Subclinical Obsessive-compulsive Disorder Research Articles

Remediating rigid rule-following in subclinical obsessive-compulsive disorder using a brief mindfulness task: A case-control pilot study

A pioneering experiment by Hayes et al. (1986a, b) demonstrated the influence of instructional control and rule-governed behaviour on sensitivity to alternating reinforcement schedules. Hassoulas et al. (2017) replicated the same experimental design in a sample of participants exhibiting obsessive-compulsive behavioural (OCB) traits, supporting the results reported by the original study but also providing further insights into the maintenance of rigid rule following in OCB. The current pilot study replicated the same experimental design and procedure once again, however in considering whether a brief mindfulness-based intervention would facilitate contact with schedule contingencies in a group of participants exhibiting OCB traits. A total of 78 participants were recruited, 38 of whom exhibited OCB traits as measured using the Maudsley Obsessive-Compulsive Inventory (MOCI). The results revealed a significant difference in sensitivity to changing schedules between the group of participants exhibiting OCB traits and those with few such traits (n = 40), dependent on the degree of instructional accuracy they were provided with. The findings of the current study provide insights into the proposed concomitant administration of mindfulness-based interventions, alongside traditional first-line therapeutic modalities currently administered in the management of obsessive-compulsive disorder.

The relationship between obsessive-compulsive symptoms and real-life functioning in schizophrenia: New insights from the multicenter study of the Italian Network for Research on Psychoses.

Although obsessive-compulsive disorder (OCD) is highly prevalent in schizophrenia, its relationship with patients' real-life functioning is still controversial. The present study aims at investigating the prevalence of OCD in a large cohort of non-preselected schizophrenia patients living in the community and verifying the relationship of OCD, as well as of other psychopathological symptoms, with real-life functioning along a continuum of OCD severity and after controlling for demographic variables. A sample of 327 outpatients with schizophrenia was enrolled in the study and collapsed into three subgroups according to OCD severity (subclinical, mild-moderate, severe). A series of structural equation modeling (SEM) was performed to analyze in each subgroup the association of obsessive-compulsive symptoms with real-life functioning, assessed through the Specific Levels of Functioning Scale and the UCSD Performance-Based Skills Assessment. Moreover, latent profile analysis (LPA) was performed to infer latent subpopulations. In the subclinical OCD group, obsessive-compulsive symptoms (OCS) were not associated with functioning, whereas in the mild-moderate OCD group, they showed a positive relationship, particularly in the domains of work and everyday life skills. The paucity of patients with severe OCD did not allow performing SEM analysis in this group. Finally, LPA confirmed a subgroup with mild-moderate OCS and more preserved levels of functioning. These findings hint at a positive association between mild-moderate OCD and real-life functioning in individuals with schizophrenia and encourage a careful assessment of OCD in personalized programs to sustain daily life activities.

Top-down and bottom-up contributions to memory performance in OCD: A multilevel meta-analysis with clinical implications.

Despite extensive coverage of a relationship between memory performance and executive function in the obsessive-compulsive disorder (OCD) literature, the relative contributions of specific aspects of executive control have remained elusive. We, therefore, extend our previous multilevel meta-analysis (Persson et al., 2021), where demand on executive function was the most significant determinant of memory deficits in OCD, and provide a finer-grained analysis of executive control via a segregation into top-down (attentional control, maintenance and updating, planning) and bottom-up (perceptual integration, perceptual salience) contributions. Our multilevel meta-analytic approach allowed us to accommodate the interdependency of 255 effect sizes from 131 studies, totaling 4,101 OCD patients. Results revealed that maintenance and updating (top-down) and perceptual integration (bottom-up) predicted memory performance generally, and specifically in those with clinical OCD. Exploratory analyses suggested that this effect may be somewhat different among subclinical OCD groups; however, these findings should be considered with conceptual and analytical caveats in mind. We explain these results via deficient sensory (perceptual integration) and working memory (maintenance and updating) gating mechanisms and propose a model to accommodate their expression in OC symptoms. In conclusion, our meta-analysis has expanded understanding of cognitive performance in OCD and identifies the possibility of untapped cognitive targets for intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The thalamus and its subregions – a gateway to obsessive-compulsive disorder

