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Suppression of obsessive-compulsive symptoms after epilepsy surgery.

We report two male patients with medically intractable epilepsy and obsessive-compulsive disorder (OCD) symptoms. Both patients experienced remission of obsessive-compulsive symptoms after surgical treatment of epilepsy. Although the surgeries targeted different brain regions, the two patients had in common unilateral anterior cingulate cortex ablation. On the basis of these observations, we discuss the pathophysiology of OCD symptoms, emphasizing the role of corticosubcortical pathways in their genesis. Our data suggest that surgeries that affect neural loops associated with obsessive-compulsive symptoms can lead to an improvement of OCD; however, the structures responsible for this effect cannot be conclusively determined.

Adult↗

Influence of individual differences in craving and obsessive cocaine thoughts on attentional processes in cocaine abuse patients.

In the present pilot-study, the relation between craving, obsessive thoughts about cocaine, experienced control, and attentional bias for cocaine related words is investigated. Sixteen cocaine abuse patients participated in a reaction time (RT) experiment which was employed to measure the ability of subjects to shift their attention away from cocaine related words. Postexperiment craving was found to be positively correlated with reaction times on drug related cues, in contrast to RT on neutral cues. Furthermore, obsessive thoughts about cocaine use and the experienced cocaine use control, in the week before the experiment, were correlated in a higher degree with RTs on drug cues than postexperiment craving. Attentional bias for drug cues was evidenced in patients with higher scores on obsessive cocaine thoughts and higher craving scores. This study shows that individual differences on information processing, within a cocaine abuse patient population, are present.

Adult↗

Motivation to control one's environment in individuals with obsessive-compulsive, depressive, and normal personality traits.

This study investigated whether people are motivated for control and considered both the dispositional and situational factors that affect this motivation. Thirty male and 30 female undergraduates, divided equally among individuals with obsessive-compulsive, depressive, and normal personality styles, were given different levels of information about how to exercise control in an effective manner. Motivation for control was assessed by performance on a task in which the level of performance determined whether a subject obtained control over an outcome. In addition, feelings of self-efficacy were measured. The hypothesis that people are motivated to have personal control was confirmed. Furthermore, this motivation for control could not be accounted for by the variance attributable to feelings of self-efficacy, that is, the expectancy of gaining a good outcome by having personal control. Although feelings of self-efficacy were influenced by the level of information provided to subjects, for most subjects, the motivation for control, per se, was not affected. In contrast, obsessive-compulsive males seemed to respond differently to the information manipulation from other subjects, being motivated for control only when a higher level of information was provided. The effects of depressive and obsessive-compulsive personality styles on the motivation for control were reconsidered.

Compulsive Personality Disorder↗

Obsessive-compulsive personality disorder and eating disorders.

Obsessions, compulsions, and personality traits such as perfectionism and inflexibility are commonly described in eating disorder patients. A lack of precise clarification has existed in defining the presence of obsessive-compulsive disorder and obsessive-compulsive personality disorder in the various eating disorder subtypes. Research clarifying these definitions and the components of perfectionism as it pertains to eating disorders is reviewed in this article.

Journal Article↗

Who sees trees before forest? The obsessive-compulsive style of visual attention.

It has been suggested that individuals with obsessive-compulsive personalities tend to focus on small local details in their surroundings, whereas histrionic individuals are characterized by more global information processing. Using the global-local hierarchical-letters paradigm, we were able to provide support for the first but not the second hypothesis. Measures related to obsessive-compulsive personality disorder were associated with excessive visual attention to small details of the hierarchical letters. Specifically, the obsessive-compulsive cognitive style was associated with local interference, which reflects the effects of distraction by to-be-ignored small details on identification of global information.

Adolescent↗

A French translation of the obsessive-compulsive drinking scale for craving in alcohol-dependent patients: a validation study in Belgium, France, and Switzerland.

