Personality traits in subclinical and non-obsessive-compulsive volunteers and their parents

Predictors of psychotic experiences among adolescents with obsessive-compulsive symptoms: A data-driven machine learning approach

Aim

Prediction of future psychosis in individuals with obsessive and compulsive (OC) symptoms is crucial for treatment choice, but only a few predictors have been revealed. Although OC symptoms and psychotic experiences (PEs) are common in adolescence, no studies have revealed the predictors of subsequent PEs in adolescents with OC symptoms. We aimed to explore the predictors for subsequent PEs among adolescents with OC symptoms, using a data-driven machine-learning approach on an adolescent cohort.

Methods

We used data from a cohort study on the general population of adolescents in Tokyo (n = 3171 at age 10). Data were collected at age 10, 12, 14, and 16. We focused on a subgroup of participants who had OC symptoms at age 12. Participants who had PEs at age 10 were excluded. A machine learning method was utilized to explore over 600 potential predictors at baseline, distinguishing between those who had an onset of PEs after age 14 (n = 45) and those who never had PEs (n = 99).

Results

The predicting model demonstrated a good performance (test area under the curve = 0.80 ± 0.05). Other than known risk factors for PEs, novel predictors of subsequent PEs among adolescents with OC symptoms included: lack of interaction with people of different ages, desire to be like their father in the future, and nonworking of primary caregiver when they were 5 years old. Not sharing their belongings readily with other children was a strong predictor of having no PEs.

Conclusion

Close-knit family bonds and limited social connections outside the family predict the later PEs among adolescents with OC symptoms.

Associations between perfectionism and symptoms of anxiety, obsessive-compulsive disorder and depression in young people: a meta-analysis

Perfectionism is a transdiagnostic process contributing to the onset and maintenance of anxiety, obsessive-compulsive disorder (OCD) and depression. The aim of this systematic review and meta-analysis was to examine the association between perfectionism, and symptoms of anxiety, OCD and depression among young people aged 6-24 years. A systematic literature search retrieved a total of 4,927 articles, with 121 studies included (Mpooled age = ~17.70 years). Perfectionistic concerns demonstrated significant moderate pooled correlations with symptoms of anxiety (r = .37-.41), OCD (r = .42), and depression (r = .40). Perfectionistic strivings demonstrated significant, small correlations with symptoms of anxiety (r = .05) and OCD (r = .19). The findings highlight the substantial link between perfectionistic concerns and psychopathology in young people, and to a smaller extent perfectionistic strivings, anxiety, and OCD. The results indicate the importance of further research on early intervention for perfectionism to improve youth mental health.

Towards a better understanding of adolescent obsessive-compulsive personality traits and obsessive-compulsive symptoms from growth trajectories of perfectionism

Although there is increasing attention for the interrelationship between obsessive-compulsive personality disorder (OCPD) and obsessive-compulsive disorder (OCD), their shared characteristics in terms of childhood trait antecedents remain understudied. Perfectionism may be a viable candidate trait antecedent, given its role in the clinical manifestation of both OCPD and OCD in adulthood, and the evidence that perfectionism reflects a dispositional tendency observable from childhood onwards. However, little is known about childhood trajectories of perfectionism with prospective links to later OCPD versus OCD. Using latent growth curve modeling, this study explored the baseline and growth of childhood perfectionism in 485 community and referred children (55.5% girls, 7.17-14.78 years old, Mage = 10.74, SD = 1.50) across three waves. Adolescent OCPD traits and OCD symptoms were measured in Wave 4. An overall decreasing trend of perfectionism from childhood through adolescence appeared, without inter-individual differences in growth. Individual differences in baseline levels of childhood perfectionism were significant, and equally predicting adolescent OCPD and OCD outcomes. At a more specific level, childhood perfectionism predicted most strongly the rigid perfectionism component of OCPD, and the orderliness/cleanliness/perfectionism and obsession domain of OCD. This demonstrates the value of childhood perfectionism for understanding differential outcomes of adolescent OCPD traits and OCD symptoms.

Low Level of Perfectionism as a Possible Risk Factor for Suicide in Adolescents With Attention-Deficit/Hyperactivity Disorder

