Journal of Obsessive-Compulsive and Related Disorders最新文献

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.

Although Cognitive Behavioural Therapy (CBT) is an effective treatment for Body Dysmorphic Disorder (BDD), substantial variability exists in patient responses. The aim of this systematic review was to synthesise the emerging literature on predictors and moderators of treatment response in CBT for BDD. EMBASE, MEDLINE®, and PsycINFO databases were systematically searched for studies reporting predictor and/or moderator analyses in samples of individuals with diagnosed BDD who received CBT specifically for this disorder. Methodological quality of included studies was assessed using the methodological index for non-randomised studies (MINORS). The search identified eleven studies, examining 56 predictor variables. Nine variables (e.g. insight, depression, BDD severity) emerged as significant predictors in some but not all studies. No variables were found to consistently predict outcome at post-treatment or follow-up. Only one study reported moderator analyses and found no significant effects. In summary, although certain variables, such as insight, depression, and BDD severity, may predict response to CBT for BDD, findings have been inconsistent and common methodological flaws (e.g. inadequate statistical power) reduce the strength of evidence. Further, methodologically-robust research is needed to identify predictors and moderators of responses to CBT for BDD, in order to inform optimisation of CBT and support clinical decision-making.

Obsessive Compulsive Disorder (OCD) is a debilitating illness affecting 2% of the population. Psychological treatments consisting of exposure and response prevention (ERP) and cognitive behavioral based methods are efficacious for most individuals with OCD and have been found to yield long-term positive outcomes. Most research on such outcomes have focused on individual treatment and the outcomes associated with group-based treatments are less well established. Further, the mechanisms that account for outcomes of individual and group based treatments for OCD remain unclear. Cognitive theories suggest that changes in cognitive structures including self-related beliefs may account for treatment related changes, yet limited research has empirically examined such suggestions. This study examined the outcomes of a low-intensity 10-session group CBT program for OCD in real-world effectiveness. The final sample consisted of 78 participants (M = 34.9 years, 50% Males), who answered symptom and cognition measures following each session. Overall, using hierarchical linear modelling, it was found that the program was effective in reducing symptoms (modelled fall of 7.64 on the YBOCS). In addition, both OCD-relevant beliefs and self-ambivalence also reduced significantly, and both significantly related to symptom level. Implications are discussed.

Background

Although it has been widely established that poor social functioning is a characteristic of obsessive-compulsive disorder (OCD), little research has examined the relationship between OCD symptom subtypes and domains of social functioning. Thus, the present study sought to examine the specific ways in which impairment in social adjustment occurs in each symptom subtype of OCD.

Methods

A total of 325 adult participants with a primary diagnosis of OCD were included in the study. Hierarchical linear regressions were used to compare the extent to which OCD symptom subtypes predicted social adjustment domains after controlling for OCD and depression severity.

Results

Hoarding was shown to be significantly associated with work functioning. Whereas both contamination and symmetry subtypes were significantly associated with social functioning, only the contamination subtype was associated with functioning within the family unit. The symptom subtypes of doubt and taboo thoughts were not significantly associated with any domains of social adjustment.

Conclusion

Consistent with previous research, our results suggest a differential impact of OCD symptom subtypes on social adjustment. They offer important implications for the specific domains to target in treatment for different symptom subtypes.

A pandemic outbreak can lead to excessive, maladaptive levels of anxiety, particularly among individuals who already suffer from obsessive-compulsive disorder (OCD). The Coronavirus Disease 2019 (COVID-19) provided a novel opportunity to examine the possibility that individuals with OCD, compared to those without OCD, might experience greater distress from this common stressor. The present study examined the lasting effects of COVID-19 in the year after the outbreak. Additionally, there is limited research regarding the stability of OCD dimensions; therefore, this study examined whether the COVID-19 pandemic impacted the stability of OCD dimensions. One hundred and forty-three adults who reported they had been diagnosed with OCD and ninety-eight adults without OCD, completed an online survey assessing the impact the COVID-19 pandemic had on symptoms of OCD in the year after the initial outbreak. The OCD group showed greater concern about the pandemic and greater concern about future pandemics compared to the comparison group. In addition, COVID-19 related distress differentially related to OCD symptoms dimensions, showing the strongest association with the contamination dimension. Lastly, results showed that many individuals reported that their OCD dimension shifted to obsessions about COVID-19 from their pre-existing OCD dimension.

Background

People affected by skin picking disorder (SPD) feel a strong urge to manipulate their skin and feel incapable of stopping. First studies on cognitive-behavioral treatments found moderate to large effects on the reduction of symptomatology. We developed an easy to access cognitive-behavioral self-help program and tested its efficacy on SPD.

