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PubMedDate not supplied

An MCMI cluster typology of obsessive-compulsives: a measure of personality characteristics and its relationship to treatment participation, compliance and outcome in behavior therapy.

The two-fold purpose of this investigation was to (a) define personality subtypes among patients diagnosed with obsessive-compulsive disorder (OCD) and (b) examine the relationship between the resulting typology and treatment participation, compliance and outcome of OCD patients treated with behavior therapy, using exposure and response prevention. A hierarchical agglomerative cluster analysis was performed on the Millon Clinical Multiaxial Inventory (MCMI) scale scores of 137 OCD patients seeking outpatient treatment; four cluster types emerged. Patients' OCD symptom severity was assessed at pretreatment, posttreatment, and 6-month follow-up using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Patients with no evident personality pathology and those with dependent qualities demonstrated the best overall outcome. Patients whose personalities indicated particular difficulties with interpersonal interaction were most likely to refuse behavior therapy and, among these patients who engaged in treatment, evidenced no reduction in OCD symptoms at posttreatment and follow-up. Patients with histrionic/borderline traits showed symptom reductions at posttreatment, but did not maintain their treatment gains at follow-up. The clinical implications of these findings are discussed.

Adult↗
PubMed1997

A cognitive theory of obsessions.

It is proposed that obsessions are caused by catastrophic misinterpretations of the significance of one's thoughts (images, impulses). The obsessions persist as long as these misinterpretations continue and diminish when the misinterpretations are weakened. Evidence and arguments in support of the theory are presented, and the questions of vulnerability and the origins of the thoughts are addressed. A firmly focused treatment strategy is deduced from the theory.

Cognition↗
PubMed1999

Obsessions and compulsions in women with postpartum depression.

OBJECTIVE: The quantity, content, and intensity of the obsessions and compulsions of women with postpartum onset major depressive disorder were compared with those of women with major depressive disorder with non-postpartum onset. METHOD: Sequential cases of women with postpartum onset major depression (N = 37) and major depression (N = 28) who presented to our Women's Mood Disorders program were included. Psychiatric examination using DSM-IV criteria and the Inventory to Diagnose Depression established the diagnosis of major depression. Obsessive thoughts and compulsions were reported on the Yale-Brown Obsessive Compulsive Scale and reviewed during the psychiatric examination. Comparisons between groups were performed with chi-square statistics, Fisher exact test and its extensions, and Mann-Whitney U test. RESULTS: Although more women with postpartum onset major depression (N = 21, 57%) than major depression (N = 10, 36%) reported obsessional thoughts, the difference between the groups was not significant (p = .13). However, for women who endorsed obsessions, those with postpartum onset had a higher median number (median = 7) than women without postpartum onset (median = 2, p = .00). Most of the difference in frequency of thoughts was owing to more women with postpartum onset major depression having aggressive thoughts (N = 20, 95%) than women with major depression (N = 6, 60%, Fisher exact p = .03). The most frequent content of the aggressive thoughts for women with postpartum onset major depression was causing harm to their newborns or infants. The presence or number of obsessional thoughts or compulsions was not related to severity of the depressive episode. CONCLUSION: Childbearing-aged women commonly experience obsessional thoughts or compulsions in the context of major depressive episodes. Women with postpartum onset major depression experience disturbing aggressive obsessional thoughts more frequently than women with non-postpartum major depression.

Adolescent↗
PubMed1995

Compulsive eating, obsessive thoughts of food, and their relation to assertiveness and depression in women.

Fifty-three self-defined compulsive eaters recruited from weight loss programs and a college population and prescreened to eliminate probable anorexics and bulimics participated in this study. They completed the Three Factor Eating Questionnaire, Beck Depression Inventory, Compulsive Eating Scale, Eating Obsessive-Compulsive Questionnaire, Personal Assertion Analysis, and provided demographic information. Participants had high scores for compulsive eating and disinhibition and low scores for depression. The best predictors of compulsive eating were disinhibition and obsessive thoughts of food, which accounted for 61% of the variance. Twenty-one percent of the sample reported a history of sexual abuse. Thirty-one percent of the sample were classified as medically obese, yet 49% perceived themselves to be moderately to very overweight.