IntroductionHigher thalamic volume has been found in children with obsessive-compulsive disorder (OCD) and children with clinical-level symptoms within the general population (Boedhoe et al. 2017, Weeland et al. 2021a). Functionally distinct thalamic nuclei are an integral part of OCD-relevant brain circuitry.ObjectivesWe aimed to study the thalamic nuclei volume in relation to subclinical and clinical OCD across different age ranges. Understanding the role of thalamic nuclei and their associated circuits in pediatric OCD could lead towards treatment strategies specifically targeting these circuits.MethodsWe studied the relationship between thalamic nuclei and obsessive-compulsive symptoms (OCS) in a large sample of school-aged children from the Generation R Study (N = 2500) (Weeland et al. 2021b). Using the data from the ENIGMA-OCD working group we conducted mega-analyses to study thalamic subregional volume in OCD across the lifespan in 2,649 OCD patients and 2,774 healthy controls across 29 sites (Weeland et al. 2021c). Thalamic nuclei were grouped into five subregions: anterior, ventral, intralaminar/medial, lateral and pulvinar (Figure 1).ResultsBoth children with subclinical and clinical OCD compared with controls show increased volume across multiple thalamic subregions. Adult OCD patients have decreased volume across all subregions (Figure 2), which was mostly driven by medicated and adult-onset patients.Conclusions Our results suggests that OCD-related thalamic volume differences are global and not driven by particular subregions and that the direction of effects are driven by both age and medication status.DisclosureNo significant relationships.

Cognitive Rigidity, Habitual Tendencies, and Obsessive-Compulsive Symptoms: Individual Differences and Compensatory Interactions.

Recent theories have posited a range of cognitive risk factors for obsessive-compulsive disorder (OCD), including cognitive inflexibility and a maladaptive reliance on habits. However, empirical and methodological inconsistencies have obscured the understanding of whether inflexibility and habitual tendencies indeed shape OCD symptoms in clinical and sub-clinical populations, and whether there are notable interactions amongst these traits. The present investigation adopted an interactionist individual differences approach to examine the associations between behaviorally-assessed cognitive flexibility and subclinical OCD symptomatology in a healthy population. It also explored the nature of the interactions between cognitive flexibility and habitual tendencies, and the degree to which these cognitive traits predict subclinical OCD symptomatology. Across two studies, including a preregistration, Bayesian and regression analyses revealed that cognitive inflexibility and compulsive habitual tendencies act as unique and independent predictors of subclinical OCD symptomatology in healthy populations. Furthermore, there was a significant interaction between cognitive rigidity and habitual compulsivity, which accounted for 49.4% of the variance in subclinical OCD symptomatology in Study 1, and 37.3% in Study 2. In-depth analyses revealed a compensatory effect between cognitive inflexibility and habitual compulsivity such that both are necessary for OCD symptomatology, but neither is sufficient. These results imply that in order to generate reliable and nuanced models of the endophenotype of OCD symptomatology, it is essential to account for interactions between psychological traits. Moreover, the present findings have important implications for theories on the cognitive roots of OCD, and potentially in the development of interventions that target both cognitive inflexibility and habitual compulsivity.

