Types Of Obsessions Research Articles

Linking obsessions to morality: A cross-cultural study among Turkish and Belgian university students.

The present study examines the links between different types of morality and obsessions in university students from Leuven, Belgium (N = 252) and İstanbul, Turkey (N = 301) using validated scales for morality and obsessions. Belgium and Turkey were chosen as two exemplar cultural contexts expected, and in the current study found, to differ in the relative levels of individualizing and binding morality. We hypothesized that obsessions involving potential harm (e.g., aggressive obsessions) are cross-culturally associated with individualizing morals, and obsessions indicating impurity (e.g., contamination) are cross-culturally associated with binding morals. Moreover, we expected that cultural differences in the frequency of obsessions could be linked to differences in culturally prevalent moralities. As predicted, contamination obsessions were cross-culturally linked to binding morals. Also, the frequency of contamination obsessions was higher in the Turkish sample compared to the Belgian, which was predicted by higher levels of binding morals in Turkey. Doubts were cross-culturally endorsed at similar rates and were associated with individualizing morals. Aggressive obsessions were relatively more frequent in the Belgian compared to the Turkish sample, however-unexpectedly-these intrusions were not positively linked to either type of morality, neither in Belgium nor in Turkey. Taken together, these findings provide initial support for the role of morality in obsessive-compulsive disorder (OCD), at least for certain types of obsessions (contamination and doubts), as well as suggest that some differences in the moral foundations may play a role in explaining the prevalence of certain obsessions (i.e., contamination).

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

Comparison of retrospective and prospective memory in subtypes of obsessive-compulsive disorder.

Retrospective and prospective memory deficits play a role in maintaining and perpetuating the symptoms of obsessive-compulsive disorder (OCD), but less is known about these deficits in different subtypes of OCD. The aim of the present study was to evaluate the retrospective and prospective memory in patients suffering from cleaning, checking, symmetry, and religious obsessions. In a comparative causal method, 60 participants aged 28 to 55, in 2023, were selected by convenience sampling and placed in five groups of individuals with cleaning, checking, symmetry, religious obsessions, and a healthy group. Participants completed self-report questionnaires and neurocognitive tools. Results showed that defects in retrospective memory were significant in all types of obsessions (p<0.05) except religious obsessions. Also, this defect was more severe in checking obsession disorder compared to other types of OCD. Also, the finding indicated that the defect in prospective memory was significant only in checking obsession disorder (p<0.05). Retrospective and prospective memory impairments and their relationship with deficits in executive functions can be different depending on the type of OCD. Based on the findings, impairment of executive function indirectly by impacting the impairment of other cognitive mechanisms diminishes confidence in retrospective and prospective memory which leads to compulsive behaviors in individuals with contamination and checking obsessions. Also, the impairment of retrospective memory in symmetry obsessions might have a relationship with information encoding, which in turn leads to difficulty recalling information from memory.

Experience of Iranian Patients with Obsessive-Compulsive Disorder from the COVID-19 Pandemic: A Qualitative Study

Background: During the COVID-19 pandemic, different environ-mental stressors and the difficult lockdown conditions exacerbated the signs and symptoms of Obsessive-Compulsive Disorder (OCD). The aim of this study is to qualitatively investigate and deeply understand the experiences of patients during the epidemic and its effect on the exacerbation of their symptoms to help plan the treatment of OCD during these kinds of periods.&#x0D; Method: This was a descriptive phenomenological study using Colaizzi’s approach, conducted on OCD patients who visited Tehran Psychiatric Institute. Semi-structured interviews were conducted with the patients and continued until reaching saturation. Lincoln and Guba’s trustworthiness criteria for qualitative research (credibility, dependability, transferability, and confirmability) were used to ensure the accuracy and precision of the findings.&#x0D; Results: Fourteen participants with a mean age of 30.3 years took part in this study. The data analysis revealed three themes: the pandemic disrupting OCD patients’ mental structure (OCD exacerbation, increased tensions in interpersonal relationships, mental exhaustion), rationalization of OCD symptoms in the context of COVID-19 (not feeling excluded, conflict resolution with the family, theoretically taking revenge on others), and the assimilation of COVID-19 within OCD (adaptation of the mental world to the world of COVID-19, altered content of obsession, and altered pattern of obsession).&#x0D; Conclusion: The stress induced by the COVID-19 pandemic can impact OCD in different ways, mostly by exacerbating the symptoms, adding new symptoms, and altering the type of obsession. The stress of infection is the most important factor in OCD exacerbation.

