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Sarawgi S, Mathews RE. Emotion Regulation in Pediatric Obsessive-Compulsive Disorder and Related Interventions: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2025; 12:400. [PMID: 40310027 PMCID: PMC12026322 DOI: 10.3390/children12040400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2025] [Revised: 03/18/2025] [Accepted: 03/20/2025] [Indexed: 05/02/2025]
Abstract
BACKGROUND/OBJECTIVES Maladaptive emotion regulation (ER) and emotion dysregulation (ED) have long been associated with obsessive-compulsive disorder (OCD) as etiological and maintaining factors. Despite building interest in the field along with ancillary research into "rage OCD" (likely an example of ED), targeting the relationship between OCD and ER/ED has been understudied in pediatric OCD populations. The aim of this review was to elucidate the current state of the literature regarding ER/ED, its relationship to pediatric OCD, and related interventions. METHODS A scoping review examined how ER/ED are related to OCD, particularly in pediatric populations, and the efficacy of interventions to affect ER/ED for youth, with a focus on youth diagnosed with OCD. RESULTS A total of 182 publications were reviewed. While not always consistent, a majority of studies found a significant relationship between measures of ER or ED and OCD broadly, as well as with specific OCD symptom dimensions. A number of previously existing interventions, adaptations of those interventions, and newly presented interventions were found to affect ER/ED in youth; however, few studies have effectively targeted ER/ED for pediatric OCD, specifically. As such, the mechanism of change is not well understood. CONCLUSIONS Findings from this review suggest that the increasing focus on ER/ED in pediatric OCD is warranted and in need of continued research. ER/ED can be effectively changed by interventions in youth, but the role ER/ED-change plays in pediatric OCD symptom improvement remains unclear. Implications for future study are examined.
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Affiliation(s)
- Shivali Sarawgi
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
| | - Rachel E. Mathews
- Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- College of Medicine, University of Cincinnati, Cincinnati, OH 45221, USA
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Tian Y, Shi W, Tao Q, Yang H, Guo H, Wen B, Liu Z, Sun J, Chen H, Zhang Y, Cheng J, Han S. Altered controllability of functional brain networks in obsessive-compulsive disorder. J Psychiatr Res 2025; 182:522-529. [PMID: 39908970 DOI: 10.1016/j.jpsychires.2025.01.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 01/02/2025] [Accepted: 01/29/2025] [Indexed: 02/07/2025]
Abstract
Disruptions in the dynamic transitions between brain states have been implicated in cognitive, emotional, and behavioral dysregulations across various mental disorders. However, the irregularities in dynamic brain state transitions associated with obsessive-compulsive disorder (OCD) remain unclear. The present study included 99 patients with OCD and 104 matched healthy controls (HCs) to investigate alterations in dynamic brain state transitions by using network control theory. Functional controllability metrics were computed and compared between the OCD group and HCs. Additionally, abnormal functional connectivity (FC) between the brain regions with statistical differences in functional controllability and remaining brain regions were assessed. Patients with OCD exhibited significantly decreased average controllability (AC) and increased modal controllability (MC) in the right parahippocampal gyrus (PHG), compared to the HCs. Further analysis showed significantly decreased FC between the right PHG and bilateral superior temporal gyrus and occipital gyrus, left postcentral gyrus, and right cingulate gyrus in OCD patients. The results suggest aberrant brain state transitions in OCD patients, alongside widespread disruptions within the brain functional connectome. This study highlights the critical role of altered functional controllability within the right PHG in the neuropathological mechanisms of OCD, providing novel insights into the pathogenesis of OCD.
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Affiliation(s)
- Ya Tian
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, China; Henan Engineering Technology Research Center for Detection and Application of Brain Function, China; Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, China; Henan Key Laboratory of Imaging Intelligence Research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Wenqing Shi
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, China; Henan Engineering Technology Research Center for Detection and Application of Brain Function, China; Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, China; Henan Key Laboratory of Imaging Intelligence Research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Qiuying Tao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, China; Henan Engineering Technology Research Center for Detection and Application of Brain Function, China; Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, China; Henan Key Laboratory of Imaging Intelligence Research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Huiting Yang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, China; Henan Engineering Technology Research Center for Detection and Application of Brain Function, China; Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, China; Henan Key Laboratory of Imaging Intelligence Research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Huirong Guo
- Department of Psychiatry, First Affiliated Hospital of Zhengzhou University, China
| | - Baohong Wen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, China; Henan Engineering Technology Research Center for Detection and Application of Brain Function, China; Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, China; Henan Key Laboratory of Imaging Intelligence Research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Zijun Liu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, China; Henan Engineering Technology Research Center for Detection and Application of Brain Function, China; Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, China; Henan Key Laboratory of Imaging Intelligence Research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Jin Sun
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, China; Henan Engineering Technology Research Center for Detection and Application of Brain Function, China; Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, China; Henan Key Laboratory of Imaging Intelligence Research, China; Henan Engineering Research Center of Brain Function Development and Application, China
| | - Huafu Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, China; Henan Engineering Technology Research Center for Detection and Application of Brain Function, China; Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, China; Henan Key Laboratory of Imaging Intelligence Research, China; Henan Engineering Research Center of Brain Function Development and Application, China.
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, China; Henan Engineering Technology Research Center for Detection and Application of Brain Function, China; Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, China; Henan Key Laboratory of Imaging Intelligence Research, China; Henan Engineering Research Center of Brain Function Development and Application, China.
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, China; Zhengzhou Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging, China; Henan Engineering Technology Research Center for Detection and Application of Brain Function, China; Henan Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment, China; Henan Key Laboratory of Imaging Intelligence Research, China; Henan Engineering Research Center of Brain Function Development and Application, China.
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3
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Sevincok D, Ozaydin Y, Ozgur BG, Ozbek MM, Aksu H, Sevincok L. The relationship between parental obsessive-compulsive disorder and children's cognitive disengagement syndrome (Sluggish Cognitive Tempo). Clin Child Psychol Psychiatry 2024; 29:1448-1461. [PMID: 38807463 DOI: 10.1177/13591045241257019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Although the impact of parental obsessive-compulsive disorder (OCD) on children is well known, there is a still need to investigate additional psychopathological effects that parental OCD may have on children. To our knowledge, the relationship between Cognitive Disengagement Syndrome (CDS), previously referred to as Sluggish Cognitive Tempo CDS in children and parents' OCD has not been investigated to date. In this study, we examined the relationship between parental OCD and children's CDS, while adjusting for parental anxiety, depression, as well as symptoms of internalization, externalization, and Attention Deficit Hyperactivity Disorder (ADHD) in their children. 50 parents with OCD and 45 healthy parents were assessed through Yale-Brown Obsessive-Compulsive Scale, Beck Depression Inventory, and Beck Anxiety Inventory (BAI). The children were applied Child Behavior Checklist, Children ADD/ADHD DSM-IV Based Diagnostic Screening, and Barkley Child Attention Scale (BCAS). BCAS showed significant correlations with BAI (r = 0.280, p = .049), child ADHD-hyperactivity/impulsivity (r = 0.407, p = .003), and ADHD-inattention (r = 0.628, p < .001). The severity of ADHD-inattention (β = 0.618, p = .001) and parental OCD (β = 0.275, p = .016) were significant predictors of CDS severity in the children. Our findings may suggest a significant association between the severity of CDS and ADHD-inattention in children and parental OCD, even after controlling for parental anxiety.
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Affiliation(s)
- Doga Sevincok
- Department of Child and Adolescent Psychiatry, Balikli Rum Hospital, Turkey
| | - Yigit Ozaydin
- Department of Child and Adolescent Psychiatry, Aydin Adnan Menderes University, Turkey
| | - Borte Gurbuz Ozgur
- Department of Child and Adolescent Psychiatry, Aydin Adnan Menderes University, Turkey
| | | | - Hatice Aksu
- Department of Child and Adolescent Psychiatry, Aydin Adnan Menderes University, Turkey
| | - Levent Sevincok
- Department of Psychiatry, Aydin Adnan Menderes University, Turkey
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Öztürk Y, Özyurt G, Turan S, Tufan AE, Akay AP. Emotion dysregulation and social communication problems but not ToM properties may predict obsessive-compulsive disorder symptom severity. Nord J Psychiatry 2023; 77:778-787. [PMID: 37665655 DOI: 10.1080/08039488.2023.2251953] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/06/2023] [Accepted: 08/16/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE Studies have shown that theory of mind, emotion regulation and pragmatic abilities are negatively affected in people with obsessive-compulsive disorder (OCD). We aimed to investigate theory of mind (ToM) abilities, social responsiveness, pragmatic language, and emotion regulation skills in children with OCD and to compare them to healthy controls. METHODS This study was designed as a single-center, cross-sectional, case-control study. ToM abilities were evaluated via "Reading the Mind in the Eyes Test" (RMET), "Faces Test", "Faux-Pas Test", "Comprehension Test" and "Unexpected Outcomes Test". Social responsiveness, pragmatic language and emotion regulation were evaluated by Social Responsiveness Scale (SRS), Children's Communication Checklist- Second Edition (CCC-2), Difficulties in Emotion Regulation Scale (DERS) and Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Within the study period, we enrolled 85 adolescents (42 with OCD and 43 controls). RESULTS The OCD group performed significantly lower than healthy controls in the Faux Pass and Comprehension tests (p = 0.003 for both). We found a statistically significant difference between groups in terms of the goal, strategy, non-acceptance subscales of the DERS (p < 0.001, p = 0.006, p = 0.008, respectively) as well as the total DERS score (p < 0.001). CY-BOCS total scores correlated significantly and negatively with Comprehension, Faux Pas and Unexpected Outcomes tests, and positively with CCC total, SRS total and DERS total scores. In regression analysis the DERS, SRS and CCC tests emerged as significant predictors of CY-BOCS total score. CONCLUSION Addressing ToM, pragmatic, and ER difficulties when planning the treatment of young people with OCD may contribute to positive outcomes.