Introduction: Suicide is one of the leading causes of death among adolescents. Although it is known that both perfectionism and attention-deficit/hyperactivity disorder ('ADHD') are important risk factors for suicide, there are no studies that have investigated the relationship between suicidal behavior and perfectionism among people with ADHD. Aim: The current study investigates the association between perfectionism and suicide in adolescents with ADHD. Method: Subjects included 88 adolescents with ADHD and 96 non-clinical control adolescents. We used the Multidimensional Perfectionism Scale to evaluate perfectionism as well as its separate traits, and the Mini International Neuropsychologic Interview Kid to evaluate psychiatric disorders and suicidal behavior. Differences between the groups were statistically evaluated using t-tests, a Poisson regression analysis with suicide as a discrete variable, and a logistic regression analysis with suicide as a binary variable. Results: Compared to the control group, the ADHD group showed a significantly lower level on the adaptive 'Organization' trait of perfectionism, but not on any other trait, and a significantly higher level of suicidal behavior. Logistic regression results indicated a significant association for perfectionism in general (OR = 0.93, p = 0.003), and for the 'Personal Standards' trait (OR: 0.82, p = 0.039). Poisson regression analysis also showed a significant association with perfectionism in general (IRR = 0.90; p < 0.001) and with the 'Personal standards' trait model (IRR = 0.81, p = 0.019). Discussion: Our results indicate that a low level of perfectionism, in particular 'Personal standards', may be a risk factor for suicidal behavior in adolescents with ADHD. We recommend that psychoeducation and therapy of adolescents with ADHD should consider focusing on adaptive perfection as a possible risk factor for suicide as well.

Intolerance of uncertainty and maladaptive perfectionism as maintenance factors for eating disorders and obsessive-compulsive disorder symptoms

OBJECTIVE

Eating disorders (EDs) are highly comorbid with obsessive-compulsive disorder (OCD). In order to develop treatments which better address commonly comorbid ED and OCD symptoms, it is important to identify potential shared mechanisms. Two potential shared mechanisms are maladaptive perfectionism and intolerance of uncertainty (IU). We aimed to assess how maladaptive perfectionism and IU may contribute to the maintenance of ED and OCD symptoms in individuals with EDs.

METHODS

In the current study (N = 168 individuals with an ED), we analysed cross-sectional and prospective path models of maladaptive perfectionism and IU as maintenance factors of ED and OCD symptoms.

RESULTS

We found that IU was associated with both ED and OCD symptoms, and maladaptive perfectionism was associated with ED symptoms. We also found that maladaptive perfectionism and IU prospectively predicted OCD symptoms, but not ED symptoms.

CONCLUSIONS

Overall, these findings suggest that it may be beneficial to target both maladaptive perfectionism and IU in individuals with a current ED diagnosis in order to prevent the development of OCD symptoms.

Metabolic state and value-based decision-making in acute and recovered female patients with anorexia nervosa

BACKGROUND

Patients with anorexia nervosa forgo eating despite emaciation and severe health consequences. Such dysfunctional decision-making might be explained by an excessive level of self-control, alterations in homeostatic and hedonic regulation, or an interplay between these processes. We aimed to understand value-based decision-making in anorexia nervosa and its association with the gut hormone ghrelin. Besides its homeostatic function, ghrelin has been implicated in the hedonic regulation of appetite and reward via the modulation of phasic dopamine signalling.

METHODS

In a cross-sectional design, we studied acutely underweight (n = 94) and recovered (n = 37) patients with anorexia nervosa of the restrictive subtype, as well as healthy control participants (n = 119). We assessed plasma concentrations of desacyl ghrelin and parameters of delay discounting, probability discounting for gains and losses, and loss aversion.

RESULTS

Recovered patients displayed higher risk aversion for gains, but we observed no group differences for the remaining decision-making parameters. Desacyl ghrelin was higher in acutely underweight and recovered participants with anorexia nervosa relative to healthy controls. Moreover, we found a significant group × desacyl ghrelin interaction in delay discounting, indicating that in contrast to healthy controls, acutely underweight patients with anorexia nervosa who had high desacyl ghrelin concentrations preferably chose the delayed reward option.

LIMITATIONS

We probed decision-making using monetary rewards, but patients with anorexia nervosa may react differently to disorder-relevant stimuli. Furthermore, in contrast to acyl ghrelin, the functions of desacyl ghrelin are unclear. Therefore, the interpretation of the results is preliminary.

CONCLUSION

The propensity for risk aversion as found in recovered patients with anorexia nervosa could help them successfully complete therapy, or it could reflect sequelae of the disorder. Conversely, ghrelin findings might be related to a mechanism contributing to disease maintenance; that is, in acutely underweight anorexia nervosa, a hungry state may facilitate the ability to forgo an immediate reward to achieve a (dysfunctional) long-term goal.

Imagery Rescripting on Guilt-Inducing Memories in OCD: A Single Case Series Study

BACKGROUND AND OBJECTIVES

Criticism is thought to play an important role in obsessive-compulsive disorder (OCD), and obsessive behaviors have been considered as childhood strategies to avoid criticism. Often, patients with OCD report memories characterized by guilt-inducing reproaches. Starting from these assumptions, the aim of this study is to test whether intervening in memories of guilt-inducing reproaches can reduce current OCD symptoms. The emotional valence of painful memories may be modified through imagery rescripting (ImRs), an experiential technique that has shown promising results.

METHODS

After monitoring a baseline of symptoms, 18 OCD patients underwent three sessions of ImRs, followed by monitoring for up to 3 months. Indexes of OCD, depression, anxiety, disgust, and fear of guilt were collected.