Perceived traumatic and stressful etiology of obsessive-compulsive disorder

A growing body of research has highlighted connections between obsessive-compulsive disorder (OCD) symptoms and traumatic and stressful life events. However, findings regarding the impact of traumatic and stressful events on posttraumatic stress symptoms are mixed, with some studies suggesting that the perception of an event as traumatic—regardless of the strict definition of trauma—may be most predictive of outcomes. Despite this, research has yet to ask individuals with OCD, themselves, why they believe their OCD developed; instead, findings linking trauma exposure and OCD are largely causally extrapolated. The current study examined the perceptions of OCD etiology in 45 individuals with OCD enrolled in residential treatment and qualitative responses were coded as traumatic, stressful, or other (i.e., non-event) etiologies. Nearly half of the sample (44.4%) believed their OCD developed following an identifiable event, six of whom identified a distinguishable traumatic event (13.3% overall). Individuals with perceived traumatic etiologies consistently endorsed engagement in more types of obsessions and compulsions, particularly in the past, and implicated themes of symmetry/exactness, repeating, checking, scrupulosity, pathological doubt, and hoarding. Findings suggest that events that occur pre-OCD onset may be likely to be perceived as the catalyst for OCD and may ultimately impact the theme and severity of symptoms in intuitive ways. • This study examined individual's subjective perceptions of why their OCD developed. • Nearly half of the sample attribute their OCD etiology to an identifiable event. • Traumatic etiology is more strongly related to symptoms than stressful etiology. • Traumatic etiology is related to obsessions and compulsions, especially in the past. • Traumatic etiology is consistently related to symmetry obsessions and compulsions.

Bodily obsessions: intrusiveness of organs in somatic obsessive–compulsive disorder

In this paper, I will provide a phenomenological analysis of somatic obsessions at times present in obsessive–compulsive disorder. I will compare two different types of bodily obsessions, which have a different neurological-physiological underpinning: anguishing awareness of one’s own heartbeat and of one’s own breathing. In addition, I will contrast these two with how one experiences one’s own liver. I will use the concepts "tactility obsessions” and "motility obsessions”, which I have coined for the purpose of this comparison. In other words, these are obsessions concerning the felt sense of one’s autonomous organs and obsessions concerning one’s ability to voluntarily move. Ultimately, I claim that the core lived experience in somatic obsessive–compulsive disorder should not only be understood as having to do with intruding and "distorted thoughts” concerning bodily processes, but could also be understood as having to do with a felt sense of our organs interrupting and intruding our daily lives.

Augmentation with transcranial direct current stimulation in difficult to treat obsessive-compulsive disorder: A case report

