J Obsessive Compuls Relat Disord [JOURNAL]
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109 papers
Intolerance of uncertainty as a factor linking obsessive-compulsive symptoms, health anxiety and concerns about the spread of the novel coronavirus (COVID-19) in the United States.
Wheaton MG, Messner GR, Marks JB
J Obsessive Compuls Relat Disord · 2021 Jan · PMID 33251098 · Full text
The novel coronavirus disease (COVID-19) has had a significant impact on public health, economic activity, and mental health as it spread across the globe. Research from past pandemics links excessive anxiety about illne...
The novel coronavirus disease (COVID-19) has had a significant impact on public health, economic activity, and mental health as it spread across the globe. Research from past pandemics links excessive anxiety about illness-related threats with symptoms of health anxiety and obsessive-compulsive disorder (OCD). In the present study, we investigated whether intolerance of uncertainty (IU), a psychological vulnerability factor involved in both OCD and health anxiety, accounts for a portion of the relationship between these symptoms and fear of COVID-19 during the early stages of the outbreak in the Unites States. We administered measures of concern about the spread of COVID-19 (Coronavirus Threat Scale; CTS), health anxiety, and OCD symptoms to a large sample of community adults in the United States (n = 738) recruited through Amazon MTurk. Results revealed that concern about COVID-19 was moderately and positively correlated with both OCD and health anxiety symptoms, as well as IU. Moreover, regression analyses found that IU partially accounted for the connections between concern about the spread of COVID-19 and OCD and health anxiety symptoms. These results highlight IU as a potential mechanism connecting OCD and health anxiety to anxiety about pandemic threats. Clinical implications, limitations, and future directions for research are discussed.
Dimensions of interoception in obsessive-compulsive disorder.
Eng GK, Collins KA, Brown C … +4 more , Ludlow M, Tobe RH, Iosifescu DV, Stern ER
J Obsessive Compuls Relat Disord · 2020 Oct · PMID 33194538 · Full text
Interoceptive sensibility (IS) refers to the subjective experience of perceiving and being aware of one's internal body sensations, and is typically evaluated using self-report questionnaires or confidence ratings. Here...
Interoceptive sensibility (IS) refers to the subjective experience of perceiving and being aware of one's internal body sensations, and is typically evaluated using self-report questionnaires or confidence ratings. Here we evaluated IS in 81 patients with OCD and 76 controls using the Multidimensional Scale of Interoceptive Awareness (MAIA), which contains 8 subscales assessing adaptive and maladaptive responses to sensation. Compared to controls, OCD patients showed hyperawareness of body sensations. Patients also demonstrated a more maladaptive profile of IS characterized by greater distraction from and worry about unpleasant sensations, and reduced tendency to experience the body as safe and trustworthy. These findings were independent of medication status and comorbidities in the patient group. Correlational analyses showed that subscales of the MAIA were differentially associated with OCD symptom dimensions. These findings indicate that patients with OCD show abnormality of IS that is independent of confounding factors related to medication and comorbidities and associated with different OCD symptom dimensions. Future work would benefit from examining neural correlates of these effects and evaluating whether dimensions of IS are impacted by treatments for the disorder.
Symptom Trajectories of Early Responders and Remitters among Youth with OCD.
Rech M, Weinzimmer S, Geller D … +9 more , McGuire JF, Schneider SC, Patyk KC, De Nadai AS, Cepeda SC, Small BJ, Murphy TK, Wilhelm S, Storch EA
J Obsessive Compuls Relat Disord · 2020 Oct · PMID 35990243 · Full text
OBJECTIVES: This study examined the phenomenology and predictors of early response and remission among youth with obsessive-compulsive disorder (OCD) receiving cognitive-behavioral therapy (CBT). METHODS: One hundred and...
