Obsessive-compulsive Symptom Dimensions Research Articles

Breaking the cycle: Exploring the relationship of metacognition beliefs, obsessive-compulsive symptoms, and psychosocial performance among individuals diagnosed with schizophrenia.

This research paper explores the intricate relationship between metacognitive dysfunctional beliefs, obsessive-compulsive symptoms, and psychosocial performance in patients diagnosed with schizophrenia. Understanding these dynamics can help mental health nurses identify and address each patient's needs more effectively. It can guide them in devising personalized care plans that not only manage the symptoms but also improve the underlying mechanism that exacerbates the psychotic symptoms and social functioning and the overall quality of life. Moreover, the findings of this research can contribute to developing training programs for mental health nurses, equipping them with the necessary skills and knowledge to provide optimal care. What the paper adds to existing knowledge? • This study provides empirical evidence of the significant positive correlation between OCS and metacognitive dimensions in individuals with schizophrenia. • It highlights the role of certain demographic factors, such as younger age and single marital status, in increasing the likelihood of elevated OCS. • It underscores the inverse relationship between higher metacognitive dysfunctional beliefs and lower levels of psychosocial functioning. • It identifies age and metacognitive scores as crucial predictors of psychosocial functioning across various domains. What are the implications for practice? • The findings suggest that therapeutic nursing interventions for individuals diagnosed with schizophrenia should address metacognitive dysfunctional beliefs to improve overall functioning and well-being. • Clinicians, including psychiatrists and psychiatric nurses, should consider the patient's age, marital status, and metacognitive scores when assessing the risk of elevated OCS and devising treatment plans. • The study emphasizes the need for comprehensive psychiatric nursing assessment, including metacognitive dysfunction and OCS evaluation. What are the implications for future research? • Future research could explore the causal relationships between metacognitive dysfunctional beliefs, OCS, and psychosocial functioning in schizophrenia. • Longitudinal studies could provide insights into the progression of these relationships over time and the impact of therapeutic interventions. • Further research could also investigate the effectiveness of specific therapeutic strategies such as Metacognitive Therapy (MCT), Schema Therapy (ST), Cognitive Enhancement Therapy (CET), and Cognitive Behaviour Therapy (CBT) to address this population's metacognitive dysfunctional beliefs. BACKGROUND: Schizophrenia is a chronic mental health disorder that significantly impacts an individual's cognitive, emotional and social functioning. Recent research has highlighted the role of metacognitive beliefs and obsessive-compulsive symptoms (OCS) in the psychosocial performance of individuals diagnosed with schizophrenia. Understanding these relationships could provide valuable insights for developing more effective nursing interventions. This study aimed to investigate the relationship between metacognitive beliefs, OCS and psychosocial performance among individuals diagnosed with schizophrenia. A cross-sectional survey was conducted involving 174 purposively selected participants diagnosed with schizophrenia. The Meta-Cognitions Questionnaire-30, Young Adult Self-Report Scale for OCS and Specific Level of Functioning Scale were used to gather the necessary data. The study found a significant positive correlation between OCS and metacognitive dimensions. Age was a significant predictor with an Oddis Ratio of 2.471. The metacognitive dysfunction was a highly significant predictor in univariate and multivariate analyses, with Oddis Ratios of 1.087 and 1.106, respectively. The study also discovered that higher levels of metacognitive dysfunctional beliefs were associated with lower levels of psychosocial functioning. Age and the metacognitive dysfunction score were significant predictors of psychosocial functioning scores, accounting for 26.8% of the variance in these scores. The study reveals a compelling inverse relationship between higher metacognitive dysfunctional beliefs and lower levels of psychosocial functioning in individuals diagnosed with schizophrenia. It also identifies certain demographic factors, such as younger age, as significant contributors to elevated OCS. Importantly, metacognitive dysfunction emerged as a critical predictor of psychosocial functioning across various domains. These findings underscore the potential of incorporating metacognitive-focused interventions in the treatment plans for schizophrenia patients. By addressing these cognitive patterns, healthcare professionals can enhance overall functioning and well-being in individuals diagnosed with schizophrenia.

