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Yang L, Chen D, Zhang X, Huang F, Li Z, Yang X. A comparison of 'not just right experiences' in obsessive-compulsive disorder, anxiety and depressive disorders and non-clinical controls in China. Clin Psychol Psychother 2023. [PMID: 37749937 DOI: 10.1002/cpp.2916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE The aim of this study is to investigate the characteristics of 'not just right experiences' (NJREs) in patients with obsessive-compulsive disorder (OCD), anxiety disorders (ADs) or major depressive disorder (MDD), compared with those of healthy controls (HCs). METHOD One hundred adults with OCD, 86 adults with ADs, 57 adults with MDD and 60 HCs were enrolled in the study. The Not Just Right Experiences Questionnaire Revised (NJRE-QR), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used to evaluate clinical symptoms in patients with OCD, ADs or MDD. The Obsessive Belief Questionnaire-44 (OBQ-44) was used to evaluate OC beliefs in the OCD patients. The HCs only received assessment using the NJRE-QR. Analysis of variance (ANOVA) and covariance (ANCOVA) were performed to compare the NJREs scores across the groups, while Pearson correlation and partial correlation analyses were used to examine the association between NJREs and other clinical features. The contribution of NJREs to predict OC symptoms was determined by multiple stratified linear regression. RESULTS Individuals with OCD had significantly higher scores for the number of NJREs than ADs, but not MDD. The severity of NJREs was also significantly higher in patients with OCD than those with MDD or ADs (F = 5.23 and F = 19.79, respectively, P < 0.01). All the clinical scores in the NJRE-QR were significantly higher than those in the HC group. The number and severity of NJREs correlated significantly with the Y-BOCS total score (r = 0.29 and r = 0.39, respectively, P < 0.01). NJREs showed an independent contribution to OC symptoms, which alone explained 8% of the variation (F = 16.49, ΔR2 = 0.08; P < 0.01). CONCLUSION NJREs are related closely to OC symptoms, with their severity discriminating between OCD patients and those with ADs or MDD. NJREs were more specific for OCD in the Chinese population and are therefore worthy of further study in the future.
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Affiliation(s)
- Lijuan Yang
- Department of Clinical Psychology, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Daning Chen
- Department of Clinical Psychology, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Clinical Psychology Department, Second People's Hospital of Guizhou Province, Guiyang, China
| | - Xiaodong Zhang
- Department of Clinical Psychology, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Fangfang Huang
- Department of Clinical Psychology, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Department of Preventive Medicine, College of Basic Medicine and Forensic Medicine, Henan University of Science and Technology, Henan, China
| | - Zhanjiang Li
- Department of Clinical Psychology, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiangyun Yang
- Department of Clinical Psychology, Beijing Anding Hospital, National Clinical Research Center for Mental Disorders, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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García-Batista ZE, Guerra-Peña K, Alsina-Jurnet I, Cano-Vindel A, Álvarez-Hernández A, Cantisano-Guzmán LM, Bordas-Puras M, Moretti L, Medrano LA. Design and validation of virtual environments for the treatment of cleaning obsessive-compulsive disorder. Heliyon 2022; 8:e12487. [PMID: 36575692 PMCID: PMC9780645 DOI: 10.1016/j.heliyon.2022.e12487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 04/22/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022] Open
Abstract
During the coronavirus outbreak, it was noted that pre-existing psychological illnesses worsened, and numerous research indicate that those with contamination-related obsessions and cleaning compulsions (C-OCD) may be more affected. Virtual Reality (VR) and other immersive technologies have shown to be effective for the treatment of disorders related to anxiety, thus showing their potential to transform OCD treatment by means of integrating virtual elements. VR exposure has shown benefits compared to live or imagined exposure, however, to be effective it must be able to elicit high emotional arousal in users. Based on this, the present work aimed to develop different virtual environments scenarios and evaluate their efficacy in generating an emotional response in people with C-OCD symptoms. Based on the literature review, two virtual scenarios were created (dirty public bathroom and unhygienic kitchen). Subsequently, two groups were then constituted: C-OCD group (n = 20, aged between 18 and 48 years) characterized by an obtained score of more than 13 points (cut-point) in the Yale-Brown Scale for Obsessive-Compulsive Disorder (Y-BOCS) and by showing C-OCD symptoms when doing the structured interview (SCID-I), and a control group (n = 20, aged between 18 and 56 years), all participants were residents of the Dominican Republic. Exposure to the virtual environments generated high levels of state and subjective anxiety in both groups, although significantly higher in the C-OCD group. The results obtained indicate that the VR scenarios developed are suitable for eliciting emotional responses and, consequently, that they can be used to complement the treatment of C-OCD.
