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Results for “Obsessive Behavior”

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PubMed2007

Persistent psychosocial problems in children who develop posterior fossa syndrome after medulloblastoma resection.

PURPOSE: Posterior fossa syndrome (PFS) occurs in approximately 20% of patients after resection of a tumor from the posterior fossa. Few descriptions of persistent psychosocial consequences exist. We assessed whether the development of PFS is associated with increased risk for emotional, behavioral, and social problems after the cessation of cancer treatment. PROCEDURES: Medical charts and neuropsychological data from 21 children (range = 6-17 years old, median = 9.8) were reviewed. All participants were survivors of childhood medulloblastoma and had been treated with surgical resection of the tumor, craniospinal radiation, +/- chemotherapy, and had comprehensive neuropsychological evaluations 1-2 years post-treatment. Six of the 21 were diagnosed with PFS. A series of chi-square tests were conducted to determine whether a relationship existed between PFS and clinically significant levels of emotional, behavioral, and social problems as measured by parent-report on the Achenbach Child Behavior Checklist (CBCL) and Conners' Parent Rating Scale-93 (CPRS-93). RESULTS: Children who developed PFS were significantly more likely to exhibit obsessive-compulsive type (i.e., perfectionistic) behaviors, withdrawal behaviors, social problems, and internalizing problems (all P < 0.05) than those who did not develop PFS. Additionally, children with PFS were more likely to evidence anxious-shy behaviors, attention problems, and somatic complaints, although these differences were not statistically significant. CONCLUSION: Results from the current preliminary study suggest that PFS may place children at increased risk for emotional, behavioral, and social problems long after completion of their cancer treatment.

Adolescent↗
PubMed1992

Obsessive compulsive disorder: a clinical update.

Recent epidemiologic studies have indicated that obsessive compulsive disorder is a fairly common psychiatric condition. In this article, obsessive compulsive disorder, its subtypes, and epidemiologic features are described. The common obsessions and compulsions are discussed, as are the comorbid conditions. Currently, etiologic hypotheses revolve around serotonergic and dopaminergic neurotransmitter systems. Management of patients with obsessive compulsive disorder involves education, pharmacotherapy, and behavior therapy, and recent advances in such treatments offer patients hope. Psychotherapy has not proved useful. In refractory cases, psychosurgical intervention remains an option.

Behavior Therapy↗
PubMed1993

MMPI correlates of psychotherapy compliance among obsessive-compulsives.

The purpose of this investigation was to examine the relationship between compliance with a behavior therapy program and personality characteristics of obsessive-compulsive disorder (OCD) outpatients (n = 169), as measured by the Minnesota Multiphasic Personality Inventory (MMPI). Compliance was defined as the number of scheduled behavior therapy sessions canceled or missed by patients. Standard multiple regression analysis revealed that higher scores on scales 8 (Schizophrenia), 2 (Depression), and 0 (Social Introversion) contributed significantly to the prediction of compliance among OCD patients engaged in behavior therapy.

Adult↗
PubMed2001

Repetitive behaviors in Tourette's syndrome and OCD with and without tics: what are the differences?

Gilles de la Tourette Syndrome (GTS) and obsessive-compulsive disorder (OCD) share obsessive-compulsive phenomena. The aims of this study were to compare the OC symptom distribution between GTS and OCD and to investigate whether a subdivision of these phenomena into obsessions, compulsions and 'impulsions' is useful in distinguishing GTS and OCD patients. Thirty-two GTS, 31 OCD (10 with tics, 21 without tics) and 29 control subjects were studied using the Leiden repetitive behaviors semi-structured interview to assess GTS as well as OCD-related behaviors. Each reported repetitive thought or action was evaluated on the presence of anxiety and on goal-directedness. This information was used to define whether the behavior was an obsession, compulsion, or 'impulsion'. Both the GTS and OCD study groups showed higher scores than control subjects on rating scales measuring depression, OC behavior and anxiety. In GTS, Y-BOCS severity scores and trait anxiety were lower than in the OCD groups. Furthermore, GTS patients differed from OCD patients in the distribution of symptoms. Aggressive repetitive thoughts, contamination worries and washing behaviors were reported more frequently by tic-free OCD, while mental play, echophenomena, touching and (self)-injurious behaviors were reported more frequently by GTS. OCD individuals with tics were intermediate, but closer to tic-free OCD. GTS individuals reported significantly more 'impulsions' and fewer obsessions and compulsions than OCD individuals with and without tics. Factor analysis revealed three factors accounting for 44% of the variance, resulting in an 'impulsive' factor related to GTS, a 'compulsive' factor related to OCD and an 'obsessive' factor related to tic-free OCD. In conclusion, OCD individuals reported more anxiety and goal-directedness associated with their behaviors than did GTS subjects. The distinction between obsessions, compulsions and impulsions is of importance in identifying Tourette-related vs. non-Tourette-related repetitions.