The emergence of new obsessions and compulsions after COVID-19: a case report

IntroductionThe coronavirus pandemic has affected mental health since its outbreak in 2019 and several studies have revealed that obsessive-compulsive disorder (OCD) patients were adversely affected.ObjectivesThe aim of our present report is to study the impact of the coronavirus infection on OCD.MethodsWe illustrate a case of new emerging obsessions and compulsions after a COVID-19 infection in a patient consulting at the Psychiatry C department of the Hedi Chaker University Hospital.ResultsMr. HB first presented in our outpatient unit of the Psychiatry C department at the age of 32. His medical history was unremarkable except for a COVID-19 infection in June 2022 that did not cause any organic complications. His family history was negative without neurological and psychiatric diseases. Further history revealed that OCD symptoms already started before his infection with COVID-19. At that time, he suffered from compulsions with the urge to constantly wash his hands and check rituals, but his symptoms were not severe enough to make him seek a psychiatric consult or treatment. However, since July 2022, soon after his infection with COVID-19, he suffered from new obsessions and compulsions, he would spend hours calculating all the numbers he sees and counting the number of letters in the words he came across. Non-surprisingly, OCD symptoms caused relevant problems in social life, and at work, he had difficulties concentrating and working. Due to his symptoms, he had neglected hobbies, avoided social contact, spent less time with his family, and even had suicidal thoughts. Therefore, pharmacotherapy with clomipramine was initiated with a maximal dose of 150 mg/d. Because of adverse events and lack of efficacy, he stopped medication and decided to consult our department to seek a different treatment. Therefore, sertraline was started at the dose of 50 mg/d along with psychotherapy.ConclusionsPeople with OCD are likely to be more susceptible to the mental health impact of COVID-19. Responses to the pandemic are not only associated with an increase in all Obsessive-Compulsive (OC) symptoms and their severity but also the emergence of new types of obsessions and compulsions. Consequently, therapists should consider the effects of the pandemic on all OC symptom dimensions and adjust their treatment plans accordingly.Disclosure of InterestNone Declared

The contribution of inferential confusion and fear of self to psychological models of obsessive-compulsive symptoms: A dimensional approach

Current psychological models of obsessive-compulsive disorder account for a surprisingly small degree of variability in obsessive-compulsive (OC) symptoms in statistical models. The current study examined whether constructs from the inference-based approach to OCD (i.e., inferential confusion and fear of self) explain OC symptom dimensions above and beyond what is explained by the prevailing cognitive appraisal model. Undergraduate participants (N = 339) completed a battery of self-report questionnaires assessing OC symptoms, obsessive beliefs, inferential confusion, and fear of self. Results revealed that both psychological models together accounted for about one quarter of the variance in OC symptoms. The inference-based approach concepts most closely aligned with responsibility, symmetry, and unacceptable thoughts, and added explanatory value to appraisal models of these symptom domains. Limitations and future directions are discussed.

Self-Compassion and Obsessive–Compulsive Symptoms in a Non-Clinical Sample: Insights from Network Analysis and Canonical Correlation Analysis

ObjectivesThe goal of the present study was to investigate the hypothesized complex interactions between dimensions of self-compassion and obsessive-compulsive symptoms (OCD) in a non-clinical sample.MethodFour hundred and twenty-four individuals (273 women) ranging in age from 18 to 83 years (M = 41.00; SD = 14.50) participated in the cross-sectional survey. The participants completed the Self-Compassion Scale (SCS) and the Obsessive-Compulsive Inventory—Revised (OCI-R). ResultsCertain dimensions of self-compassion were found to be associated with specific OCD symptoms, with positive dimensions (except Common humanity) correlating with reduced Obsessing, Hoarding, and Ordering, and negative dimensions correlating with all OCD symptoms. Canonical correlation analysis indicated three significant linkages: (1) between Isolation, Over-identification, and Obsessing, (2) between Self-judgment, Over-identification, Ordering, and Checking, and (3) between Self-judgment and Neutralizing. Exploratory graph analysis challenged the structure of the SCS and the OCI-R, suggesting two dimensions of self-compassion, compassionate self-reference and uncompassionate self-reference; and two dimensions of OCD, obsessing and other OCD symptoms. The Obsessing subscale appeared as a bridge between uncompassionate self-reference and OCD symptoms. Compassionate self-reference was negatively correlated with uncompassionate self-reference and obsessing, whereas uncompassionate self-reference was positively correlated with obsessing and OCD symptoms.ConclusionsInvestigation of the associations between self-compassion and psychopathology should avoid aggregating the uncompassionate and compassionate dimensions of self-compassion. The significant associations in the network of self-compassion and OCD symptoms were between uncompassionate self-reference, obsessing, and OCD symptoms.PreregistrationThis study is not pre-registered.