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Affiliation(s)
- Yusuf Öztürk
- Department of Child and Adolescent Psychiatry, Bolu Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - Gonca Özyurt
- Department of Child and Adolescent Psychiatry, Izmir Katip Çelebi University Medical Faculty, İzmir, Turkey
| | - Serkan Turan
- Department of Child and Adolescent Psychiatry, Uludağ University Medical Faculty, Bursa, Turkey
| | - Ali Evren Tufan
- Department of Child and Adolescent Psychiatry, Bolu Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - Aynur Pekcanlar Akay
- Department of Child and Adolescent Psychiatry, Dokuz Eylul University Medical Faculty, Izmir, Turkey
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5
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Wong SMY, Chen EYH, Lee MCY, Suen YN, Hui CLM. Rumination as a Transdiagnostic Phenomenon in the 21st Century: The Flow Model of Rumination. Brain Sci 2023; 13:1041. [PMID: 37508974 PMCID: PMC10377138 DOI: 10.3390/brainsci13071041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/15/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Rumination and its related mental phenomena share associated impairments in cognition, such as executive functions and attentional processes across different clinical conditions (e.g., in psychotic disorders). In recent decades, however, the notion of rumination has been increasingly narrowed to the "self-focused" type in depressive disorders. A closer review of the literature shows that rumination may be construed as a broader process characterized by repetitive thoughts about certain mental contents that interfere with one's daily activities, not only limited to those related to "self". A further examination of the construct of rumination beyond the narrowly focused depressive rumination would help expand intervention opportunities for mental disorders in today's context. We first review the development of the clinical construct of rumination with regard to its historical roots and its roles in psychopathology. This builds the foundation for the introduction of the "Flow Model of Rumination (FMR)", which conceptualizes rumination as a disruption of a smooth flow of mental contents in conscious experience that depends on the coordinated interactions between intention, memory, affect, and external events. The conceptual review concludes with a discussion of the impact of rapid technological advances (such as smartphones) on rumination. Particularly in contemporary societies today, a broader consideration of rumination not only from a cognition viewpoint, but also incorporating a human-device interaction perspective, is necessitated. The implications of the FMR in contemporary mental health practice are discussed.
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Affiliation(s)
- Stephanie M Y Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Eric Y H Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Michelle C Y Lee
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Y N Suen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Christy L M Hui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
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6
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ÖZDEMİR E, HACIÖMEROĞLU AB. Transdiagnostic Approach and Obsessive Compulsive Disorder. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1110989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
The categorical approach of traditional psychiatric nosology has been a forceful approach for a very long time for explaining psychological disorders which are defined by symptom based diagnostic categories. However, in recent years, the importance of the "transdiagnostic" approach which is a new classification system is increasing. The transdiagnostic approach aims to examine dimensionally the common cognitive, behavioral, interpersonal and biological processes underlying many psychopathologies away from the categorical approach that classifies psychopathologies according to observable symptoms. This approach intends to treat the disorders through the common underlying processes and risk factors, thus heterogeneous and comorbid symptoms are better addressed and diagnostic categories that may change during treatment are avoided. In this review study, the current problems in diagnosing based on classification and gaps in the field were examined, and the approach itself was proposed as a solution. RDoC (Research Domain Criteria) which is a new classification system for psychiatric disorders within the scope of the approach, has created a new structure using modern research approaches in genetics, neuroscience and behavioral sciences. In the present study, the definition and emergence of the transdiagnostic approach, obsessive compulsive disorder and RDoC in the context of transdiagnostic approach and transdiagnostic treatment are explained. This review is intended to be a resource for both basic psychopathology research and the development of treatment methods within the framework of a transdiagnostic approach.
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Ferrández-Mas J, Moreno-Amador B, Marzo JC, Falcó R, Molina-Torres J, Cervin M, Piqueras JA. Relationship between Cognitive Strategies of Emotion Regulation and Dimensions of Obsessive-Compulsive Symptomatology in Adolescents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050803. [PMID: 37238351 DOI: 10.3390/children10050803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023]
Abstract
Cognitive emotion regulation refers to the management of one's emotions through cognitive strategies. Studies have found that individuals with obsessive-compulsive symptoms utilize emotion regulation strategies differently compared to those without these symptoms. This study aims to investigate the relationship between cognitive strategies for emotion regulation and specific dimensions of obsessive-compulsive symptoms in adolescents. A cross-sectional descriptive study was conducted with 307 adolescents between 12 and 18 years old. Associations between sociodemographic variables, obsessive-compulsive symptoms, and emotion regulation strategies were examined using regression and network analyses. Regression results indicated that emotion regulation strategies and gender accounted for 28.2% of the variation in overall obsessive-compulsive symptoms (p < 0.001) and that emotion regulation explained most variance in the symptom dimension of obsessing. Network analysis showed that self-blame and catastrophizing were uniquely linked to overall obsessive-compulsive symptoms, while several strategies were uniquely linked to specific symptom dimensions. The adaptive strategy that demonstrated the strongest association with obsessive-compulsive symptoms was refocus on planning, while maladaptive strategies included catastrophizing, self-blame, and rumination. In conclusion, the results support the relationship between cognitive strategies for emotion regulation and dimensions of obsessive-compulsive symptoms in adolescents, though these relations appear complex and require further investigation. Addressing emotion regulation in the prevention of obsessive-compulsive symptoms may be warranted, but prospective studies are needed.
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Affiliation(s)
- Jesús Ferrández-Mas
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Alicante, Spain
| | - Beatriz Moreno-Amador
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Alicante, Spain
| | - Juan C Marzo
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Alicante, Spain
| | - Raquel Falcó
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Alicante, Spain
| | - Jonatan Molina-Torres
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Alicante, Spain
| | - Matti Cervin
- Department of Clinical Sciences Lund, Lund University, Box 117, 221 00 Lund, Sweden
- Child and Adolescent Psychiatry, Skåne, Sofiavägen 2E, 221 85 Lund, Sweden
| | - José A Piqueras
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Alicante, Spain
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8
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Cooper SE, Hunt C, Stasik-O'Brien SM, Berg H, Lissek S, Watson D, Krueger RF. The Placement of Obsessive-Compulsive Symptoms Within a Five-Factor Model of Maladaptive Personality. Assessment 2023; 30:891-906. [PMID: 35098736 DOI: 10.1177/10731911211070623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dimensional models of obsessive-compulsive (OC) symptoms, as seen in obsessive-compulsive disorder (OCD), are instrumental in explaining the heterogeneity observed in this condition and for informing cutting-edge assessments. Prior structural work in this area finds that OC symptoms cross-load under both Negative Affectivity and Psychoticism traits within the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Alternative Model of Personality Disorder (AMPD). However, tests of OC symptoms in conjunction with assessments of the full AMPD structure and its 25 lower-level facets representing narrower symptom content are lacking. We applied joint exploratory factor analysis to an AMPD measure (Personality Inventory for DSM-5; PID-5) and OC symptom data from two separate samples (total N = 1,506) to locate OC symptoms within AMPD space. OC symptoms cross-loaded on Negative Affectivity, Psychoticism, and on the low end of Disinhibition. We also report exploratory analyses of OC symptom subscales with PID-5 variables. Results are discussed in the context OC symptoms' location in PID-5 space, implications for assessment, and placement of OCD within the Hierarchical Taxonomy of Psychopathology.
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Affiliation(s)
| | | | | | - Hannah Berg
- University of Minnesota Twin Cities, MN, USA
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9
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Delz AK, Gaynor K, O'Connor R, Schmieder L, Somers E. A confirmatory factor analysis of a cognitive model of COVID-19 related anxiety and depression. Acta Psychol (Amst) 2023; 234:103861. [PMID: 36774772 PMCID: PMC9910022 DOI: 10.1016/j.actpsy.2023.103861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
The mental health impact of the COVID-19 pandemic has been significant, with many regions across the globe reporting significant increases in anxiety, depression, trauma, and insomnia. This study aims to validate a potential cognitive model of maintenance factors of COVID-19 related distress by examining psychological predictors of distress, and their goodness-of-fit as a coherent model. Participants from the general population (n = 555) were recruited using a cross-sectional on-line survey design, assessing Demographic factors, Anxiety, Depression, Loneliness, COVID-19 related distress, Trauma Cognitions related to COVID-19, Rumination, Safety Behaviours, Personality Factors, and Mental Effort related to COVID-19. A series of stepwise linear regressions found that components of the model were significant and accounted for a large percentage of variance when examining Covid-19 related distress (R2 = 0.447 Covid Stress Scale), Anxiety (R2 = 0.536 DASS-Anxiety Subscale) and Depression (R2 = 0.596 Depression DASS-subscale). In a confirmatory factor analysis, Loneliness, Post-Traumatic Cognitions about Self, Post-Traumatic Cognitions about the World, Emotional Stability, and Mental Effort related to COVID-19 loaded onto a single factor. The final model showed adequate fit (CFI = 0.990, TLI = 0.983, RMSEA = 0.053 (0.027-0.080), GFI = 0.986, SRMR = 0.0216, χ2 = 23.087, p = .006). The results highlight the importance of cognitive factors, such as post-traumatic cognitions, rumination, and mental effort in maintaining COVID-19 related distress.
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Affiliation(s)
| | - Keith Gaynor
- DETECT, Early Intervention in Psychosis Service, Blackrock, Dublin, Ireland.
| | - Rachael O'Connor
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Luisa Schmieder
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Ellen Somers
- School of Psychology, University College Dublin, Dublin, Ireland
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10
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Liekefett L, Christ O, Becker JC. Can Conspiracy Beliefs Be Beneficial? Longitudinal Linkages Between Conspiracy Beliefs, Anxiety, Uncertainty Aversion, and Existential Threat. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2023; 49:167-179. [PMID: 34964375 PMCID: PMC9896259 DOI: 10.1177/01461672211060965] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/30/2021] [Indexed: 02/06/2023]
Abstract
Research suggests that conspiracy beliefs are adopted because they promise to reduce anxiety, uncertainty, and threat. However, little research has investigated whether conspiracy beliefs actually fulfill these promises. We conducted two longitudinal studies (NStudy 1 = 405, NStudy 2 = 1,012) to examine how conspiracy beliefs result from, and in turn influence, anxiety, uncertainty aversion, and existential threat. Random intercept cross-lagged panel analyses indicate that people who were, on average, more anxious, uncertainty averse, and existentially threatened held stronger conspiracy beliefs. Increases in conspiracy beliefs were either unrelated to changes in anxiety, uncertainty aversion, and existential threat (Study 2), or even predicted increases in these variables (Study 1). In both studies, increases in conspiracy beliefs predicted subsequent increases in conspiracy beliefs, suggesting a self-reinforcing circle. We conclude that conspiracy beliefs likely do not have beneficial consequences, but may even reinforce the negative experience of anxiety, uncertainty aversion, and existential threat.