Adult↗
PubMed1999

Obsessive-compulsive disorder: diagnosis and treatment.

Obsessive-compulsive disorder (OCD) is a chronic, disabling anxiety disorder that is characterized by recurrent obsessions and uncontrolled compulsions such as repetitive behavioral or mental acts that are performed in response to an obsession. OCD often occurs comorbidly with a number of depressive and anxiety disorders. In addition, patients with OCD suffer significant personal and social morbidity and may have difficulty maintaining a job, finishing school, and developing relationships. The backbone of pharmacologic treatment for OCD is a 10- to 12-week trial with a selective serotonin reuptake inhibitor (SSRI) in adequate doses. In most cases, treatment should be initiated with an SSRI because of the superior safety, tolerability, and equivalent efficacy of this class of drugs compared with clomipramine. When dealing with patients who do not respond to one SSRI, effective alternatives include switching to a different SSRI, combining another medication or behavioral therapy with SSRI therapy, considering novel or experimental drug treatments, or employing nonpharmacologic biological approaches, such as electroconvulsive therapy, neurosurgery, or repetitive transcranial magnetic stimulation. This article provides an update on the diagnosis and medical management of OCD and will discuss guidelines for the use of SSRIs and novel approaches for managing treatment-refractory patients.

Anxiety Disorders↗
PubMed1980

Obsessions: source of inefficiency in the workplace.

Obsessions are persistent, intrusive, unwanted ideas that are unproductive and anxiety-arousing. Although the magnitude of their importance in the workplace has not been established by acceptable scientific research criteria, they are in all probability a major source of inefficiency in jobs involving a high percentage of intellectual effort. The current body of knowledge of clinical psychiatry and behavioral psychology can provide rudimentary insights and hypotheses. The need is emphasized for further research to elucidate more precisely the extent of the problem.

Behavior Therapy↗
PubMed1994

Psychosocial treatment for obsessive-compulsive disorder.

State-of-the-art psychosocial treatment for obsessive-compulsive disorder is based on behavior therapy strategies and techniques with adjunctive pharmacological treatment. The critical therapeutic element is the prolonged confrontation of the individual with the stimuli that provokes obsessive thoughts or compulsive actions, without the individual then engaging in cognitive or ritualistic avoidance behaviors. For the clinician, a decision model for treating this disorder is drawn from recent behavioral and pharmacological research, as well as from the individual's self-help capacities. Judicious use of currently available treatments can reduce suffering and restore lost psychosocial functioning in obsessive-compulsive patients and their families.

Adult↗
PubMed2000

Characterization of trichotillomania. A phenomenological model with clinical relevance to obsessive-compulsive spectrum disorders.

Multiple approaches to characterization of TTM have been developed, including categoric definitions and dimensional considerations. When TTM is viewed in the context of other disorders with common comorbidities and overlapping similar phenomenologies, such as OCD, body dysmorphic disorder, skin picking, TS, and olfactory reference syndrome, clinical approaches to assessment and differential diagnosis are more complex. This article presents a general overview of TTM included as a background for a heuristic clinical framework for assessing obsessive-compulsive spectrum disorders. A comprehensive behavioral model of TTM as a template is presented in the context of a broader, phenomenologic approach to assessment of several other disorders. These additional conditions were chosen on clinical grounds because they seem to share some phenomenologic characteristics with TTM. It is hoped that combining a phenomenologic approach to the differentiation of repetitive behaviors (as has been valuable in advancing the understanding of repetitive behaviors in TS and OCD), coupled with a paradigmatic comprehensive behavioral assessment and treatment model of TTM, may foster the validation of such approaches for other putative obsessive-compulsive spectrum disorders. Also, the relative intensity and frequency ascribed to the various behavioral and phenomenologic components of the conditions depicted represent clinical impressions, with varying degrees of empiric support, and require objective validation. This approach is meant to serve as a point of departure for clinical assessment of these complex, interesting, and sometimes incompletely diagnosed and inadequately treated conditions. It is hoped that empiric validation or refutation of this conceptualization will stimulate additional research and provide clinicians with a general framework for assessing patients suffering from these difficult conditions. For more information about trichotillomania, contact The Trichotillomania Learning Center (TLC), 1215 Mission Street, Santa Cruz, CA 95060 (831-457-1004; www.trich.org).