Experiential avoidance and obsessive-compulsive symptoms in University students

Experiential avoidance is functional diagnostic dimension which refers to the unwillingness to engage with distressing thoughts, feelings, memories, and other internal experiences, despite the subsequent impairment it may cause. The spectrum of obsessive-compulsive symptoms (OCS) is often associated with anxiety and avoidant behaviors. It is still unknown the relation of each OCD dimension with experiential avoidance. This study aims to examine the relationship between dimensions of obsessive-compulsive symptoms and experiential avoidance in a college student sample. A total of 390 undergraduate students participated in this investigation, completing online surveys including DYBOC-short version and the Brief Experiential Avoidance Questionnaire (BEAQ), alongside assessments of anxiety (Generalized Anxiety Disorder 7-Item Scale) and depressive symptoms (Patient Health Questionnaire-9). The findings indicated a significant correlation between experiential avoidance, obsessive-compulsive symptom scores, and depression scores within a non-clinical sample.

Is Acceptance and Commitment Therapy Effective for Any Obsessive-Compulsive Symptom Dimensions?

Acceptance and commitment therapy (ACT) has been recently introduced for treating obsessive-compulsive disorder (OCD). Although there are data supporting the efficacy of ACT, only few studies have investigated the effectiveness of ACT against any obsessivecompulsive (OC) symptom dimension or a specific dimension alone. In total, 64 patients with OCD received an 8-session ACT group program. All measures were evaluated before and after treatment. The Dimensional Obsessive-Compulsive Scale was used to assess OCD severity across the four empirically supported symptom dimensions (i.e., contamination, responsibility for harm, unacceptable thoughts, and symmetry). ACT processes were evaluated using the Acceptance and Action Questionnaire-II (AAQ-II), Acceptance and Action Questionnaire for Obsessions and Compulsions (AAQOC), and Cognitive Fusion Questionnaire. After an 8-week program, there were significant reductions in all four OC symptom dimensions after ACT. The unacceptable thoughts and contamination domains had medium effect size. The responsibility for harm and symmetry dimensions had small effect size. The unacceptable thoughts dimension was significantly correlated with all ACT process measures. The symmetry dimension was significantly correlated with AAQ-OC and AAQ-II scores while the responsibility for harm dimension was correlated with AAQ-II alone. However, the contamination dimension was not associated with any process measures. ACT may be effective for managing all four symptom dimensions with small to moderate effect size. Moreover, depending on the symptom dimension, there may be different relationship patterns between symptom reduction and changes in ACT processes.

Obsessive-Compulsive Symptoms in Children Are Related to Sensory Sensitivity and to Seeking Proxies for Internal States.

Symptoms of obsessive-compulsive disorder are related to atypical sensory processing, particularly sensory over-responsivity, in both children and adults. In adults, obsessive-compulsive symptoms are also associated with the attenuation of access to the internal state and compensatory reliance on proxies for these states, including fixed rules and rituals. We aimed to examine the associations between sensory over-responsivity, the tendency to seek proxies for internal states, and obsessive-compulsive symptoms in children. Parents of 404 children between 5 and 10 years of age completed online measures of obsessive-compulsive symptoms, seeking proxies for internal states, sensory over-responsivity, and anxiety. Linear regression, dominance analysis, and network analysis were used to explore the unique associations between these variables. The tendency to seek proxies for internal states was more strongly associated with obsessive-compulsive symptoms than with anxiety symptoms and uniquely associated with all major obsessive-compulsive symptom dimensions except obsessing. Both the tendency to seek proxies for internal states and sensory over-responsivity were significantly associated with obsessive-compulsive symptoms, but the association was significantly stronger for the tendency to seek proxies for internal states. While limited by the sole reliance on the parent-report, the present study shows that the tendency to seek proxies for internal states could help clarify the developmental processes involved in the onset of obsessive-compulsive symptoms during childhood and that sensory sensitivity may be important to consider in this process.