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11
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Kalanthroff E, Wheaton MG. An Integrative Model for Understanding Obsessive-Compulsive Disorder: Merging Cognitive Behavioral Theory with Insights from Clinical Neuroscience. J Clin Med 2022; 11:7379. [PMID: 36555995 PMCID: PMC9784452 DOI: 10.3390/jcm11247379] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
Several models have been proposed for the emergence and maintenance of obsessive-compulsive disorder (OCD). Although these models have provided important insights and inspired treatment development, no single model has yet sufficiently accounted for the complexed phenotype of the disorder. In the current paper, we propose a novel model that integrates elements from cognitive behavioral models of OCD with neurocognitive approaches to the disorder. This Reciprocal Interaction Model (RIM) for OCD is based on two assumptions: (a) similar observed symptoms can stem from different etiological processes; and (b) neuropsychological deficits (such as reduced response inhibition and overreliance on the habit formation system) and cognitive behavioral processes (such as temporary reduction in anxiety after engaging in compulsive behaviors) mutually affect each other such that abnormalities in one system influence the second system and vice-versa-creating a vicious cycle of pathological processes. Indeed, the bidirectional inhibitory connection between anxiety/obsessions and executive control is at the heart of the model. We begin by briefly reviewing the current models for OCD. We then move on to describe the RIM, the supporting evidence for the model, the model's predictions, and potential clinical implications.
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Affiliation(s)
- Eyal Kalanthroff
- Department of Psychology, The Hebrew University of Jerusalem and Israel, Jerusalem 91905, Israel
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12
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See CCH, Tan JM, Tan VSY, Sündermann O. A systematic review on the links between emotion regulation difficulties and obsessive-compulsive disorder. J Psychiatr Res 2022; 154:341-353. [PMID: 36049435 DOI: 10.1016/j.jpsychires.2022.07.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 06/23/2022] [Accepted: 07/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Growing evidence suggests a link between emotion regulation (ER) deficits and obsessive-compulsive symptoms (OCS). AIMS A systematic review was conducted to integrate empirical research on the nature of ER difficulties associated with obsessive-compulsive disorder (OCD), validated measures of ER for OCD and evidence base for psychological interventions targeting ER difficulties in OCD. METHODS Database searches were conducted on CINAHL, Cochrane Library, EMBASE, MEDLINE, PUBMED, PsycINFO and Scopus with keywords related to ER and OCD. 2609 articles were found, six were identified from other sources and 21 studies were included in this review. The review was registered on PROSPERO (CDR42020184076). RESULTS The non-acceptance of emotions was the most consistently related to OCS - albeit not uniformly with all OCS dimensions. There was also some evidence suggesting that difficulties in impulse-control, accessing effective ER strategies and engaging in goal-directed behaviours to be related to OCS. No OCD-specific ER measure was identified. Interventions with ER components appeared to be promising for the treatment of OCD. FUTURE DIRECTIONS Recommendations on how to build on the existing literature and improve the quality of evidence were provided.
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Affiliation(s)
- Cassandra C H See
- Department of Psychology, National University of Singapore, Block AS4, 9 Arts Link, Singapore, 117570, Singapore.
| | - Jia Min Tan
- Department of Psychology, National University of Singapore, Block AS4, 9 Arts Link, Singapore, 117570, Singapore
| | - Vanessa S Y Tan
- Department of Psychology, National University of Singapore, Block AS4, 9 Arts Link, Singapore, 117570, Singapore
| | - Oliver Sündermann
- Department of Psychology, National University of Singapore, Block AS4, 9 Arts Link, Singapore, 117570, Singapore
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13
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Chen F, Yan W, Calhoun VD, Yu L, Chen L, Hao X, Zheng L. A fast online questionnaire for screening mental illness symptoms during the COVID-19 pandemic. Transl Psychiatry 2022; 12:311. [PMID: 35927227 PMCID: PMC9352665 DOI: 10.1038/s41398-022-02086-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 07/16/2022] [Accepted: 07/21/2022] [Indexed: 11/22/2022] Open
Abstract
The COVID-19 pandemic has caused massive effects on the situation of public mental health. A fast online questionnaire for screening and evaluating mental symptoms is urgent. In this work, we developed a new 19-item self-assessment Fast Screen Questionnaire for Mental Illness Symptoms (FSQ-MIS) to quickly identify mental illness symptoms. The FSQ-MIS was validated on a total of 3828 young adult mental disorder patients and 984 healthy controls. We applied principal component analysis (PCA), receiver operating characteristic (ROC) curve, and general log-linear analysis (GLA) to evaluate the construct and parallel validity. Results demonstrate that the proposed FSQ-MIS shows high test-retest reliability (0.852) and split-half reliability (0.844). Six factors obtained using PCA explained 54.3% of the variance and showed high correlations with other widely used scales. The ROC results (0.716-0.983) revealed high criterion validity of FSQ-MIS. GLA demonstrated the advantage of FSQ-MIS in predicting anxiety and depression prevalence in COVID-19, supporting the efficiency of FSQ-MIS as a tool for research and clinical practice.
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Affiliation(s)
- Fang Chen
- Department of Psychiatry, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Weizheng Yan
- Department of Psychiatry, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, USA
| | - Vince D Calhoun
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, USA
| | - Linzhen Yu
- Department of Psychiatry, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lili Chen
- Department of Psychiatry, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaoyi Hao
- Department of Psychiatry, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Leilei Zheng
- Department of Psychiatry, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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14
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Hong D, Zhu Y, Chen R, Xiao B, Huang Y, Yu M. The bidirectional effects of obsessive-compulsive symptoms and difficulties in emotion regulation in Chinese adults during the COVID-19 pandemic-a dynamic structural equation model. BMC Psychol 2022; 10:129. [PMID: 35597999 PMCID: PMC9123828 DOI: 10.1186/s40359-022-00841-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 05/12/2022] [Indexed: 01/01/2023] Open
Abstract
Background With the accumulation of negative emotions brought by COVID-19-related dysfunctional beliefs, individuals adopted obsessive–compulsive (OC) symptoms (e.g., over-checking the wearing of masks) and formed difficulties in emotion regulation (DER). This study focused on the temporal dynamics of the bidirectional relation between OC symptoms and DER, which had a devastating effect on the individual's mental health. As an extension, we further explored whether OC and DER and their relationship affect sleep problems. Methods In February 2020, a 14-day (twice a day, of 28 measurement intervals) online questionnaire survey was conducted on 122 Chinese adults (aged 18–55 years; 63 females). Subsequently, this research applied a dynamic structural equation model with a cross-lagged relationship and a time series. Health anxiety, anxiety, and depression were controlled as covariates. Results Both OC symptoms and DER had a significant autoregressive and cross-lagged effect. Comparatively speaking, DER was a stronger predictor of OC symptoms than OC’s prediction of DER. Moreover, both higher levels of OC symptoms and DER were related to the severity of sleep problems. Conclusions More guidance on intervening in OC symptoms and identifying emotion regulation should be added to reduce the negative impact of the COVID-19 pandemic on public mental health. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00841-5.
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Affiliation(s)
- Danping Hong
- Guangdong Provincial Key Laboratory of Social Cognitive Neuroscience and Mental Health, Department of Psychology, Sun Yat-Sen University, Guangzhou, 510006, People's Republic of China.,School of Psychology, South China Normal University, Guangzhou, 510631, People's Republic of China
| | - Yawen Zhu
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University, Lanzhou, 730070, People's Republic of China
| | - Runting Chen
- Guangdong Provincial Key Laboratory of Social Cognitive Neuroscience and Mental Health, Department of Psychology, Sun Yat-Sen University, Guangzhou, 510006, People's Republic of China
| | - Bihong Xiao
- Guangdong Provincial Key Laboratory of Social Cognitive Neuroscience and Mental Health, Department of Psychology, Sun Yat-Sen University, Guangzhou, 510006, People's Republic of China
| | - Yueyi Huang
- Guangdong Provincial Key Laboratory of Social Cognitive Neuroscience and Mental Health, Department of Psychology, Sun Yat-Sen University, Guangzhou, 510006, People's Republic of China
| | - Meng Yu
- Guangdong Provincial Key Laboratory of Social Cognitive Neuroscience and Mental Health, Department of Psychology, Sun Yat-Sen University, Guangzhou, 510006, People's Republic of China.
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15
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Lin SS, Gao JF. Woman diagnosed with obsessive-compulsive disorder became delusional after childbirth: A case report. World J Clin Cases 2022; 10:3261-3267. [PMID: 35603337 PMCID: PMC9082687 DOI: 10.12998/wjcc.v10.i10.3261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/22/2021] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a common mental disorder that varies greatly in manifestation and causes much distress to individuals. We describe a case in which a Chinese woman with OCD became delusional after childbirth, and discuss the possible phenomenological and psychological alterations.
CASE SUMMARY A 27-year-old woman presented to the Psychiatry Department of our hospital with obsessions and compulsions. After taking medication, her symptoms were alleviated. Three years later, during her pregnancy, the obsessions returned and even progressed into paranoid delusions after childbirth. After multiple adjustments of treatment along with several fluctuations, she finally achieved remission and gained reasonable insight.
CONCLUSION This case suggests that the patient with OCD appeared to move along a continuum of beliefs, and highlights the importance of effective intervention during pregnancy, which would exert a significant impact on postpartum exacerbation outcomes.