The Obsessive-Compulsive Drinking Scale (OCDS) is an instrument developed to measure cognitive aspects of alcohol craving. The aim of this study was to validate the French translation of the OCDS according to the international methodology as published by Hunt and coworkers (see text), including forward-backward translations, patient interviews (9 patients), patient's perception of acceptability (15 patients), and final validation within a treatment program (50 patients). All 74 patients were native French-speaking alcohol-dependent patients from Belgium, France, and Switzerland. The derived aggregated total (TOT) score and both subscores corresponding to the obsessive (OB) and compulsive (CP) dimensions were shown to be asymptomatically normal. Good internal consistencies were found, with Cronbach alpha: TOT = 0.88; OB = 0. 82; CP = 0.79. The test-retest procedure was used to examine intrarater reliability (r = 0.81). The construct validity was examined with linear correlation of the two main components: r(OB, CP) = 0.62; r(OB, TOT) = 0.86; r(CP, TOT) = 0.92. Principal-components analysis revealed two main factors: the first factor representing the total scale score, while the obsessive and compulsive subscale scores were distributed along factor two. The translated scale seems to be psychometrically as valid as the original English scale and confirms the psychometric properties of the OCDS.

Adult↗

Neurological soft signs in female trichotillomania patients, obsessive-compulsive disorder patients, and healthy control subjects.

Female trichotillomania patients, obsessive-compulsive disorder patients, and normal control subjects did not differ in total scores on a neurological soft signs battery. Further studies should determine whether the increased neurological soft signs present in obsessive-compulsive disorder and perhaps in obsessive-compulsive spectrum disorders are associated with male gender only.

Adult↗

Induction of compulsive-like washing by blocking the feeling of knowing: an experimental test of the security-motivation hypothesis of obsessive-compulsive disorder.

BACKGROUND: H. Szechtman and E. Woody (2004) hypothesized that obsessive-compulsive disorder results from a deficit in the feeling of knowing that normally terminates thoughts or actions elicited by security motivation. To test the plausibility of this proposed mechanism, an experiment was conducted to produce an analog of washing in obsessive-compulsive disorder by eliciting a scenario of potential harm and using hypnosis to block changes in internally generated feelings that would normally occur during washing. RESULTS: Participants reacted with increased disgust, anxiety, and heart rate to their mental images of contamination and potential danger. As predicted, high but not low hypnotizable participants showed a significant prolongation of washing when change in feelings during washing was blocked hypnotically. CONCLUSION: Results show that blocking the affective signal that is normally generated during security-related behaviors, such as washing, leads to prolonged performance of these behaviors. This finding lends support to the plausibility of the proposed model of obsessive-compulsive disorder.

Journal Article↗

Obsessive-compulsive disorder and anorexia nervosa in a high school athlete: a case report.

OBJECTIVE: To describe the case of a basketball and track athlete who presented with both anorexia nervosa and obsessive- compulsive disorder (OCD). BACKGROUND: OCD is a psychiatric condition known to appear with significant frequency among those with anorexia. Although treatable with drug and behavioral therapy, it must be specifically sought because some of its symptoms are similar to those of anorexia nervosa. DIFFERENTIAL DIAGNOSIS: Obsessive-compulsive disorder, anxiety disorder. TREATMENT: Behavioral therapy involves exposure to the obsessive fears without allowing the patient to ritualize. This is best used in combination with drugs that selectively block the reuptake of serotonin in the brain. UNIQUENESS: Anorexia nervosa is notoriously difficult to treat. In our patient, anorexic symptoms all but disappeared along with the OCD in a matter of weeks, once treatment of the OCD began. Lengthy treatment for anorexia alone had been unsuccessful. CONCLUSIONS: OCD occurs frequently in patients with anorexia, and successful treatment requires that both conditions be specifically identified and managed. Athletic trainers may be the first to recognize key signs and symptoms of this illness; by referring the individual for psychiatric evaluation, they can be instrumental in helping the patient to obtain appropriate treatment.

Journal Article↗

Are "obsessive" beliefs specific to OCD?: a comparison across anxiety disorders.

Cognitive models of obsessive-compulsive disorder (OCD) assign a central role to maladaptive beliefs about threat, uncertainty, importance and control of thoughts, responsibility, and perfection. Previous research has demonstrated that such beliefs relate to specific OCD symptoms in a theoretically meaningful way. The aim of the present study was to determine whether these beliefs are endorsed more strongly by OCD patients than by those with other anxiety disorders. Eighty-nine adult OCD patients, 72 anxious control (AC) patients, and 33 nonclinical control (NCC) participants completed a measure of obsessive beliefs as well as measures of depression and trait anxiety. Compared to NCCs and ACs, OCD patients more strongly endorsed beliefs related to threat estimation, tolerance of uncertainty, importance and control of thoughts, and perfectionism, but not inflated responsibility. Using revised, condensed subscales, OCD patients differed from ACs on beliefs about perfectionism and certainty and about importance and control of thoughts, but not on beliefs about threat estimation and inflated responsibility. When controlling for depression and trait anxiety, the OCD and AC group did not differ on most belief domains, except for a belief that it is possible and necessary to control one's thoughts. Results are discussed in light of evolving cognitive-behavioral theories that highlight appraisals of thought control and the use and effectiveness of varying thought control strategies.