Autistic Traits and Obsessive-Compulsive Disorder in Patients with Migraine With or Without Aura

Background: Migraine is one of the most common neurological disorders and often shows comorbidity with psychiatric disorders. Data regarding comorbidity between migraine and autism spectrum disorder (ASD) are limited. In addition, although anxiety disorders such as obsessive compulsive disorder (OCD) are commonly encountered with migraine, and the fact that the OCD and ASD relationship is well established, there are conflicting results concerning the possible relationships between migraine and OCD. The purpose of this study is to understand is there any relationship between ASD, OCD and migraine. Methods: The study included only females, 40 with migraine and 26 without migraine or any other type of headache syndrome or neurological disorders. The study included people aged between 20 and 61 years of age. Migraineurs were divided into two groups according to the presence/absence of aura. Demographic and clinical variables were recorded. Diagnosis of OCD was made by using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Obsessive-compulsive symptoms (OCS) and OCD severity and content was assessed by the Yale Brown Obsession and Compulsion Scale (YBOCS). Autistic traits were rated by use of the Autism Spectrum Quotient (AQ). Results: The YBOCS and AQ total scores were higher in patients with migraine (vs. controls) and those with aura (vs. non-aura); however, in both of these comparisons, the ‘attention switching’ and ‘imagination’ subscales (of the AQ) were found to be similar among the compared groups. Subclinical OCD was significantly more frequent in migraineurs (vs. controls) and those with aura (vs. non-aura). OCD diagnosis was similar among migraineurs and controls, but the aura group had significantly higher frequency of OCD compared to the non-aura group. Conclusion: According to our results, migraine and the presence of aura in migraineurs appear to be associated with OCD and autistic traits (as measured by the YBOCS and the AQ).

The Habitual Tendencies Questionnaire: A tool for psychometric individual differences research.

Habits are automatic responses to learned stimuli or contextual cues that are insensitive to goals. Although habits may allow for automated behaviours that increase efficiency in our daily lives, an over-reliance on habits has been suggested to contribute to disorders such as obsessive-compulsive disorder (OCD). There are currently few established measures of individual differences in habitual tendencies. To fill this gap, the present study generated and validated a novel 11-item scale, the Habitual Tendencies Questionnaire (HTQ), to measure individual differences in habitual tendencies in the general population. In Study 1, factor analysis revealed three underlying subcomponents of the HTQ: Compulsivity, Preference for Regularity, and Aversion to Novelty, with Compulsivity showing the strongest association with subclinical OCD symptomatology. Study 2 validated the HTQ and replicated the findings of Study 1 in a larger sample, and explored relationships with other personality traits. The results emphasise the importance of measuring individual variation in habitual thinking styles, illustrating that different facets of habitual tendencies may contribute to diverse behavioural and clinical outcomes. The present investigation provides a new, reliable way of measuring habitual tendencies and has important implications for future explorations into the nature of individual differences from a dimensional perspective to psychiatry.

Altered fronto-amygdalar functional connectivity predicts response to cognitive behavioral therapy in pediatric obsessive-compulsive disorder.

Based on findings from adults with obsessive-compulsive disorder (OCD), this study examined alterations in resting-state functional connectivity (rs-fc) between the basolateral amygdala (BLA) and the ventromedial prefrontal cortex (vmPFC) in children and adolescents with OCD. We also assessed whether such BLA-vmPFC connectivity changed with or predicted response to exposure and response prevention (E/RP), the first-line treatment for pediatric OCD, given the involvement of these regions in fear processing, regulation, and extinction learning-a probable mechanism of action of E/RP. Resting state functional magnetic resonance imaging scans were acquired from 25 unmedicated, treatment-naïve pediatric patients with OCD (12.8 ± 2.9 years) and 23 age- and sex-matched healthy controls (HCs; 11.0 ± 3.3 years). Patients completed a 12-16-week E/RP intervention for OCD. Participants were rescanned after the 12-16-week period. ANCOVAs tested group differences in baseline rs-fc. Cross-lagged panel models examined relationships between BLA-vmPFC rs-fc and OCD symptoms pre- and posttreatment. All tests were adjusted for participants' age, sex, and head motion. Right BLA-vmPFC rs-fc was significantly reduced (more negative) in patients with OCD relative to HCs at baseline, and increased following treatment. In patients, more positive (less negative) right BLA-vmPFC rs-fc pretreatment predicted greater OCD symptoms reduction posttreatment. Changes in BLA-vmPFC rs-fc was unassociated with change in OCD symptoms pre- to posttreatment. These results provide further evidence of the BLA-vmPFC pathway as a potential target for novel treatments or prevention strategies aimed at facilitating adaptive learning and fear extinction in children with OCD or subclinical OCD symptoms.