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Affiliation(s)
- Si-Si Lin
- Department of Psychiatry and Psychology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang Province, China
| | - Jing-Fang Gao
- Department of Psychiatry and Psychology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang Province, China
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16
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Wang P, Yan Z, Chen T, Cao W, Yang X, Meng F, Liu Y, Li Z. Visuospatial working memory capacity moderates the relationship between anxiety and OCD related checking behaviors. Front Psychiatry 2022; 13:1039849. [PMID: 36699497 PMCID: PMC9868399 DOI: 10.3389/fpsyt.2022.1039849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/16/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Compulsive checking behavior is the most prevalent compulsive behavior in patients with obsessive-compulsive disorder (OCD). While some studies have shown that anxiety and executive function influence compulsive checking behavior, the relationship between these constructs is inconclusive. Hence, we sought to explore the interplay between executive function, anxiety and compulsive checking behavior. MATERIALS AND METHODS 47 healthy participants (HC) and 51 patients with OCD participated in the study. Symptoms and emotional states were assessed using the Yale-Brown Obsessive Compulsive Scale, the Obsessive-Compulsive Inventory-Revised, the Beck Anxiety Inventory, and the Beck Depression Inventory. Participants also completed three tests of neuropsychological functioning: the Stop Signal Task, the Spatial working memory Task, and the Wisconsin card sorting test. We analyzed the relationships between anxiety, executive function, and compulsive checking symptoms. RESULTS Patients with OCD showed significantly greater anxiety (p < 0.001) and impairments in visuospatial working memory function (p = 0.030) compared to HC participants, while inhibition and set-shifting were not significantly different between the two groups. Visuospatial working memory was negatively related to compulsive checking behavior (p = 0.016). Visuospatial working memory also played a moderating role in the positive relationship between anxiety and compulsive checking behavior (β = -0.281, p = 0.022). CONCLUSION Anxiety symptoms play an important role in explaining compulsive checking behavior in patients with OCD who have relatively weak visuospatial working memory ability. These findings provide a foundation for further research regarding the roles of emotion and cognitive inflexibility in compulsive checking behavior in patients with OCD.
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Affiliation(s)
- Pengchong Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zijun Yan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Tao Chen
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia.,School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Wenwen Cao
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiangyun Yang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fanqiang Meng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuqing Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhanjiang Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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17
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Hong D, Zhu Y, Yu M. How health anxiety affected obsessive-compulsive symptoms during the COVID-19 pandemic in China: The mediation of difficulties in emotion regulation and the moderation of pathological personality traits. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021; 185:111254. [PMID: 34545259 PMCID: PMC8443869 DOI: 10.1016/j.paid.2021.111254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 01/04/2023]
Abstract
Health anxiety (HA) was/is a common negative emotional problem during the COVID-19 pandemic. According to the cognitive model of HA, individuals with HA continued to adopt a series of maladaptive and repetitive behaviors which were associated with obsessive-compulsive symptoms (OCS; including over-washing, over-checking, obsessing, and metal neutralizing). The priority of the present study was to explore how HA specifically affected OCS and whether difficulties in emotion regulation (DER) and pathological personality traits (PPT) affected the relationship between the HA and OCS. We distributed an online survey from February 1 to February 17 in 2020 (N = 1546, with average age of 25.8, and 32.7% of males) from 219 cities in China. Results showed that only four dimensions (i.e., Nonacceptance, Impulse, Non-clarity and Non-awareness) of the DER scale mediated in the predictive path of HA on OCS, which constituted a multiple mediating model. The other moderated mediation model further showed that, with higher PPT, the more significant the impact of HA was on DER, revealing PPT's moderator role between HA and OCS.
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Affiliation(s)
- Danping Hong
- School of Psychology, South China Normal University, Guangzhou 510631, PR China
| | - Yawen Zhu
- Key Laboratory of behavioral and mental health of Gansu Province, School of Psychology, Northwest Normal University, Lanzhou 730070, PR China
| | - Meng Yu
- Guangdong Provincial Key Laboratory of Social Cognitive Neuroscience and Mental Health, Department of Psychology, Sun Yat-Sen University, Guangzhou 510006, PR China
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18
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Eichholz A, Schwartz C, Meule A, Heese J, Neumüller J, Voderholzer U. Self‐compassion and emotion regulation difficulties in obsessive–compulsive disorder. Clin Psychol Psychother 2020; 27:630-639. [DOI: 10.1002/cpp.2451] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/20/2020] [Accepted: 03/20/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Angelika Eichholz
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Caroline Schwartz
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Adrian Meule
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- Schoen Clinic Roseneck Prien am Chiemsee Germany
| | - Julia Heese
- Schoen Clinic Roseneck Prien am Chiemsee Germany
| | - Jakob Neumüller
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy University Hospital, LMU Munich Munich Germany
- Schoen Clinic Roseneck Prien am Chiemsee Germany
- Department of Psychiatry and Psychotherapy University Hospital of Freiburg Freiburg Germany
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19
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Jansen M, Overgaauw S, De Bruijn ERA. Social Cognition and Obsessive-Compulsive Disorder: A Review of Subdomains of Social Functioning. Front Psychiatry 2020; 11:118. [PMID: 32231594 PMCID: PMC7082418 DOI: 10.3389/fpsyt.2020.00118] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 02/10/2020] [Indexed: 12/12/2022] Open
Abstract
Disturbances in social cognitive processes such as the ability to infer others' mental states importantly contribute to social and functional impairments in psychiatric disorders. Yet, despite established social, emotional, and cognitive problems, the role of social cognition in obsessive-compulsive disorder is largely overlooked. The current review provides a first comprehensive overview of social (neuro)cognitive disturbances in adult patients with obsessive-compulsive disorder. Results of our review indicate various social cognitive alterations. Patients with obsessive-compulsive disorder show deficits in the recognition of affective social cues, specifically facial expressions of disgust, and more general deficits in theory of mind/mentalizing. Additionally, patients show heightened affective reactions and altered neural responding to emotions of self and others, as well as poor emotion regulation skills, which may contribute to poor social functioning of patients. However, the discrepancies in findings and scarcity of studies make it difficult to draw firm conclusions with regard to the specificity of social cognitive disturbances. The review offers directions for future research and highlights the need to investigate obsessive-compulsive disorder from an interactive social neurocognitive perspective in addition to the prevalent passive spectator perspective to advance our understanding of this intricate and burdensome disorder.
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Affiliation(s)
- Myrthe Jansen
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
| | - Sandy Overgaauw
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
| | - Ellen R A De Bruijn
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, Netherlands.,Leiden Institute for Brain and Cognition (LIBC), Leiden University, Leiden, Netherlands
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20
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Xu C, Chen J, Cui Z, Wen R, Han H, Jin L, Wan G, Wei Z, Peng Z. Abnormal Anhedonia as a Potential Endophenotype in Obsessive-Compulsive Disorder. Neuropsychiatr Dis Treat 2020; 16:3001-3010. [PMID: 33324061 PMCID: PMC7733443 DOI: 10.2147/ndt.s268148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/02/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is often accompanied by cognitive, particularly executive function, impairments. Recently, anhedonia has emerged as an apparently important symptom of OCD reflecting altered emotion regulation. These two aspects are often comorbid in OCD. However, little is known about whether anhedonia may be a trait marker for OCD. METHODS To verify the role of executive function and evaluate the role of anhedonia in OCD and its relationship with OCD symptoms, we recruited 60 OCD patients, 30 unaffected first-degree relatives (FDRs), and 60 healthy controls (HCs). Participants completed psychometric testing to assess depression, anxiety, and anhedonia symptoms, as well as two cognitive tests to assess executive function, namely the Wisconsin Card Sorting Test (WCST) and the Stroop Color-Word Test (SCWT). RESULTS Compared to HCs, OCD patients and FDRs had significantly lower anticipatory and consummatory pleasure scores. The severity of anticipatory anhedonia correlated positively with obsessive-compulsive symptoms (r = 0.253, p = 0.009), even after controlling for depression and anxiety symptoms. Compared to HCs, OCD patients and FDRs made more errors and achieved fewer categories in the WCST. For all three SWCT components, OCD patients and FDRs took more time to name colors than HCs, but the three groups had similar numbers of errors. CONCLUSION This family-based study showed dampened pleasure together with cognitive dysfunction in OCD patients. The similar consummatory pleasure findings between OCD and FDR groups suggest anhedonia may be considered as a candidate OCD endophenotype.
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Affiliation(s)
- Chuanyong Xu
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Jierong Chen
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People's Republic of China
| | - Zitian Cui
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Rongzhen Wen
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Hongying Han
- Department of Psychiatry, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Lili Jin
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Guobin Wan
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People's Republic of China
| | - Zhen Wei
- Department of Child Psychiatry and Rehabilitation, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, People's Republic of China
| | - Ziwen Peng
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, People's Republic of China
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21
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Yazici KU, Yazici IP. Decreased theory of mind skills, increased emotion dysregulation and insight levels in adolescents diagnosed with obsessive compulsive disorder. Nord J Psychiatry 2019; 73:462-469. [PMID: 31403840 DOI: 10.1080/08039488.2019.1652341] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background: An abnormal interaction between cognition and emotion may contribute to the development of obsessive-compulsive disorder (OCD). Aims: In this study, we aimed to evaluate theory of mind and emotion regulation skills in adolescents diagnosed with OCD. In addition, the results were evaluated in accordance with patients' insight levels. Methods: This study was conducted with 50 patients, who were aged between 11 and 16 and who were newly diagnosed with OCD and 50 healthy individuals. The Turkish version of the Schedule for Affective Disorders and Schizophrenia for School Age Children - Present and Lifetime was used to diagnose OCD and other comorbidities. The Children's Yale-Brown Obsessive Compulsive Scale, the Children's Depression Inventory, and the State-Trait Anxiety Inventory for Children were used for clinical evaluation. The intelligence levels were assessed using the Wechsler Intelligence Scale for Children-Revised Short Form. Reading the Mind in the Eyes Test was used in patients. The Difficulties in Emotion Regulation Scale was also used to evaluate the skills of regulating emotions. Results: Patients with OCD had lower ability with regard to reading minds in the eyes and emotion regulation than the healthy individuals. Patients with OCD, who had a poor insight, had more difficulty in reading minds in the eyes and emotion regulation than those with good insight. Conclusions: This study supports the idea that OCD is related to deficits in theory of mind and emotion regulation skills. Thus, further studies are required to confirm the findings of this study.