Adult↗

The efficacy of non-invasive brain stimulation interventions in obsessive-compulsive disorder management: A network meta-analysis of randomized controlled trials.

Non-invasive brain stimulation (NIBS) has been widely used as an alternative treatment for obsessive compulsive disorder (OCD). However, the most effective NIBS parameters are unclear. To compare the efficacy of NIBS in OCD. We conducted a systematic review and network meta-analyses (NMA) to combine direct and indirect comparisons of NIBS.Systematic searches were conducted in Cochrane CENTRAL, EMBASE, PubMed, and Web of Science from inception to June 20, 2025. Forty-two randomized sham-controlled trials (n = 1456) were included. All statistical analyses were conducted with R statistical software. Bayesian NMAs mainly using the BUGSnet package and gemtc package. Five NIBS protocols produced statistically significant reductions in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores compared with sham stimulation: high-frequency rTMS over the FzFCz (Hf-rTMS-FzFCz; MD -11.77, 95% CrI -20.62 to -3.09), low-frequency rTMS over F3F4 (Lf-rTMS-F3F4; MD -9.93, 95% CrI -18.07 to -1.65), low-frequency rTMS over FCz (Lf-rTMS-FCz; MD -3.25, 95% CrI -6.06 to -0.40), high-frequency deep TMS over FzFC (Hf-dTMS-FzFC; MD -6.48, 95% CrI -12.32 to -0.50), and 2 mA anodal tDCS over F3 with cathodal over Fp2 (MD -9.34, 95% CrI -16.01 to -3.03).For secondary outcomes, high-frequency deep rTMS over FzFCz produced the largest reduction both in depressive symptoms (SMD -1.24, 95% CrI -1.92 to -0.55) and anxiety scores (SMD -1.88, 95% CrI -2.62 to -1.11), but had no effect on Clinical Global Impression-Severity (CGI-S) scores.Specific NIBS protocols are safe and effective adjunctive treatments for OCD, with promising yet inconclusive improvements in comorbid depressive symptoms. Further high-quality, head-to-head trials are needed.

Humans↗

Development and initial validation of the obsessive beliefs questionnaire and the interpretation of intrusions inventory.

In 1995 the Obsessive Compulsive Cognitions Working Group initiated a collective process to develop two measures of cognition relevant to current cognitive-behavioural models of OCD. An earlier report (Behav. Res. Therapy, 35 (1997) 667) describes the original process of defining relevant domains. This article describes the subsequent steps of the development and validation process: item generation, scale reduction, and initial examination of reliability and validity. Two scales were developed. The Obsessive Beliefs Questionnaire consists of 87 items representing dysfunctional assumptions covering six domains: overestimation of threat, tolerance of uncertainty, importance of thoughts, control of thoughts, responsibility, and perfectionism. The Interpretation of Intrusions Inventory consists of 31 items that refer to interpretations of intrusions that have occurred recently. Three of the above domains are represented: importance of thoughts, control of thoughts, and responsibility. The item reduction and validation analyses were conducted on clinical and non-clinical samples from multiple sites. Initial examination of reliability and validity indicates excellent internal consistency and stability and encouraging evidence of validity. However, high correlations indicating overlap between some of the scales, particularly importance of thoughts, control of thoughts, and responsibility will need to be addressed in subsequent empirical and theoretical investigations.

Adolescent↗

Neuropsychological functioning in a subclinical obsessive-compulsive sample.

BACKGROUND: Previous neuropsychological research has suggested that the study of psychometrically defined subclinical samples might be a valid approach to understand the underlying pathophysiology of obsessive-compulsive disorder (OCD). This approach has the potential benefit of overcoming some of the methodological problems linked to the use of clinical samples. METHODS: A group of subclinical obsessive-compulsive (OC) subjects (n = 35), selected on the basis of their scores on the Padua Inventory, and a control group were assessed on executive functioning tasks and other neuropsychological tests which have been demonstrated to be impaired in clinical OCD patients and/or in those with several basal ganglia disorders. RESULTS: Subclinical OC subjects needed significantly more moves than controls to reach the solution criteria on the Tower of Hanoi puzzle, and performance on this test was positively correlated with total score and the Checking factor of the Padua Inventory. There were no between-group differences on the other frontal lobe tests. CONCLUSIONS: The results suggest that deficits in manipulating spatial information might be basic in OCD, and are congruent with the involvement of the frontostriatal circuits in the disorder.

