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PubMed1992

The Symptom Checklist-90: Obsessive-Compulsive Subscale: A reliability and validity study.

Twenty-three nondepressed patients with DSM-III obsessive-compulsive disorder completed the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Symptom Checklist-90 (SCL-90), and the National Institute of Mental Health Global Obsessive-Compulsive Scale (NIMH-GOCS) once a week for a total of three times during a 2-week medication-free period and 10 times during a 10-week double-blind drug treatment period. The pretreatment test-retest reliabilities were determined for the Y-BOCS, NIMH-GOCS, and the SCL-90-Obsessive-Compulsive Subscale (SCL-90-OCS). Comparisons of the three instruments revealed that the Y-BOCS and the NIMH-GOCS were significantly more reliable than the SCL-90-OCS. Posttreatment correlations were obtained between change scores on the Y-BOCS and NIMH-GOCS and the SCL-90-OCS. Correlations were high and statistically significant for both the Y-BOCS and the NIMH-GOCS, but the correlations of the SCL-90-OCS with the Y-BOCS, NIMH-GOCS, Physician's Global Rating, and the Patient's Global Rating were poor. The findings suggest that the SCL-90-OCS may not be a sensitive instrument in assessing change in obsessive-compulsive symptoms.

Adult↗
PubMed2006

Probability of obsessive and compulsive symptoms in Huntington's disease.

BACKGROUND: The purpose of this study was to examine the probability of obsessive and compulsive (OC) symptoms across stages of Huntington's disease (HD) with both cross sectional and longitudinal data. METHODS: We present the largest sample to date of individuals at risk for HD (N = 3964). Obsessive and compulsive symptoms were assessed with the Unified Huntington's Disease Rating Scale OC items. RESULTS: The probability of meeting the threshold for obsessions and compulsions increased with greater disease severity. Those with no motor abnormalities ("at risk") had a 7% probability of obsessions and a 3.5% probability of compulsions; the peak probability for obsessions (24%) and compulsions (12%) occurred in patients with advanced disease with significant functional disability. CONCLUSIONS: The probability of OC symptoms is more than three times greater by stages 3 and 4 (clearly manifest disease) than in our at-risk group with no apparent motor abnormalities.

Adult↗
PubMed2004

Obsessive-compulsive symptoms: the contribution of metacognitions and responsibility.

Two different cognitive models of obsessive-compulsive symptoms were evaluated. One model [Salkovskis, P. M. (1985). Obsessional-compulsive problems a cognitive-behavioral analysis. Behaviour Research and Therapy, 23, 571-583.] gives a central and necessary role to beliefs and appraisals concerning responsibility. The other [Wells, A. (1997). Cognitive therapy of anxiety disorders: a practice manual and conceptual guide. Chichester, UK: Wiley.] attaches a central and necessary role to metacognitive beliefs about the meaning and danger of thoughts/feelings and the need for control. We tested the unique contributions of responsibility or metacognitions to obsessive-compulsive symptoms whilst controlling for their intercorrelations and worry. Consistent with each model, responsibility and metacognitions were positively associated with obsessive-compulsive symptoms, even when worry was controlled for. However, responsibility was not associated with obsessive-compulsive symptoms when metacognitions and worry were controlled, but the relationship between metacognitive beliefs and obsessive-compulsive symptoms was independent of responsibility and worry. Responsibility did not add anything to the variance in symptoms explained by metacognitions. The data provide further support for the metacognitive model.

Adult↗
PubMed2006

The children's Yale-Brown obsessive-compulsive scale: psychometric properties of child- and parent-report formats.