Pavlovian-to-instrumental transfer in subclinical obsessive–compulsive disorder

Pavlovian-to-instrumental transfer (PIT) refers to the effect of stimuli that have been associated with a pleasant or aversive event on instrumental behaviors. Given that obsessive–compulsive disorder (OCD) is linked to excessive compulsions, which in the laboratory can be tested via testing instrumental responses, we assessed PIT effects in individuals with subclinical levels of OCD. Participants from a nonclinical population were separated in groups with low (OC−) and high (OC+) levels of OCD. Participants learned to associate one button press ( R1) with the cancellation of an aversive outcome ( O1) and another button press ( R2) with the cancellation of another aversive outcome ( O2). Subsequently, they watched stimuli of five different colors ( S1– S5) that were followed by O1, O2, a novel negative outcome ( O3: video of a house on fire), or two neutral outcomes ( O4: plus sign; O5: caret symbol), respectively. In the last phase, participants saw S1– S5 while they were allowed to press the R1 or the R2 button. Contrary to predictions, the OC− compared to OC+ group showed somewhat stronger specific PIT effects, indicated by more R1 and R2 responses during the presentation of the S1 and S2, respectively. No reliable evidence was found for general PIT.

The Role of Perceived Control in the Psychophysiological Responses to Disgust of Subclinical OCD Women.

Obsessive‒compulsive disorder (OCD), and especially contamination obsessions and washing compulsions, has been related to disgust. However, when its cardiovascular correlates have been studied, contradictory results have been found, including heart rate accelerations and decelerations. The aim of this study is to analyze emotional, cognitive, and cardiovascular responses in nonclinical (control) and subclinical participants with obsessive‒compulsive contamination/washing symptoms when confronted with a disgusting stimulus. Twenty-seven participants (14 subclinical OCD) completed a behavioral avoidance task with a contamination-based stimulus while their heart rate and subjective variables were measured. Results showed heart rate reductions in both samples, whereas subjective measures reflected higher disgust, anxiety, dirtiness, and emotional valence in the subclinical sample. However, at the same time, the sense of dominance was lower in the control group. In conclusion, our results support a heart rate deceleration during exposure to a disgusting stimulus dissociated from the subjective experience.

Contamination-fear in subclinical obsessive-compulsive disorder: A further proof for no preferential processing of disorder-related stimuli

How do individuals with obsessive-compulsive disorder (OCD) process and respond to images of rotten food or dirty toilets? In contrast to other fear-related disorders, evidence for attentional biases and preferential processing of disorder-related stimuli in samples of OCD is mixed. To address methodological problems of previous studies and to increase validity, we used two independent samples of participants with contamination fear and two sets of standardized stimuli in an established experimental paradigm. In two experiments, we compared evaluation and visual processing of contamination-fear related (CFr) stimulus material in individuals with high (HCF) and low (LCF) contamination fear. In experiment 1, we selected CFr stimuli from a database with disgust-related images (DIRTI). Even though the HCF group rated CFr images as being more unpleasant, arousing, and disgusting, we found no indicators of preferential processing (larger priming effects or faster responses). In experiment 2, we selected CFr stimuli from a database with images specifically chosen to evoke symptom-related anxiety in OCD patients (BOCD-PS). Again, negative evaluations of stimuli did not transfer into enhanced information processing. We conclude that early information processing of CFr stimuli is fundamentally different to that of fear-related stimuli in anxiety disorders; probably because of the triggered disgust response.

An epidemiological study of prevalence and comorbidity of obsessive compulsive disorder symptoms (SOCD) and stress in Pakistani Adults.