Adult↗

The contribution of perceived control of stressful life events and thought suppression to the symptoms of obsessive-compulsive disorder in both non-clinical and clinical samples.

The two studies presented in this paper investigated the impact of controllable versus uncontrollable stressful life events (SLE) and low versus high thought suppression upon symptoms of obsessive-compulsive disorder (OCD) in both a non-clinical sample (Study 1) and a clinical sample (Study 2). The sample for Study 1 consisted of 269 undergraduate university students and the sample for Study 2 consisted of 91 participants obtained from the Obsessive Compulsive and Anxiety Disorders Foundation of Victoria, Australia. Participants in both studies were given identical questionnaires measuring anxiety, depression, thought suppression, OCD, and, the control, magnitude and number of SLEs suffered during the previous 18 months. In both studies, analysis of covariance (ANCOVA) followed by post hoc tests indicated that high OCD scores were associated with high thought suppression and low perceived control over high magnitude stressful life events relative to controls. The results suggest that high thought suppression coupled with low control over stressful life events may interact with other predisposing factors, such as genetic vulnerability to produce OCD symptoms.

Adolescent↗

Obsessive compulsive disorder in childhood.

Obsessive compulsive disorder (OCD) involves obsessions and compulsions that cause impairment and distress, and which interfere with children's developmental adaptation and daily functioning. Furthermore, OCD often disrupts peer and family relationships and school performance and may compromise physical health. Once considered rare, recent epidemiologic studies report prevalence rates ranging from 1% in prepubertal children to 4% in adolescents. In addition, children with OCD are at high risk for comorbid psychopathology. Recent theoretic formulations for OCD encourage the integration of both psychological and biological perspectives. To fully understand the cause and course of OCD, integrated assessment of psychological and biological vulnerability as well as prospective longitudinal studies are needed.

Age of Onset↗

Reactive-narcissistic character, obsessional personality and obsessive-compulsive behaviour: a study of the validity of Sandler and Hazari's typology.

Sandler & Hazari's (1960) questionnaire measuring reactive-narcissistic character and obsessional personality was filled in by 120 medical students. Principal components analysis was applied to their scores. The resulting factor structure is highly similar to Sandler & Hazari's. Both reactive-narcissistic character and obsessional personality can be measured in a reliable way. In support of the hypotheses, reactive-narcissism is correlated positively with achievement motivation, but shows no correlation with traits reflecting lack of self-confidence (external locus of control and negative fear of failure), nor with aggression. Contrary to expectation, a positive correlation was found with control uncertainty. According to expectation obsessionality is correlated negatively with achievement motivation and positively with traits reflecting lack of self-confidence and with aggression. The hypothesis that obsessional subjects exhibit more obsessive-compulsiveness in a decision-making task than reactive-narcissistic subjects could not be confirmed. Results are discussed in the light of previous findings. The conclusion is that the typology as measured by Sandler & Hazari's (1960) questionnaire has high construct validity. The question whether the typology is predictive of future obsessive-compulsive behaviour remains unanswered.

Achievement↗

The familial and developmental context of obsessive-compulsive disorder.

This article discusses developmental and familial factors in childhood obsessive-compulsive disorder (OCD) highlighting the spectrum of normative to pathologic obsessions and rituals. In addition, it explores the possible role of family functioning in the emergence and maintenance of OCD in childhood and adolescence. Finally, it posits a developmental model that integrates genetic and neurobiologic vulnerability, cognitive models of information processing, behavioral coping strategies, and familial and peer relationships.

Child↗

[Is an obsessive-compulsive disorder in children an anxiety disorder?].

Concerning the update reconsideration of anxiety disorders of children, should childhood obsessive-compulsive disorder be assimilated as an anxiety disorder? Authors attempted to answer to this question by taking into account various levels of consideration which lead them to position childhood obsessive-compulsive disorder in the vicinity of anxiety disorders.

Adolescent↗