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Affiliation(s)
- Kemal Utku Yazici
- Department of Child and Adolescent Psychiatry, Firat University Medical Faculty , Elazig , Turkey
| | - Ipek Percinel Yazici
- Department of Child and Adolescent Psychiatry, Firat University Medical Faculty , Elazig , Turkey
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22
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Ouimet AJ, Ashbaugh AR, Radomsky AS. Hoping for more: How cognitive science has and hasn't been helpful to the OCD clinician. Clin Psychol Rev 2019; 69:14-29. [DOI: 10.1016/j.cpr.2018.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 12/19/2022]
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23
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Anger Rumination is not Uniquely Characteristic of Obsessive-Compulsive Disorder. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019; 140:10-14. [PMID: 31937983 DOI: 10.1016/j.paid.2018.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Although anger has been observed in obsessive-compulsive disorder (OCD), it remains unclear if rumination about anger is characteristic and/or unique to OCD. The present study examines whether types of anger rumination are endorsed more strongly by OCD patients compared to clinical and nonclinical controls. Patients with OCD (n = 30), generalized anxiety disorder (GAD; n = 29), and non-clinical controls (NCC; n = 30) completed measures of OCD symptoms, anger rumination, and trait anxiety. Patients with OCD and GAD significantly differed from NCC's (all ps < .001), but not each other (all ps > .10), in anger afterthoughts, thoughts of revenge, angry memories, and understanding causes of anger. However, the group differences were no longer significant when controlling for trait anxiety. A dimensional approach revealed that OCD symptoms were correlated with anger rumination domains overall. However, these associations were also no longer significant after controlling for trait anxiety. These findings suggest that anger rumination may emerge in OCD largely as an artifact of trait anxiety/negative affect that is associated with but not unique to the disorder. The implications of these findings for conceptualizing emotion and its regulation in OCD are discussed.
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24
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Symptom-Specific Threat Perception Mediates the Relationship Between Obsessive Beliefs and OCD Symptoms. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10004-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Narayanaswamy JC, Jose D, Agarwal SM, Kalmady SV, Baruah U, Shivakumar V, Prasad C, Viswanath B, Rao NP, Venkatasubramanian G, Janardhan Reddy YC. Neuro-hemodynamic endophenotypes of emotional interference in OCD: fMRI study using emotion counting stroop task. Asian J Psychiatr 2019; 39:35-41. [PMID: 30528906 DOI: 10.1016/j.ajp.2018.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 11/14/2018] [Accepted: 11/24/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND We sought to examine the endophenotype pattern of neuro-hemodynamic substrates of emotion counting Stroop (ecStroop) paradigm in patients with OCD, their unaffected siblings [first degree relatives-FDR] and healthy controls (HC). METHODS OCD patients (medication naïve)[N = 16], their unaffected siblings(FDR)[N = 16] and HC [N = 24] were compared using an established ecStroop paradigm in a 3-Tesla fMRI. The relative BOLD signals corresponding to the three types of conditions (neural words-N, words with negative emotional salience-E and words with salience for OCD-O) were examined in the apriori hypothesized brain regions. RESULTS Both in O minus N contrast and O minus E contrast, the groups demonstrated significant differential activation of right insula (BA 13). The post-hoc analyses showed in patients and FDRs relative to HC the following: significant hyperactivation of insula in O minus E contrast; significant hyperactivation of right insula and right DLPFC (BA 9) in O minus N contrast. CONCLUSIONS The neuro-hemodynamic responses corresponding to the obsessive words in insula and DLPFC could be potential endophenotypes. "Threat relatedness" might thus have a vulnerability meaning in the pathogenesis and neurobiological basis of OCD.
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Affiliation(s)
- Janardhanan C Narayanaswamy
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India.
| | - Dania Jose
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Sunil V Kalmady
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Upasana Baruah
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Venkataram Shivakumar
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Chandrajit Prasad
- Department of Neuroimaging & Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Biju Viswanath
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Naren P Rao
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ganesan Venkatasubramanian
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Y C Janardhan Reddy
- Obsessive-Compulsive Disorder Clinic, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India; Translational Psychiatry Laboratory, Neurobiology Research Centre, National Institute of Mental Health and Neurosciences, Bangalore, India
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Schultz C, Lambek R, Højgaard D, Söchting I, Thastum M, Hove Thomsen P, Anna Hybel K. Psychometric validation of a Danish version of the Obsessive Beliefs Questionnaire - Child Version (OBQ-CV). Nord J Psychiatry 2018; 72:621-629. [PMID: 30383480 DOI: 10.1080/08039488.2018.1513068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIM The aim of the study was to examine the psychometric properties of a Danish version of the Obsessive Beliefs Questionnaire - Child Version (OBQ-CV). The OBQ-CV assesses dysfunctional beliefs concerning responsibility/threat estimation, perfectionism/uncertainty, and importance/control of thoughts, which according to cognitive theories are important in the development and maintenance of obsessive-compulsive disorder (OCD). METHODS The study included a pediatric sample (age 7-17 years) consisting of 57 children and adolescents with OCD, 49 children and adolescents with an anxiety disorder (AD), and 58 typically developing (TD) children and adolescents without a psychiatric diagnosis. All participants completed the OBQ-CV and the Child Behavior Checklist - the School Age Scales (CBCL/6-18). The Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) was used to assess OCD symptom severity in the OCD group. RESULTS Confirmatory factor analyses supported the three-factor structure and thereby the construct validity of the OBQ-CV. Gender was not associated with subscale scores, whereas age influenced the subscale scores differently in the three groups. Reliability analyses showed acceptable to excellent internal consistency and acceptable test-retest reliability of the instrument. There were significant differences between the OCD group and the TD group, supporting the criterion validity. Results on convergent validity were mixed. CONCLUSIONS Overall, results supported the reliability and validity of the Danish OBQ-CV and thus the use of the questionnaire for future clinical and research purposes.
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Affiliation(s)
- Cecilie Schultz
- a Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital , Psychiatry , Aarhus , Denmark
| | - Rikke Lambek
- b Department of Psychology and Behavioural Sciences , Aarhus University , Aarhus , Denmark
| | - David Højgaard
- a Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital , Psychiatry , Aarhus , Denmark
| | - Ingrid Söchting
- c Psychology Clinic , University of British Columbia , Vancouver , Canada
| | - Mikael Thastum
- b Department of Psychology and Behavioural Sciences , Aarhus University , Aarhus , Denmark
| | - Per Hove Thomsen
- a Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital , Psychiatry , Aarhus , Denmark
| | - Katja Anna Hybel
- a Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital , Psychiatry , Aarhus , Denmark
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Wang R, Fan Q, Zhang Z, Chen Y, Zhu Y, Li Y. Anterior thalamic radiation structural and metabolic changes in obsessive-compulsive disorder: A combined DTI-MRS study. Psychiatry Res Neuroimaging 2018; 277:39-44. [PMID: 29807209 DOI: 10.1016/j.pscychresns.2018.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 03/13/2018] [Accepted: 05/11/2018] [Indexed: 12/11/2022]
Abstract
Numerous studies indicate the cortico-striato-thalamo-cortical (CSTC) circuit plays an important role in the pathophysiology of obsessive-compulsive disorder (OCD). The anterior thalamic radiation (ATR), as a major fiber in the fronto-thalamic circuitry, contributes to symptomology of OCD. However, the underlying biochemical mechanism in relation with its structural alteration remains not understood. This study investigated the structural abnormality of ATR and its correlation with thalamic metabolic alteration in OCD, using diffusion tensor image (DTI) and proton magnetic resonance spectroscopy (1H-MRS). Twenty-six unmedicated adult OCD patients and twenty-six matched healthy controls participated in DTI study. Thirteen OCD patients and thirteen healthy controls, a subset of DTI participants, took part in MRS study. The results showed that mean fiber length of right ATR negatively correlated with ipsilateral thalamic choline (Cho) level in OCD patients. Additionally, significantly higher Cho concentration was detected in right thalamus of OCD patients compared to healthy controls. Moreover, the mean fractional anisotropy (FA) value of right ATR positively correlated with patients Yale-Brown Obsessive Compulsive Scale (YBOCS) total score, as well as YBOCS compulsion score. These results suggested the coupling of structural and metabolic changes in right ATR, which might serve as a multi-modal biomarker contributing to the pathogenesis of OCD.
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Affiliation(s)
- Ruilin Wang
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Qing Fan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030,China.
| | - Zongfeng Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030,China
| | - Yongjun Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030,China
| | - Yajing Zhu
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Yao Li
- Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China.
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Ching THW, Williams MT, Siev J, Olatunji BO. Responsibility/Threat Overestimation Moderates the Relationship Between Contamination-Based Disgust and Obsessive-Compulsive Concerns About Sexual Orientation. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1109-1117. [PMID: 29476409 DOI: 10.1007/s10508-018-1165-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 06/03/2017] [Accepted: 01/29/2018] [Indexed: 06/08/2023]
Abstract
Disgust has been shown to perform a "disease-avoidance" function in contamination fears. However, no studies have examined the relevance of disgust to obsessive-compulsive (OC) concerns about sexual orientation (e.g., fear of one's sexual orientation transforming against one's will, and compulsive avoidance of same-sex and/or gay or lesbian individuals to prevent that from happening). Therefore, we investigated whether the specific domain of contamination-based disgust (i.e., evoked by the perceived threat of transmission of essences between individuals) predicted OC concerns about sexual orientation, and whether this effect was moderated/amplified by obsessive beliefs, in evaluation of a "sexual orientation transformation-avoidance" function. We recruited 283 self-identified heterosexual college students (152 females, 131 males; mean age = 20.88 years, SD = 3.19) who completed three measures assessing disgust, obsessive beliefs, and OC concerns about sexual orientation. Results showed that contamination-based disgust (β = .17), responsibility/threat overestimation beliefs (β = .15), and their interaction (β = .17) each uniquely predicted OC concerns about sexual orientation, ts = 2.22, 2.50, and 2.90, ps < .05. Post hoc probing indicated that high contamination-based disgust accompanied by strong responsibility/threat overestimation beliefs predicted more severe OC concerns about sexual orientation, β = .48, t = 3.24, p < .001. The present study, therefore, provided preliminary evidence for a "sexual orientation transformation-avoidance" process underlying OC concerns about sexual orientation in heterosexual college students, which is facilitated by contamination-based disgust, and exacerbated by responsibility/threat overestimation beliefs. Treatment for OC concerns about sexual orientation should target such beliefs.
