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Religious obsessions and compulsions in a non-clinical sample: the Penn Inventory of Scrupulosity (PIOS).

The present investigation reports on the development and psychometric evaluation of the Penn Inventory of Scrupulosity (PIOS), a 19-item self-report scale measuring religious obsessive-compulsive symptoms. Factor analysis yielded a two factor solution with the first subscale measuring fears about having committed sin, and the second measuring fears concerning punishment from God. Using a sample of college students, the PIOS was shown to be internally consistent and possess good convergent and discriminant validity. Highly devout participants evidenced higher scores on both PIOS subscales, but devout Jews evidenced fewer fears of sin and punishment from God compared to devout Protestants or Catholics. The PIOS has utility both as a research and clinical tool.

Adolescent↗

The impact of personality on symptom expression in obsessive-compulsive disorder.

Previous research conducted on the five-factor model of personality (FFM) in obsessive-compulsive disorder (OCD) has demonstrated that community and clinical participants score significantly higher than controls on the domains and facets of neuroticism and extraversion and selective facets of agreeableness and conscientiousness. However, studies have yet to examine the extent to which personality traits, as assessed by the FFM, are associated with the specific symptoms of OCD. The purpose of this study was to examine further the personality predictors of obsessive-compulsive symptoms in clinical participants using the facets of the FFM. Patients with a DSM-IV diagnosis of OCD (N = 56) completed the Revised NEO Personality Inventory, the Yale Brown Obsession Compulsion Scale, and the Beck Depression Inventory. Lower scores on openness to ideas were uniquely associated with greater obsession severity, whereas lower openness to actions was uniquely associated with greater compulsive severity. In contrast with past research that has emphasized the association between neuroticism and extraversion and dimensionally rated obsessive-compulsive symptoms, this study demonstrates the specific associations between selective facet traits of openness and clinical obsessions and compulsions. Whereas tendencies toward negative affectivity may confer a nonspecific vulnerability to the development of OCD, facets of openness may impact on the particular expression and severity of obsessive-compulsive symptoms.

Adult↗

[Refining the indications for atropine-coma therapy].

Atropine-comatose therapy was performed in 18 patients with schizophrenia and disorders in the framework of an obsessive-syndrome. Improvement was seen in 11 of the 18 patients. A psychopathological analysis of obsessive disorders in this group of patients demonstrated that they were characterized by manifold traits, instability, abstract content of obsessions, a tendency towards their complication and expansion of obsessional disturbances. The absence of any effect was seen in 7 of the cases. They were characterized by montony, monomorphism, everday content and by their structure were near to constitutionally conditioned psychasthenic doubtfulness.

Atropine↗

[Compulsive phenomena in children with tic disorder and attention deficit-hyperactive disorder].

Tic disorders (TD), obsessive-compulsive disorders (OCD) and attention-deficit/hyperactivity disorder (ADHD) are often associated with deficits of impulse control and aggressive behavior. Tic disorders and OCD are closely related on epidemiological, psychopathological and neurobiological levels, whereas ADHD and OCD phenomena seem to be at opposite poles. Research evidence on the clinical significance of associated obsessive-compulsive behavior is reviewed and linked to our own new data. Thus the analyses of a worldwide database on Tourette's Syndrome (TS) (N = 4,833) showed that that the associated symptomatology of the OCD spectrum has to emphasized. In further investigations, premonitory sensorimotor phenomena reminiscent of OCD were more frequent in children with tic disorders as they grew older. Obsessive-compulsive behavior concomitant with TS was particularly associated with impulsive and aggressive behavior, as well as with depression and anxiety. The data suggest a reduced serotonergic transmission. Self-reports by children with ADHD, as opposed to those by their parents, mentioned a significantly higher quantitative degree of OC phenomena than those by children with TS. These findings suggest that OC symptoms in children with ADHD have so far been neglected in assessments by others. In summary, a complex psychopathological pattern of tic, OC behavior, impulsivity and internalizing symptomatology emerges that requires discriminating assessment and treatment.

Adolescent↗

Over-valued ideas: a conceptual analysis.