Objective:To investigate the prevalence and comorbidity of subclinical obsessive compulsive disorder (SOCD) symptoms and stress across gender, marital and employment statuses.Methods:A cross-sectional research was conducted from December, 2016 to March 2017 at two universities of cosmopolitan city Lahore. Two self-report scales measuring SOCD symptoms and stress were used to collect data from 377 adults selected through simple random sampling technique, proportionately distributed across gender, marital and employment status.Results:From the total sample, 52% reported low level of stress and 48% faced high level of stress. Significant differences in prevalence were observed across marital and employment statuses whereas for men and women, it was observed same (24%). Comorbidity of high level of SOCD symptoms and high level of stress was seen 34%.Conclusion:Significant prevalence and comorbidity exists between SOCD symptoms and stress and more studies addressing diverse population are needed.

Compulsivity and probabilistic reversal learning in OCD and cocaine addiction

Compulsive behavior is a core symptom of both obsessive compulsive disorder (OCD) and cocaine addiction (CA). Across both pathologies, one can identify a priori goal-directed actions (purportedly anxiolytic checking or washing in OCD and pleasure-seeking drug use in addiction) that turn into rigid, ritualized and repetitive behaviors over which the patient loose control. One possible psychopathological mechanism underlying compulsivity is behavioral inflexibility, namely a deficit in the aptitude to dynamically adapt to novel contexts and changing reward rules. The probabilistic reversal learning paradigm allows to objectively assess behavioral flexibility by challenging participants with a task where they have to learn through trials-and-errors which of two stimuli is the most-often rewarded one, while adjusting to sudden inconspicuous contingency reversals. We therefore hypothesized that both OCD and CA would be associated with impaired cognitive flexibility, as measured through perseverative response rate following contingency reversals in this task. Interestingly, impulsivity may also be assessed within this task via the tendency of participants to switch from one stimulus to the other following probabilistic errors. To investigate cognitive inflexibility in relation to CA and OCD respectively, we first compared the performance in a probabilistic reversal learning task of cocaine users, ex cocaine users (abstinent for 2 months or more), and controls, as well as that of participants from the general population whose obsessive-compulsive traits were assessed using the OCI-R, a well-validated self-questionnaire. Our task yielded results similar to those found in the literature: cocaine addicts changed their responses more often, and learned less effectively. Ex-cocaine addicts performed better than addicts but worse than controls, suggesting that addicts’ poor results may be in part explained by reversible cognitive consequences of addiction. Addicts with less cognitive impairments may also be less likely to relapse. Regarding the relationship of flexibility to subclinical OCD traits, we found no link between OCI-R score and perseveration, or between impulsiveness and excessive switching.

Obsessions and Compulsions in Postpartum Women Without Obsessive Compulsive Disorder.

To describe the prevalence of obsessions and compulsions and the specific symptoms present in postpartum women without obsessive compulsive disorder (OCD). In this prospective cohort, women were screened with the Yale Brown Obsessive Compulsive Scale at 2 weeks postpartum. Demographics and comorbid psychiatric symptoms were compared between women with screen-positive OCD, screen-negative OCD but with some endorsed symptoms (subclinical OCD), and no OCD symptoms. The prevalence of each specific set of obsessive and compulsive symptoms and the rate of impairment from those symptoms were compared. Of the 461 women included, 52 (11.2%) screened positive for OCD, while 173 (37.5%) reported experiencing subclinical obsessions or compulsions. This subclinical OCD was associated with an increased rate of depression (24%) and state-trait anxiety (8%) compared with women who did not endorse experiencing any obsessions or compulsions. Aggressive, religious, and somatic obsessions as well as obsessions with symmetry, when present, were most likely to result in OCD screen positivity. Nearly half of all women who screen negative for OCD experienced obsessions or compulsions that did not result in OCD screen positivity. However, the presence of these subclinical obsessions and compulsions is associated with an increased rate of depression or anxiety.