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Affiliation(s)
- Terence H W Ching
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA.
| | - Monnica T Williams
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, 06269, USA
| | - Jedidiah Siev
- Department of Psychology, Swarthmore College, Swarthmore, PA, USA
| | - Bunmi O Olatunji
- Department of Psychological Sciences, Vanderbilt University, Nashville, TN, USA
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Fontenelle LF, Frydman I, Hoefle S, Oliveira-Souza R, Vigne P, Bortolini TS, Suo C, Yücel M, Mattos P, Moll J. Decoding moral emotions in obsessive-compulsive disorder. Neuroimage Clin 2018; 19:82-89. [PMID: 30035005 PMCID: PMC6051311 DOI: 10.1016/j.nicl.2018.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/07/2018] [Accepted: 04/01/2018] [Indexed: 11/20/2022]
Abstract
Background Patients with obsessive-compulsive disorder (OCD) exhibit abnormal neural responses when they experience particular emotions or when they evaluate stimuli with emotional value. Whether these brain responses are sufficiently distinctive to discriminate between OCD patients and healthy controls is unknown. The present study is the first to investigate the discriminative power of multivariate pattern analysis of regional fMRI responses to moral and non-moral emotions. Method To accomplish this goal, we performed a searchlight-based multivariate pattern analysis to unveil brain regions that could discriminate 18 OCD patients from 18 matched healthy controls during provoked guilt, disgust, compassion, and anger. We also investigated the existence of distinctive neural patterns while combining those four emotions (herein termed multiemotion analysis). Results We found that different frontostriatal regions discriminated OCD patients from controls based on individual emotional experiences. Most notably, the left nucleus accumbens (NAcc) discriminated OCD patients from controls during both disgust and the multiemotion analysis. Among other regions, the angular gyrus responses to anger and the lingual and the middle temporal gyri in the multi-emotion analysis were highly discriminant between samples. Additional BOLD analyses supported the directionality of these findings. Conclusions In line with previous studies, differential activity in regions beyond the frontostriatal circuitry differentiates OCD from healthy volunteers. The finding that the response of the left NAcc to different basic and moral emotions is highly discriminative for a diagnosis of OCD confirms current pathophysiological models and points to new venues of research.
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Affiliation(s)
- Leonardo F Fontenelle
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil.
| | - Ilana Frydman
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Sebastian Hoefle
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | | | - Paula Vigne
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro, Brazil
| | - Tiago S Bortolini
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Chao Suo
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
| | - Murat Yücel
- Brain & Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Victoria, Australia
| | - Paulo Mattos
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Jorge Moll
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
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Thorsen AL, de Wit SJ, de Vries FE, Cath DC, Veltman DJ, van der Werf YD, Mataix-Cols D, Hansen B, Kvale G, van den Heuvel OA. Emotion Regulation in Obsessive-Compulsive Disorder, Unaffected Siblings, and Unrelated Healthy Control Participants. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 4:352-360. [PMID: 29753591 DOI: 10.1016/j.bpsc.2018.03.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 02/19/2018] [Accepted: 03/12/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Functional neuroimaging endophenotypes of obsessive-compulsive disorder (OCD) have been suggested during executive tasks. The purpose of this study was to investigate whether behavioral and neural responses during emotion processing and regulation also represent an endophenotype of OCD. METHODS Forty-three unmedicated adult OCD patients, 19 of their unaffected siblings, and 38 healthy control participants underwent 3T functional magnetic resonance imaging during an emotion regulation task including neutral, fear-inducing, and OCD-related visual stimuli. Stimuli were processed during natural appraisal and during cognitive reappraisal, and distress ratings were collected after each picture. We performed between-group comparisons on task behavior and brain activation in regions of interest during emotion provocation and regulation. RESULTS Siblings reported similar distress as healthy control participants during provocation, and significantly less than patients. There was no significant three-group difference in activation during fear provocation or regulation. Three-group comparisons showed that patients had higher amygdala and dorsomedial prefrontal cortex activation during OCD-related emotion provocation and regulation, respectively, while siblings were intermediate between patients and control participants but not significantly different from either. Siblings showed higher left temporo-occipital activation (compared with both healthy control participants and patients) and higher frontolimbic connectivity (compared with patients) during OCD-related regulation. CONCLUSIONS Unaffected siblings do not show the same distress and amygdala activation during emotional provocation as OCD patients. Siblings show distinct activation in a temporo-occipital region, possibly related to compensatory cognitive control. This suggests that emotion regulation is not a strong endophenotype for OCD. When replicated, this contributes to our understanding of familial risk and resilience for OCD.
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Affiliation(s)
- Anders L Thorsen
- OCD-team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway; Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands.
| | - Stella J de Wit
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands; GGZ inGeest, Amsterdam, the Netherlands
| | - Froukje E de Vries
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands; Department of Psychiatry, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Danielle C Cath
- Department of Psychiatry, University of Groningen and University Medical Center, Groningen, the Netherlands; Department of Specialized Trainings, Drenthe Mental Health Institution, Assen, the Netherlands; Altrecht Academic Anxiety Center, Utrecht, the Netherlands
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Ysbrand D van der Werf
- Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - Bjarne Hansen
- OCD-team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Gerd Kvale
- OCD-team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Odile A van den Heuvel
- OCD-team, Haukeland University Hospital, Bergen, Norway; Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands; Amsterdam Neuroscience, Amsterdam, the Netherlands
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Obsessive–Compulsive Disorder is Characterized by a Lack of Adaptive Coping Rather than an Excess of Maladaptive Coping. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9902-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Gillett CB, Bilek EL, Hanna GL, Fitzgerald KD. Intolerance of uncertainty in youth with obsessive-compulsive disorder and generalized anxiety disorder: A transdiagnostic construct with implications for phenomenology and treatment. Clin Psychol Rev 2018; 60:100-108. [DOI: 10.1016/j.cpr.2018.01.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 12/12/2017] [Accepted: 01/31/2018] [Indexed: 12/15/2022]
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Thorsen AL, Hagland P, Radua J, Mataix-Cols D, Kvale G, Hansen B, van den Heuvel OA. Emotional Processing in Obsessive-Compulsive Disorder: A Systematic Review and Meta-analysis of 25 Functional Neuroimaging Studies. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:563-571. [PMID: 29550459 DOI: 10.1016/j.bpsc.2018.01.009] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 01/11/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Patients with obsessive-compulsive disorder (OCD) experience aversive emotions in response to obsessions, motivating avoidance and compulsive behaviors. However, there is considerable ambiguity regarding the brain circuitry involved in emotional processing in OCD, especially whether activation is altered in the amygdala. METHODS We conducted a systematic literature review and performed a meta-analysis-seed-based d mapping-of 25 whole-brain neuroimaging studies (including 571 patients and 564 healthy control subjects) using functional magnetic resonance imaging or positron emission tomography, comparing brain activation of patients with OCD and healthy control subjects during presentation of emotionally valenced versus neutral stimuli. Meta-regressions were employed to investigate possible moderators. RESULTS Patients with OCD, compared with healthy control subjects, showed increased activation in the bilateral amygdala, right putamen, orbitofrontal cortex extending into the anterior cingulate and ventromedial prefrontal cortex, and middle temporal and left inferior occipital cortices during emotional processing. Right amygdala hyperactivation was most pronounced in unmedicated patients. Symptom severity was related to increased activation in the orbitofrontal and anterior cingulate cortices and precuneus. Greater comorbidity with mood and anxiety disorders was associated with higher activation in the right amygdala, putamen, and insula as well as with lower activation in the left amygdala and right ventromedial prefrontal cortex. CONCLUSIONS Patients with OCD show increased emotional processing-related activation in limbic, frontal, and temporal regions. Previous mixed evidence regarding the role of the amygdala in OCD has likely been influenced by patient characteristics (such as medication status) and low statistical power.
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Affiliation(s)
- Anders Lillevik Thorsen
- Obsessive-Compulsive Disorder (OCD) team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway.
| | - Pernille Hagland
- Obsessive-Compulsive Disorder (OCD) team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Joaquim Radua
- FIDMAG Germanes Hospitalàries, Centre for Biomedical Research in Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden; Department of Psychosis Studies, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, United Kingdom
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Gerd Kvale
- Obsessive-Compulsive Disorder (OCD) team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Bjarne Hansen
- Obsessive-Compulsive Disorder (OCD) team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Odile A van den Heuvel
- Obsessive-Compulsive Disorder (OCD) team, Haukeland University Hospital, Bergen, Norway; Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, The Netherlands; Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands
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Tibi L, van Oppen P, van Balkom AJLM, Eikelenboom M, Hendriks GJ, Anholt GE. The relationship between cognitions and symptoms in obsessive-compulsive disorder. J Affect Disord 2018; 225:495-502. [PMID: 28865371 DOI: 10.1016/j.jad.2017.08.072] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 08/18/2017] [Accepted: 08/27/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND The cognitive theory of obsessive-compulsive disorder (OCD) ascertains that catastrophic (mis)interpretations of normally occurring intrusive thoughts are related to the maintenance of OCD. Nonetheless, findings supporting the relationship between cognitive biases and OCD symptoms are largely inconsistent. In the present study we examined the relationship between OCD cognitions and symptoms among 382 OCD patients participating in the longitudinal Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. METHODS OCD cognitions and OC, anxiety and depressive symptoms were assessed using self-report questionnaires at baseline and at two-year follow-up. Baseline multiple regression analyses assessed the specificity of OC cognitions to OCD symptoms. Cross-lagged analyses examined whether cognitions predict OCD symptoms at two-year follow up. RESULTS Baseline analyses demonstrated significant relationships between comorbid anxiety, depressive severity and OC cognitions, adjusted for OCD symptoms (β = .283, p < .001 and β = .246, p < .001, respectively). OCD severity adjusted for comorbid symptoms was unrelated to cognitions at baseline (β = .040, p = n.s). Unique associations were found between cognitions and two OCD symptom subtypes (Impulses: β = .215, p < .001; Rumination/doubting: β = .205, p < .001). Longitudinal analyses yielded non-significant associations between OCD cognitions and symptom severity. Prospective analyses of cognitions and OCD symptom subtypes yielded significant effects for both bidirectional and unidirectional associations (β = .11-.16, p < .05). LIMITATIONS Given the naturalistic design of the study, we did not assess therapeutic interventions between baseline and follow-up. CONCLUSIONS Results only partially concord with the predictions of the cognitive theory of OCD. Future studies should focus on mechanisms alternative to cognitions when investigating the course of OCD.