Animals↗
PubMed1992

Adaptive and maladaptive behavior in Prader-Willi syndrome.

The development and profiles of adaptive and maladaptive behavior of 21 adolescents and adults with Prader-Willi syndrome were cross-sectionally examined with the Vineland Adaptive Behavior Scales and Achenbach's Child Behavior Checklist (CBCL). Adaptive strengths emerged for the group as a whole in daily living skills, and this strength became more pronounced with increasing age. A relative weakness was found in socialization, most notably in coping skills. CBCL findings indicated that externalizing behaviors were particularly heightened in adolescence and that many behaviors previously described as either emerging or worsening in adolescence also persist into the adult years (e.g., temper tantrums, arguing, irritability, stubbornness, lying, skin picking, obsessions, defiance). Certain elevated CBCL behaviors were unique to young versus old age groups, and aging in this syndrome may be associated with heightened confusion, withdrawal, and fatigue. The need to study adaptive and maladaptive features in a wider age range of subjects with Prader-Willi syndrome was emphasized.

Activities of Daily Living↗
PubMed1990

Impulse control in obsessive-compulsive disorder: a biopsychopathological approach.

1. The dichotomy between behaviors (some pathological, some falling into the realm of criminality) characterized by an excessive impulsivity and others, such as obsessive-compulsive disorder (OCD), in which a high resistance towards inner or outer impulses dominate, can not be sustained any more. 2. Classical descriptions of OCD include behavior patterns of low control of impulses, and individuals showing "low control of impulse disorders" are, more often than not, high controllers in the periods of time when the impulsivity is in the background. 3. Evidence from biological research and from treatment outcome studies also suggest common traits in the "hyponomic" (impulsive) and "hypernomic" (obsessive) individuals, related to serotonin (5-HT) metabolism disturbances.

Humans↗
PubMed2000

Glutamatergic drugs exacerbate symptomatic behavior in a transgenic model of comorbid Tourette's syndrome and obsessive-compulsive disorder.

We previously created a transgenic mouse model of comorbid Tourette's syndrome and obsessive-compulsive disorder (TS+OCD), by expressing a neuropotentiating cholera toxin (CT) transgene in a subset of dopamine D1 receptor-expressing (D1+) neurons thought to induce cortical and amygdalar glutamate output. To test glutamate's role in the TS+OCD-like disorder of these transgenic mice (D1CT-7 line), the effects of glutamate receptor-binding drugs on their behavior were examined. MK-801, a non-competitive NMDA receptor antagonist that indirectly stimulates cortical-limbic glutamate output, aggravated a transgene-dependent abnormal behavior (repetitive climbing and leaping) in the D1CT-7 mice at doses insufficient to induce stereotypies, and more readily induced stereotypies and limbic seizure behaviors at high doses. NBQX, a seizure-inhibiting AMPA receptor antagonist, reduced only the MK-801-dependent stereotypic and limbic seizure behavior of D1CT-7 mice, but not their transgene-dependent behaviors. These data imply that TS+OCD-like behavior is mediated by cortical-limbic glutamate, but that AMPA glutamate receptors are not an essential part of this behavioral circuit. Our findings lead to the prediction that the symptoms of human Tourette's syndrome and obsessive-compulsive disorder are elicited by excessive forebrain glutamate output.

Animals↗
PubMed1999

Compulsive physical activity in adolescents with anorexia nervosa: a psychobehavioral spiral of pathology.

The excessive exercising that is frequently observed in anorexia nervosa (AN) has been viewed both as an addictive behavior and as a type of obsessive compulsive disorder. The present study tested a nonrecursive structural equation model that specified associations among personality factors, cognitions, and behavior in the development and progression of excessive exercise in adolescent patients with AN. As proposed, findings indicated that both addictive personality and obsessive-compulsive personality contributed to excessive exercising by means of their influence on obligatory/pathological cognitions about exercising. Childhood physical activity also predicted excessive exercising. The implications of these results are discussed from a psychobiological perspective.

Adolescent↗