RESULTS

Patients reported a significant decrease in OCD symptoms. The mean value on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) changed from 25.94 to 14.11. At the 3-month follow-up, 14 of the 18 participants (77.7%) achieved an improvement of ≥35% on the Y-BOCS. Thirteen patients reported a reliable improvement, with ten reporting a clinically significant change (reliable change index = 9.94). Four reached the asymptomatic criterion. Clinically significant changes were not detected for depression and anxiety.

CONCLUSIONS

Our findings suggest that after ImRs intervention focusing on patients' early experiences of guilt-inducing reproaches there were clinically significant changes in OCD symptomatology. The data support the role of ImRs in reducing OCD symptoms and the previous cognitive models of OCD, highlighting the role of guilt-related early life experiences in vulnerability to OCD.

Heavy Study Investment in Italian College Students. An Analysis of Loscalzo and Giannini's (2017) Studyholism Comprehensive Model

Loscalzo and Giannini (2017) recently proposed the construct of studyholism (or obsession toward study) and a theoretical model highlighting its potential antecedents and outcomes. This study aims to analyze some of these antecedents and outcomes by means of a path analysis including both studyholism and study engagement. The participants are 1,958 Italian college students aged between 18 and 60 years (M age = 23.53 ± 4.43) and heterogeneous as far as their year and major of study are concerned, as well as concerning the city in which they attended their courses. They filled some instruments that allow evaluating studyholism and study engagement, along with individual and situational antecedents (e.g., worry and overstudy climate) and outcomes (e.g., sleep quality, study-relationships conflict, dropout intention). In addition to the path model we performed aiming to test the direct effects we hypothesized, we performed two MANOVAs for analyzing if there were differences on the antecedents and outcomes among the four kinds of student suggested by Loscalzo and Giannini (2017; i.e., engaged studyholics, disengaged studyholics, engaged students, and detached students). The results of this study support Loscalzo and Giannini's (2017) conceptualization of studyholism as an internalizing disorder, since worry is the strongest predictor of studyholism (β = .67, p < .001). In addition, in line with Loscalzo and Giannini's (2017) theorization, we found some differences among the four kinds of student on both the antecedents and outcomes we analyzed. This study has critical theoretical, preventive, and clinical implications. It supports the definition of studyholism as an OCD-related disorder. Also, about preventive implications, it shows that interventions aiming to favor students' wellbeing should target also engaged students, since study engagement predicts social impairment as well as studyholism. Finally, it suggests that in a clinical setting, it is important to distinguish between disengaged studyholics and engaged studyholics as they have different relationships with some antecedents and outcomes; also, they both have functional impairment, even if in different areas.

Obsessive-Compulsive Tendencies Are Related to a Maximization Strategy in Making Decisions

The present studies were motivated by the hypothesis that attenuated access to internal states in obsessive-compulsive (OC) individuals, which leads to extensive reliance on external proxies, may manifest in a maximizing decision making style, i.e., to seeking the best option through an exhaustive search of all existing alternatives. Following previous research, we aimed to explore the possible relationships between OC tendencies, seeking proxies for internal states, indecisiveness and maximization. In Study 1, we measured levels of OC tendencies, seeking proxies for internal states, indecisiveness, maximization, depression and anxiety in an online Hebrew speaking sample (N = 201). In Study 2, we administrated the same questionnaires to an online English speaking sample (N = 240) and in addition, examined participants' decision making strategies in a hypothetical situation. The participants in both studies were unscreened adults. Correlational and linear regressions analyses indicated that OC tendencies are related to maximization, even when levels of indecisiveness, depression and anxiety are controlled for. Moreover, the findings suggested that reliance on external proxies may partially account for the aforementioned association. Possible implications and future directions are discussed.

Obsessive-Compulsive Disorder in Paediatric and Adult Samples: Nature, Treatment and Cognitive Processes. A Review of the Theoretical and Empirical Literature

The appraisal model of obsessive-compulsive disorder (OCD) suggests that six key appraisal domains contribute to the aetiology and maintenance of OCD symptoms. An accumulating body of evidence supports this notion and suggests that modifying cognitive appraisals may be beneficial in reducing obsessive-compulsive symptomatology. This literature review first summarises the nature of OCD and its treatment, followed by a summary of the existing correlational and experimental research on the role of cognitive appraisal processes in OCD across both adult and paediatric samples. While correlational data provide some support for the relationship between cognitive appraisal domains and OCD symptoms, results are inconclusive, and experimental methods are warranted to determine the precise causal relationship between specific cognitive appraisal domains and OCD symptoms.