The children's Yale-Brown obsessive-compulsive scale (CY-BOCS) is a commonly used, psychometrically sound clinician-rated instrument of pediatric obsessive-compulsive disorder (OCD) severity. Given the relatively direct rating format and potential benefits of alternative versions that could be easily administered to patients and parents, we developed and examined the psychometric properties of child- and parent-report formats of the CY-BOCS severity items. A total of 53 children and adolescents (8-17 years old) with OCD and their parents was administered the CY-BOCS, children's Yale-Brown obsessive-compulsive scale-child report (CY-BOCS-CR), children's Yale-Brown obsessive-compulsive scale-parent report (CY-BOCS-PR), and other measures of obsessive-compulsive symptoms, internalizing, and externalizing symptoms. In general, reliability and convergent and divergent validity of the CY-BOCS-CR/PR were satisfactory. Psychometric properties for the CY-BOCS-CR in those children and adolescents with externalizing behavior problems were lower relative to those without externalizing problems. Exploratory factor analyses identified a two-factor structure in both measures comprised of disturbance and severity factors. This study provides preliminary support for the use of child- and parent-report versions of the CY-BOCS.

Adolescent↗
PubMed2004

Psychometric evaluation of the Children's Yale-Brown Obsessive-Compulsive Scale.

This study evaluated the psychometric properties of the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). A total of 61 children and adolescents, aged 4-18 years, who were diagnosed with obsessive-compulsive disorder (OCD) participated. Thirty-seven of these children also participated in a second CY-BOCS administration by the same rater an average of 41 days later. Good internal consistency and test-retest reliability were found for the CY-BOCS Obsession and Compulsion Severity Scores and the Total Score. CY-BOCS scores demonstrated strong correlations with clinician-rated measures of impairment, obsessions, and compulsions. In addition, CY-BOCS scores were moderately related to measures of depression, aggressive behavior, and symptoms of attention deficit hyperactivity disorder, but were not significantly related to clinician ratings of tics or self-reports of general anxiety. Findings suggest that the CY-BOCS is a reliable and valid instrument for the assessment of childhood obsessions and compulsions.

Adolescent↗
PubMed2005

Obsessive-compulsive disorder symptom dimensions show specific relationships to psychiatric comorbidity.

The goals of this study were to examine relationships among symptom categories in obsessive-compulsive disorder (OCD), to establish OCD symptom dimensions by factor- and cluster-analytic analyses, and to explore associations between OCD symptom dimensions and comorbid neuropsychiatric conditions. A total of 317 OCD participants underwent a systematic diagnostic interview using the Structured Clinical Interview for DSM-IV. OCD symptoms assessed by the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist (N=169) and by the Thoughts and Behaviors Inventory (N=275) were subjected to factor and cluster analyses. An identical four-factor solution emerged in two different data sets from overlapping samples, in agreement with most smaller factor-analytic studies employing the YBOCS checklist alone. The cluster analysis confirmed the four-factor solution and provided additional information on the similarity among OCD symptom categories at five different levels. OCD symptom dimensions showed specific relationships to comorbid psychiatric disorders: Factor I (aggressive, sexual, religious and somatic obsessions, and checking compulsions) was broadly associated with comorbid anxiety disorders and depression; Factor II (obsessions of symmetry, and repeating, counting and ordering/arranging compulsions) with bipolar disorders and panic disorder/agoraphobia; and Factor III (contamination obsessions and cleaning compulsions) with eating disorders. Factors I and II were associated with early onset OCD. This study encourages the use of cluster analyses as a supplementary method to factor analyses to establish psychiatric symptom dimensions. The frequent co-occurrence of OCD with other psychiatric disorders and the relatively specific association patterns between OCD symptom dimensions and comorbid disorders support the importance of OCD subtyping for treatment, genetic, and other research studies of this heterogeneous disorder.

Anxiety Disorders↗
PubMed2006

Obsessive-compulsiveness and impulsivity in a non-clinical population of adolescent males and females.

