Journal of Obsessive-Compulsive and Related Disorders最新文献

Emotion regulation (ER), executive function (EF) and aggression have all been separately linked with hoarding behaviours. This study aimed to investigate whether difficulties with ER, deficits in EF, and an increase in aggression are linked with hoarding behaviours in a community sample, whilst controlling for anxiety, depression, age, and sex. Using a correlational design, we recruited 225 adults who completed questionnaires of anxiety and depression, hoarding severity, difficulties with ER, EF, and aggression. Two hierarchical multiple regressions were conducted to uncover which factors predicted an increase in hoarding behaviours, as well as the unique variance of these contributing factors. They revealed that difficulties with ER and physical aggression both contributed unique variance to hoarding severity scores. Further research is needed to fully uncover the relationship between aggression and HD, and the interconnection between EF and ER. The current study, although not without its limitations, has implications for further research in clinical samples.

Prior research has yielded inconsistent findings on neurocognitive deficits, particularly in response inhibition and set shifting, when comparing patients with trichotillomania (TTM) to healthy comparison groups. This study used baseline data (N = 36) from a clinical trial of behavior therapy for TTM to test two possible explanations for these mixed results: (a) neurocognitive deficits are only noted among more severely symptomatic patients with TTM; and (b) age of onset is differentially associated with deficits in response inhibition vs. set shifting. Results were inconsistent with these hypotheses. Age of onset was not significantly correlated with either neurocognitive assessment. Interviewer ratings of TTM symptom severity or impairment were not significantly related to neurocognitive test performance. Self-reported symptom severity correlated significantly with motor response inhibition, but in the direction opposite to our expectation, such that faster reaction times to inhibit a dominant response were associated with more severe symptoms. Discussion centered on several possible explanations, including the possibilities that either (a) measurement methods or (b) variation across samples in the prevalence of ADHD comorbidity, not measured in this study, could explain mixed findings on the neuropsychological profile of TTM.

Background

Obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) have been reported in dementia and mild cognitive impairment (MCI). We investigated the comorbidity of OCD and OCS in patients with a diagnosis of dementia or MCI and the risk of developing dementia or MCI for those with a diagnosis of OCD or OCS later in life.

Methods

We conducted a systematic review, searching databases up to March 2023. The quality assessment was performed using the Weight of Evidence (WoE) framework, and a narrative synthesis was completed.

Results

Twenty studies met our inclusion criteria. The presence of methodological limitations and potential biases was observed in the studies included in this review. The majority were of moderate quality, were conducted in samples selected from tertiary care or research settings. OCS was present in 21–100% of patients with frontotemporal dementia (FTD) and 10–45% of patients with Alzheimer's disease (AD).

Conclusion

OCS is a common symptom in FTD, particularly behavioural variation FTD (bvFTD). The onset of OCD or OCS later in life should warrant careful screening and follow-up to monitor for potential cognitive changes and the risk of developing dementia.

The Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS) is a semi-structured interview designed to assess the severity of current BDD. The aim of the study was to examine the factor structure and construct validity of the BDD-YBOCS. The sample included 366 adults with BDD who completed the BDD-YBOCS and other measures of BDD severity/impairment, psychiatric distress (i.e., anxiety and depression) and quality of life. Exploratory factor analysis supported two factors that were weakly correlated with each other (r = 0.21) (1) Severity (i.e., time, distress, interference, and avoidance; 31.6% of the variance): and (2) Resistance/Control (i.e., reduced effort to resist symptoms and lack of control over symptoms; 16.7% of the variance). The Severity factor had good internal consistency (α = 0.82) and good construct validity (rs = 0.69-0.81 with BDD severity/impairment; rs = 0.38-0.56 with depression and anxiety; and rs = 0.48-0.53 with functional impairment and quality of life). The Resistance/Control factor had acceptable internal consistency (α = 0.74) but more limited construct validity (rs = 0.27-0.28 with BDD severity/impairment (rs = 0.04-0.20 with depression and anxiety and rs = 0.05-0.14 with functional impairment and quality of life). Implications for the conceptualization and assessment of BDD severity are discussed.

