Obsessive-compulsive Symptomatology Research Articles

Eating disorder as a modern obsessive-compulsive syndrome.

Psychiatric symptomatology is clearly influenced by social factors. Such classical symptoms of the hysterical or conversion disorder as glove and stocking paralysis were once fairly widespread but appear today only in rather backward and poorly educated social groups throughout the world. Such a finding decidedly indicates social and educational causes. The purpose of this paper is to show that social and educational factors have also influenced obsessive-compulsive symptomatology; classical obsessive-compulsive neurosis has emerged today in a form involving food and disorders of eating. Among women of Western culture, the conditions known as anorexia nervosa and bulimia are the modern obsessive-compulsive disorders. First, social factors and individual diagnostic considerations, based on intensive long-term assessment of patients with these conditions, will be discussed. Then, results of a controlled diagnostic study of eating-disorder patients, also based on long-term observation, will be presented, and overall nosological implications discussed.

Psychiatric symptoms in medical students

The current study examined the presence of psychiatric symptomatology in a sample of medical students. Results demonstrated that while medical students evidenced levels of symptomatology that were considerably lower than those previously reported in outpatient psychiatric samples, they evidenced considerably higher symptom levels than those previously reported in a general population survey. Compared to the general population, medical students showed a mild elevation in somatic symptoms, a moderate elevation in anxiety and depressive symptoms, and a substantial elevation in obsessive-compulsive symptomatology and in interpersonal sensitivity. The marked elevations in obsessive-compulsive symptomatology and in interpersonal sensitivity may reflect, in part, a sensitization to excessive performance demands that is manifested by anxiety-induced cognitive inefficiencies such as indecisiveness, blocking, or memory impairment and by excess sensitivity to the evaluative opinions of other individuals. In comparing students from the four classes, there was no significant relationship between the year in school and symptom level. In examining sex differences, women reported a significantly higher level of total symptomatology and higher symptom levels on four of the five subscales examined. The largest sex differences were observed in the symptom areas of depression and interpersonal sensitivity.

An Experimental Investigation of the Use of Positive Imagery in the Treatment of Phobias

This investigation examined the relative effectiveness of positive imagery and active-involvement imagery in the systematic desensitization treatment of phobias. Immediately after imagining hierarchy phobic scenes, clients in the positive imagery group ( N = 9) imagined pleasant, relaxing scenes while clients in the active-involvement imagery group ( N = 10) imagined themselves attempting to cope directly with the phobic stimulus and behaving in a relaxed and competent manner. At the end of treatment both groups showed substantial and equal improvement in the severity of their specific fear compared to a waiting list control group ( N = 6). The positive imagery group showed greater reductions in general distress and obsessive-compulsive symptomatology. Follow-up assessment conducted one year after the termination of therapy revealed that the improvement was maintained in both treatment groups. On within treatment measures, the positive imagery group showed greater reductions in forehead electromygraphic activity during phobic scenes after repeated presentations of the phobic scene-positive scene sequence and the active-involvement imagery group showed greater reductions in self-report of fear across repeated presentations of their imagery sequence. The clinical usefulness of the imagery treatments and their theoretical foundations are discussed.

Use of clomipramine in treatment of obsessive-compulsive symptomatology.

An open clinical trial was conducted on the use of oral clomipramine in the treatment of obsessive-compulsive symptomatology in patients with various primary psychiatric diagnoses. The overall success rate of the 50 patients was 60%; those with a primary diagnosis of obsessive-compulsive disorder had an 80% success rate. No significant differences in outcome were observed by current age, age of illness onset, duration of illness, or severity of illness. Minnesota Multiphasic Personality Inventories of a subsample of the population revealed a significantly higher T score for depression in the successful patients. Since 83% of the successful patients had adequate prior treatments on other antidepressants without improvement in their obsessive-compulsive symptoms, it would appear that clomipramine is effective in treating obsessive-compulsive symptoms as well as depressive symptoms.

Obsessional personality traits and ABO blood types.

The relation of ABO blood types to obsessional personality traits, as measured by the Leyton Obsessional Inventory (LOI), was studied in a sample of 600 normal individuals. High scorers of the LOI trait portion demonstrated a significantly lower incidence of phenotype O and a significantly higher incidence of phenotypes AB, A and B, taken together, compared to those of a general population sample and the entire study group. Findings of the present study, in conjunction with previous findings concerning a lower incidence of phenotype O and a higher incidence of phenotype A in obsessive compulsive patients, could be interpreted as indicating that phenotype O may be associated with personality traits hindering the development of obsessive-compulsive symptomatology.

Functional classification of obsessive-compulsive phenomena

A classification of obsessive-compulsive phenomena based on the functional definition of obsessions as anxiety/discomfort producing and compulsions as anxiety/discomfort reducing is proposed. Based on the assumption of a functional equivalence between external and internal obsessive-compulsive behavior, four essential obsessive-compulsive forms are derived: (1) obssesions, (2) obsessions plus successful compulsions (anxiety/discomfort reducing), (3) obsessions plus obsessionalized compulsions (anxiety increasing), and (4) rituals consisting mainly of stereotyped, overt or covert behaviors (autonomous of anxiety/discomfort and/or obsessions). In addition, it is hypothesized that forms 1–4 represent developmental stages in the progress of obsessive-compulsive symptomatology, increasing in the order specified in complexity and severity and having varying prognostic implications. Finally, an attempt is made to suggest stage-specific behavioral treatment strategies.