Obsessive-compulsive and impulsive behaviors co-occur in certain psychiatric conditions. Some have suggested that these disturbances constitute a spectrum of altered psychologies and behaviors that share an underlying neuropathology. We investigate here whether obsessive-compulsiveness and impulsivity reflect related psychological dimensions in a non-clinical adolescent population. Out of 720 high-school students, 672 and 682 completed a questionnaire interview with a Chinese version of the Maudsley Obsessive-Compulsive Inventory (MOCI) and the Barratt Impulsiveness Scale (BIS-11), respectively. Both MOCI and BIS-11 demonstrated good overall internal consistency, each with three major factors identified with Principal Component Analysis. In the 638 participants who completed both questionnaires, the total MOCI and BIS-11 scores did not correlate with each other. However, the MOCI factor "repetitive checking and attention to details" correlated negatively with the BIS-11 factor "inability to plan and look ahead" for all participants, and for males and females separately. The same MOCI factor also correlated negatively with the BIS-11 factors "lack of perseverance and self-control" and "novelty-seeking and acting without thinking" for all participants, and for females but not for males. The MOCI factor "doubt and intrusive thoughts" correlated positively with the BIS-11 factor "lack of perseverance and self-control" for all participants, and for males but not for females. These results suggested that the relationship between obsessive-compulsiveness and impulsivity as measured by the MOCI and the BIS-11 is complicated, with gender playing an important modulatory role. We discuss the relevance of these findings to developing a conceptual scheme to characterize and study the neurobiological basis of obsessive-compulsive and impulsive behaviors.

Adolescent↗
PubMed2004

The presence of magical thinking in obsessive compulsive disorder.

Two research groups have raised the possibility that magical ideation may be a fundamental feature of obsessive-compulsive disorder. It has been proposed to underlie thought action fusion and superstitious beliefs. In this study, the Magical Ideation scale, the Lucky Behaviours and Lucky Beliefs scales, the Thought Action Fusion-Revised scale, the Padua Inventory, and the Obsessive Compulsive Inventory-Short Version were completed by 60 obsessive compulsive patients at a hospital clinic. Of all the measures, the Magical Ideation (MI) scale was found to be the most strongly related to obsessive compulsive symptoms. Large and significant relationships between MI scores and the measures of OCD were obtained even when alternative constructs (Lucky Behaviours, Lucky Beliefs, Thought Action Fusion-Revised scales) were held constant. No other variable remained significantly related to the Obsessive Compulsive Inventory-Short Version when magical ideation scores were held constant. The findings suggest that a general magical thinking tendency may underpin previous observed links between superstitiousness, thought action fusion and OCD severity.

Adolescent↗
PubMed1998

Relationships between worry, obsessive-compulsive symptoms and meta-cognitive beliefs.

The present study had two principal aims. First, the overlap between the revised Padua Inventory (PI-WSUR) a measure of obsessive-compulsive symptoms (Burns et al., 1996) and worry was assessed. Second, the relationship between meta-cognitive beliefs, proneness to pathological worry and obsessive-compulsive symptoms was explored when controlling for the interdependency of worry and obsessive-compulsive measures. The results indicate that whilst the PI-WSUR shows reduced overlap with the Penn State Worry Questionnaire, there are still problematic levels of overlap with a more content-based measure of worry. Results of multiple regression analyses demonstrated that specific sets of meta-cognitive beliefs were associated with worry proneness and obsessive-compulsive symptoms. The present data are consistent with recent formulations of generalized anxiety disorder and obsessive-compulsive disorder.

Adult↗
PubMed1999

The Overvalued Ideas Scale: development, reliability and validity in obsessive-compulsive disorder.

