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PubMed1999

Responsibility and perfectionism in OCD: an experimental study.

Cognitive models of obsessive-compulsive disorder (OCD) suggest a number of different variables that may play a role in the development and maintenance of obsessive compulsive symptoms [Freeston, M. H., Rhéaume, J., & Ladouceur, R. (1996) Correcting faulty appraisals of obsessional thoughts. Behaviour Research and Therapy, 34, 433-446]. This study's aim was to verify the effect of perfectionism and excessive responsibility on checking behaviors and related variables. Twenty-four moderately perfectionistic subjects (MP) and 27 highly perfectionistic subjects (HP) were submitted to a manipulation of responsibility (low and high). After each manipulation, they had to perform a classification task during which checking behaviors were observed. Results indicate that more checking behaviors (hesitations, checking) occurred in the high responsibility condition than in the low responsibility condition for subjects of both groups. After executing the task in the high responsibility condition, HP subjects reported more influence over and responsibility for negative consequences than MP subjects. These results suggest that high perfectionistic tendencies could predispose individuals to overestimate their perceived responsibility for negative events. Furthermore, perfectionism could be conceived as playing a catalytic role in the perception of responsibility. Results are discussed according to cognitive models of OCD.

Adult↗
PubMed2000

Functional and dysfunctional perfectionists: are they different on compulsive-like behaviors?

Both perfectionism and excessive responsibility have been linked to obsessive compulsive disorder (OCD). Up to now however, a greater number of studies have focused on the role of responsibility. The present study compared compulsive-like behavior of people with different styles of perfectionism. Sixteen functional perfectionists (FP) and 16 dysfunctional perfectionists (DP) were compared on three different tasks in order to explore OC type behavior such as doubting, checking and intrusions. Results show that DP participants, compared to FP participants, scored higher on an OC behavior scale, took significantly more time to complete a precision task and precipitated their decision when confronted with ambiguity. The two groups also tended to differ in their intrusive thoughts following an unsolved problem; FP participants were more preoccupied about solving the problem than about the quality of their performance, contrary to DP subjects. Results are discussed according to theoretical models of OCD.

Adult↗
PubMed2003

Reduced heart rate variability in chronic alcohol abuse: relationship with negative mood, chronic thought suppression, and compulsive drinking.

BACKGROUND: Previous research suggests that heart rate variability (HRV) may be an important factor in various maladaptive psychological conditions. METHODS: This study was conducted to investigate vagal tone assessed as tonic vagally mediated heart rate variability in alcoholic (n = 49) and control subjects (n = 45). RESULTS: Alcoholic subjects had faster heart rate and lower preimaginary exposure levels of HRV compared with the control group. An increase in HRV was observed in the alcoholic group when subjects were exposed to an imaginary alcohol script. Tonic HRV was found to be related inversely to negative mood and chronic thought suppression and positively to positive mood. Furthermore, the compulsive subscale of the Obsessive Compulsive Drinking Scale (OCDS) was inversely related to HRV during the imaginary alcohol exposure. CONCLUSIONS: It is concluded that the findings are in agreement with the neurovisceral integration model of affective regulation, which claims that dysfunctional psychologic states are rooted in an impaired inhibitory mechanism that is associated with low HRV.

Adult↗
PubMedDate not supplied

[Frequency of obsessive compulsive symptoms and disorder in patients with schizophrenia: importence for prognosis].

OBJECTIVE: The objective is to study the comorbidity rate of obsessive compulsive disorder and obsessive compulsive symptoms in patients with schizophrenia and their relation with the course of this illness. DESIGN: 73 out-patients from Istanbul Medical Faculty Department of Psychiatry and 4th Unit of Bakirköy Mental Hospital who met the DSM III-R criteria for schizophrenia were recruited for this study. Other inclusion criteria were being out of acute exacerbation phase of schizophrenia. Yale-Brown Obsessive-Compulsive Scale, Yale Brown Obsessive Compulsive Symptom Screening Inventory were applied to patients. RESULTS: Comorbidity rate of obsessive-compulsive disorder in patients with schizophrenia was 9.6%, and also obsessive compulsive symptoms were detected 31% of patients. Aggressive obsessions were seen most frequently. These symptoms were also reported more frequently in the patients whose Global Assessment of Functionality score was higher than 45 points. Suicide attempts in psychiatric history were significantly higher for patients with obsessive-compulsive symptoms. CONCLUSION: Our findings indicate that obsessive-compulsive symptoms are seen more frequently than previously reported, and have no major effect upon the course of schizophrenia.