Method

The program includes modules on self-awareness, psychoeducation, strategies to control picking and relapse-prevention. In a multiple baseline-design 43 women diagnosed with SPD accessed the online program. Symptomatology was assessed via skin picking scales before, throughout, and after the completion of the intervention. We analyzed the data using a repeated measurement ANOVA and planned contrasts.

Results

We found significant large effects for skin picking symptom reduction throughout a 6-month follow-up (0.325 ≤ η_p² ≤ 0.430) for completers (n = 25). In planned contrasts the significant reduction of symptoms (after baseline self-monitoring) to 6-month follow-up was large (0.281 ≤ η_p² ≤ 0.375).

Conclusions

With the internet-based self-help program Knibbelstopp we implemented an efficacious self-help tool for SPD, which requires further investigation regarding generalizability of this effect. Our self-help program is accessible online and may help to improve the health care situation for German speaking individuals with SPD.

Body-focused repetitive behaviors (BFRBs) are frequent but under-treated psychological disorders. The present study examined efficacy of three behavioral self-help techniques to reduce BFRBs: habit reversal training (HRT), decoupling (DC), and decoupling in sensu (DC-is). A total of 391 participants with BFRBs were randomly assigned to either HRT, DC, DC-is, or to a waitlist control group (WLC). After six weeks, a post assessment was conducted. The Generic Body-Focused Repetitive Behavior Scale-36 (GBS-36) served as the primary outcome. There were significant main effects for improvement in BFRB and depressive symptomatology over time, regardless of group assignment. For all GBS-36 scales, treatment groups showed greater improvement than WLC. DC and DC-is consistently showed greater improvements compared to WLC. According to moderator analyses individuals with more severe symptoms in the HRT and DC-is conditions benefited to a greater extent compared to WLC in terms of BFRB symptomatology. Also, individuals in DC condition with more severe depressive symptomatology showed a better outcome compared to HRT and WLC. Moreover, individuals with trichotillomania benefited more from DC or DC-is than from HRT. Subjective ratings of the techniques were satisfactory and comparable across groups, with DC-is receiving slightly lower subjective ratings. Future research should address the effects of the techniques when combined with psychotherapy. Also, long-term effects should be evaluated.

Obsessive-compulsive disorder (OCD), anxiety disorders, and depressive disorders are highly comorbid, and each contribute to significant functional impairment for affected youth. Comorbid anxiety disorders in depressed youth have been associated with greater depressive symptom severity and impairment, but the impact of comorbid OCD in this population remains unclear. Accordingly, the present study examined the differential clinical characteristics of youth with depression and comorbid OCD relative to age/gender matched depressed youth with no such comorbidity and to those with depression and a comorbid (non-OCD) anxiety disorder. A sample of 797 youth and young adults ages 8–20 years who met diagnostic criteria for depression alone, depression with co-occurring OCD or any anxiety disorder were included in the present study. Rates of comorbid anxiety and OCD were very high (60.5% and 15.5%, respectively). Relative to youth with only depression, depressed youth with comorbid OCD or anxiety had greater severity of depression, suicidality, and overall impairment in social, physical, and emotional functioning. These results highlight the contribution of OCD or anxiety comorbidity in more complex clinical presentations for depressed youth.

Relationship obsessive–compulsive disorder (ROCD) is a disabling presentation of obsessive-compulsive disorder (OCD) centering on close interpersonal relationships. Previous studies focused on the personal consequences of ROCD symptoms. Yet, studies investigating the consequences of ROCD symptoms on one's partner are scarce. In this study, we assessed whether exposure to romantic partners' elevated ROCD symptoms would heighten participants' ROCD symptoms and would increase participants' evaluation of their own and their partners' susceptibility to infidelity. Heterosexual couples (N_couples = 50; M_age = 25.8) completed self-report questionnaires. One randomly selected partner of each romantic dyad was then randomly allocated to being exposed to information suggesting their partner has low (low-exposure) or high (high-exposure) levels of ROCD symptoms. Results indicated that participants in the high-exposure group showed higher ROCD symptoms than participants in the low-exposure group. Exposure to allegedly elevated levels of partners' ROCD symptoms also led participants to evaluate their own and their partners' susceptibility to infidelity as higher than participants in the low-exposure group, particularly among participants with pre-existing ROCD symptoms. These results illustrate a ‘contagious’ effect of unmediated exposure to partners' ROCD symptoms and its potentially unfavorable consequences. Clinical implications regarding partner involvement in the treatment of ROCD are discussed.