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Affiliation(s)
- Zoilo Emilio García-Batista
- Pontificia Universidad Católica Madre y Maestra (PUCMM), 1 ½ Autopista Duarte Av., Santiago de los Caballeros, Santiago 51000, Dominican Republic
- Corresponding author.
| | - Kiero Guerra-Peña
- Pontificia Universidad Católica Madre y Maestra (PUCMM), 1 ½ Autopista Duarte Av., Santiago de los Caballeros, Santiago 51000, Dominican Republic
| | - Ivan Alsina-Jurnet
- Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Sagrada Família, 7. Vic, 08500 Catalunya, Spain
| | | | - Adriana Álvarez-Hernández
- Pontificia Universidad Católica Madre y Maestra (PUCMM), 1 ½ Autopista Duarte Av., Santiago de los Caballeros, Santiago 51000, Dominican Republic
| | - Luisa Marilia Cantisano-Guzmán
- Pontificia Universidad Católica Madre y Maestra (PUCMM), 1 ½ Autopista Duarte Av., Santiago de los Caballeros, Santiago 51000, Dominican Republic
| | - Marlia Bordas-Puras
- Pontificia Universidad Católica Madre y Maestra (PUCMM), 1 ½ Autopista Duarte Av., Santiago de los Caballeros, Santiago 51000, Dominican Republic
| | - Luciana Moretti
- Pontificia Universidad Católica Madre y Maestra (PUCMM), 1 ½ Autopista Duarte Av., Santiago de los Caballeros, Santiago 51000, Dominican Republic
- Universidad Siglo 21, Calle de los Latinos, 8555 Córdoba, Argentina
| | - Leonardo Adrián Medrano
- Pontificia Universidad Católica Madre y Maestra (PUCMM), 1 ½ Autopista Duarte Av., Santiago de los Caballeros, Santiago 51000, Dominican Republic
- Universidad Siglo 21, Calle de los Latinos, 8555 Córdoba, Argentina
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Ferrante D, D'Olimpio F. Who guards over obsessive fear of guilt? The case of Not Just Right Experiences and disgust. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Shephard E, Stern ER, van den Heuvel OA, Costa DL, Batistuzzo MC, Godoy PB, Lopes AC, Brunoni AR, Hoexter MQ, Shavitt RG, Reddy JY, Lochner C, Stein DJ, Simpson HB, Miguel EC. Toward a neurocircuit-based taxonomy to guide treatment of obsessive-compulsive disorder. Mol Psychiatry 2021; 26:4583-4604. [PMID: 33414496 PMCID: PMC8260628 DOI: 10.1038/s41380-020-01007-8] [Citation(s) in RCA: 85] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 12/11/2022]
Abstract
An important challenge in mental health research is to translate findings from cognitive neuroscience and neuroimaging research into effective treatments that target the neurobiological alterations involved in psychiatric symptoms. To address this challenge, in this review we propose a heuristic neurocircuit-based taxonomy to guide the treatment of obsessive-compulsive disorder (OCD). We do this by integrating information from several sources. First, we provide case vignettes in which patients with OCD describe their symptoms and discuss different clinical profiles in the phenotypic expression of the condition. Second, we link variations in these clinical profiles to underlying neurocircuit dysfunctions, drawing on findings from neuropsychological and neuroimaging studies in OCD. Third, we consider behavioral, pharmacological, and neuromodulatory treatments that could target those specific neurocircuit dysfunctions. Finally, we suggest methods of testing this neurocircuit-based taxonomy as well as important limitations to this approach that should be considered in future research.
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Affiliation(s)
- Elizabeth Shephard
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil. .,Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.
