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PubMed1990

[Obsessive-compulsive behavior and progressive supranuclear palsy].

A case of progressive supranuclear palsy characterized by a loss of self-activation and a compulsive behaviour of the obsessive type is reported. The pathological examination was remarkable for the intensity of pallidal lesions and their diffusion to both the external and internal segments. While the loss of self-activation seemed to result from a damaged cortico-subcortical circuit forming a limbic loop, the compulsive behaviour of the obsessive type may have resulted from the interruption of a frontal-caudal-pallidal-luysian circuit.

Globus Pallidus↗
PubMed2006

Behavioral inhibition and obsessive-compulsive disorder.

Behavioral inhibition is frequently cited as a vulnerability factor for development of anxiety. However, few studies have examined the unique relationship between behavioral inhibition and obsessive-compulsive disorder (OCD). Therefore, the current study addressed the relationship between behavioral inhibition and OCD in a number of ways. In a large unselected student sample, frequency of current OC symptoms was significantly correlated with retrospective self-reports of total levels of childhood behavioral inhibition. In addition, frequency of current OC symptoms was also significantly correlated with both social and nonsocial components of behavioral inhibition. Further, there was evidence for a unique relationship between behavioral inhibition and OC symptoms beyond the relationship of behavioral inhibition and social anxiety. In addition, results showed that reports of childhood levels of behavioral inhibition significantly predicted levels of OCD symptoms in adulthood. Finally, preliminary evidence suggested that behavioral inhibition may be more strongly associated with some types of OC symptoms than others, and that overprotective parenting may moderate the impact of behavioral inhibition on OC symptoms. The current findings suggest the utility of additional research examining the role of behavioral inhibition in the etiology of OCD.

Adult↗
PubMed2000

Initial courtship behavior and stalking: how should we draw the line?

As noted by Schaum and Parrish (1995), stalking blurs the boundaries between normal courtship and obsessive behavior. Consequently, stalking proves an elusive phenomenon to define and to study. Where does courtship end and stalking begin? To address this question, 197 women and 44 men from the University of Pittsburgh who had loved someone who did not love them in return were surveyed about their feelings and actions in response to this rejection. Factor analyses revealed six groupings of behaviors in response to unrequited courtship: approach, surveillance, intimidation, harming oneself, verbal abuse/mild physical harm, and extreme physical harm. Approach behavior was reported to be used more often by men, but there were no significant differences between men and women in the self-reported prevalence of other types of courtship behaviors. Correlations reveal that feelings of anger and depression were the most common predictors of violent behavior for both men and women. Pursuer-perceptions of what behaviors connoted "going too far" in pursuit of a relationship proved unreliable. However, when pursuers were asked whether their love interest was afraid of them, fear was a reaction perceived in response to intimidation. Although it is likely that pursuer perceptions of where to draw the line would differ from the view of the love object, these results suggest that engaging in intimidation would be an appropriate place to draw the line between courtship and stalking.

Adolescent↗
PubMed2005

Some thoughts on the neurobiology of stalking.

The authors examine the crime of stalking, including the cognitive traits, emotional reactions, attachment pathology, violence patterns and sex differences of samples of stalking offenders. They focus on two common types of stalkers: 1) those who sustain pursuit of a former sexual intimate who has rejected them; and 2) those who pursue a stranger or acquaintance who has failed to return the stalker's romantic overtures. The authors discuss data from neuroimaging (fMRI) studies of romantic love which suggest that these forms of stalking may be associated with heightened activity of subcortical dopaminergic pathways of the "Reward System" of the brain, perhaps in combination with low activity of central serotonin. The authors propose that this set of neural correlates may contribute to the stalker's focused attention, increased energy, following behaviors, obsessive thinking about and impulsivity directed toward the victim. To further explore the neural systems associated with stalking behavior, they also discuss several biopsychological phenomena associated with romantic rejection, including the "protest response," "frustration attraction," "abandonment rage" and "mate guarding." They illustrate the parallels between stalking and addiction. They conclude that stalking may be associated with a specific set of biological components and they offer suggestions for further research into this pathological emotional/motivational state.

Brain↗
PubMed1984

Psychiatric disorders of pre-adolescence in Japan.

We have classified 200 pre-adolescent patients, with whom we have met during the last three years, into the following four types: school refusal and obsessive behavior, psychosomatic disorders, depressive reactions, and schizophrenic disorders. During our therapeutic process, we realized that even though their symptoms seemed varied and severe, they disappeared after comparatively short periods. The pre-adolescent period is a turning point at which the children depart from their earlier relationships with parents and start to form new ones with friends. We facilitated the patients' developmental process in this period so that they would recover naturally by themselves. However, when we looked at the social phenomena which influence the family and children, we noticed that some factors interfered with the pre-adolescents trying to get over the above-mentioned turning point.