Relationship between Two Aspects of Perfectionism and Obsessive-Compulsive Symptoms

In this study was investigated the relationship between two aspects of perfectionism (Concern over Mistakes and Personal Standards) and obsessive-compulsive symptoms. College students (57 men and 193 women: M age = 19.5 yr., SD = 1.9) majoring in psychology were from introductory psychology classes and a psychological assessment practice class. They completed the Padua Inventory, which assesses obsessive-compulsive symptoms, and the subscales of Concern over Mistakes and Personal Standards of the Frost Multidimensional Perfectionism Scale, which assess the tendency to be concerned about making mistakes and the tendency to set excessively high standards, respectively. Multiple regression analysis indicated that only the Concern over Mistakes scores predicted significantly all Padua Inventory subscale scores. Perhaps only being concerned over making mistakes may be associated with obsessive-compulsive symptoms. The tendency to set high standards was not strongly correlated with obsessive-compulsive symptoms. Further, the relationship between setting high standards and having obsessive-compulsive symptoms reported in previous studies may be spurious. Further work is required to untangle these associations.

Are obsessive-compulsive symptoms impulsive, compulsive or both?

BACKGROUND

The relationships between obsessive-compulsive symptoms and distinct forms of impulsivity and compulsivity are unclear. Such examination would be relevant in terms of how best to classify psychiatric disorders and in understanding candidate 'traits' that extend across a continuum between normalcy and clinical disorders.

METHOD

515 young adults (aged 18-29years) completed the Padua Inventory and undertook detailed clinical and neurocognitive assessments. Relationships between obsessive-compulsive symptoms and distinct types of impulsivity and compulsivity were evaluated using linear regression modeling.

RESULTS

Obsessive-Compulsive symptoms were significantly predicted by female gender, lower quality of life, psychiatric disorders in general (but not impulse control disorders), and worse extra-dimensional set-shifting. Obsessive-Compulsive symptoms were not significantly predicted by alcohol/nicotine consumption, stop-signal reaction times, or decision-making abilities.

CONCLUSION

These data indicate that obsessive-compulsive symptoms are more related to certain forms of compulsivity than to impulsivity. These findings have important implications for diagnostic conceptualizations and neurobiological models.

Comparison of Perfectionism and Related Positive-Negative Dimension in People With High Traits on Obsessive Compulsive and Eating Disorder Characteristics

BACKGROUND

Psychopathological perfectionism is often correlated with obsessive compulsive eating disorders.

OBJECTIVES

The purpose of this study was to investigate perfectionism in people with high traits of obsessive compulsive and eating disorder characteristics.

MATERIALS AND METHODS

This study was an expo fact research. The statistical population of the research comprised of male and female undergraduate students at Tabriz and Sarab branches of Payam- e- Noor University, Tabriz Islamic University and Azarbaijan Shahid Madani university in the academic year 2012 - 2013. A group of 640 university students, using the stratified random sampling method were screened by the obsessive compulsive inventory and the eating attitude test, then a group of 143 participants with high obsessive compulsive traits with another 137 participants with high eating disorder characteristics were selected and assessed with the Perfectionism Inventory. Data were analyzed using one way analysis of variance.

RESULTS

The results showed that perfectionism and related negative dimension are more commonly found in people with high obsessive-compulsive traits than eating disorder characteristics (P < 0.02). The results showed the highest contribution of maladaptive perfectionism in predicting obsessive-compulsive features and pathological eating attitude. Also, no difference was found between the two groups in terms of negative perfectionism.

CONCLUSIONS

The greater association of perfectionism with symptoms of obsessive-compulsive is consistent with its phenomenological feature. Fear of failure may motivate the behavioral components of perfectionism that aim to focus on careful checking, reassurance seeking and excessive consideration before making a decision.

Obsessive-Compulsive Symptomatology, Religiosity Levels and the Illusion-of-Control Paradigm in a Non-Clinical Undergraduate Sample

The present research employed the illusion-of-control paradigm to investigate the relationships between Obsessive-Compulsive disorder (OCD) symptoms, religiosity levels, and illusory sense of control (SC). An opportunistic sample of 60 undergraduate students was presented with a pre-programmed series of neutral visual stimuli (i.e. lines) and was expected to try to control the sequence through the use of keyboard presses. Participants assessed their perceived level of control twice throughout the computerised task. In addition, the study was interested at examining the relationship between religiosity and OC behaviour and the Santa Clara Strength of Religious Faith Questionnaire (SCSRF) was employed. In proportion to predictions, OCD symptoms were correlated with higher illusory SC; furthermore, religiosity levels were related to some degree to OCD symptoms. The essential role of mental control in OCD is discussed, particularly the significant clinical implications of such an association. Furthermore, the possible contribution of religious affiliations to the maintenance of OC behaviour is further discussed.

