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PubMed1993

Can the Yale-Brown Obsessive Compulsive Scale be used to assess trichotillomania? A preliminary report.

Given recent conceptualizations of trichotillomania (TM) as a variant of obsessive compulsive disorder (OCD), clinician-rated measures of obsessive compulsive symptoms have been adapted for use in the assessment of TM. Although the reliability and validity of these instruments have been well-documented in patients with OCD, psychometric properties have not been examined systematically in patients with TM. Here, we evaluate the reliability and validity of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) in a sample of 11 patients with a primary diagnosis of TM. Data addressed the utility of the Y-BOCS for evaluating symptoms of TM, and provided information regarding the proposed overlap between OCD and TM. Initial analyses suggested that interrater reliability, internal consistency, and test-retest reliability for the total score were adequate. However, the range of scores was somewhat restricted, and suggested in particular that interference in daily functioning from TM symptoms is quite low. Both internal consistency and test-retest reliability for the Target Behaviors subscale were inadequate, suggesting that this combined score is inappropriate for use with TM patients. Concurrent validity data using the total score were mixed, although the Y-BOCS did appear to be sensitive to change in TM symptoms over treatment. Implications for the use of the Y-BOCS with TM patients and hypothesized phenomenological differences between TM and OCD are discussed.

Adult↗
PubMed1993

Appraisal of cognitive intrusions and response style: replication and extension.

In a replication and extension of an earlier study of cognitive intrusions, appraisal and response strategies (Freeston, Ladouceur, Thibodeau & Gagnon, Behaviour Research and Therapy, 29, 585-597, 1991a), cognitive intrusions were studied among 534 outpatients and escorts recruited in waiting rooms of two large urban hospitals. Appraisals of high probability and low disapproval were associated with greater use of continued attention strategies whereas appraisals of low probability and high disapproval were associated with greater use of escape/avoidance strategies. These results support the distinction between the ego-dystonic nature of obsessional intrusive thoughts and ego-syntonic concerns about subjectively probable events found in worry.

Adult↗
PubMed1993

Compulsivity and superstitiousness.

The relationship between superstitious beliefs and behaviors, and measures of obsessive-compulsive experiences was examined in this study. Both superstitious beliefs and superstitious behaviors were correlated with measures of compulsivity and obsessionality. Compulsive checking, but not compulsive cleaning (from the MOCI and the CAC-R) were correlated with superstitiousness. Both subscales from the Obsessional Thoughts Questionnaire were correlated with superstitiousness. The implications of these findings for the role of perceived control in obsessive-compulsive phenomena were discussed.

Adult↗
PubMed1995

The utilization of nonpatient samples in the study of obsessive compulsive disorder.

Obsessive compulsive disorder (OCD) is increasingly studied in nonpatients, primarily through the selection of individuals who score high on a self-report measure of OCD. The usefulness of this methodology for understanding OCD presupposes that some of the individuals in the high-scoring group meet diagnostic criteria for OCD, that the obsessive-compulsive behaviors in the high-scoring individuals are stable across time to a certain degree, and that the features associated with OCD in patients also are found in the high-scoring nonpatients. Two studies are reported which provide support for these three assumptions. Together the studies suggest that OCD can be productively examined by the selection of individuals who score high on a self-report measure of OCD. Cautions in the use of this methodology for the study of OCD are also noted.

Adult↗
PubMed1995

Reliability and validity of the Yale-Brown Obsessive-Compulsive Scale.

The reliability and validity of the Yale-Brown Obsessive-Compulsive Scale were examined according to a multi-trait multi-method approach in a sample of 54 outpatients with obsessive-compulsive disorder (OCD). Internal consistency was acceptable but was improved by deletion of items concerning resistance to obsessions and compulsions. Inter-rater reliability was excellent, but test-retest reliability over an average interval of 48.5 days was lower than desirable. The YBOCS demonstrated good convergent validity with most other measures of OCD, but divergent validity vis à vis depression was poor. Analyses of new items assessing avoidance and the duration of obsession-free and compulsion-free intervals indicated that only the avoidance rating added meaningfully to the full scale score. In future research the authors recommend deletion of the resistance items and inclusion of the avoidance item to yield a revised 9-item YBOCS total score.

Adult↗
PubMed1995

Memory for actual and imagined events in OC checkers.

Information-processing theorists have suggested that obsessive-compulsive (OC) checking may be a function of either (1) an impaired memory of emotional events, (2) an attenuated ability to distinguish between real and imagined events or (3) a dissatisfaction with one's recall without actual memory impairment. These hypotheses were tested by having OC and control Ss engage in real and imagined actions. Some of the actions were designed to produce anxiety in the OC Ss while other events were designed to be emotionally neutral. No differences in reality-monitoring ability were found between OC and control Ss. Contrary to our prediction, OC Ss recall of their last actual behavior was superior to controls, but only for those actions that elicited anxiety. OC Ss, but not controls, reported that they desired higher levels of memory vividness than they were able to produce. The potential mechanism whereby dissatisfaction with memory vividness could contribute to repetitive checking is discussed.