Severity and Changes in OCD Dimensions during COVID-19: A Two-Year Longitudinal Study.

The COVID-19 pandemic appears to be associated with a worsening of obsessive-compulsive symptoms in both young people and adults with OCD and it is necessary to analyze the variables involved in this worsening over time. The main aim of this study was to examine long-term changes in total severity and obsessive-compulsive dimensions in obsessive-compulsive patients during the COVID-19 pandemic. A total 250 OCD patients were selected from various associations, clinical centers and hospitals. We discarded 75 as they did not meet the inclusion criteria. A total of 175 obsessive-compulsive participants aged between 16 and 58 years old (M = 33.33, SD = 9.42) were evaluated in obsessive-compulsive symptom severity and dimensions OCD assessed using the Y-BOCS and D-YBOCS scales in T1 (April-June 2020) and in T2 (March-April 2022). The evaluation was carried out through an online survey and face-to-face with a professional clinician at both time points. Intragroup differences in severity were observed, reaching higher scores for patients with contamination, somatic, aggressive and religious. Some patients changed their main dimension, increasing the percentage of patients with contamination and somatic obsessions. COVID-19 was associated with both changes in severity and also affected some dimensions more than others, particularly those related to the virus itself (contamination and somatic).

Obsessive-Compulsive Symptom Dimensions and Their Relationships with Obsessive Beliefs: A Structural Equation Modeling Analysis.

Dysfunctional beliefs are central in the development and maintenance of obsessive-compulsive disorder (OCD) as well as its treatment. Yet, research suggests that not all dysfunctional beliefs are equally important for each of the symptom dimensions of OCD. However, results are inconsistent in that studies contradict each other regarding the associations between specific symptom dimensions and belief domains. The aim of the present study was to clarify which belief domain is specifically associated with which OCD symptom dimension. Results could help to tailor treatments more specifically to the patient's OCD symptom dimension. In- and outpatients with OCD (N = 328; 43.6% male and 56.4% female) filled out questionnaires on symptom dimensions of OCD (Obsessive-Compulsive Inventory Revised) and dysfunctional beliefs (Obsessive Beliefs Questionnaire). A structural equation model analysis was conducted to identify the associations between dysfunctional beliefs and symptom dimensions. Our results showed that perfectionism/intolerance of uncertainty was associated with hoarding and symmetry/ordering, (2) overestimation of threat/inflated responsibility was associated with checking compulsions, and (3) importance of thoughts/control of thoughts was associated with obsessing. These results were largely supported by a backward selection. Our results demonstrated associations of specific dysfunctional beliefs and specific OCD symptom dimensions. However, future studies are necessary to replicate these findings with other measures (e.g., clinician ratings).

Obsessive-compulsive symptom profiles vary by index trauma type in a trauma-exposed community sample

Trauma exposure has been associated with the development or worsening of obsessive-compulsive (OC) symptoms and predicts poorer response to treatment for OCD. Although several studies have examined the relationship between OC symptoms and trauma, extant research is limited by a dearth of studies considering both OC symptom dimensions and trauma type, and by a static conceptualization of OC symptoms. Because most individuals experience OC symptoms across dimensions, profiles of OC symptoms would better reflect the dynamic presentation of OC symptoms following trauma exposure. Accordingly, the aim of the present study was to replicate and extend prior work by examining both between-group and within-group how the presentation of OC symptom dimensions varies across several trauma types in a large sample of adults with a history of trauma exposure (N = 329). Participants were grouped based on the nature of their index trauma and a profile analysis was performed. Significant between-group differences provided evidence that certain types of traumatic events have unique associations with particular OC symptom dimensions. Moreover, unique profiles of OC symptoms characterize survivors of different trauma types, a conceptualization that provides nuance for how survivors present in the real world. Study limitations and implications are discussed.