Sir, Obsessive-compulsive disorder (OCD) is associated with a lowered life quality and a greater degree of dysfunction in social and occupational functioning.[1] A significant proportion of patients with OCD, are resistant to therapy.[2] Numerous neuromodulation approaches, including deep brain stimulation (DBS), transcranial direct current stimulation (tDCS), and repetitive transcranial magnetic stimulation (TMS), have been utilized in conjunction with conventional pharmacological and psychological treatments.[3] tDCS, a noninvasive form of neurostimulation, has demonstrated a potential role as a safe and successful treatment for OCD in several trials.[2] The orbitofrontal cortex and the supplementary motor area (SMA) are the two most promising stimulation sites.[4] We present a case of a young male suffering from OCD who has a poor response to pharmacological treatment. A young male of 27 years attended the adult psychiatry outpatient department with complaints of recurrent repetitive sexual thoughts, excessive doubts, and repeated checking behavior for 3 years. The patient also had low mood, decreased interest in activities that were previously enjoyable, reduced interaction with friends and family members, disturbed sleep, disturbed sleep, and low confidence. There was no past or family history of any psychiatric or substance use. He was diagnosed with OCD, mixed obsessional thoughts and acts, and moderate depressive episodes. The patient was given an adequate trial on escitalopram (maximum 60mg/day) which was later augmented with ondansetron (8mg/day) and aripiprazole (5mg/day) but had a poor response to treatment. The patient was switched to fluvoxamine (maximum 300mg/day), clomipramine (50 mg), and buspirone (10mg), which were tried for a month, during which the patient had maintained adherence. However, the patient had only minimal response to treatment. Hence, the patient was admitted with a plan to augment the therapy with tDCS. Along with fluvoxamine 300 mg/day, clomipramine 50 mg/day, buspirone 10 mg/day, and tDCS sessions were administered (once daily for the first 10 sessions, followed by twice daily for the subsequent ten sessions). A 2-mA current was used with a ramp time of 20 s. The total duration of the session was 20 min and 40 s. Anode placement was done over SMA to target OC symptoms and cathode over the right dorsolateral prefrontal cortex (DLPFC) to target the depressive symptoms, concurrently. After 20 sessions, there was a significant reduction in YBOCS scores up to 46.4%, i.e., from an initial score of 28/40 to 15/40. Similarly, the HAM-D score changed from the initial score of 17/50 to 6/50 (64.7% reduction from the baseline severity score). The benefit was sustained for the next 4 months during the follow-up. Augmentation with tDCS can be effective for severely ill OCD patients unresponsive to drugs and behavioral therapy. Among the various types of obsessions, sexual obsessions are considered to be relatively resistant to treatment. In our case, the sexual obsessions responded well to tDCS augmentation. The patient did not report any major side effects, other than mild headaches following the initial few sessions. DBS and TMS received the most evidence, while for tDCS, evidence is less as of now.[5] However, studies in this area are few, and a well-defined protocol is lacking regarding the frequency of sessions, number of sessions, electrode placement, and the target brain areas. Hence, more RCTs in this area will help to increase the armamentarium in the treatment of resistant OCD. As a large number of patients with OCD often have comorbid depressive episodes, placement of anode over SMA and placement of cathode over the right DLPFC may be helpful in treating both conditions concurrently. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient (s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

A cross-sectional study of the phenomenology of obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is a clinical syndrome whose hallmarks are excessive, anxiety-evoking thoughts and compulsive behaviours that are generally recognised as unreasonable, but which cause significant distress and impairment. Heterogeneous nature of OCD presentation makes its conceptualisation as a complicated one. Phenomenological studies are needed to understand various heterogeneity OCD. This study is intended to see various phenomenological subtypes of OCD in the local population. This is a hospital-based cross-sectional study. Two hundred consecutive OCD patients attending psychiatry OPD analysed for the various social-demographic features and phenomenological findings. In our study, 48% of the sample had only obsessions, 19% had only compulsions, while 33% had a mixed presentation, studying the subtypes, the study revealed that 36.5% of the sample who presented with fear of contamination and 11.5 % samples have an aggressive obsession and another 11.5 % samples have symmetry obsession. 28% had contamination obsessions, 9% had sexual obsessions, 7% had somatic obsessions while 9% had religious obsessions, and 6% had various types of obsessions. When compulsion was assessed, it was found to be checking 28(77.8%), cleaning 25 (69%), repeating 18(50%), counting 6(16%), ordering 4 (11%), collecting 4(11%) and miscellaneous 15(42%) when subtyped. Studying the phenomenological pattern in OCD patient would help in better understanding of the illness of the patients, it also tries to attempt the relationship between sociocultural issues and OCD. Though the neurobiology is similar in all individuals, phenomenology differs between individuals concerning gender, religion and culture.

Correlates of obsessive-compulsive symptoms among Black Caribbean Americans

Despite the rapid growth of the Black Caribbean population in the United States, we know little about the presentation and prevalence of obsessive-compulsive disorder (OCD) among these groups. This study examines the demographic correlates and the effect of racial discrimination on OCD symptoms among a nationally-representative sample of Black Caribbean and African American adults (n = 5191). Drawing on the Composite International Diagnostic Interview Short Form (CIDI-SF) for OCD, we examine two types of obsessions (harm and contamination) and four types of compulsions (repeating, washing, ordering, and counting). There we no significant differences between Black Caribbeans and African Americans in obsessions and compulsions. Analysis among Black Caribbeans found that compared with Jamaican and Trinidadian Americans, Haitian American individuals reported the fewest number of obsessions and compulsions. We show that Black Caribbean Americans with lower income, lower self-rated physical and mental health, and more experiences with racial discrimination report higher levels of OCD. More specifically, racial discrimination was associated with contamination and harm obsessions, as well as washing and repeating compulsions. Our findings highlight the need to consider specific domains of OCD relative to Black Caribbeans, and the relationship between social and demographic variables on symptomology.