| | - Emily R. Stern
- Department of Psychiatry, The New York University School of Medicine, New York, USA.,Nathan Kline Institute for Psychiatric Research, Orangeburg, New York, USA
| | - Odile A. van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy & Neurosciences, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Daniel L.C. Costa
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo C. Batistuzzo
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Priscilla B.G. Godoy
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Antonio C. Lopes
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Andre R. Brunoni
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo Q. Hoexter
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Roseli G. Shavitt
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Janardhan Y.C Reddy
- Department of Psychiatry OCD Clinic, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | - Christine Lochner
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Dan J. Stein
- SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - H. Blair Simpson
- Center for OCD and Related Disorders, New York State Psychiatric Institute and the Department of Psychiatry, Columbia University Irving Medical Center, New York New York
| | - Euripedes C. Miguel
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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Mathes BM, Day TN, Wilver NL, Redden SA, Cougle JR. Indices of change in exposure and response prevention for contamination-based OCD. Behav Res Ther 2020; 133:103707. [PMID: 32758679 DOI: 10.1016/j.brat.2020.103707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 06/04/2020] [Accepted: 07/29/2020] [Indexed: 01/29/2023]
Abstract
Few studies have examined indices of change in treatment for obsessive compulsive disorder (OCD). The current study evaluated within- and between-session trajectories of fear, disgust, and urge to wash in exposure and response prevention (ERP) for contamination-based OCD and tested whether change in these indices were associated with treatment outcomes. Forty-one participants (75.6% female) engaged in three sessions of ERP for contamination OCD. Participants provided ratings of fear, disgust, and urge to wash during each session, and contamination symptoms were assessed at pre- and post-treatment and two-week follow-up. Fear, disgust, and urge to wash all significantly decreased both within and between sessions. Both fear and disgust declined significantly faster than urge to wash within session, though declines in fear and disgust did not significantly differ from each other. Within-session changes in fear were significantly associated with reduced symptoms at post-treatment, whereas within-session changes in disgust were associated with symptoms at two-week follow-up. The current study highlights the roles of fear and disgust in the context of ERP as unique indicators of treatment outcome for contamination-based OCD. Only within-session fear was uniquely associated with treatment outcome at post, while within-session disgust predicted outcome at follow-up. Theoretical and clinical implications are discussed.
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Affiliation(s)
- Brittany M Mathes
- Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA
| | - Taylor N Day
- Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA
| | - Natalie L Wilver
- Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA
| | - Sarah A Redden
- Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA
| | - Jesse R Cougle
- Florida State University, 1107 West Call Street, Tallahassee, FL, 32304, USA.
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Cervin M, Perrin S, Olsson E, Claesdotter-Knutsson E, Lindvall M. Incompleteness, harm avoidance, and disgust: A comparison of youth with OCD, anxiety disorders, and no psychiatric disorder. J Anxiety Disord 2020; 69:102175. [PMID: 31896022 DOI: 10.1016/j.janxdis.2019.102175] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 11/12/2019] [Accepted: 12/16/2019] [Indexed: 11/24/2022]
Abstract
Psychological models of pediatric obsessive-compulsive disorder (OCD) place a heavy emphasis on harm avoidance as a maintaining factor and target for treatment. Incompleteness and disgust may also play a role in pediatric OCD but remain understudied. Youth with OCD (n = 100), anxiety disorders (n = 96), and no impairing psychiatric symptoms (n = 25) completed self-report measures of trait-level incompleteness, harm avoidance, and disgust and current symptoms of OCD, anxiety, and depression. Group differences and associations between emotions, symptoms, and pre- to post-treatment change in overall OCD severity were examined. Youth with OCD and anxiety disorders scored higher on harm avoidance and disgust than youth with no psychiatric disorder. Youth with OCD scored higher on incompleteness than youth with anxiety disorders and youth with no psychiatric disorder. Harm avoidance showed unique associations to self-reported symptoms of OCD, anxiety, and depression while incompleteness was uniquely related to OCD and disgust to anxiety. Within the OCD sample, incompleteness and harm avoidance were differentially related to the major OCD symptom dimensions, and change in incompleteness was uniquely related to pre- to post-treatment change in OCD severity. Trait-level incompleteness appears to play a central role in pediatric OCD and studies investigating its direct involvement in symptoms and associations with treatment outcome are needed. The role of disgust in relation to pediatric OCD remains unclear.
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Affiliation(s)
- Matti Cervin
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund, Sweden; Skåne Child and Adolescent Psychiatry, Lund, Sweden.
| | - Sean Perrin
- Lund University, Department of Psychology, Lund, Sweden
| | - Elin Olsson
- Skåne Child and Adolescent Psychiatry, Lund, Sweden
| | - Emma Claesdotter-Knutsson
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund, Sweden; Skåne Child and Adolescent Psychiatry, Lund, Sweden
| | - Magnus Lindvall
- Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund, Sweden; Skåne Child and Adolescent Psychiatry, Lund, Sweden
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Sica C, Caudek C, Belloch A, Bottesi G, Ghisi M, Melli G, García-Soriano G, Olatunji BO. Not Just Right Experiences, Disgust Proneness and Their Associations to Obsessive–Compulsive Symptoms: A Stringent Test with Structural Equation Modeling Analysis. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10029-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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