Uncertainty, checking, and intolerance of uncertainty in subclinical obsessive compulsive disorder: An extended replication

Recently, Toffolo, van den Hout, Hooge, Engelhard, and Cath (2013, 1, 103–109) showed that individuals with subclinical OCD (OC+) respond with more checking behavior to mildly uncertain situations than individuals with low OC tendencies (OC−). The present study aimed to replicate and extend these findings by measuring Intolerance of Uncertainty (IU), and including the whole range of OC tendencies in a correlation analysis. Participants filled out the Obsessive Compulsive Inventory Revised and Intolerance of Uncertainty Scale and performed a visual search task. This task contained 50 search displays, in which participants indicated whether a target was “present” or “absent”. Target-present trials were straight-forward, but target-absent trials were ambiguous, because participants had to rely on not having overlooked the target. Results revealed that target-absent trials induced more uncertainty than target-present trials. Furthermore, OC+ participants checked longer than OC− participants in target-absent but not target-present trials. This could not be explained by higher IU in OC+ participants. There were no differences in number of fixations in absent and present trials between the groups. Finally, when looking at the whole range of OC tendencies, there was a positive relation between OC tendencies and checking behavior. The findings (partly) replicated those of Toffolo et al. (2013) and add to their robustness.

Prevalence and profile of obsessive–compulsive trait in patients with chronic migraine and medication overuse

Patients with chronic migraine (CM) and medication overuse headache (MOH) have high frequency of psychiatric comorbidity or psychopathological traits, the presence of which can influence the clinical course. The presence of subclinical obsessive compulsive disorder (OCD) is underestimated in migraine patients. The aim of this study was to estimate the prevalence and profile of obsessive-compulsive (OBS) trait in a sample of CM patients with MOH using the OBS questionnaire of Spectrum Collaborative Project. According to the new international classification of headache disorders (ICHD-III beta) criteria, 106 patients (15 M, 91 F, mean age 47.3 years) were selected in a consecutive clinical series. Our results showed that 36 % of patients with CM and MOH were positive at OBS-questionnaire. As far as the profile of OBS trait, we performed an evaluation of prevalence of items separating the first part of the questionnaire (childhood/adolescence and doubts in lifetime) from the other five domains: 21 % of the patients showed prevalence of items in childhood/adolescence domain; 79 % in doubts in lifetime domain; as for other five domains, 10.5 % of patients had prevalence of pathological answers among hypercontrol, 5.2 % in spending time, 23.7 % in perfectionism, 29 % in repetition and automation, and 31.5 % in specific themes (obsessive thoughts). The presence of subclinical OCD in migraine patients, and the link between progression to CM, particularly through MO, and OBS trait is still not well defined. The use of specific tools to assess this possible comorbidity should be encouraged in clinical and research settings.

EPA-0054 – Prevalence and severity of obsessive-compulsive disorder and its relationships with dermatological disease

Background most obsessive-compulsive disorder (OCD) patients meet psychiatrists 5 to 10 years after onset of OCD. Its relatively high prevalence ratio and the delay in seeking help suggest that patients with OCD may seek help at nonpsychiatric clinics. the present study was undertaken to provide some epidemiological data on the prevalence and severity of OCD in dermatological patients. Method The participants included 265 consecutive patients with primary dermatologic chief complaint. They were visited by a dermatologist and diagnosis of dermatological lesion was done according to ICD-10. All patients were visited by a psychiatry resident and were screened for OCD using the structured clinical interview for DSM-IV-TR (SCID-I). If the diagnosis of OCD has been made, the Yale-Brown obsessive compulsive scale(Y-BOCS) was used to evaluate the severity of OCD. To analyze the data student t-test for quantitative variables and X 2 tests for categorical variables. Results From the total of 265 patients, 24(9.1%) met the DSM-IV-TR criteria for OCD and 9(37.5%) with OCD had previously been diagnosed with OCD, however, only three were treated pharmacologically. The most symptoms were pathological doubt (29.1%), fear of contamination(29.1%)and washing (54.16%). Severity of OCD according to Y-BOCS was evaluated among patients with OCD. Six (25%) were found with subclinical OCD, 11(45.8%) had mild OCD, six(25%) had moderate OCD, and one (4.2%) was detected with sever OCD. Conclusion prevalence of OCD in dermatology clinic was higher compared with general population.