Adolescent↗
PubMed2001

The Skin Picking Scale: scale construction and psychometric analyses.

OBJECTIVE: This paper reports on the development of the Skin Picking Scale (SPS), a six-item paper-and-pencil measure for the assessment of skin picking. METHODS: 28 severe self-injurious and 77 non-self-injurious skin pickers initially completed an eight-item severity scale modeled after the Yale--Brown Obsessive--Compulsive Scale (Y-BOCS). RESULTS: Group comparisons and part--whole correlations for individual scale items resulted in a six-item scale with a total score range of 0--24. A Cronbach's alpha coefficient of.80 indicated moderate internal consistency for the scale. Construct validity was demonstrated by significant correlations between SPS total scale scores and self-reported average duration of skin picking episodes. Significant correlations were also reported between SPS total scale scores and both Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) scores, as well as self-reported intensity of emotions during the picking process. Lastly, sensitivity and specificity analyses suggest that a SPS cut-off score of 7 differentiates severe self-injurious and non-self-injurious skin pickers. CONCLUSION: The SPS is a valid and reliable self-report scale for the assessment of severity in medical and psychiatric patients who endorse skin picking.

Adolescent↗
PubMed1992

Bulimia nervosa. Four uncommon subtypes.

The histories and psychological profiles of more than 500 patients meeting DSM-III-R criteria for bulimia nervosa were reviewed. A total of 310 patients demonstrated the most characteristic pattern of bulimia, with finger-induced purging and occasional diet pill, diuretic, or laxative abuse. Seventeen patients reported binge eating with no self-induced vomiting but with severe laxative abuse (i.e., greater than or equal to 50 laxatives daily). A total of 126 patients reported bulimia with finger-induced purging and regular mild (i.e., 2-3 daily) laxative abuse. Eight patients reported bulimia without finger-induced purging, diuretic, or laxative abuse but with the regular abuse of ipecac as a means of inducing vomiting. Four clinical subtypes of bulimia were seen. These were overt bulimia, which occurred in 8.9% of the sample; obsessive-ritualistic bulimia, which occurred in 2% of the sample; sexually evocative bulimia (Fatal Attraction Syndrome), which occurred in 2.9% of the sample; and masochistic bulimia, which occurred in 4.9% of the sample. Each of these subtypes of bulimia are described and defined. The characteristic psychologic profile, clinical features, and implications for treatment and research are discussed.

Acting Out↗
PubMed2003

The preliminary development of a new self-report measure for OCD in young people.

The aim of this study was to develop a reliable self-report instrument to assess obsessive-compulsive disorder (OCD) in young people. The children's Obsessional Compulsive Inventory (CHOCI) had good internal consistency, criterion validity and was significantly correlated with the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). This preliminary new measure could serve to provide a more efficient and accessible way of assessing OCD in young people.

Adolescent↗
PubMed1988

Obsessive compulsive disorders in adolescence.

This article reports our experience with 14 adolescent cases of Obsessive Compulsive Disorder (OCD). In contradistinction to other reports in the literature, our results were quite good with these patients. Although we used recommended treatment measures (exposure in vivo and clomipramine drug therapy), we found a good prognosis to be independent to these specific measures. In fact, adolescents tend not to cooperate very well with behaviour therapy and medication. Psychotherapy, on the other hand, was often quite useful. Our conclusion is that non-specific milieu therapy leads to recovery in a majority of adolescent obsessive compulsives. We are not sure as to how long these remissions will last on follow-up.

Adolescent↗
PubMed2000

Seasonal variations in internalizing, externalizing, and substance use disorders in youth.