The presence of overvalued ideas in obsessive-compulsive disorder (OCD) has been theoretically linked to poorer treatment outcome [Kozak, M. J. & Foa, E. B. (1994). Obsessions, overvalued ideas and delusions in obsessive-compulsive disorder. Behaviour Research and Therapy, 32, 343-353]. To date, no measures have been developed which quantitatively assess levels of overvalued ideas in obsessive-compulsives. The present studies examined the psychometric properties of a scale developed to measure this form of psychopathology, the Overvalued Ideas Scale (OVIS). In study 1, 102 patients diagnosed with OCD were administered a battery of instruments including the OVIS at baseline and two weeks later, prior to initiating treatment. Results indicate that the OVIS has adequate internal consistency reliability (coefficient alpha = 0.88 at baseline), test-retest reliability (r = 0.86) and interrater reliability (r = 0.88). Moderate to high levels of convergent validity was found with measures of obsessive-compulsive symptoms, a single item assessment of overvalued ideas and psychotic symptoms. Medium levels of discriminant validity with measures of anxiety and depression was obtained in this study. Individuals determined to have high OVI showed greater stability of this pathology than those with lower OVI, suggesting that overvalued ideas are stable for extreme scorers. In study 2 a total of 40 patients participated who were diagnosed with OCD. The same battery of instruments was administered as in study 1, as well as the Beck Depression Inventory and Beck Anxiety Inventories. Results were similar to that obtained in study 1, including a relative lack of discriminant validity with self-report measures of depression and anxiety. It is suggested that further research with the OVIS may show predictive value in treatment outcome studies of OCD.

Adult↗
PubMed2004

Detecting pediatric autoimmune neuropsychiatric disorders associated with streptococcus in children with obsessive-compulsive disorder and tics.

BACKGROUND: A subgroup of children with obsessive-compulsive and tic disorders are proposed to have an infectious trigger. The purpose of this study was to investigate the relationship between group A streptococcal titers and symptom fluctuations in children with a clinical course resembling that described for pediatric autoimmune neuropsychiatric disorders associated with streptococcus. METHODS: Twenty-five children with obsessive-compulsive disorder and/or tic disorder were evaluated for neuropsychiatric severity and group A streptococcal antibody titers (streptolysin O, deoxyribonuclease B, and carbohydrate A) at 6-week intervals for > or = six consecutive evaluations (total visits=277). RESULTS: Children with large symptom fluctuations (n=15) were compared with children without dramatic fluctuations (n=10). Co-movements of obsessive-compulsive/tic severity and group A streptococcal antibodies were assessed. In subjects with large symptom changes, positive correlations were found between streptococcal titers and obsessive-compulsive severity rating changes (p=.0130). These subjects were also more likely to have elevated group A streptococcal titers during the majority of observations (p=.001). Tic symptom exacerbations occurred more often in the fall/winter months than spring/summer months (p=.03). CONCLUSIONS: Patients with marked obsessive-compulsive/tic symptom changes may be characterized by streptococcal titer elevations and exhibit evidence of seasonal tic exacerbations.

Antibodies, Bacterial↗
PubMedDate not supplied

[A study of the psychometric properties of the Icelandic translation of Obsessive Thoughts Checklist (OTC) with confirmatory factor analysis].