Ondansetron Augmentation for Treatment-Resistant Obsessive-Compulsive Disorder: A Randomized Placebo-Controlled Clinical Trial

Background: Serotonin and dopamine are involved in the development of obsessive-compulsive disorder (OCD). Approximately 40% of OCD patients do not respond to the first-line therapy of treatment using selective serotonin reuptake inhibitors. Reportedly, the response to the treatment is increased by enhancing dopamine blockers. Objectives: The purpose of this study was to evaluate the efficacy and immunogenicity of ondansetron as a booster in the treatment of OCD patients. Methods: The present double-blind, randomized clinical trial (RCT) was conducted on 40 patients (16 males and 24 females) aged 18 to 60 years who met the DSM-V-TR-based OCD diagnostic criteria and had a minimum score of 16 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The patients were randomized to receive standard treatment and ondansetron (8 mg/day) or placebo for 12 weeks. They were examined using Y-BOCS and side-effect checklist at baseline, fourth, eighth, and twelfth weeks. Results: The patients in both groups were homogeneous and comparable in terms of age, marital sex status, type of obsession, anxiety, depression, age at the onset of disease, and the duration of disease. The Y-BOCS scores in the intervention and placebo groups were 27.15 ± 3.94 vs. 26.15 ± 4.94 at baseline, 25.40 ± 3.75 vs. 25.00 ± 4.79 in the fourth week, 20.85 ± 3.69 vs. 24.05 ± 4.97 (P = 0.026) in the eighth week, and 17.95 ± 3.43 vs. 21.65 ± 4.85 (P = 0.008) in the twelfth week, respectively. Significant changes occurred between the two groups at weeks 8 and 12; the difference between the two groups was significant (P = 0.015), whereas no significant difference was observed between the two groups before week 8. Conclusions: This 12-week, double-blind, and randomized clinical trial showed that ondansetron was a booster agent with a significant effect on patients with moderate to severe OCD. This study also showed that ondansetron is generally well tolerated by OCD patients. The response to the treatment also increased from the eighth week of treatment onwards. The severity of the disease was decreased at the end of the ondansetron intervention. The adjunct ondansetron treatment was recommended for OCD patients