Over-valued ideas are truly a neglected area of psychopathology with few experimental studies published. There is a different emphasis in the USA and Europe regarding their definition. For authors in the USA an over-valued idea has become shorthand for 'poor insight' in the middle of a continuum of obsessional doubts to delusional certainty. Compared to negative thoughts, obsessions and delusions, they are often more resistant to any treatment. A better understanding of over-valued ideas is required if advances are to be made in therapy and for the development of appropriate measures to evaluate the efficacy of novel treatments. A cognitive behavioural model of over-valued ideas is presented which draws upon the philosophical distinction between beliefs and values. It is argued that over-valued ideas are associated with idealised values, which have developed into such an over-riding importance, that they totally define the 'self' or identity of the individual. Idealised values are also characterised by the rigidity with which they are held. Such patients are unable to adapt to different circumstances and ignore the consequences of acting on their value. This analysis leads to a discussion of predictions that can be tested and various strategies that can be used in cognitive behaviour therapy.

Awareness↗

Psychological and behavioral differences among females classified as bulimic, obligatory exerciser and normal control.

The compulsion to maintain a lean body shape while living in a society obsessed with food may encourage the use of dieting, binge eating and purging behaviors in young women. The body of literature on bulimia nervosa (Boskind-Lodahl and Sirlin 1977; Fairburn and Cooper 1984; Katzman and Wolchik 1984; Scott 1988) clearly establishes its relationship to the current American fashion for thinness and the value placed on physical attractiveness for self-esteem. This notion promotes a multitude of weight control strategies ranging from self-starvation (Humphrey 1983; Brownell and Foreyth 1986) to cigarette smoking (Klesges and Klesges 1988), many of which may have a profound influence on maintenance of good health. Similar to weight control, exercise behavior could be viewed as falling on a continuum from reasonable efforts to maintain physical fitness to a preoccupation with exercise that is far out of proportion to the expected benefits of a 30-minute, three to five day a week routine. Characteristics of obligatory exercise have been described by several researchers and include maintaining a rigid schedule of intense exercise; resisting temptation to lapse into nonexercising; feelings of guilt and anxiety when the exercise schedule is violated; compensatory increase in exercise to make up for lapses; pushing oneself even when tired, ill, or injured; mental preoccupation with exercise; and detailed recordkeeping on exercise (Yates et al. 1983; Blumenthal et al. 1984; Nudelman et al. 1988). In a competitive society, obsessive exercise behaviors may be linked to the development of rigid dietary guidelines while one strives toward the "optimal" lean-fat ratio of body composition.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

A multimodality approach to inpatient treatment of obsessive-compulsive disorder.

A case of severely incapacitating obsessive-compulsive neurosis is treated in an inpatient setting for 13 weeks with a combination of insight-oriented, group, family, and behavioral therapies. The synergistic effects of these modalities and the therapeutic community are discussed. Stable changes are evident 2 1/2 years after admission.

Adolescent↗

Cognitive aspects of nonclinical obsessive-compulsive hoarding.

Research on the cognitive variables associated with obsessive-compulsive hoarding is scarce. In this study, we investigated cognitive variables that may contribute to the maintenance and possibly etiology of hoarding. College students who characterized themselves as either "packrats" (nonclinical hoarders; n=21) or not (control participants; n=20) completed questionnaires assessing hoarding behavior and beliefs about hoarding, and completed a task requiring them to categorize diverse objects and trinkets of minimal value into groups. The results revealed that nonclinical hoarders, relative to control participants, rated the categorization task as significantly more stressful and difficult. Relative to control participants, hoarders took longer to complete the task and sorted objects into more categories. These findings suggest that underinclusiveness and indecisiveness, characteristic of clinical hoarders, are evident in nonclinical hoarders as well.

Adult↗

Issues Involved in Recognizing Obsessive-Compulsive Disorder in Developmentally Disable Clients.

Certain unusual behaviors in people with developmental disabilities might be unrecognized obsessive-compulsive disorder (OCD). Compulsions, in persons unable to think abstractly or count, can appear differently from compulsions in persons able to comprehend concepts like contamination and counting sequences. The content of obsessive speech also varies depending on the comprehension and vocabulary of the person with OCD. People not showing classic symptoms of OCD have been at risk for this disorder not being recognized. Researchers report that certain medications are ineffective or worsen OCD, and that developmentally disabled people with undiagnosed OCD are at risk for being put on such medications. This article provides information to facilitate the recognition of OCD in developmentally disabled clients.