Adolescent↗
PubMed1985

[Various features of the favorable dynamics of obsessive fears with onset in childhood].

Peculiarities of the formation of the syndrome of obsessive fears originating in childhood and showing a favourable outcome are considered. Thirty-eight subjects (aged 17-24 years) taken off the psychiatric registry in connection with recovery were examined. A comparative analysis of 2 groups of patients with different clinical manifestations and age at the disease onset allowed the identification of conditions contributing to a favourable time course of obsessive fears. The author outlines the optimum therapeutic measures compensating neurotic disorders in children and adolescents with obsessive fears.

Adolescent↗
PubMed2006

Psychological differences between children with and without soiling problems.

OBJECTIVES: Previous studies, based on clinic samples, report that childhood soiling is associated with behavior problems and reduced self-esteem. This population-based study investigates the prevalence of psychological problems associated with childhood soiling. METHODS: A total of 8242 children aged 7-8 years born to mothers in the United Kingdom-based Avon Longitudinal Study of Parents and Children were studied. Parents completed postal questionnaires assessing common childhood emotional and behavioral problems, and children were asked questions at a research clinic concerning their behavior, friendships, bullying, and self-esteem. The rate of psychological problems was compared in children who soil frequently (once a week or more), those who soil occasionally (less than once a week), and those with no soiling problems (controls). Analyses were adjusted for developmental delay, gender, sociodemographic background, and stressful life events. RESULTS: Children who soil were reported by their parents to have significantly more emotional and behavioral problems compared with children who do not soil. Children who soil frequently had significantly more problems than those who soil occasionally. The rate of attention and activity problems, obsessions and compulsions, and oppositional behavior was particularly high in frequently soiling children. Children with soiling problems reported significantly higher rates of involvement in overt bullying (as both perpetrator and victim) and antisocial activities compared with controls. CONCLUSIONS: The current study finds significantly higher rates of behavior and emotional problems, bullying, and antisocial activities in children who soil compared with those who do not soil. Children who soil frequently are more likely to have these problems than those who soil occasionally.

Aggression↗
PubMed2006

The structure of childhood obsessions and compulsions: dimensions in an outpatient sample.

While obsessive-compulsive disorder (OCD) is defined as a unitary condition, prior research has identified meaningful and distinct symptom dimensions in adult samples. In contrast, there have been no investigations of symptom dimensions in samples of children diagnosed with OCD. The present study sought to address this gap. Children diagnosed with OCD (n = 137) were administered the Children's Yale-Brown Obsessive-Compulsive Scale symptom checklist and severity index. Symptoms were analyzed using principal components analysis. As with adult samples, four factors were identified from the checklist. However, these four factors (compulsions, sexual/aggressive obsessions, superstitions, and hoarding/ordering/somatic concerns) were different in content from adult studies. Further, several symptoms significantly contributed to more than one dimension. Each dimension was significantly correlated with scores from the severity index, with the exception of the obsession score with the hoarding/ordering/somatic concerns factor. Results suggest that there are distinct dimensions of symptoms in childhood OCD, but that these dimensions do not correspond to those identified in adults. Instead, it appears that some factors share variance, and the dimensions themselves are separated based upon developmental trajectories. The dimensions examined may be useful in future treatment studies using pharmacological and/or behavioral interventions.

Adolescent↗
PubMed1980

Obsessional personality traits and ABO blood types.