Neurocognitive deficits in obsessive compulsive disorder: A state or trait phenomenon?

Background: Studies have shown that in obsessive-compulsive disorder (OCD), there is impairment of neurocognitive functioning during the symptomatic phase. However, studies that explore the state or trait dependent nature of these neurocognitive deficits are largely lacking. By comparing the neuropsychological functions of the clinical and subclinical group of OCD patients and healthy controls; we tried to establish whether neuropsychological deficits in OCD were state dependent or independent. Materials and Methods: Twenty mild to moderate OCD patients, 15 subclinical (remitted) OCD patients, and 20 matched healthy controls were compared and assessed on computerized battery of neuropsychological tests including Wisconsin card sorting test, continuous performance test, and spatial working memory test. The observations were statistically analyzed. Results: Executive functions in both the subclinical and clinical groups performed poorly when compared to healthy controls. The patient groups made significantly more wrong responses, more missed responses and took more time to respond. On the test of spatial working memory, the mild to moderate OCD patients showed significant impairment, but not the subclinical patients group. Conclusion: Thus, we conclude that cognitive dysfunctions are core and enduring deficits of OCD, they seem to continue into the subclinical- well state. Certain cognitive deficits, depending on their presence or absence in subclinical cases, may be identified as state or trait markers of OCD.

Socio-demographic and psychopathological risk factors in obsessive-compulsive disorder: Epidemiologic study of school population

We assessed the presence of emotional disorders (obsessive-compulsive, anxiety and depressive) in 1,514 Spanish non-referred children (8–12 years old) to investigate the predictive ability of psychopathological and socio-demographic characteristics, and identify which of these were possible correlates for clinical obsessive-compulsive disorder (OCD) and subclinical OCD. At one year later, 562 subjects (risk group and without risk group) were re-assessed and we established the OCD diagnoses or the subclinical OCD diagnoses. We found that 20 participants presented clinical OCD and 46 participants presented subclinical OCD. Somatic and separation anxiety symptomatology were good predictors for clinical OCD, and obsessive concern was a predictor for subclinical OCD. Clinical OCD was associated with order/checking/pollution symptoms and with a lower socioeconomic status (SES). Subclinical OCD was associated with hyperactive and impulsive manifestations, obsessive concern, and superstition/mental compulsion. An early detection and the follow-up of anxiety or obsessive symptoms in children may be important for preventing the course of OCD.

Mild Uncertainty Promotes Checking Behavior in Subclinical Obsessive-Compulsive Disorder

Patients with obsessive-compulsive disorder respond to clinical uncertainty with perseverative checking, which, ironically, enhances uncertainty. However, patients also display general subclinical uncertainty, which may tempt vulnerable individuals to seek reassurance by perseveration in response to mild uncertainty that is superimposed on general uncertainty. An experimental eye-tracking paradigm was developed to investigate whether mild uncertainty indeed induces checking behavior in people with high obsessive-compulsive tendencies (OC+, n = 34), compared to people with low obsessive-compulsive tendencies (OC–, n = 31). Participants were presented 50 visual search displays, and they indicated whether a target was “present” or “absent.” Decisions about target presence induced little uncertainty, but decisions about its absence were more ambiguous, because participants relied on not having overlooked the target. Results revealed no differences on target-present trials. However, in target-absent trials, OC+ participants searched longer and used more fixations. Thus, even in mildly uncertain situations, individuals with subclinical obsessive-compulsive disorder respond with more checking behavior, which has implications for treatment.