The Obsessive Thoughts Checklist (OTC) differs from several other measures of obsessive-compulsive symptoms in its focus on obsessive thoughts instead of compulsive behaviour. The OTC has been used in several studies in France and abroad and support for the discriminant and convergent validity of the instrument has been gathered. The authors of the OTC recently reported 3 underlying factors in this instrument: a perfectionism/verification factor, a contamination factor and a responsibility factor. In an earlier study of the OTC a 2 factor solution was however suggested. It therefore seems important to further elucidate the factorial structure of this instrument using confirmatory factor analysis. In this study data on the Icelandic translation of the OTC from three samples of Icelandic college students were submitted first to an exploratory and then to a confirmatory factor analysis. The total number of subjects was 614 college students, 254 men and 360 women with a mean age of 24.4 (sd = 5.0). The results of the exploratory factor analysis (PCA) submitted to a varimax rotation are presented in table I. The 3 expected factors were reproduced with few cross-loadings. In the confirmatory factor analysis the fit of three models to the data were evaluated: a 1 factor model, the 2 factor model of Bouvard et al. and the 3 factor model of Bouvard et al.. An initial examination of the data led to logarithmic transformation of 18 items to reduce skewness in their distributions. The data was subsequently subjected to a confirmatory factor analysis to compare the three-factor model with the two-factor and one-factor models for the OTC. The factors for the three- and two-factor models were allowed to correlate freely. The data were analysed using the EQS procedure, and the models tested were covariance structure models. Table II presents the goodness of fit indices for all three models. The results show that none of the three models provide an overall appropriate fit for the data. However, the fit indices for the three-factor model were considerably higher than found for the two or one factor models and the RMSEA index for the three-factor model suggested an acceptable fit for that model. Although the three-factor model suggests the best fit of all three models, the fit indices were still unacceptably low. Further examination of the data revealed a pattern of standardized residuals suggesting that this might in part be attributable to three items from the responsibility factor (items 26, 19 and 15) not being well specified within the model. When the residuals for these items were allowed to correlate, the fit of the model was substantially improved (CFI = 0.85; GFI = 0.87; AGFI = 0.85; RMSEA = 0.062). This indicates that a revision of the responsibility scale might be appropriate. Table III provides the means, standard deviations and the alpha coefficients for the 3 subscales of the OTC as well as for the total scale. In one subsample of the study (sample 1, n = 169) the OTC was administered together with the Padua Inventory-Washington State Revision (PI-WSUR) measuring obsessive-compulsive symptoms, the Penn State Worry Questionnaire (PSWQ) and the Community Epidemiological Scale-Depression (CES-D) measuring depression. In order to investigate the convergent validity and divergent of the OTC its correlation with the PI-WSUR was compared with its correlations with PSWQ and CES-D. These correlations shown in table IV support the convergent and divergent validity of the OTC. In another subsample of the study (sample 2, n = 296) the OTC was administered together with the Maudsley Obsessive Compulsive Inventory (MOCI). For samples 1 and 2, zero order and partial correlations were calculated between the subscales of the OTC and the subscales of the other instruments. As shown in table V the strongest correlations between the checking/perfectionism and the contamination subscales of the OTC were with corresponding subscales of the PI-WSUR and the MOCI. It is concluded that the factorial, the convergent and the divergent validities of the Icelandic translation of the OTC are supported in a student population even though the somewhat suboptimal fit of the three-factor model may indicate that a revision of the responsibility factor might be in order. This should however be further studied in a clinical population.

Adult↗
PubMed1985

Obsessive-compulsive disorder in dermatologic practice.

Until recently, obsessive-compulsive disorder has been thought of as a rare illness with a poor prognosis. Epidemiologic studies have found that obsessive-compulsive disorder has a lifetime prevalence rate of 2% to 3%, double that of panic disorder or schizophrenia. Many patients with primary obsessive-compulsive disorder present initially to their medical specialist. Because of the frequency of nonspecific dermatitis in compulsive hand washers, as well as the number of patients presenting with somatic obsessions, dermatologists should be familiar with this disorder. The early recognition and diagnosis of obsessive-compulsive disorder has taken on increasing importance because of the development of effective pharmacologic and behavioral treatment strategies.

Adult↗
PubMed1998

Diagnosis of obsessive-compulsive illness.

Obsessive-compulsive illness has long been subject to diagnostic neglect. Moreover, obsessive-compulsive features often underlie or are intercurrent with other symptom pictures and may be quite debilitating. Diagnostic dilemmas are discussed regarding obsessive-compulsive illness and its relation to eating disorders, generalized anxiety disorder, mood disorders, alcohol abuse, and adult attention deficit disorder. Some difficulties in eliciting and recognizing obsessive-compulsive illness are presented. These include patient secrecy, shame, and social and personality features of health professionals. Specific pharmacologic and therapeutic interventions are effective when directed at the intercurrent or underlying obsessive-compulsive illness.

Adult↗
PubMedDate not supplied

Overlapping and distinctive features of hypochondriasis and obsessive-compulsive disorder.