Seasonal variations were assessed in symptoms of internalizing (anxiety and mood), externalizing (attention-deficit/hyperactivity and oppositional defiant disorders), and substance use disorders in youth. This study is based on secondary data analysis of two NIMH-funded epidemiologic-services studies: (a) Alternative Service Use Patterns by Youth with Serious Emotional Disturbance (N=936, ages 9-17); and (b) Methods for the Epidemiology of Child and Adolescent Mental Disorders (N=1285, ages 9-17). Child psychiatric diagnoses were measured by the Diagnostic Interview Schedule for Children. Variables that indicate site of the interview and service system, as well as age, gender, and ethnicity, were used as covariates. Significant annual variations were found in symptom counts of overanxious disorder, obsessive-compulsive disorder, separation anxiety disorder, social phobia, and major depressive disorder, with the estimated nadir in August-October. There may be weak seasonal variations in attention-deficit/hyperactivity disorder with estimated nadir in August, oppositional defiant disorder with estimated nadir in August-September, and marijuana use with estimated zenith in August-September. Significant seasonality in alcohol, other substance use, agoraphobia, and panic disorder was not found. There may be an instrument-specific bias in estimated nadir. Real nadirs may be up to 3 months prior to the estimated nadirs specified above. Findings suggest that seasonality in symptoms should be considered when assessment instruments of childhood psychiatric disorders are developed, as well as when epidemiological and clinical data are collected and analyzed.

Adolescent↗
PubMed2001

Religiosity and religious obsessions in obsessive-compulsive disorder.

Religion has often been thought to play a part in the genesis of some cases of obsessive-compulsive disorder (OCD). In this study, we explored the relationship between religiosity, religious obsessions, and other clinical characteristics of OCD. Forty-five outpatients with OCD were evaluated with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and the Yale-Brown Obsessive-Compulsive Checklist (Y-BOCC) as well as the Religious Practices Index (RPI), which was developed for this study. On the basis of these evaluations, 42% of the patients were found to have religious obsessions. Despite differences in the frequency of religious obsessions found in this study compared with others, a factor analysis revealed the symptom dimensions to be similar to those found in other OCD samples. There was no significant difference in the overall severity of obsessions and compulsions between patients with and without religious obsessions. RPI scores did not differ significantly between groups. We failed to find a relationship between RPI scores or religious obsessions and any particular type of obsession or compulsion. A logistic regression analysis revealed that the sole predictor of the presence of religious obsessions was a higher number of types of obsessions. In conclusion, we failed to find a conclusive relationship between religiosity and any other clinical feature of OCD, including the presence of religious obsessions. On the other hand, we showed that the patients who tend to have a variety of obsessions are more likely also to have religious obsessions. Thus, religion appears to be one more arena where OCD expresses itself, rather than being a determinant of the disorder.

Adult↗
PubMed2002

Dimensional structure of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).

The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) is a widely used instrument to assess obsessive-compulsive symptomatology. The present study provides evidence that the Y-BOCS is best represented by a three-dimensional model comprising severity of obsessions (factor 1), severity of compulsions (factor 2) and resistance to symptoms (factor 3). On the basis of exploratory factor analysis, this structure was found for both baseline (n = 109) and discharge ratings (n = 68) following a multimodal cognitive-behavioral intervention. The factor solution remained essentially unchanged when two optional items (items 1b and 6b) were dropped from analysis. The three-factor structure was replicated with confirmatory factor analysis and showed better fit than previously proposed single- and two-factor models. For future research, we propose a new Y-BOCS scoring algorithm that takes this factor structure into account. A further result was that resistance significantly declined in response to cognitive-behavioral intervention, whereas drug treatment alone did not seem to moderate this variable according to previous research conducted by Kim et al. [Psychiatry Research 51 (1994) 203-211].

Adult↗
PubMed2002

Error-related brain activity in obsessive-compulsive undergraduates.

Error-related negativity (ERN/Ne) is a component of the event-related brain potential (ERP) associated with monitoring action and detecting errors. It is a sharp negative deflection that generally occurs from 50 to 150 ms following response execution and has been associated with activity involving the anterior cingulate cortex (ACC). An enhanced ERN has recently been observed in patients with obsessive-compulsive disorder (OCD). We extended these findings by measuring the ERN in college undergraduates with OC characteristics as measured by the Obsessive-Compulsive Inventory (OCI). Eighteen high-OC subjects and 17 low-OC subjects performed a modified Stroop task with equal emphasis placed on speed and accuracy. Response-locked ERPs revealed a frontally maximal negativity associated with erroneous responses that was significantly larger in the high-OCI group. There were no performance differences between the two groups. Our results support the view that the characteristics associated with OCD are related to hyper-functioning error and action-monitoring processes.

Adolescent↗
PubMed2003

Obsessive-compulsive behaviors in parents of multiplex autism families.