Adult↗
PubMed1994

Obsessive intrusive thoughts in nonclinical subjects. Part II. Cognitive appraisal, emotional response and thought control strategies.

This second part of the study reports on the appraisal and thought control responses of 270 students to their most upsetting intrusive thought. Multiple regression analysis revealed that belief that one could act on the intrusive thought and perceived uncontrollability of the thought were the two most important predictors of the frequency, or persistence of the distressing intrusion. Intrusions rated as very difficult to control were also associated with increased belief that one could act on the intrusion, avoidance of situations that may trigger the intrusion, reduced success with one's most typical thought control strategy and higher thought frequency. Based on the Padua Inventory Total score, high and low obsessional Ss were selected. Highly obsessional individuals reported more unwanted obsessive intrusive thoughts and rated their thoughts as significantly more frequent and believable than low obsessive individuals. The type of thought control strategy typically used was not a factor in thought frequency and controllability, nor did it differentiate between high and low obsessional groups. The results are discussed in terms of Salkovskis' cognitive model of obsessions and intrusive thoughts.

Anxiety↗
PubMed1994

The Thought Control Questionnaire: a measure of individual differences in the control of unwanted thoughts.

Previous research has suggested that unpleasant and unwanted thoughts are a frequent experience in both normal and clinical populations. This paper describes the development and validation of a questionnaire that assesses strategies for controlling such thoughts. Analyses of the Thought Control Questionnaire (TCQ) demonstrated five replicable factors: Distraction; Social Control; Worry; Punishment and Reappraisal. Significant associations were found between the punishment and worry subscales of the TCQ and various measures of emotional vulnerability and perceptions of impaired control over cognition. The implications of these findings are discussed in relation to the literature on thought suppression, worry and mental self-regulation.

Adaptation, Psychological↗
PubMed1995

The structure of obsessive-compulsive symptoms.

In the present study, the structure of obsessive-compulsive symptoms was investigated by means of the Padua Inventory (PI). Simultaneous Components Analysis on data from obsessive-compulsives (n = 206), patients with other anxiety disorders (n = 222), and a non clinical sample (n = 430) revealed a five-factor solution. These factors are: (I) impulses; (II) washing; (III) checking; (IV) rumination; and (V) precision. Forty-one items were selected as measure of these factors. The reliability for the five subscales, assessing each of the five factors, was found to be satisfactory to excellent. Four subscales (washing, checking, rumination and precision) discriminated between panic disorder patients, social phobics and normals on the one hand and obsessive compulsives on the other. The Impulses subscale discriminated between obsessive-compulsives on the one hand and normals on the other, but not between obsessive-compulsives and social phobics or panic patients. Some evidence in support of the construct validity was found. The Padua Inventory-Revised (41-items) appears to measure the structure of obsessive compulsive symptoms: The main types of behaviours and obsessions as seen clinically are assessed by this questionnaire, apart from obsessional slowness.

Adult↗
PubMed1996

Revision of the Padua Inventory of obsessive compulsive disorder symptoms: distinctions between worry, obsessions, and compulsions.

The Padua Inventory (PI), a self-report measure of obsessive and compulsive symptoms, is increasingly used in obsessive compulsive disorder (OCD) research. Freeston, Ladouceur, Rheaume, Letarte, Gagnon and Thibodeau (1994) [Behaviour Research and Therapy, 32, 29-36], however, recently showed that the PI measures worry in addition to obsessions. In an attempt to solve this measurement problem, this study used a content distinction between obsessions and worry to revise the PI. The revision was constructed to measure five content dimensions relevant to OCD i.e. (1) obsessional thoughts about harm to oneself or others; (2) obsessional impulses to harm oneself or others; (3) contamination obsessions and washing compulsions; (4) checking compulsions; and (5) dressing/grooming compulsions. A total of 5010 individuals participated in the study, 2970 individuals completing the PI and the Penn State Worry Questionnaire (PSWQ) and an additional 2040 individuals completing only the PI. The results provided support for the reliability and validity of the revision. In addition, the revision of the PI was more independent of worry, as measured by the PSWQ, than the original PI. Support was thus found for the validity of the content distinction between obsessions and worry. The importance of this content distinction is also discussed for the evaluation of other hypothesized distinctions between obsessions and worry.

Adult↗
PubMed1995

The value of possessions in compulsive hoarding: patterns of use and attachment.

Hoarding behavior, patterns of use of possessions, and emotional attachment to possessions were examined among a sample of female undergraduates and a sample of community volunteers. Hoarding behavior was associated with a decreased frequency of use of possessions and excessive concern about maintaining control over possessions. Furthermore, high scores on the hoarding scale were associated with higher levels of perceived responsibility for: (1) being prepared; and (2) the well-being of the possession. Hoarding was also associated with greater emotional attachment to possessions and to the reliance on possessions for emotional comfort. The implications of these findings for the definition of hoarding are discussed.