The spectrum of obsessive-compulsive disorders has received a great deal of theoretical attention, but there has been relatively little associated empirical research. The purpose of this study was to compare three groups of patients; those diagnosed with hypochondriasis (HC, a proposed spectrum condition), obsessive-compulsive disorder (OCD) and those with both OCD and HC (OCD/HC). The results show that patients with HC scored highest on a measure of overvalued ideas, and that the HC and HC/OCD groups scored significantly higher on measures of panic and agoraphobic cognitions. The groups also differed significantly for symptoms associated with compulsions. The patient groups were not different for measures of obsessions, depression, and anxiety. The results provide partial support for inclusion of HC in the spectrum of obsessive-compulsive disorders, but also provide indirect support for the association between HC and panic disorder. These results are interpreted in light of distinguishing characteristics among obsessive-compulsive spectrum conditions.

Adult↗
PubMedDate not supplied

Fixity of belief, perceptual aberration, and magical ideation in obsessive-compulsive disorder.

Clinicians and researchers have pondered the intersection of obsessive-compulsive disorder (OCD) and psychosis. We examined the records of 395 individuals seeking treatment for OCD and classified participants according to their most frequent or distressing obsession and compulsion. All participants completed measures of fixity of belief, perceptual distortions, magical ideation, and psychotic symptoms. Results indicated that individuals who reported fear of harming self or others via overwhelming impulse or by mistake, and those with religious obsessions, had poorer insight and more perceptual distortions and magical ideation than did individuals with other types of obsessions. These results did not appear to reflect mere differences in OCD severity. Results are discussed in light of previous findings showing that psychotic-like symptoms are associated with attenuated treatment outcome in OCD. More research is needed to assess the absolute magnitude of psychotic-like features in OCD patients with impulse/mistake and religious obsessions and to examine whether these features interfere with standard cognitive-behavioral therapy.

Adult↗
PubMed2004

A study of the psychometric properties of the Obsessive Beliefs Inventory and Interpretations of Intrusions Inventory on clinical Italian individuals.

Forty-three individuals with obsessive-compulsive disorder (OCD), 17 with generalized anxiety disorder (GAD) and 50 non-clinical controls (SC), completed the Italian versions of the Obsessive Beliefs Questionnaire (OBQ) and the Interpretations of Intrusions Inventory (III), along with measures of obsessive-compulsive (OC) symptoms, depression, anxiety and worry. OBQ and III showed an excellent reliability and temporal stability. The six OBQ subscales were reasonably distinct from each other, whereas the three subscales of the III were highly interrelated. The OBQ, and in less measure the III, discriminated between OCD, GAD, and normal controls. In the OCD cohort, the two instruments correlated moderately with a measure of obsessive-compulsive symptoms but also with a measure of worry. However, a linear regression analysis evidenced a specific relationship between the OBQ and obsessive-compulsive symptoms over and above worry. Overall, at least three cognitive domains (intolerance of uncertainty, excessive concern about the importance of controlling one's thoughts and perfectionism) seemed specific to OCD, whereas overimportance of thoughts and inflated responsibility barely discriminate clinically anxious individuals from non-clinical ones. It is concluded that OBQ and III are useful measures in Italian individuals and that more research is warranted to possibly refine these two instruments.

Adult↗
PubMedDate not supplied

Health concerns in patients with obsessive-compulsive disorder.

In the present study, individuals with obsessive-compulsive disorder (OCD) who also had excessive health concerns (n = 56) were compared with OCD individuals without such concerns (n = 343) regarding their OCD symptom severity, types of obsessions and compulsions, insight into the irrationality of their obsessions, and prevalence of generalized anxiety disorder. While the presence of health concerns did not affect the severity of OCD symptoms, the groups differed with respect to the types of symptoms displayed: those with health concerns had more somatic and harm obsessions, and checking compulsions: whereas those without such concerns had more contamination obsessions and washing compulsions. The insight of both groups ranged from poor to excellent, yet the number of individuals with poor insight was greater among those with health concerns than those without. Generalized anxiety disorder was also more prevalent among OCD individuals with excessive health concerns.

Adult↗