The effects of brief emotional acceptance instructions on emotional distress and compulsive urges of various obsessive-compulsive symptoms dimensions

Background and Objectives: Emotion regulation (ER) deficits are increasingly implicated in obsessive-compulsive symptoms (OCS). The ER difficulty of ‘non-acceptance of emotions’ has been most consistently found to correlate with OCS – albeit not uniformly with all OCS dimensions. This study examined the causal relationships between the acceptance of emotions and four OCS dimensions: contamination, responsibility of harm, unacceptable thoughts and symmetry. Methods: Participants in this online study rated their baseline emotional distress and compulsive urges to OC scenarios corresponding to each OCS dimension. After completing questionnaires on ER, OCS, anxiety and depressive symptoms, participants were randomly assigned to two conditions and instructed to observe and accept their emotions (acceptance condition; n = 180) or observe their emotions (control condition; n = 185) as they re-read the scenarios. Participants then rated their post-manipulation emotional distress and compulsive urges to each scenario. Results: The instructions to accept emotions resulted in lower compulsive urges to the responsibility of harm scenario, for participants with lower baseline compulsive urges. There were no other group differences on post-manipulation measures. Conclusions: The current findings suggest that even brief instructions to accept one’s emotions reduced compulsive urges, pointing to the potential clinical utility of enhancing the acceptance of emotions.

Impact of the COVID-19 pandemic on obsessive-compulsive symptoms in the Swiss general population.

In the early stages of the COVID-19 pandemic, mental-health experts called attention to a possible deterioration of obsessive-compulsive symptoms (OCSs). In particular, people suffering from a fear of contamination were considered a vulnerable population. The aim of this study was to investigate the change in OCSs from before to during the pandemic within the Swiss general population, and to examine a possible relationship of OCSs to stress and anxiety. This cross-sectional study was implemented as an anonymized online survey (N = 3,486). The Obsessive-Compulsive Inventory-Revised (OCI-R) was used to assess global OCS severity (range: 0-72, clinical cut-off > 18) and specific OCS dimensions (range: 0-12) during the second wave of the pandemic and retrospectively for before the pandemic. Participants were asked to report stress and anxiety in the previous 2 weeks before the survey. Participants reported significantly higher OCI-R total scores during (12.73) compared to before the pandemic (9.04, mean delta increase: 3.69). Significantly more individuals reported an OCI-R total score exceeding the clinical cut-off during (24%) than before the pandemic (13%). OCS severity increased on all symptom dimensions, but was most pronounced on the washing dimension (all with p < 0.001). Self-reported stress and anxiety were weakly associated with differences in severity in total score and symptom dimensions (with R2 < 0.1 and p < 0.001). Our results indicate that the full spectrum of people with OCS should be considered as risk groups for symptom deterioration during a pandemic and when assessing its possible long-term effects of such.

The contribution of guilt sensitivity in the prediction of obsessive-compulsive disorder symptom dimensions: Replication and extension

BackgroundObsessive-compulsive disorder (OCD) is associated with particular cognitive processes, such as beliefs about the importance of intrusive thoughts. The present study examined the explanatory power of guilt sensitivity to OCD symptom dimensions after controlling for well-established cognitive predictors. Methods164 patients with OCD completed self-reported measures of OCD and depressive symptoms, obsessive beliefs, and guilt sensitivity. Bivariate correlations were examined, and latent profile analysis (LPA) was used to generate groups based on symptom severity scores. Differences in guilt sensitivity were examined across latent profiles. ResultsGuilt sensitivity was most strongly associated with unacceptable thoughts and responsibility for harm OCD symptoms, and moderately with symmetry. After controlling for depression and obsessive beliefs, guilt sensitivity added explanatory power to the prediction of unacceptable thoughts. LPA identified 3 profiles; profile-based subgroups significantly differed from one another in terms of guilt sensitivity, depression, and obsessive beliefs. ConclusionsGuilt sensitivity is relevant to various OCD symptom dimensions. Above and beyond depression and obsessive beliefs, guilt sensitivity contributed to the explanation of repugnant obsessions. Theory, research, and treatment implications are discussed.

Relationship between Cognitive Strategies of Emotion Regulation and Dimensions of Obsessive-Compulsive Symptomatology in Adolescents.