Boys' serotonin transporter genotype affects maternal behavior through self-control: a case of evocative gene-environment correlation

Self-control, involving processes such as delaying gratification, concentrating, planning, following instructions, and adapting emotions and behavior to situational requirements and social norms, may have a profound impact on children's adjustment. The importance of self-control suggests that parents are likely to modify their parenting based on children's ability for self-control. We study the effect of children's self-control, a trait partially molded by genetics, on their mothers' parenting, a process of evocative gene-environment correlation. Israeli 3.5-year-old twins (N = 320) participated in a lab session in which their mothers' parenting was observed. DNA was available from most children (N = 228). Mothers described children's self-control in a questionnaire. Boys were lower in self-control and received less positive parenting from their mothers, in comparison with girls. For boys, and not for girls, the serotonin transporter linked polymorphic region gene predicted mothers' levels of positive parenting, an effect mediated by boys' self-control. The implications of this evocative gene-environment correlation and the observed sex differences are discussed.

Obsessions and Compulsions Are Associated With Different Cognitive and Mood Factors

This study examined whether nonclinical obsessions and nonclinical compulsions relate differently to cognitive and mood factors such as responsibility, perfectionism, trait anxiety and depressed mood. Two hundred and three nonclinical undergraduate psychology students (70.4% females, 29.6% males, mean age = 18.7,SD= 1.1) completed questionnaires. After controlling for the relationship between obsessions and compulsions, obsessions were found to relate significantly more strongly to depressed mood, trait anxiety, socially prescribed perfectionism and responsibility than compulsions. Conversely, compulsions were found to relate more strongly to self-oriented perfectionism than obsessions. These results were interpreted as providing support for the notion that obsessive-compulsive disorder (OCD) is maintained by a conflicted mental representation of the self and the world. Obsessions were interpreted as reflecting an overdeveloped vigilance for threat, responsibility and need for social approval. Compulsions were interpreted as emanating from the belief that the self is self-sufficient and resourceful, and that the world is ordered and systematic. Implications for the treatment of OCD were discussed.

A Comparison of Checking-related Beliefs in Individuals with Obsessive Compulsive Disorder and Normal Controls

The potential roles of perceived danger, responsibility, thought-action fusion, confidence in memory, intolerance of uncertainty and need to control one's thoughts in mediating compulsive checking were examined. Belief ratings were obtained from 21 individuals with compulsive checking concerns and 21 nonclinical controls about the most prominent checking concern of each individual with obsessive compulsive disorder (OCD), with controls being yoked to individuals with OCD on the basis of gender and age. If control participants and individuals with OCD have some similar beliefs regarding, for example, locking their front door, then it follows that those beliefs are unlikely to be mediating or driving the disorder. Large and significant differences were found between sufferers of OCD and nonclinical controls on ratings of beliefs concerning the probability and severity of harm, intolerance of uncertainty and the need to control thoughts. However, no differences were found between individuals with OCD checking concerns and nonclinical controls in ratings of beliefs concerning perceived personal responsibility, thought-action fusion (TAF) and confidence in memory. The findings concerning personal responsibility are of particular interest and suggest that perceptions of harm or a negative outcome may be a necessary precursor to perceptions of responsibility and the decision to act.

Compulsive exercise and eating disorders

The aim of this review was to develop an empirically supported cognitive behavioural model of compulsive exercise within the context of the eating disorders. A systematic review of the correlates and predictors of compulsive exercise among eating disordered patients identified four key correlates. These were subsequently validated by a second review, incorporating both the clinical and non-clinical as well as the exercise science literatures. A proposed model is presented which is both evidence-based and testable.

Development and initial validation of the obsessive belief questionnaire-child version (OBQ-CV)

BACKGROUND

Cognitive models of obsessive-compulsive disorder (OCD) propose that beliefs are important in the etiology and maintenance of OCD and that these beliefs develop during childhood [Neal et al., 1991: Psychol Bull 109:400-410; Rachman, 1997: Behav Res Ther 35:793-802; Cronbach, 1951: Psychometrika 16:297-334]. However, the ability to test these predictions has been hampered by the lack of a standardized measure of OCD-related beliefs for youth. Therefore, this article presents initial data on a youth version of the widely used Obsessive Belief Questionnaire (OBQ) [Bonett, 2002: J Educ Behav Stat 27:335-340].

METHODS

Data examining the psychometric properties of the Obsessive Belief Questionnaire-Child Version (OBQ-CV) are presented from two pediatric OCD samples: a North American (n=29, aged 9-17 years) and a Dutch sample (n=48, aged 8-18 years).

RESULTS

Preliminary findings from both samples support the internal consistency, retest reliability, and convergent validity of the OBQ-CV.

CONCLUSIONS

Results of this study suggest that the OBQ-CV is a promising tool for examining the role of cognitions in pediatric OCD. Development of the OBQ-CV to augment the existing adult version of the scale creates unique opportunities for investigating the role of cognitions in OCD across the lifespan.