The relation of ABO blood types to obsessional personality traits, as measured by the Leyton Obsessional Inventory (LOI), was studied in a sample of 600 normal individuals. High scorers of the LOI trait portion demonstrated a significantly lower incidence of phenotype O and a significantly higher incidence of phenotypes AB, A and B, taken together, compared to those of a general population sample and the entire study group. Findings of the present study, in conjunction with previous findings concerning a lower incidence of phenotype O and a higher incidence of phenotype A in obsessive compulsive patients, could be interpreted as indicating that phenotype O may be associated with personality traits hindering the development of obsessive-compulsive symptomatology.

ABO Blood-Group System↗
PubMed1999

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↗
PubMed1994

Obsessive-compulsive disorder: a concealed diagnosis.

Epidemiologic data suggest that obsessive-compulsive disorder is the fourth most common mental disorder, after phobias, substance abuse and depression, and is nearly as common as asthma and diabetes mellitus. The understanding of obsessive-compulsive disorder and its treatment have significantly improved over the past decade. Positron emission tomographic scanning has demonstrated characteristic changes in the cerebral metabolism of patients with obsessive-compulsive disorder. Selective serotonin reuptake inhibitors have been shown to alleviate the symptoms of this disorder. Treatment of obsessive-compulsive disorder includes drug therapy, behavior therapy and family therapy. The family physician can play a key role in recognizing the clinical markers of obsessive-compulsive disorder and negotiating a treatment plan that significantly lessens the psychosocial morbidity associated with it.

Algorithms↗
PubMed2004

Anxiolytic-like activity of MGS0039, a potent group II metabotropic glutamate receptor antagonist, in a marble-burying behavior test.

Glutamatergic abnormalities are involved in several psychiatric disorders. Clinical evidence demonstrates altered glutamatergic neurotransmission in patients suffering from obsessive-compulsive disorder. MGS0039, (1R,2R,3R,5R,6R)-2-amino-3-(3,4-dichlorobenzyloxy)-6-fluorobicyclo[3.1.0]hexane-2,6-dicarboxylic acid, is a novel group II metabotropic glutamate (mGlu) receptor antagonist. We examined MGS0039's potential anti-obsessive-compulsive disorder activity, using the marble-burying behavior test as a model of obsessive-compulsive disorder. MGS0039 as well as LY341495 ((2S,1'S,2'S)-2-(9-xanthylmethyl)-2-(2'-carboxycycloprolyl)glycine), another group II mGlu receptor antagonist, inhibited marble-burying behavior. We also demonstrated that this effect was significantly attenuated by a group II mGlu receptor agonist. This data indicates that group II mGlu receptor antagonists may exert anti-obsessive-compulsive disorder effects in clinical use.

Animals↗
PubMed1978

Changes of behavior, fear and thought in the treatment by response prevention--a case study of obsessive compulsive disorder.

A 15-year-old boy with compulsive hand washing and fear of contamination was treated by response prevention. Each series of the response prevention was experimentally divided into four periods: total response prevention, partial response prevention, free hand washing under noticed observation, and free from prevention and free from observation periods. After nine repeats of the series he became free of the symptoms. Temporal increase of fear and appearance of "freezing" phenomenon were observed in the total response prevention periods. Besides decrease in fear and hand washing, there was observed a change of his thought on symptoms with progress of the treatment. Based on these observations and results, the mechanism of treatment of response prevention was discussed.

Adolescent↗
PubMed1988

Obsessions/counter-obsessions: a construction/reconstruction of meaning.

In this article, obsessions and phobic responses are examined in relation to the maintenance and development of a cross-generational coalition organized by a premise about exclusivity, as well as the specific, idiosyncratic "signature premises" characteristic to each case. It is suggested that the obsession develops when a developmental or situational crisis conflicts with the exclusive relationship definition (that is, coalition). Two forms of intervention for disrupting obsessions--the "conversation" and the "counter-obsession"--are discussed and illustrated. Both interventions conceptualize the obsession as an oscillation between remaining in the coalition and not remaining in the coalition, and both interventions challenge the signature premise that defines the coalition.

Compulsive Behavior↗