THE EFFICIENCY OF THE REGISTERED-AXIAL CLASSIFICATION OF OBSESSIVE-COMPULSIVE DISORDER

&nbsp; Rather simple in using, the registered-axial classification of the obsessive-compulsive disorder offers to define an OCD register (neurotic, psychopathic, psychotic, depressive, or vegetative). Furthermore, for diagnose adjustment or for the needs of different expertises, the respective axes are used (axis I – syndromes or particularity; axis II – ego-syntonic / ego-dystonic perception of symptoms; axis III – the level of awareness of obsessions; axis IV – chronization (dynamics); axis V – sensory phenomena, influence of the register to qualities of obsessions). Moreover, the above-mentioned classification allows interpreting the obsessive-compulsive disorder as a special phenomenon – a register-sensitive symptom; and this interpretation changes the theoretical views about the OCD. It is better to image such fact like a process, when every register sufficiently transfigures the main plots and qualities of obsessions. Thus, this theoretical statement allows differentiating almost the whole range of known obsessions and compulsions. The article objective is to introduce a new classification of the obsessive-compulsive disorder, which allows unifying the whole data about the OCD in the ICD and the DSM. Besides, the new concept will help differentiate and systematize the different types of obsessions and compulsions. By using such classification, it is easy to develop the general theory of obsessive conditions for needs of psychological and psychiatric expertises. 20 persons with the age from 23 to 62 were studied. Five psychological diagnostic methods were used: Yale-Brown obsessive-compulsive scale (Y-BOCS), Beck Depression Inventory, the inquirer of К.&nbsp;Leonhard−G. Shmishek, Rorschach test, Taylor Manifest Anxiety Scale (MAS). The obsessive-compulsive disorder is not an independent disorder. What is more, the experimental data confirmed the main hypothesis concerning the sufficient interconnection between the register of a main disorder and obsession symptoms (register-sensitivity). Therefore, this fact proved the topicality of the new registered-axial classification for the obsessive-compulsive disorder. Besides, the new classification points to some limitations of the Y-BOCS pathopsychological method. Namely, the absent etiological subscale in the scale decreases its efficiency. We determined, that the depression indirectly affects the development of the obsessive-compulsive symptomatology (the correlation between Beck Depression Inventory and Taylor Manifest Anxiety Scale was detected). Moreover, these data allows reviewing the depressive register of the register-axial classification not only as the theoretical aspect, but also as the practical factor. The review of the psychopathic register determined that some combinations of accentuations lead to the development of the OCD (stuck (rigid) – unstable (excitable) (t =0,007685, p&lt;0,05); emotive (labile) – unstable (excitable) (t =0,007685, p&lt;0,05); cyclotymic – excited (t&nbsp;=0,007685, p&lt;0,05). The separate cyclothymic (cycloid) accentuation is also statistically significant (t&nbsp;=0,007685, p&lt;0,05). Consequently, such data allow us to forecast that there are several types of the obsessive-compulsive personality disorders (OCPD) with rather different particularity. The data of the projective method –Rorschach test – confirm the idea, that the certain responders (30 % of the sample) with obsessions are expected to have some psychotic disorders (thus, the necessity to consider a separate category – the psychotic OCD register - was confirmed). The Pearson correlation coefficient, being calculated for the experimental and control group, demonstrates, that the positive correlations between Y-BOCS and Taylor Manifest Anxiety Scale (MAS) were detected (r&nbsp;= 0,656816) in the control group. Thus, the growth of anxiety affects to some degree the intensity of obsessions and compulsions, but this statement is quite fair only for those responders, who feel very mild OCD symptoms. Yet, anxiety is not significant for the patients with the intensive symptoms (probably, because of some compensatory mechanisms). The obsessions of different registers have different qualitative characteristics (their symptoms are different). Hence, the difficulties in the psychological and drug therapy of the obsessive-compulsive disorder is explained by the fact that several registers of the OCD may appear in the anamnesis (up to 5 registers). Finally, the efficiency of the registered-axial classification of the obsessive-compulsive disorder was proved. Such classification is worth introducing for the needs of the ICD and the DSM. &nbsp

Clinico-epidemiological Profile of Obsessive Compulsive Patients in a Tertiary Care Hospital in Mangalore, India: A Retrospective Study

Introduction: Obsessive-compulsive disorder (OCD) is the fourth most common mental illness. It is associated with a wide range of functional impairments and therefore adversely affects the quality of life of patients. Objectives: To assess the risk factors, clinical features and management practices of OCD based on findings were stated in medical records. Methodology: The secondary data from the medical records of 9 OCD patients admitted in a tertiary care hospital over the past 10 years were recorded in a semi-structured proforma. Severity of OCD was assessed using Yale Brown Obsessive Compulsive Scale scores. Results: Mean age of onset among all patients (n=9) was 27.9±15.2 years. Family history of OCD was reported among 3(33.3%) patients. Six had predominant obsessions while the rest 3 had mixed type. The most common type of obsession was of sexual type reported among 3 patients. The most common compulsion reported was the checking type which was present among 2 patients. Reduced concentration, suicidal ideation and anhedonia were present each among 5(55.6%) patients. Depression was the most common co-morbidity reported among 5(55.6%) patients. Severity of OCD was mild among 5(55.6%). Fluvoxamine was the most common drug [5(55.6%)] used to treat OCD. Outcome of treatment was reported poor among 3(33.3%) patients. It was good/moderate among 1(25%) patient residing in urban area in comparison to 5(100%) from rural areas (p=0.048). Conclusion: Mean age of onset was found to be delayed among patients probably due to delay in identification of OCD. Hence awareness generation and early screening need to be initiated for early identification of OCD. The majority of OCD patients had positive history of suicide ideation and depression as co-morbidity, indicating the need of screening patients for these conditions.

Leczenie zaburzeń obsesyjno-kompulsyjnych (OCD) i zaburzeń powiązanych (OCRD)

The purpose of this article is to present an overview of current knowledge on the treatment of obsessive-compulsive and obsessive-compulsive-related disorders (OCRD - according to DSM-5). The article presents commonly used pharmacological treatments and psychotherapy, as well as surgical and other forms of treatment. According to the analyses that have been made, the variety of responses to the pharmacological treatment of obsessive-compulsive disorders (OCD) depending on the kinds of symptoms is not relevant enough to justify these other forms of treatment. Instead, the choice of medication should be made based on other factors, such as the severity of symptoms and the level of insight into the illness or the symptoms of other disorders co-occurring with the obsessions. These factors are also significant in psychotherapy, but in this case, the dependency between the types of obsessions and compulsions and the therapeutic approach has greater importance. Generally speaking, in OCRD treatment, atendency to use other forms of treatment can be observed for disorders based mainly on the mechanism of compulsivity or impulsivity. Hopes for a more effective treatment are related to the types of pharmacological treatment and modifications of psychotherapeutic methods based on the development happening in the cognitive behavioural approach.