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Affiliation(s)
- Lee Tibi
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Patricia van Oppen
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, GGZ InGeest, Amsterdam, The Netherlands
| | - Anton J L M van Balkom
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, GGZ InGeest, Amsterdam, The Netherlands
| | - Merijn Eikelenboom
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, GGZ InGeest, Amsterdam, The Netherlands
| | - Gert-Jan Hendriks
- Institute of Integrated Mental Health Care "Pro Persona", Centre for Anxiety Disorders "Overwaal", Lent, The Netherlands; University Center for Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Psychiatry, Radboud University Medical Centre, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Gideon E Anholt
- Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Bhikram T, Abi-Jaoude E, Sandor P. OCD: obsessive-compulsive … disgust? The role of disgust in obsessive-compulsive disorder. J Psychiatry Neurosci 2017; 42:300-306. [PMID: 28375077 PMCID: PMC5573572 DOI: 10.1503/jpn.160079] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Recent research has identified the important role of disgust in the symptomatology of obsessive-compulsive disorder (OCD). Exaggerated and inappropriate disgust reactions may drive some of the symptoms of OCD, and in some cases, may even eclipse feelings of anxiety. This paper reviews behavioural and neuroimaging research that recognizes the prominent role of disgust in contributing to OCD symptoms, especially contamination-based symptoms. We discuss how elevated behavioural and biological markers of disgust reported in OCD populations support the need for alternative clinical treatment strategies and theoretical models of OCD.
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Affiliation(s)
- Tracy Bhikram
- Correspondence to: T. Bhikram, University Health Network, Tourette Syndrome Neurodevelopmental Clinic, 399 Bathurst St, Toronto, ON M5T 2S8;
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Houben K, Jansen A. When food becomes an obsession: Overweight is related to food-related obsessive-compulsive behavior. J Health Psychol 2017; 24:1145-1152. [PMID: 28810380 DOI: 10.1177/1359105316687632] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In this study, it was examined whether overweight is associated with food-related obsessions and compulsions. Participants with a healthy weight (n = 27) and participants who were overweight (n = 33) filled out the Yale-Brown-Cornell Eating Disorder Scale, the Eating Obsessive-Compulsive Scale, and the Emotional and Behavioral Reactions to Intrusions Questionnaire to assess frequency, distress, control, and reactance associated with food-related preoccupations and compulsions. Overweight participants showed increased food-related preoccupations, compulsive eating, and heightened emotional and behavioral reactance compared to participants with a healthy weight. Increased food-related obsessive-compulsiveness was also associated with unhealthy eating patterns.
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Santamaría-García H, Soriano-Mas C, Burgaleta M, Ayneto A, Alonso P, Menchón JM, Cardoner N, Sebastián-Gallés N. Social context modulates cognitive markers in Obsessive-Compulsive Disorder. Soc Neurosci 2017; 13:579-593. [DOI: 10.1080/17470919.2017.1358211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Carles Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain
- Department of Psychiatry, CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
- Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miguel Burgaleta
- Center for Brain and Cognition, Department of Technology, Universitat Pompeu Fabra, Barcelona, Spain
| | - Alba Ayneto
- Center for Brain and Cognition, Department of Technology, Universitat Pompeu Fabra, Barcelona, Spain
| | - Pino Alonso
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain
- Department of Psychiatry, CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain
- Department of Psychiatry, CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Narcis Cardoner
- Department of Psychiatry, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain
- Department of Psychiatry, CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Nuria Sebastián-Gallés
- Center for Brain and Cognition, Department of Technology, Universitat Pompeu Fabra, Barcelona, Spain
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Wang R, Fan Q, Zhang Z, Chen Y, Tong S, Li Y. White matter integrity correlates with choline level in dorsal anterior cingulate cortex of obsessive compulsive disorder patients: A combined DTI-MRS study. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:3521-3524. [PMID: 29060657 DOI: 10.1109/embc.2017.8037616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Structural and functional neuroimaging studies have indicated that the cortico-striato -thalamo-cortical (CSTC) circuit contributes to the pathophysiology of obsessive compulsive disorder (OCD). As an essential component of CSTC circuit, the dorsal anterior cingulate cortex (dACC) plays an important role for its advanced function in cognition and emotion control. A comprehensive understanding of the dACC disruption in OCD pathological mechanism is desired. In this study, we performed a combined diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS) study in 15 OCD patients and 15 healthy controls to investigate the association between structural abnormality and metabolic alterations within the dACC area. We found a positive correlation between the dACC fractional anisotropy (FA) value and choline concentration in patients. Moreover, the FA was positively associated with OCD clinical symptom, especially the compulsive behavior, which showed the clinical relevance of dACC white matter integrity in OCD. To our knowledge, the present work is the first combined DTI-MRS study of OCD. Our findings demonstrated the co-occurrence of structural and metabolic changes within dACC in OCD patients. It was suggested that the disrupted white matter integrity might be accompanied with degraded cellular membrane turnover.
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Zhu Y, Fan Q, Zhang Z, Zhang H, Tong S, Li Y. Spontaneous neuronal activity in insula predicts symptom severity of unmedicated obsessive compulsive disorder adults. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:5445-8. [PMID: 26737523 DOI: 10.1109/embc.2015.7319623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Emerging evidence has suggested that the pathophysiology of obsessive compulsive disorder (OCD) might involve widely distributed large-scale brain systems. The dysfunction within salience network, which is comprised of dorsal anterior cingulated cortex (dACC) and bilateral insular areas, has been proposed to contribute to OCD onset. The mechanism underlying salience network abnormality remains unclear and it is worthwhile to investigate its clinical relevance using functional neuroimaging approaches. In this study, we performed the spontaneous brain activity measurement using resting-state functional magnetic resonance imaging (fMRI) on unmedicated OCD patients (n=23). Specifically, the amplitude of low frequency (0.01-0.08 Hz) fluctuations (ALFF) was calculated for regions in salience network. The voxel-based Pearson's correlative analysis was conducted to explore the relationship beween ALFF measures and symptom severity for OCD patients. The results showed that the spontaneous neuronal activity in insula was significantly correlated to OCD clinical symptoms, especially compulsive behaviors. Our findings consolidated that the salience network played an important role in the pathogenesis of OCD and the intensity of intrinsic brain activity in insula provided a predictive biomarker for OCD symptom severity.
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40
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The clinical inadequacy of the DSM-5 classification of somatic symptom and related disorders: an alternative trans-diagnostic model. CNS Spectr 2016; 21:310-7. [PMID: 26707822 DOI: 10.1017/s1092852915000760] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The Diagnostic and Statistical of Mental Disorders, Fifth Edition (DSM-5) somatic symptom and related disorders chapter has a limited clinical utility. In addition to the problems that the single diagnostic rubrics and the deletion of the diagnosis of hypochondriasis entail, there are 2 major ambiguities: (1) the use of the term "somatic symptoms" reflects an ill-defined concept of somatization and (2) abnormal illness behavior is included in all diagnostic rubrics, but it is never conceptually defined. In the present review of the literature, we will attempt to approach the clinical issue from a different angle, by introducing the trans-diagnostic viewpoint of illness behavior and propose an alternative clinimetric classification system, based on the Diagnostic Criteria for Psychosomatic Research.
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Zhu Y, Fan Q, Zhang H, Qiu J, Tan L, Xiao Z, Tong S, Chen J, Li Y. Altered intrinsic insular activity predicts symptom severity in unmedicated obsessive-compulsive disorder patients: a resting state functional magnetic resonance imaging study. BMC Psychiatry 2016; 16:104. [PMID: 27084762 PMCID: PMC4833895 DOI: 10.1186/s12888-016-0806-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 04/06/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Previous neuroimaging data indicated that the dysfunction in cortico-striato-thalamo-cortical (CSTC) circuit contributed to the neuropathological mechanism of obsessive-compulsive disorder (OCD). Whereas, emerging work has shown that the pathophysiology of OCD might be related to more widely distributed large-scale brain systems including limbic system and the salience network. This study aims to investigate the aberrant spontaneous neuronal activity within the whole brain, and its association with the symptom severity for unmedicated OCD patients. METHOD Twenty-eight unmedicated OCD adults and twenty-eight matched healthy controls were recruited for a resting state functional magnetic resonance imaging (fMRI) study. The amplitude of low-frequency fluctuation (ALFF) analysis over whole brain was performed to examine the intrinsic cerebral activity of subjects. In addition, we conducted the voxel-based Pearson's correlative analysis to probe into the relationship between ALFF values and symptom severity for OCD patients. RESULTS Our results showed that OCD patients had increased ALFF measures in the left frontopolar cortex and left orbital frontal cortex (OFC), with decreased ALFF values in the right insula. Moreover, the right insular intrinsic activity was significantly correlated with total YBOCS score (r = 0.611, p = 0.002) and compulsion score (r = 0.640, p = 0.001) for OCD patients. CONCLUSION The results showed abnormal intrinsic neuronal activity within CSTC circuit and salience network of OCD patients. Our finding of aberrant insular activity advanced the understanding of OCD pathophysiology beyond the traditional CSTC circuit. To the best of our knowledge, it is the first finding about a reduced insular activity at the resting state for unmedicated OCD patients, which might serve as an informative biomarker for OCD pathophysiology.
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Affiliation(s)
- Yajing Zhu
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Qing Fan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haiyin Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianyin Qiu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ling Tan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zeping Xiao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shanbao Tong
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jue Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Yao Li
- Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
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42
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Pino MC, De Berardis D, Mariano M, Vellante F, Serroni N, Valchera A, Valenti M, Mazza M. Two systems for empathy in obsessive-compulsive disorder: mentalizing and experience sharing. ACTA ACUST UNITED AC 2016; 38:307-313. [PMID: 27007147 PMCID: PMC7111355 DOI: 10.1590/1516-4446-2015-1679] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 07/04/2015] [Indexed: 01/10/2023]
Abstract
Objective: To investigate empathic abilities in patients with obsessive-compulsive disorder (OCD) compared to control subjects. OCD is characterized by persistent obsessions and compulsions. Previous studies have proposed specific emotion recognition deficits in patients with OCD. The ability to recognize emotion is part of the broad construct of empathy that incorporates mentalizing and experience-sharing dimensions. Methods: Twenty-four subjects with a diagnosis of OCD and 23 control subjects underwent empathic measures. Results: Patients with OCD compared to control subjects showed deficits in all mentalizing measures. They were incapable of understanding the mental and emotional states of other people. On the other hand, in the sharing experience measures, the OCD group was able to empathize with the emotional experience of other people when they expressed emotions with positive valence, but were not able to do when the emotional valence was negative. Conclusion: Our results suggest that patients with OCD show a difficulty in mentalizing ability, whereas the deficit in sharing ability is specific for the negative emotional valence.