Cognitive emotion regulation refers to the management of one's emotions through cognitive strategies. Studies have found that individuals with obsessive-compulsive symptoms utilize emotion regulation strategies differently compared to those without these symptoms. This study aims to investigate the relationship between cognitive strategies for emotion regulation and specific dimensions of obsessive-compulsive symptoms in adolescents. A cross-sectional descriptive study was conducted with 307 adolescents between 12 and 18 years old. Associations between sociodemographic variables, obsessive-compulsive symptoms, and emotion regulation strategies were examined using regression and network analyses. Regression results indicated that emotion regulation strategies and gender accounted for 28.2% of the variation in overall obsessive-compulsive symptoms (p < 0.001) and that emotion regulation explained most variance in the symptom dimension of obsessing. Network analysis showed that self-blame and catastrophizing were uniquely linked to overall obsessive-compulsive symptoms, while several strategies were uniquely linked to specific symptom dimensions. The adaptive strategy that demonstrated the strongest association with obsessive-compulsive symptoms was refocus on planning, while maladaptive strategies included catastrophizing, self-blame, and rumination. In conclusion, the results support the relationship between cognitive strategies for emotion regulation and dimensions of obsessive-compulsive symptoms in adolescents, though these relations appear complex and require further investigation. Addressing emotion regulation in the prevention of obsessive-compulsive symptoms may be warranted, but prospective studies are needed.

The association between stressful experiences and OCD symptoms in young adults at transdiagnostic risk

BackgroundIt is unclear whether there is a specific association between stressful experiences and obsessive-compulsive symptoms or whether this relationship is due to stressful experiences increasing risk for psychopathology generally. AimsThe current study examined the association between stressful experiences and obsessive-compulsive symptom dimensions, while adjusting for coexisting psychiatric symptoms and psychological distress in a young adult transdiagnostic at-risk sample. MethodsForty-three participants completed self-report measures assessing obsessive-compulsive symptoms, stressful experiences, and a range of other psychiatric symptoms. Regression models examined the relationship between stressful experiences and different obsessive-compulsive symptoms dimensions (i.e., symmetry, fear of harm, contamination, and unacceptable thoughts), adjusting for the influence of coexisting psychiatric symptoms and psychological distress. ResultsThe results showed that there was an association between stressful experiences and obsessive-compulsive symptoms dimension of symmetry. Symptoms of borderline personality disorder were positively associated with the obsessive-compulsive symptom dimensions of symmetry and fear of harm symptoms. Symptoms of psychosis were found to be negatively associated with the obsessive-compulsive symptoms dimension of fear of harm. ConclusionsThese findings have implications for understanding the psychological mechanisms that underlie symmetry symptoms and highlight the need to study OCS dimensions separately to inform more precise, mechanism-targeted interventions.

Core clinical symptoms and suicidal ideation in patients with obsessive-compulsive disorder: A network analysis.

Suicidality in obsessive-compulsive disorder (OCD) is underestimated and it is important for clinicians to understand the factors that contribute to suicidal ideation. The present study aimed to estimate a network of the core clinical symptoms of OCD including obsessions, compulsions, and obsessive-compulsive (OC) symptom dimensions, depressive symptoms, and psychological traits, and to examine which symptoms contribute to suicidal ideation in patients with a primary diagnosis of obsessive-compulsive disorder. A total of 444 patients with OCD were assessed with the Yale-Brown Obsessive-Compulsive Scale, the Montgomery-Asberg Depression Rating Scale, and various other measures. Network analysis was conducted to estimate the network of obsessive-compulsive and depressive symptoms, psychological traits including alexithymia and impulsivity, and demographic covariates. Symptoms directly related to suicidal ideation in the network were examined for their relative contribution to suicidal ideation. Suicidal ideation was directly related to degree of control over compulsive behaviors, distress associated with compulsive behaviors, time spent performing compulsive behaviors, and unacceptable thoughts, along with depressive symptoms and alexithymia. In the network of OC and depressive symptoms the most central symptoms among the former were interference due to compulsive behaviors and interference due to obsessive thoughts, and among the latter were pessimistic thoughts and reported sadness. The findings suggest that along with depressive symptoms and alexithymia, compulsions and unacceptable thoughts dimension may contribute to suicidality, and thus, should be carefully monitored in patients with OCD.

How much are they predictive for obsessive-compulsive symptom dimensions: beliefs, emotions, emotional schemas?