Adjustment Disorders↗
PubMed2004

Genetic and environmental contributions to the Child Behavior Checklist Obsessive-Compulsive Scale: a cross-cultural twin study.

CONTEXT: We have reported elsewhere on the development of an 8-item Obsessive-Compulsive Scale (OCS) contained in the Child Behavior Checklist (CBCL) to identify children who meet criteria for DSM-IV obsessive-compulsive disorder. Twin studies of obsessive-compulsive disorder have indicated a significant genetic component to its expression. OBJECTIVE: To determine the relative contributions of genetic and environmental influences on childhood obsessive-compulsive behavior using the CBCL OCS in twin samples. DESIGN: The CBCL data were received by survey of twins in the Netherlands Twin Registry (NTR) and the Missouri Twin Study (USA/MOTWIN). SETTING: General community twin samples. PARTICIPANTS: Participants were 4246 twin pairs aged 7 years, 2841 aged 10 years, and 1562 aged 12 years (who also participated in the study at 7 and 10 years of age) from the NTR and 1461 mixed-age twin pairs (average age, approximately 9 years) from the USA/MOTWIN. MAIN OUTCOME MEASURES: Model fitting to test for genetic and environmental influences, sex differences, and sibling interaction/rater contrast effects on the CBCL OCS. RESULTS: In each case, the best-fitting model was one that indicated significant additive genetic influences (range, 45%-58%; 95% confidence interval [CI], 45%-61%), and unique environmental influences (range, 42%-55%; 95% CI, 39%-55%), with shared environmental influences in the NTR sample aged 12 years (16%). Sex differences were seen in the mixed-age USA/MOTWIN model, but not in the NTR samples. No evidence of dominance, sibling interaction, or rater-contrast effects was seen. These data were relatively consistent across age and cultures. CONCLUSIONS: The CBCL OCS is influenced by genetic factors (approximately 55%) and unique environmental factors (approximately 45%) in the younger sample, with common environmental influences only at 12 years of age. These effects do not vary with differences in sex or sibling interaction/rater contrast effects. Our data reveal higher genetic influences for obsessive-compulsive behavior and do not demonstrate genetic differences across sex.

Age Factors↗
PubMed1995

Perfectionism in anorexia nervosa.

Although it is well accepted that most patients with anorexia nervosa are perfectionistic, little work has been done in characterizing this behavior. Anorexics were assessed by two new multidimensional instruments that were designed to measure multiple aspects of perfectionism. Both scales confirm that underweight, malnourished patients with anorexia nervosa are perfectionistic. Importantly, elevated perfectionism scores, persisted after weight restoration. Anorexics experienced their perfectionism as self-imposed, and not as a response to other's expectations. Perfectionism is a dimension of the rigid, obsessive behaviors that may contribute to resistance to treatment and relapse in anorexia nervosa. Thus, these scales may be of value in assessing response to treatment.

Adult↗
PubMed1990

Adolescence and eating disorder: the obsessive-compulsive syndrome.

Although it is widely recognized that eating disorders primarily begin during the adolescent period, the centrality of obsessive-compulsive symptomatology and dynamisms and their relationship to adolescent conflict and development has not been generally accepted or understood. Social pressures toward conformity with the ideal of feminine thinness, which are especially influential during the adolescent period, combine with obsessive-compulsive predispositions to produce eating disorder symptoms and patterns of behavior. Obsessive preoccupation with images of food as well as ruminative calorie counting, and ritualistic behavior regarding food, use of laxatives, and vomiting, together with an underlying focus on control, undoing and other obsessive-compulsive defenses, and a sado-masochistic orientation to the body all point to an essential obsessive-compulsive disorder. The presence of dysphoric affect and the erratic success of antidepressant medication with eating disorder patients has led to a belief in an underlying affective disorder. However, careful assessment of eleven studies presenting differential diagnostic data regarding anorexia nervosa reveals that noneating related obsessive-compulsive patterns and symptoms are second overall in incidence to depressive patterns and symptoms. With critical re-evaluation of data presented, the obsessive-compulsive condition equals or supersedes the depressive one in many samples. Moreover, given the intense achievement orientation of persons with obsessive-compulsive illness, along with other psychodynamic factors, depressive symptoms could well be considered a secondary breakdown effect. If the all-pervasive obsessive-compulsive nature of eating-related symptomatology discussed here is taken into consideration, depressive symptoms must be considered either secondary or incidental. As patients with eating disorders are notoriously secretive and oftentimes misleading about their symptoms and themselves, a diagnostic assessment of such patients in intensive treatment at a long-term hospital facility was carried out. Compared with a control group randomly selected from the remainder of the hospital patient population, obsessive-compulsive manifestations of rumination, ritualistic behavior, excessive cleanliness, excessive orderliness, perfectionism, miserliness, rigidity, and scrupulousness and self-righteousness were all significantly associated with the eating disorder patient group. The current eating disorder picture, therefore, appears to be a modern form of obsessive-compulsive illness beginning during the adolescent period.

