OC-specific threats in the treatment of OCD. Limitations and future directions are discussed.