How much are they predictive for obsessive-compulsive symptom dimensions: beliefs, emotions, emotional schemas?

Obsessive compulsive symptom dimensions are linked to altered white-matter microstructure in a community sample of youth

Obsessive-compulsive symptoms (OCS) are common in school-aged children and predict the development of obsessive compulsive disorder (OCD). White-matter abnormalities have been described in OCD, but the white matter correlates of OCS in the developing brain are unclear. Some correlates of OCS (or a diagnosis of OCD) may reflect correlates of a transdiagnostic or even general psychopathology factor. We examined these questions in a large sample of typically developing youth (N = 1208), using a hierarchical analysis of fixel-based white matter measures in relation to OCS and general psychopathology. General psychopathology was associated with abnormalities in the posterior corpus callosum and forceps major in an age-dependent manner, suggesting altered maturation (specifically, hypermaturation in younger subjects). A unidimensional measure of OCS did not associate with any white-matter abnormalities, but analysis of separate OCS dimensions (derived from factor analysis within this sample) revealed the ‘Bad Thoughts’ dimension to associate with white-matter abnormalities in dorsal parietal white-matter and descending corticospinal tracts, and the ‘Symmetry’ dimension to associate with abnormalities in the anterior corpus callosum. Repetition/checking and Symmetry OCS were additionally associated with posterior abnormalities overlapping with the correlates of general psychopathology. Contamination symptoms had no white-matter correlates. Secondary analysis of fractional anisotropy (FA) revealed distinct white-matter abnormalities, suggesting that fixel-based and FA analyses identify distinct features of white matter relevant to psychopathology. These findings suggest that OCS dimensions correlate with dissociable abnormalities in white matter, implicating separable networks. Future studies should examine these white-matter signatures in a longitudinal framework.

Factor structure of the Dimensional Yale-Brown Obsessive-Compulsive Scale in a large sample of adults with obsessive-compulsive disorder.

Objectives:Although the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) is a widely used instrument for assessing different obsessive-compulsive symptom dimensions, its factor structure has never been studied in a Brazilian population. Thus, we aimed to assess the goodness-of-fit indexes and factor loadings of two higher-order models of the DY-BOCS using confirmatory factor analysis (CFA) in a large obsessive-compulsive disorder (OCD) sample.Methods:We tested two CFA models in a sample of 955 adults with OCD who had been assessed with the DY-BOCS in a cross-sectional multi-site study. The first model encompassed the symptom checklist (present or absent), whereas the second focused on items related to severity scores.Results:Both models presented adequate goodness-of-fit indexes. The comparative fit index, Tucker-Lewis index, and omega were > 0.9, while the root mean square error of approximation was ≤ 0.06 for both models. Factor loadings for each item of each dimension are presented and discussed.Conclusion:Higher-order factor models showed adequate goodness-of-fit indexes, indicating that they appropriately measured OCD dimensions in this Brazilian population.

Psychological flexibility and inflexibility in obsessive-compulsive symptom dimensions, disability, and quality of life: An online longitudinal study

Early intervention in obsessive-compulsive disorder has recently gained traction. However, to address obsessive-compulsive (OC) symptoms before they progress to clinical levels, it is important to investigate potential processes involved in driving OC symptoms, as well as the processes driving the lower quality of life, impairments in functioning, and increased comorbidities that are already present in the subthreshold phase of the disorder. This study aimed to investigate the role of 12 psychological flexibility and inflexibility processes in predicting quality of life, disability, and OC symptoms over six months while controlling for psychological distress. An online community sample of 766 individuals from Amazon Mechanical Turk was evaluated at baseline and again at 6-month follow-up with a survey battery assessing OC symptom dimensions, psychological in/flexibility processes, psychological distress, and sociodemographic information. Results revealed that greater self-as-content was associated with more severe mental contamination and unacceptable thoughts at baseline. No other psychological inflexibility processes were associated with OC symptom severity or disability cross-sectionally or longitudinally. The study did not provide support for psychological flexibility processes being associated with quality of life at any time point. These findings suggest that self-as-content may be related to OC symptom severity, and potentially more so than other inflexibility processes. With this knowledge, self-as-content requires more research attention in relation to OC symptoms, as well as research on processes that have the potential to improve important non-psychiatric outcomes.