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Affiliation(s)
- Maria C Pino
- Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'Ambiente, Università degli studi dell'Aquila, L'Aquila, Italy
| | - Domenico De Berardis
- Dipartimento di Salute Mentale, U.O.S. Servizio di Diagnosi e Cura, Teramo, Italy.,Dipartimento di Neuroscienze, Imaging e Scienze Cliniche, Chieti, Italy
| | - Melania Mariano
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Università degli studi dell'Aquila, L'Aquila, Italy
| | - Federica Vellante
- Dipartimento di Neuroscienze, Imaging e Scienze Cliniche, Chieti, Italy
| | - Nicola Serroni
- Dipartimento di Salute Mentale, U.O.S. Servizio di Diagnosi e Cura, Teramo, Italy
| | | | - Marco Valenti
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Università degli studi dell'Aquila, L'Aquila, Italy.,Centro di Riferimento Regionale per l'Autismo, ASL 1, L'Aquila, Italy
| | - Monica Mazza
- Dipartimento di Scienze Cliniche Applicate e Biotecnologiche, Università degli studi dell'Aquila, L'Aquila, Italy
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Catastrophic Thinking: A Transdiagnostic Process Across Psychiatric Disorders. COGNITIVE THERAPY AND RESEARCH 2016. [DOI: 10.1007/s10608-016-9763-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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44
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Paul S, Simon D, Endrass T, Kathmann N. Altered emotion regulation in obsessive-compulsive disorder as evidenced by the late positive potential. Psychol Med 2016; 46:137-147. [PMID: 26370494 DOI: 10.1017/s0033291715001610] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is associated with marked anxiety, which triggers repetitive behaviours or mental rituals. The persistence of pathological anxiety and maladaptive strategies to reduce anxiety point to altered emotion regulation. The late positive potential (LPP) is an event-related brain potential (ERP) that reflects sustained attention to emotional stimuli and is sensitive to emotion-regulation instructions. We hypothesized that patients with OCD show altered electrocortical responses during reappraisal of stimuli triggering their symptoms. METHOD To test our hypothesis, ERPs to disorder-relevant, generally aversive and neutral pictures were recorded while participants were instructed to either maintain or reduce emotional responding using cognitive distraction or cognitive reappraisal. RESULTS Relative to healthy controls, patients with OCD showed enhanced LPPs in response to disorder-relevant pictures, indicating their prioritized processing. While both distraction and reappraisal successfully reduced the LPP in healthy controls, patients with OCD failed to show corresponding LPP modulation during cognitive reappraisal despite successfully reduced subjective arousal ratings. CONCLUSIONS The results point to sustained attention towards emotional stimuli during cognitive reappraisal in OCD and suggest that abnormal emotion regulation should be integrated in models of OCD.
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Affiliation(s)
- S Paul
- Department of Psychology,Humboldt-Universität zu Berlin,Germany
| | - D Simon
- Department of Psychology,Humboldt-Universität zu Berlin,Germany
| | - T Endrass
- Department of Psychology,Humboldt-Universität zu Berlin,Germany
| | - N Kathmann
- Department of Psychology,Humboldt-Universität zu Berlin,Germany
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45
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Doron G, Derby D, Szepsenwol O, Nahaloni E, Moulding R. Relationship Obsessive-Compulsive Disorder: Interference, Symptoms, and Maladaptive Beliefs. Front Psychiatry 2016; 7:58. [PMID: 27148087 PMCID: PMC4834420 DOI: 10.3389/fpsyt.2016.00058] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 03/24/2016] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Obsessive preoccupation, doubts, and compulsive behaviors focusing on one's romantic relationship and partner are receiving increasing clinical, theoretical, and empirical attention. Commonly referred to as relationship obsessive-compulsive disorder (ROCD), such symptoms have been linked with decreased relational and sexual functioning and lower mood, even after controlling for other obsessive-compulsive disorder (OCD) symptoms. To date, however, these symptoms have been studied in community samples alone. In the present study, we compared levels of interference, OCD, and mood symptoms between clinical participants with ROCD, OCD, and community controls. We also examined group differences in maladaptive beliefs previously linked with OCD and ROCD. METHOD Participants included 22 ROCD clients, 22 OCD clients, and 28 community controls. The Mini International Neuropsychiatric Interview was used to attain clinical diagnoses of OCD and ROCD. The Yale-Brown Obsessive-Compulsive Scale was used to evaluate primary-symptoms severity. All participants completed measures of symptoms and dysfunctional beliefs. RESULTS ROCD clients reported more severe ROCD symptoms than the OCD and control groups. ROCD and OCD clients did not differ in severity of their -primary-symptoms. ROCD clients scored higher than the other groups on maladaptive OCD-related and relationship-related beliefs. Finally, ROCD clients showed more severe depression symptoms than community controls. CONCLUSION ROCD is a disabling presentation of OCD that warrants research attention. Maladaptive OCD-related and relationship-related beliefs may be implicated in the development and maintenance of ROCD.
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Affiliation(s)
- Guy Doron
- Department of Psychology, Interdisciplinary Center (IDC) Herzliya , Herzliya , Israel
| | - Danny Derby
- Cognetica - The Israeli Center for Cognitive Behavioral Therapy , Tel Aviv , Israel
| | - Ohad Szepsenwol
- Department of Psychology, University of Minnesota , Minneapolis, MN , USA
| | - Elad Nahaloni
- Cognetica - The Israeli Center for Cognitive Behavioral Therapy , Tel Aviv , Israel
| | - Richard Moulding
- Centre for Mental Health and Wellbeing Research (CMHWR), School of Psychology, Deakin University , Burwood, VIC , Australia
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Thorsen AL, van den Heuvel OA, Hansen B, Kvale G. Neuroimaging of psychotherapy for obsessive-compulsive disorder: A systematic review. Psychiatry Res 2015; 233:306-13. [PMID: 26228566 DOI: 10.1016/j.pscychresns.2015.05.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 10/20/2014] [Accepted: 05/11/2015] [Indexed: 10/23/2022]
Abstract
The symptoms of obsessive-compulsive disorder (OCD) include intrusive thoughts, compulsive behavior, anxiety, and cognitive inflexibility, which are associated with dysfunction in dorsal and ventral corticostriato-thalamocortical (CSTC) circuits. Psychotherapy involving exposure and response prevention has been established as an effective treatment for the affective symptoms, but the impact on the underlying neural circuits is not clear. This systematic review used the Medline, Embase, and PsychINFO databases to investigate how successful therapy may affect neural substrates of OCD. Sixteen studies measuring neural changes after therapy were included in the review. The studies indicate that dysfunctions in neural function and structure are partly reversible and state-dependent for affective symptoms, which may also apply to cognitive symptoms. This is supported by post-treatment decreases of symptoms and activity in the ventral circuits during symptom provocation, as well as mainly increased activity in dorsal circuits during cognitive processing. These effects appear to be common to both psychotherapy and medication approaches. Although neural findings were not consistent across all studies, these findings indicate that people with OCD may experience functional, symptomatic, and neural recovery after successful treatment.
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Affiliation(s)
- Anders Lillevik Thorsen
- OCD-team, Haukeland University Hospital, Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
| | - Odile A van den Heuvel
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands; Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Bjarne Hansen
- OCD-team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Gerd Kvale
- OCD-team, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Bergen, Norway
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Barahmand U, Tavakolian E, Alaei S. Association of metacognitive beliefs, obsessive beliefs and symptom severity with quality of life in obsessive-compulsive patients. Arch Psychiatr Nurs 2014; 28:345-51. [PMID: 25439977 DOI: 10.1016/j.apnu.2014.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 08/20/2014] [Indexed: 11/20/2022]
Abstract
The aim of this study was to evaluate the association of obsessive beliefs, obsessive-compulsive disorder severity and metacognitive beliefs to the quality of life in patients with obsessive-compulsive disorder (OCD). Sixty one adults with a principal diagnosis of OCD were recruited for the study. Participants were assessed by trained clinicians using an unstructured clinical interview, the Obsessive Beliefs Questionnaire, the Yale-Brown Obsessive-Compulsive Scale, the Metacognitive Beliefs Questionnaire and the WHO Quality of Life Questionnaire. Data were analyzed using Pearson's of correlation coefficients and multiple regression analyses. Findings indicate that obsessive beliefs, severity total OCD and metacognitive beliefs were associated with total quality of life scores. Regression analysis revealed that while OCD total severity explained 40.1% of the variance in total quality of life, obsessive beliefs (perfectionism/certainty domain) and metacognitions (cognitive self-consciousness and negative beliefs about thoughts in general) explained an additional 13.7%, 7.7% and 5.4% of the variance in QoL. Findings indicate that the metacognitive beliefs associated with OCD symptom severity are different from that associated with quality of life. The implications are that metacognitive therapy aimed at symptom reduction may not necessarily result in improved QoL in OCD patients.
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Affiliation(s)
| | | | - Sarah Alaei
- University of Mohaghegh Ardabili, Ardabil, Iran.
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van den Heuvel OA, Veale D, Stein DJ. Hypochondriasis: considerations for ICD-11. BRAZILIAN JOURNAL OF PSYCHIATRY 2014; 36 Suppl 1:21-7. [DOI: 10.1590/1516-4446-2013-1218] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | - David Veale
- King's College London, UK; South London and Maudsley NHS Foundation Trust, UK
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Abstract
Cognitive theories of obsessive-compulsive disorder (OCD) ascertain that catastrophic (mis)interpretations of normally occurring intrusive thoughts are causal to the onset and maintenance of OCD. Recently, Calkins, Berman and Wilhelm have highlighted research validating the cognitive model. However, the current comment article stresses various findings that challenge basic premises of the cognitive theory. Moreover, a review of clinical studies investigating cognitive and behavioral therapies for OCD questions the added value of cognitive interventions over and above behavior therapy consisting of exposure and response prevention for this disorder. We suggest an alternative, potentially more useful route of investigation, stressing executive (dis)functions as the cause of OCD patients to (automatically) act on internal and external stimuli. We further suggest that dysfunctional beliefs proposed as paramount in the pathogenesis of OCD according to the cognitive model may be less important and specific than formerly believed.
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