Journal Article↗

Current issues in the pharmacologic management of obsessive compulsive disorder.

In spite of significant advances in the development of behavioral and pharmacologic strategies for the treatment of obsessive compulsive disorder, little is known about the comparative efficacy and safety of those treatments. In addition, questions about the dose and duration in maintenance treatment remain unknown. This article reviews current issues in the pharmacologic management of patients with obsessive compulsive disorder.

Anti-Anxiety Agents↗

Sequential super-stereotypy of an instinctive fixed action pattern in hyper-dopaminergic mutant mice: a model of obsessive compulsive disorder and Tourette's.

BACKGROUND: Excessive sequential stereotypy of behavioral patterns (sequential super-stereotypy) in Tourette's syndrome and obsessive compulsive disorder (OCD) is thought to involve dysfunction in nigrostriatal dopamine systems. In sequential super-stereotypy, patients become trapped in overly rigid sequential patterns of action, language, or thought. Some instinctive behavioral patterns of animals, such as the syntactic grooming chain pattern of rodents, have sufficiently complex and stereotyped serial structure to detect potential production of overly-rigid sequential patterns. A syntactic grooming chain is a fixed action pattern that serially links up to 25 grooming movements into 4 predictable phases that follow 1 syntactic rule. New mutant mouse models allow gene-based manipulation of brain function relevant to sequential patterns, but no current animal model of spontaneous OCD-like behaviors has so far been reported to exhibit sequential super-stereotypy in the sense of a whole complex serial pattern that becomes stronger and excessively rigid. Here we used a hyper-dopaminergic mutant mouse to examine whether an OCD-like behavioral sequence in animals shows sequential super-stereotypy. Knockdown mutation of the dopamine transporter gene (DAT) causes extracellular dopamine levels in the neostriatum of these adult mutant mice to rise to 170% of wild-type control levels. RESULTS: We found that the serial pattern of this instinctive behavioral sequence becomes strengthened as an entire entity in hyper-dopaminergic mutants, and more resistant to interruption. Hyper-dopaminergic mutant mice have stronger and more rigid syntactic grooming chain patterns than wild-type control mice. Mutants showed sequential super-stereotypy in the sense of having more stereotyped and predictable syntactic grooming sequences, and were also more likely to resist disruption of the pattern en route, by returning after a disruption to complete the pattern from the appropriate point in the sequence. By contrast, wild-type mice exhibited weaker forms of the fixed action pattern, and often failed to complete the full sequence. CONCLUSIONS: Sequential super-stereotypy occurs in the complex fixed action patterns of hyper-dopaminergic mutant mice. Elucidation of the basis for sequential super-stereotypy of instinctive behavior in DAT knockdown mutant mice may offer insights into neural mechanisms of overly-rigid sequences of action or thought in human patients with disorders such as Tourette's or OCD.

Animals↗

The effect of m-CPP on tics and obsessive-compulsive phenomena in Gilles de la Tourette syndrome.

RATIONALE: Family genetic and phenomenological studies support an interrelationship between Gilles de la Tourette syndrome (GTS) and obsessive-compulsive disorder (OCD). Some authors consider GTS as part of a serotonergically mediated cluster of OCD spectrum disorders. OBJECTIVE: To study serotonergic mechanisms in GTS, the effect of the relatively selective 5-HT2c agonist meta-chlorophenylpiperazine (m-CPP) was assessed. METHODS: We studied the behavioural effects of m-CPP on tics, obsessions, compulsions and impulsions of GTS. Twelve medication-free GTS patients (ten men, two women) were included in a single dose 0.5 mg/kg oral m-CPP challenge study with a double-blinded placebo-controlled cross-over design. Global symptom scores, target symptom scores as well as biochemical measures were followed up to 24 h after baseline. RESULTS: While m-CPP caused a significant rise in plasma cortisol and prolactin levels, no significant effects were found on the tics, obsessions and compulsions. Impulsions showed a trend to ameliorate. CONCLUSIONS: This study does not support a predominant role for 5-HT on the tics in GTS. The trend of impulsions to ameliorate after m-CPP can be interpreted as circumstantial support for impulsivity-related 5-HT hypofunctionality in GTS. However, the large variability of m-CPP plasma concentrations found in this study casts doubts upon the reliability of m-CPP as a probe for challenge studies.

Adult↗