A Reliability Generalization Study of the Frost Multidimensional Perfectionism Scale (F–MPS)

Perfectionism has been identified as a common concern among clients who seek counseling services. For more than 20 years, the Frost Multidimensional Perfectionism Scale (F–MPS) has been used extensively to measure the construct of individuals' perfectionism. The current study used reliability generalization to identify the average score reliability as well as variables explaining the variability of score reliability. Typical reliability across subscale scores ranged from .71 to .86 with the Doubt about Action subscale showing the least variability and the Organization subscale showing the most. In addition, sex, language, and standard deviation of the scale had statistically significant relations to reliability estimates.

The Obsessive Beliefs Questionnaire (OBQ): examination in nonclinical samples and development of a short version

The study aimed to examine the factor structure of the Obsessive Beliefs Questionnaire (OBQ), the most widely used measure of dysfunctional beliefs in obsessive-compulsive disorder (OCD). Multiple exploratory methods (exploratory factor analysis, cluster analysis by variable, multidimensional scaling) were used to examine the questionnaire. Confirmatory factor analyses were also performed in two large nonclinical samples from Australia (N = 1,234) and Israel ( N = 617). Our analyses suggested a four-factor solution with 38 items, where threat and responsibility formed separate dimensions (the "OBQ-TRIP"). This version had superior fit statistics across the two divergent confirmatory samples, when compared with four alternative models suggested by previous authors. Of the OBQ dimensions, the threat scale correlated most strongly with OCD symptom measures, even when controlling for depression. A short, 20-item version of the scale is offered for further study. Implications and limitations are discussed.

Perfectionism in obsessive-compulsive and eating disorders

OBJECTIVE: The main aims of this article are twofold. First, to assess perfectionism dimensions in obsessive-compulsive disorder and eating disorders in comparison with psychiatric control (depression/anxiety) and non-clinical control groups. Second, to examine if perfectionism is specifically related to these different clinical conditions. METHOD: Thirty-nine outpatients with obsessive-compulsive disorder, 24 outpatients with eating disorders, 65 outpatients with a diagnosis of depression and/or anxiety, and 70 non-clinical participants completed the Portuguese version of the Multidimensional Perfectionism Scale. RESULTS: Compared to non-clinical subjects, individuals of all clinical samples had significantly higher scores on Multidimensional Perfectionism Scale total score, Self-Oriented and Socially-Prescribed Perfectionism. There were no significantly differences in Self-Oriented Perfectionism and Multidimensional Perfectionism Scale total score in all the three clinical samples. Subjects from the eating disorders sample had significantly higher scores of Socially-Prescribed Perfectionism in comparison to obsessive-compulsive disorder and psychiatric control samples. CONCLUSION: Perfectionism showed to be related with this broad range of psychopathologies. However, the differences between eating disorders versus obsessive-compulsive disorder and psychiatric control on Socially-Prescribed Perfectionism warrant further investigation in order to clarify the specificity of this perfectionism dimension in eating disorders.

MOOD IN RELATION TO SUBCLINICAL OBSESSIVE-COMPULSIVE SYMPTOMS

Obsessive-compulsive disorder (OCD) is considered an anxiety disorder, but shows comorbidity with other disorders in the affective and impulsive-compulsive spectra, including anxiety disorders, major depression, and drug addictions. Subclinical OCD symptoms are relatively common in nonclinical populations and share common neurobiological substrates with clinical OCD. In this nonclinical community sample, the relationship between the severity of obsessions and compulsions, as measured by the Yale-Brown Obsessive Compulsive Scale, related to the intensity of negative emotions (anger, depression, tension, confusion, and fatigue) but not positive emotion (vigor), as measured by the Profile of Mood States. These relationships were independent of demographic influences and psychoactive drug use frequency (alcohol, cannabis, opioid, major stimulants, MDMA, and hallucinogens). These likely reflect common neurobiological substrates for emotional and behavioral regulation in prefrontal-subcortical/limbic circuits, which show normal variations in the general population.

Measurement of Risk-Taking in Obsessive-Compulsive Disorder

A measure of everyday risk-taking, the Everyday Risk Inventory (ERI), was developed to assess avoidance of potentially harmful ordinary activities, and some of its psychometric properties were studied. The hypothesis that outpatients with obsessive compulsive disorder (OCD) would score lower than non-patients on this and other measures of risk-taking was tested. The ERI showed good internal consistency and excellent test-retest reliability. It successfully differentiated OCD patients from non-clinical subjects. Consistent with research on sensation seeking, both age and gender were related to ERI scores, with older subjects and females showing greater risk avoidance. The ERI correlated moderately strongly with other measures of risk-taking and showed, as expected, a less strong negative association with measures of responsibility and value orthodoxy. Preliminary findings indicate that the ERI is a useful instrument for assessing non-pleasurable ordinary risk-taking. Findings are discussed in relation to possible dimensions of risk-taking in existing research on decision-making and the need for research on other patient populations.

How does locus of control and inflated sense of responsibility relate to obsessive-compulsive symptoms in Turkish adolescents?