Obsessions Across Two Cultures: A Comparison of Belgian and Turkish Non-clinical Samples.

There is a growing interest in the role of culture in Obsessive-Compulsive Disorder, yet cultural studies to date have suffered from methodological limitations and lack a clear theoretical framework. In the current study, we adopted a rigorous methodological approach, and a clear cultural psychological framework. We compared the structure and frequency of obsessions in non-clinical samples (N = 706) from Belgium, a Western culture, and Turkey, a non-Western cultural context. Obsessions were measured by a newly compiled instrument that included a broad range of obsessions. Cross-cultural equivalence of the structure of obsessions was assessed both in the pooled data, and in each culture separately. At an abstract level, we found a two-factor structure that was cross-culturally invariant, and that fit both cultures equally well. These two types of obsessions each corresponded with a different model of agency. Compared to the Turkish sample, the Belgian sample reported more obsessions that can be understood from a disjoint (independent) model of agency as frequently found in Western cultures, whereas the Turkish sample, compared to their Belgian counterparts, reported more obsessions that can be tied to a conjoint (shared) model of agency as frequently found in non-Western cultural contexts. Differences in the prevalent types of obsessions were systematic and interpretable, therefore. In addition to the cross-culturally equivalent two-factor structure, we found culture-specific factor solutions; these solutions point to cultural differences in the experience of obsessions that have yet to be fully understood. In the Discussion, we outline future directions of the research on culture and obsessions.

The linguistic construction of the self in narratives of obsessive-compulsive disorder

ABSTRACT Obsessive-compulsive disorder (OCD) is a mental health problem characterised by distressing obsessions and repetitive compulsions. The autogenous-reactive model of OCD outlines two types of obsessions: 1) reactive, which are triggered by stimuli external to the self (e.g. electrical appliances) and 2) autogenous, which are triggered by stimuli internal to the self (e.g. memories) (Lee and Kwon, 2003). This article demonstrates the differences in the linguistic construction of the self within narratives told by people with OCD about reactive and autogenous obsessions. Narratives are analysed by focusing on the entity placed as grammatical subject. It is found that, within autogenous narratives, personified thoughts and the mind are placed as grammatical subject more often than within reactive narratives. autogenous narratives. These patterns potentially construct the self as agentive and responsible in reactive obsessions but in need of protection in autogenous obsessions.

The paradox of moral cleansing: When physical cleansing leads to increased contamination concerns

Background and objectivesMoral threats, including threats to moral self-worth, have been associated with contamination concerns. Paradoxically, although self-cleansing provides temporary relief, it can worsen feelings of contamination. Self-affirmation might be an effective strategy, especially following obsessive type cognitions (e.g., responsibility beliefs) when moral threats are reactivated. MethodsIn Experiment 1, participants recalled an immoral deed and then self-cleansed (using a hand-wipe), completed a control task, or self-affirmed. Contamination concerns were subsequently measured by a washing task. In Experiment 2, the same procedure was used but obsessive-type cognitions were activated by asking participants a series of questions about obsessive beliefs. ResultsAs expected, relative to the control condition, both self-affirmation and self-cleansing resulted in less subsequent repeated washing behaviour in Experiment 1. In Experiment 2, when the immoral recall was followed by activation of obsessive-type cognitions, self-cleansing led to more guilt and repeated washing than self-affirmation and control. Rather than alleviating feelings of contamination, physical self-cleansing led to more contamination concerns and guilt when in the context of activated obsessive-type cognitions, possibly because it paradoxically makes (moral) cleanliness goals salient. LimitationsFuture research needs to test clinical populations, for whom contamination concerns are all the more central. ConclusionsThis research provides further evidence of the influence of moral threat in contamination concerns, and the limits of moral cleansing. Self-affirmation resulted in less contamination concerns under both a neutral condition and activated obsessive type cognitions.