Incompleteness, that is, a feeling that things are “not just right”, is an understudied symptom of obsessive-compulsive disorder (OCD). We used data from 167 adult individuals with OCD who received internet-delivered cognitive behaviour therapy (ICBT) to examine how incompleteness was associated with clinical characteristics and treatment outcomes. Incompleteness was assessed using the Obsessive-Compulsive Trait Core Dimensions Questionnaire (OCTCDQ). Results showed that the proposed two-factor structure of the OCTCDQ had adequate model/data fit in the present sample. Incompleteness was positively associated with baseline symmetry/ordering symptoms (β = 0.52, [95% CI 0.48 to 0.56], p < 0.001), psychiatric comorbidity (β = 0.23, [95% CI 0.21 to 0.25], p < 0.05) and self-reported symptom severity (Y-BOCS-SR β = 0.35, [95% CI 0.27 to 0.43], p < 0.001; OCI-R β = 0.46, [95% CI 0.34 to 0.59], p < 0.001). Results showed that higher degree of incompleteness predicted a worse treatment outcome on clinician-rated, but not self-rated, measures of symptom severity. Participants with a high (vs. low) degree of incompleteness were less likely to be classified as responders (39% vs. 52%) and remitters (10% vs. 34%) at post-treatment. The results suggest that incompleteness is a clinically relevant feature of OCD, which may require treatment adaptations for some patients but more research is needed to confirm that the findings are not entirely due to measurement error.

It has been suggested that maladaptive metacognition (beliefs and strategies) is related to the development and maintenance of obsessive-compulsive disorder (OCD). The aims of the study were to explore whether subgroups of pediatric OCD patients could be identified based on self-reported generic metacognition, and to compare these potential subgroups with a non-clinical control group. Additionally, differences between subgroups were examined across demographic (age and sex) and clinical characteristics (OCD severity and insight, types of OCD symptoms, and co-occurring symptoms). The study included a pooled sample of 157 pediatric OCD patients (age 7–18 years) and 58 non-clinical controls. Latent profile analyses supported a model with three profiles characterized by low, moderate, and high levels of maladaptive metacognition relative to the control group. Children and adolescents with higher age, greater OCD severity, specific OCD symptoms (e.g., aggressive, sexual, somatic, religious, and self-rated obsessing symptoms), and/or co-occurring internalizing symptoms (including anxiety and depressive symptoms) had a higher probability of belonging to a group with higher levels of maladaptive metacognition. The emergent profiles indicate heterogeneity in metacognition and clinical expression among children and adolescents with OCD, suggesting that generic metacognition could be a possible treatment target for some of these patients.

The degree to which hoarding disorder (HD) is stigmatised by the public, and that this is internalised by people with HD, is a relatively neglected research area. This review aimed to synthesise current understanding of stigma of HD and its impact on help-seeking. A systematic search was conducted to identify publications which investigated public or internalised stigma, or related concepts like shame and blame, in relation to HD. The electronic databases PsycINFO, PubMed, Embase, Scopus, Medline, CINAHL, and Web of Science were searched. Fifteen papers met inclusion criteria and were appraised for quality using the QualSyst tool. There is very little literature exploring stigma in HD and quality of research is variable. Nevertheless, the literature suggests that a significant proportion of people who hoard and their families experience stigma, and HD is stigmatised by the public and associated with more rejecting attitudes and frustration amongst professionals. Finally, research exploring the impact of stigma on help-seeking in HD tentatively suggested a negative impact of stigma. Further research is needed to replicate and extend findings and address methodological limitations to provide an understanding of stigma on which approaches to enhance wellbeing and treatment uptake in HD can be developed. Systematic review (PROSPERO) registration number: CRD42022375820.

Autism affects as many as one in 36 children, a majority of whom experience comorbid anxiety or obsessive-compulsive disorder. Obsessive-compulsive symptoms share phenotypic similarities with autism characteristics (e.g., repetitive thoughts and behaviors) and some symptoms are difficult to disentangle (e.g., obsessions from specific interests/fixations). Hence, there is a need for OCD assessments that are validated to be used among autistic youth. This study evaluated the psychometric properties of the Children's Yale-Brown Obsessive Compulsive Scale - Second Edition (CY-BOCS-II) in 91 autistic youth seeking treatment for anxiety and/or obsessive-compulsive symptoms. The CY-BOCS-II demonstrated strong convergent and divergent validity, internal consistency, and treatment sensitivity. The CY-BOCS-II is a psychometrically sound measure of obsessive-compulsive symptoms in autistic youth, although it should be evaluated across larger and more diverse samples.

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.

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation procedure that is FDA-cleared for treating obsessive-compulsive disorder (OCD). Evidence suggests that controlling brain state during rTMS treatment can influence treatment outcomes. We present the case of a patient with refractory OCD who received symptom provocation immediately preceding rTMS treatment sessions. The patient experienced more subjective and objective improvement in OCD symptoms targeted by provocations than in other symptom domains. These results suggest the importance of brain state during rTMS and could be used to guide and optimize neuromodulation treatment for OCD.