Adolescent↗
PubMed1993

[The dynamics of special forms of self injury].

The underlying psychodynamics are described on the basis of investigations undertaken with a total of 23 out-patients with self-inflicted lacerations of the skin. In many cases autoaggression was not the presenting symptom but was only mentioned by the patients in passing. The particular trigger factors and their effect is shown in two case descriptions. It appears that differences are possible between male and female patients. The character structure of the patients is usually narcissistic, the type of defence mechanisms being determined by the extent of borderline circumstances always present on first occurrence of autoaggression. Later, the original dynamics may become over-shadowed by obsessive behavior patterns. Self-inflicted wounds are seen to be part of a multiphase process which ultimately allows the patient to cope with narcissistic crises experienced as conflict situations. Withdrawal into a state of self-elected autarchy enables the patient to distance him/herself from the formerly idealized object now experienced as evil and disappointing. Pathological triangular relationships play a role here with the blood representing an important ersatz partner.

Adult↗
PubMed1996

Cattell's 16 PF and PSY inventory: relationship between personality traits and behavioral responses in patients with acute myocardial infarction.

The aim of this study was to investigate the relationships between personality and behavioral responses in patients with acute myocardial infarction. In a first step, a new instrument (PSY Inventory) for assessment of six behavioral characteristics (Sense of Responsibility, Energy and Competitiveness, Obsessive Behavior, Anger and Hostility, Stress-related Disturbances, Time Urgency) was developed by using factor analysis on intercorrelations of responses from 524 subjects of the general population. Internal consistency reliability for each of the PSY subscales was estimated by Cronbach alpha coefficients. In a second step, the PSY Inventory was administered with the Cattell 16 PF Questionnaire to 838 patients affected by acute myocardial infarction. Significant correlations although relatively low in magnitude for PSY Inventory subscales and certain scales of the Cattell 16 PF were found. With factor analysis on 22 variables (including the six PSY Inventory subscales and the 16 scales of the Cattell 16 PF), five second-order factors were identified, namely, Extraversion, Neurotic Anxiety, Superego Strength, Pathemia, and Neurotic Hostility. While a Pathemia Factor (characterized by sensitivity, imagination, and self-sufficiency) was factorially independent of scales of the PSY Inventory, Extraversion, Neurotic Anxiety, Superego Strength, and Neurotic Hostility Factors were composed of the PSY Inventory scales and Cattell 16 PF scales combined. These relationships would reflect the concordance of internal constructs for behavioral measures of the PSY Inventory and those of personality traits of the 16 PF Questionnaire in patients with acute myocardial infarction.

Adaptation, Psychological↗
PubMed2006

The Obsessive Compulsive Scale of the Child Behavior Checklist predicts obsessive-compulsive disorder: a receiver operating characteristic curve analysis.

BACKGROUND: The purpose of this study was to determine a score on the Obsessive Compulsive Scale (OCS) from the Child Behavior Checklist (CBCL) to screen for obsessive compulsive disorder (OCD) in children and to rigorously test the specificity and sensitivity of a single cutpoint. METHODS: A receiver operating characteristic (ROC) curve analysis was applied to data from 61 patients with clinically determined OCD, 64 clinical controls and 73 general population controls to determine the best sum score on the CBCL-OCS to predict confirmed OCD in children. Using the ROC-determined cutoff, this score was applied to a national sample of CBCL data from 2460 singleton children ages 4-18 and to 20,016 children ages 7-18 from three large general population twin samples to determine the estimated prevalence in the general population. RESULTS: Using a CBCL-OCS score of 5 demonstrated an area under the curve (AUC) of .88 with high sensitivity (92%) and moderate specificity (67%) compared to clinical controls. Compared to the general population controls, the AUC was .96 with high sensitivity (92%) and specificity (89%). In the twin samples, the number of participants with CBCL-OCS scores above this cutpoint was 2.3-7.1%. CONCLUSIONS: These findings suggest that the OCS of the CBCL may provide a highly effective way to screen for childhood OCD, and that the prevalence of childhood OCD may have been underestimated, thus prompting the need for further research into screening children for this condition.

Adolescent↗