Psychotic and obsessive symptoms: A case report

A 28-year-old patient who began three months of symptoms of low mood, apathy and anhedonia. The patient in this last month had accepted a job but the first day had left by “feeling incapable”. He asked for specialized help. He was diagnosed with severe depressive episode and antidepressant treatment. Some weeks of patient treatment did not improve. He began to voice greater feelings of hopelessness and ideas of active death secondary to his process. He was admitted a partial hospitalization for further control and evaluation. In his evolution, visual hallucinations and a mild delusional ideation of unstructured surveillance and injury were observed. The patient verbalized with little repercussion these sensoperceptive alterations. Neuroleptic treatment was given but we could not manage high doses because of poor tolerance and side effects of treatment. The symptomatology did not improve and the patient's anguish increased. In the moments of greater distress, the patient performed superficial cuts on his forearms that he criticized. During the following months, symptoms of an obsessive type were observed, which had already pre-entered but had been reactivated. He began to perform rituals of verification with important repercussion.DiscussionIn the scientific literature the relationship between psychosis and obsession has been studied on many occasions, without reaching firm conclusions. In 2004, Poyurosvsky postulated the possible diagnosis of a subgroup called “schizo-obsessive” that included both disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

OCD Taboo Thoughts and Stigmatizing Attitudes in Clinicians.

Individuals who suffer from obsessive-compulsive disorder have persistent intrusive thoughts that cause severe distress that impairs daily functioning. These individuals often conceal their intrusive thoughts and delay help-seeking for fear of being stigmatized. Stigma can be problematic when it is present among mental health professionals because they may distance themselves from their clients and have a negative outlook on treatment outcome. To date there has not been any research that focuses on stigma that clinician's may hold towards obsessive-compulsive disorder or specific obsessions; however, there is evidence that mental health professionals may have prejudices towards individuals who suffer from other mental illnesses. The current study aimed to explore clinician and student clinician attitudes about obsessional content from varying symptom dimensions. Results indicated participants were more likely to socially reject or be concerned by individuals with obsessions related to contamination, harming, and sexual obsessions than those with scrupulous obsessions, and that they would be less likely to reveal sexual obsessions to others if they were experiencing them than the other three types of obsessions.

The Features of Comorbidity of Childhood ADHD in Patients With Obsessive Compulsive Disorder

Objective: Our aim is to investigate the impact of childhood ADHD comorbidity on the clinical features of obsessive compulsive disorder (OCD). Method: Ninety-five adult outpatients with a diagnosis of OCD were assessed by using the Schedule for Affective Disorders and Schizophrenia for School Age Children–Present and Lifetime Version, ADHD module, and the Yale–Brown Obsessive Compulsive Scale. Patients with or without childhood ADHD were compared in terms of the sociodemographic and clinical features, psychiatric comorbidities, and rating scales. Results: The rate of episodic course of OCD (p < .001), religious and sexual obsessions (p = .009, p = .020, respectively), lifetime comorbidity of bipolar disorder (BD), social anxiety disorder (SAD; p = .001, p = .009, respectively), and tic disorder (TD) comorbidity (p < .001) were higher in the OCD + ADHD group than in the OCD without ADHD group. Conclusion: Childhood ADHD may be associated with higher rates of BD, SAD, and TD comorbidity and episodic course of OCD as well as higher frequency of certain types of obsessions.

Obsessive-Compulsive Disorder Presenting as Gender Dysphoria/Gender Incongruence: A Case Report and Literature Review

ABSTRACT Objective: With the intensified public awareness and media coverage of issues concerning gender identity and gender incongruence, distinguishing true gender dysphoria or incongruence from the sexual obsessions of obsessive-compulsive disorder (OCD) is especially important. Although intrusive sexual obsessions are not uncommon in OCD, obsessions concerning sexual content are more difficult for clinicians to identify as OCD than other types of obsessions (e.g., obsessions concerning contamination). Making the correct diagnosis helps ensure that appropriate clinical treatment can be offered. Methods: We present a case report of a homosexual, single, young male with new-onset intrusive repetitive obsessive thoughts that he was transgender. The case report is accompanied by a review of the pertinent endocrine and psychiatric literature. Results: A Yale-Brown Obsessive Compulsive Scale indicated a significant negative impact of the patient's symptoms. Conclusion: To our knowledge, this is the first cas...