This study aimed to examine the effects of responsibility attitudes, locus of control and their interactions on the general obsessive-compulsive (OC) symptomatology and the dimensions of OC symptoms in a sample of Turkish adolescents (n=385), their ages varied from 16 to 20 with a mean of 17.23 (S.D.=.68). The results of the present study revealed a significantly positive relationship between responsibility attitudes and general OC symptomatology. However, locus of control did not appear as a significant predictor of general OC symptomatology. Furthermore, results revealed that there was a significant interaction effect of responsibility attitudes with locus of control on OC symptomatology. That is, an inflated sense of responsibility and the presence of an external locus of control produced the highest level of OC symptoms. Related to the dimensions of OC symptoms, responsibility was a weak predictor of obsessive thinking symptoms, and a moderate predictor of cleanliness and checking symptoms. Locus of control and its interaction with responsibility attitudes only significantly predicted obsessional thinking symptoms.

The association between parental bonding and obsessive compulsive disorder in offspring at high familial risk

BACKGROUND

The aim of the current study is to estimate the association between parenting factors derived from the Parental Bonding Instrument (PBI) and a lifetime DSM-IV diagnosis of OCD.

METHOD

Data were from approximately 1200 adults from 465 families assessed as part of a large family and genetic study of OCD. The association of three parenting factors, for fathers and mothers, with offspring OCD status were examined; analyses were stratified by parental OCD status and family loading for OCD (multiplex versus sporadic).

RESULTS

Three factors were derived by principal components factor analysis of the PBI (maternal and paternal care, overprotection and control). Maternal overprotection was associated with OCD in offspring with familial OCD (familial cases) but only if neither parent was affected with OCD, which suggests independent but additive environmental and genetic risk (OR = 5.9, 95% CI 1.2, 29.9, p = 0.031). Paternal care was a protective factor in those not at high genetic risk (sporadic cases) (OR = 0.2, 95% CI 0.0, 0.8, p = 0.027). Maternal overprotection was also associated with offspring OCD in sporadic families (OR = 2.9, 95% CI 1.3, 6.6, p = 0.012). The finding that parental overprotection and care were not associated with offspring OCD when at least one parent had OCD addressed directly the hypothesis of maternal or paternal OCD adversely impacting parenting.

CONCLUSIONS

This study provides evidence that aspects of parenting may contribute to the development of OCD among offspring. Prospective studies of children at risk for OCD are needed to explore the direction of causality.

Confidence in memory and other cognitive processes in obsessive–compulsive disorder

Previous studies have implicated beliefs about one's memory (i.e., meta-memory), in maintaining the symptoms of obsessive-compulsive disorder (OCD), particularly with respect to checking rituals. However, most research has focused on task- or situation-specific perceptions about memory performance. Expanding on this research, we undertook two studies with analogue and clinical cohorts to examine the relationship between general 'trait' beliefs about memory and related processes and OCD symptoms. Trait meta-memory as measured in the current study was conceptualised as a multi-dimensional construct encompassing a range of beliefs about memory and related processes including confidence in one's general memory abilities, decision-making abilities, concentration and attention, as well as perfectionistic standards regarding one's memory. Meta-memory factors were associated with OCD symptoms, predicting OCD symptoms over-and-above mood and other OCD-relevant cognitions. Meta-memory factors were found to be particularly relevant to checking symptoms. Implications for theory and research are discussed.

Behavioral inhibition and obsessive-compulsive disorder

Behavioral inhibition is frequently cited as a vulnerability factor for development of anxiety. However, few studies have examined the unique relationship between behavioral inhibition and obsessive-compulsive disorder (OCD). Therefore, the current study addressed the relationship between behavioral inhibition and OCD in a number of ways. In a large unselected student sample, frequency of current OC symptoms was significantly correlated with retrospective self-reports of total levels of childhood behavioral inhibition. In addition, frequency of current OC symptoms was also significantly correlated with both social and nonsocial components of behavioral inhibition. Further, there was evidence for a unique relationship between behavioral inhibition and OC symptoms beyond the relationship of behavioral inhibition and social anxiety. In addition, results showed that reports of childhood levels of behavioral inhibition significantly predicted levels of OCD symptoms in adulthood. Finally, preliminary evidence suggested that behavioral inhibition may be more strongly associated with some types of OC symptoms than others, and that overprotective parenting may moderate the impact of behavioral inhibition on OC symptoms. The current findings suggest the utility of additional research examining the role of behavioral inhibition in the etiology of OCD.

Responsibility and obsessive–compulsive disorder: An experimental test

To test the causal status of responsibility in obsessive-compulsive disorder (OCD), an experiment was executed in which responsibility was experimentally manipulated. OCD patients, non-OCD anxiety controls, and non-patients executed a classification task in either a high or a low responsibility (LoRes) condition. Subjective ratings related to danger and responsibility indicated that the manipulation was successful. Subjective OCD-like experiences and checking behaviors were higher in OCD patients in the high responsibility (HiRes) condition than in all other groups. Although the checking subscale of the Padua Inventory correlated with subjective ratings in the OCD patients in the HiRes condition, it was not associated with checking behaviors. The results confirm the hypothesis that responsibility plays a causal role in OCD.