Adult↗
PubMed1990

Alpha 2-adrenoreceptor status in obsessive-compulsive disorder.

Ten patients with obsessive-compulsive disorder (OCD) and 13 normal control subjects received intravenous infusions of 2 X 10(-6) g/kg of clonidine and normal saline on separate days. Responses to the drug relating to plasma growth hormone (GH), 3-methoxy-4-hydroxyphenylglycol (MHPG), heart rate, blood pressure, and several symptoms were determined. Additionally, platelet alpha 2-adrenoreceptor binding was measured in most of the subjects. GH, MHPG, blood pressure, and heart rate responses to clonidine did not differ between groups. As expected, patients reported more symptoms than normal subjects, and clonidine was sedating for both groups. Patients did not differ from normal subjects in the symptom response to clonidine. The maximum number of binding sites (Bmax) for tritiated clonidine was significantly greater in OCD patients than in normals. This pattern of alpha 2-adrenoreceptor status is different than the patterns in major depression and panic anxiety.

Adult↗
PubMed1991

Serotonin uptake and imipramine binding in the blood platelets of obsessive-compulsive disorder patients.

14C-Serotonin (5-HT) uptake and 3H-imipramine binding (IB) were studied in the blood platelets of 20 obsessive-compulsive disorder (OCD) patients, 53 normal controls (5-HT uptake) and 32 normal controls (IB binding). The maximum number of binding sites (Bmax) was significantly decreased in OCD patients compared to normal controls, but there was no difference in the affinity for 3H-imipramine (Kd). The affinity for 5-HT uptake (Km) was also decreased in the OCD patients but the maximum velocity of 5-HT uptake sites (Vmax) was not significantly different in OCD patients and normal volunteers. There were trends for the Slowness Subscale of the Maudsley Obsessional-Compulsive Inventory (MOCI) to be positively correlated with the Km of 5-HT uptake (p = 0.094), whereas the Global Scale, Checking Subscale, and Doubting Conscientiousness Subscale of MOCI were negatively correlated with the Kd of IB (p = 0.066, p = 0.08, and p = 0.062, respectively). The results provide further evidence for the dysfunction of the serotonergic system in OCD.

Adult↗
PubMed1996

Elevated cerebrospinal fluid corticotropin-releasing factor in Tourette's syndrome: comparison to obsessive compulsive disorder and normal controls.

Stress- and anxiety-related fluctuations in tic severity are cardinal features of Tourette's syndrome (TS), and there is evidence for involvement of noradrenergic mechanisms in the pathophysiology and treatment of the disorder. To examine further the pathobiology of this enhanced vulnerability to stress and anxiety, we measured central activity of corticotropin-releasing factor (CRF) in patients with TS and the related condition, obsessive compulsive disorder (OCD). Lumbar cerebrospinal fluid (CSF) was obtained in a standardized fashion for measurement of CRF from 21 medication-free outpatients with TS, 20 with OCD, and 29 healthy controls. The TS patients had significantly higher levels of CSF CRF than both the normal controls and the OCD patients. However, there was no difference in CSF CRF between the OCD patients and the normal controls. Group differences in CSF CRF were unrelated to current clinical ratings of depression, anxiety, tics, and obsessive compulsive behaviors. Although the functional significance of this finding remains to be elucidated, these results are consistent with the hypothesis that stress-related neurobiological mechanisms may play a role in the pathobiology of TS.

Adolescent↗
PubMedDate not supplied

Posttraumatic obsessive-compulsive disorder: a case study.

Recent epidemiologic evidence has pointed to a disproportionate rate of obsessive-compulsive disorder (OCD) among high-combat-exposed Vietnam veterans. This case report describes an individual without previous overt psychopathology who under the stress of combat developed concurrent OCD and posttraumatic stress disorder (PTSD) persisting for more than 20 years. Phenomenologic, behavioral, psychodynamic, and biologic considerations all help to elucidate the potential role of emotional trauma in the pathogenesis of obsessions and compulsions.

Combat Disorders↗
PubMed1991

Post-traumatic stress disorder: issues of co-morbidity.

There is considerable controversy over whether or not post-traumatic stress disorder (PTSD) should be considered as a separate diagnostic entity. The present study utilized the Symptom Checklist-90 (SCL-90) in order to examine the degree of overlap between PTSD and the related diagnoses of anxiety, depression and obsession-compulsion in a group of Israeli Lebanon War PTSD casualties. We found that the SCL-90 was able both to identify and discriminate between the clinical groups. Multiple discriminant analysis showed that although there is overlap between PTSD and obsessive-compulsive disorder, PTSD is, in fact, discriminated from all the other patient groups.

Adult↗