Parents of autistic probands with high and low rates of repetitive behaviors were compared for rates of obsessive-compulsive traits and disorder. The rate of repetitive behaviors was assessed using the Autism Diagnostic Interview-Revised (ADI-R) in 176 autistic probands from 57 multiplex families. Obsessive-compulsive disorder (OCD) in parents was determined by direct interview using a parental history questionnaire, with screening for obsessive-compulsive traits using the Yale-Brown Obsessive-Compulsive Scale checklist. Children who had high total scores on the repetitive behavior domain of the ADI-R were significantly more likely to have one or both parents with obsessive-compulsive traits or disorder compared with children who had low total scores on this domain. Children with high scores on D1/D2 of the ADI-R (narrow restricted interests and rituals) were significantly more likely to have one or both parents with OCD, especially fathers, than those with low D1/D2. The occurrence of obsessive-compulsive traits or disorder in parents of autistic children in multiplex families is significantly more likely if autistic children have a high occurrence of repetitive behaviors. Dichotomizing autistic probands by severity and type of repetitive behaviors (circumscribed interests and compulsive rituals) may yield more homogenous groups, which could be helpful in genetic linkage studies.

Adult↗
PubMed2003

Implications of compulsive and impulsive traits for serotonin status in women with bulimia nervosa.

Studies of bulimia nervosa (BN) often report decreased brain serotonin (5-hydroxytryptamine: 5-HT) activity. Across populations, impulsivity has been linked to reduced 5-HT activity, but compulsivity has been associated (at least inconsistently) with an increase. We therefore became interested in the association between behavioral-trait variations and 5-HT status in BN. In 56 bulimic and 29 non-bulimic women, we measured eating symptoms, personality traits, platelet paroxetine binding, and neuroendocrine responses following oral meta-chlorophenylpiperazine (m-CPP). Relative to normal eaters, bulimic women showed reduced density (Bmax) of platelet paroxetine-binding sites, blunted prolactin (PRL) responses following m-CPP, and (as a trend) lower basal PRL levels. However, after effects of binge-purge frequencies, body mass, and other extraneous factors were controlled, PRL levels at baseline and other moments in the serial sampling varied systematically with presence of impulsive and compulsive traits. PRL was generally low in BN, but 'high-compulsive'/'low-impulsive' traits were associated with higher (normal-range) PRL values. Comparable trait-related variations were not observed on paroxetine-binding indices. Our findings suggest that 5-HT status in BN may correspond to impulsive or compulsive traits, and they encourage multidimensional modeling of the pathophysiological role of 5-HT in BN.

Adolescent↗
PubMed2004

The medicalization of compulsive buying.

Compulsive buying has recently been the subject of numerous articles from both consumer research and psychiatric perspectives. Identified by some researchers as a compulsion and by others as an addiction, common solutions to the problem have included drug treatments, participation in self-help groups and cognitive behaviour therapy. The purpose of this article is to examine critically the labelling of compulsive buying in terms of medicalization from the perspective of both medical and non-medical social control of "deviant" consumers. We suggest that the attempt to categorize compulsive buying as an illness represents the ongoing trend to medicalize behavioural problems which may be better understood within the wider context of related phenomena such as the fiscal crisis of the 1980s and 1990s and the consumption-driven economy of North America.

Behavior, Addictive↗
PubMed2003

Anxiety and error-related brain activity.

Error-related negativity (ERN/Ne) is a component of the event-related brain potential (ERP) associated with monitoring action and detecting errors. It is a sharp negative deflection that generally occurs from 50 to 150 ms following response execution and has been associated with anterior cingulate cortex (ACC) activity. An enhanced ERN has been observed in patients with obsessive-compulsive disorder (OCD)--reflecting abnormal ACC activity hypothesized as part of the pathophysiology of OCD. We recently reported that the ERN is also enhanced in a group of college students with OC characteristics. The present study extended these findings by measuring the ERN in college undergraduates who scored high on either the Penn State Worry Questionnaire (PSWQ) or a combined version of the Snake (SNAQ) and Spider (SPQ) Questionnaires. Results indicate that, like OC subjects, subjects who score high on a measure of general anxiety and worry have enhanced error-related brain activity relative to both phobic and non-anxious control subjects. The enhanced ERN was found to generalize beyond OCD within the anxiety spectrum disorders but also shows some specificity within these disorders.

Anxiety↗