What are the roles of perfectionism and responsibility in checking and cleaning compulsions?

Empirical findings revealed that an inflated sense of responsibility has a major impact on obsessive-compulsive symptomatology (OCS). Another cognitive variable, perfectionism, is also theoretically linked to OCS. The assumption about the insufficient but necessary role of perfectionism for OCS and the view of perfectionism as a manifestation of avoidance of serious consequences led us to explore the role of an important cognitive mediator (responsibility) in this relationship. The present study aimed to explore the mediational role of responsibility for the effects of perfectionism on checking and cleaning symptom profiles of OCS in a nonclinical population in Turkey. Findings of the present study suggested that responsibility appraisals mediate effects of self-oriented and socially prescribed perfectionism on checking and the effect of socially prescribed perfectionism on cleaning. There was a partial mediation for self-oriented perfectionism on cleaning. The findings are discussed within the scope of current literature and implications for clinical applications are suggested.

The mediating effects of misinterpretation of intrusive thoughts on obsessive-compulsive symptoms

Perfectionism and inflated responsibility have both been identified as risk factors for the development and maintenance of obsessive-compulsive (OC) symptoms. The aim of the present study was to test whether the relationships between these two variables and OC symptoms are mediated by the misinterpretation of intrusive thoughts (MIT). Three hundred and three university students completed the Frost Multidimensional Perfectionism Scale, the Maudsley Obsessional Compulsive Inventory, the Responsibility Attitude Scale, and the Responsibility Interpretations Questionnaire. MIT was found to partially mediate the relationship between responsibility attitudes and OC symptoms. MIT also partially mediated the relationship between concern over mistakes and OC symptoms, even after controlling for responsibility attitudes. Both concern over mistakes and responsibility attitudes were significant predictors of MIT and OC symptoms, but responsibility was the stronger predictor when all of the variables were included in the model. Clinical implications for the treatment of OCD are discussed.

The relationship between obsessive-compulsive symptoms and appraisals of emotional states

A new measure assessing respondents' perceptions of the threat posed by their own emotions (the Perception of Threat from Emotion Questionnaire; the PTEQ) is presented. A range of data relating to the psychometric properties of the PTEQ indicates that it is a reliable measure of people's stable beliefs about their emotions, and is not highly correlated with either mood or measures of responsibility and thought-action fusion. In a student sample, regression analyses indicate that responses to the PTEQ significantly predict responses to a general measure of obsessionality (the Padua Inventory), even when levels of depression and anxiety are controlled for. Moreover, when compared with measures of responsibility and thought-action fusion, the PTEQ emerges as the strongest independent predictor of obsessionality. Of the seven different emotions to which the PTEQ relates, it is found that beliefs about 'anger' are the strongest predictor of obsessionality. Implications of these findings are discussed.

Testing the autogenous-reactive model of obsessions

Two independent studies were conducted to examine the autogenous-reactive subtype model of obsessions [Lee and Kwon, 2003]. Study 1 demonstrated that 30 obsessive-compulsive (OCD) patients' responses to autogenous versus reactive obsessions differed significantly with respect to emotional reactions, cognitive appraisals, and control strategies. Study 2 compared OCD patients whose primary obsessions were of the autogenous subtype (n=13) with OCD patients whose primary obsessions were of the reactive subtype (n=14). Results revealed significant differences between these two groups on several OCD-related domains including OCD symptom profiles, perfectionistic personality features, and dysfunctional beliefs. Theoretical and clinical implications are discussed.

Religiosity and obsessive–compulsive behavior in Israeli Jews

Individual differences in obsessive-compulsive (OC) behavior in various cultures correlate with religiosity. The current paper explored the so far unstudied relationship between religiosity and OC behavior in Israeli Jews. Two studies were conducted. Study 1 focused on the relationship between religiosity and OC behavior in a representative sample of Israeli students. Study 2 focused on religious change and OC behavior in a non-random sample of 31 individuals who had become more religious (the MR group), and 30 individuals who were less religious (the LR group) than their parents. Instruments used were the Maudsley obsessive-compulsive inventory (MOCI), the student religiosity questionnaire, and questions about parental home observance, upbringing, and changes in religiosity. In the first study, no association was found between religiosity and OC behavior. Religiosity was related to some degree to perfectionism and to the parental attitude to upbringing. In the second study, a significant difference was observed between the MR and the LR groups on OC behavior as measured by the MOCI. Conclusion, among Israeli Jews a lot of religious observance is non-reflective, and is not associated with individual differences in personality or OC symptoms. Those who undergo religious change may do so in response to their behavioral propensities. One such path is that the more OC become MR, and the less OC less religiously observant.