OBJECTIVES: This study examined the phenomenology and predictors of early response and remission among youth with obsessive-compulsive disorder (OCD) receiving cognitive-behavioral therapy (CBT). METHODS: One hundred and thirty-nine youth with a current primary diagnosis of OCD participated in this study. Participants received 10 sessions of CBT augmented by either placebo or d-cycloserine (DCS) as part of a randomized double-blind multi-site clinical trial. Early response and remission status were determined by clinician-rated global symptom improvement (CGI-I) and severity (CGI-S), respectively. RESULTS: At the mid-treatment assessment, 45.3% of youth were early responders, and 28.1% were early remitters. At post-treatment assessment, 79.1% of youth were responders and 67.6% were remitters. Early response predicted a higher likelihood of post-treatment response and remission; early remission significantly predicted a higher likelihood of post-treatment remission. Bivariate logistic regressions showed that early response was predicted by lower baseline clinician-rated global severity (CGI-S) and lower depression severity; however, only depression severity remained a significant predictor in the multivariable logistic regression model. Furthermore, bivariate logistic regressions showed that early remission was predicted by lower baseline clinician-rated global severity (CGI-S), lower depression severity, and lower obsessive-compulsive symptom severity (CY-BOCS); however, only global severity remained a significant predictor in the multivariable logistic regression model. CONCLUSIONS: Lower OCD and depression symptom severity predicted a greater likelihood of early treatment response and remission to CBT. Findings suggest that low OCD and depression symptom severity could serve as baseline characteristics to identify potential candidates for lower-intensity initial interventions in a stepped care approach. The modest predictive value of the variables examined suggests that additional factors could add to prediction of treatment response and remission.
The latent structure of olfactory reference disorder symptoms: A taxometric analysis.
Ren F, Zhou R, Zhou X … +2 more , Schneider SC, Storch EA
J Obsessive Compuls Relat Disord · 2020 Oct · PMID 32901218 · Full text
Olfactory reference disorder (ORD), a newly included disorder in the ICD-11, is characterized by 'pathological' concerns about emitting body odor. While research is emerging on the construct, no study has directly examin...
Olfactory reference disorder (ORD), a newly included disorder in the ICD-11, is characterized by 'pathological' concerns about emitting body odor. While research is emerging on the construct, no study has directly examined the boundary between ORD and normal body odor concerns. That is, should ORD be considered as categorical in nature versus a more dimensional construct? As such, the current study explored the extent to which ORD symptoms correspond to a distinct category or dimension in a mixed university student and community sample (n = 757). Three indicators, derived from the Yale-Brown Obsessive Compulsive Scale Modified for Olfactory Reference Syndrome, were submitted to three independent taxometric procedures: MAMBAC, MAXEIG, and L-Mode. Two of three procedures showed that the latent structure of ORD is dimensional rather than categorical. The comparison curve fit index profile method yielded dimensional structure. Results suggested that researchers and clinical practitioners would be well-advised to conceptualize, assess, and treat ORD symptoms in a dimensional way.
COVID-19, obsessive-compulsive disorder and invisible life forms that threaten the self.
Aardema F
J Obsessive Compuls Relat Disord · 2020 Jul · PMID 32834943 · Full text
This communication explores unique characteristics of obsessive-compulsive disorder (OCD) in the context of the current coronavirus pandemic. When do irrational fears of contamination as seen in OCD start to diverge from...
This communication explores unique characteristics of obsessive-compulsive disorder (OCD) in the context of the current coronavirus pandemic. When do irrational fears of contamination as seen in OCD start to diverge from rational fears and behaviors? The current paper argues that the personal meaning attributed to viruses and germs, including their personification as entities that possess human-like characteristics, allows them to threaten and violate an individual's identity. Specifically, it suggests that fears of contamination become obsessional when the threat of viruses and germs becomes personal, not solely in terms of its objective outcomes, but in how these life forms are able to threaten the self as the result of a fear of corruption characterizing those with OCD. The person with OCD may act as if, or believe that they are acting upon reality when they fear contagion, but are in effect only acting upon an underlying fear of inner corruption that is confused with reality itself. The current paper concludes with some clinical recommendations on how to treat obsessional fears of contamination in the context of the current pandemic.
Don't Tell Me What to Think: Comparing Self- and Other-Generated Distraction Methods for Controlling Intrusive Thinking.
Magee JC, Dreyer-Oren SE, Sarfan LD … +2 more , Teachman BA, Clerkin EM
J Obsessive Compuls Relat Disord · 2019 Oct · PMID 32832375 · Full text
Cognitive control is central to the phenomenon of intrusive thinking in obsessive-compulsive and related disorders. The current study tested how attempts at cognitive control are impacted by self- vs. other-generated dis...
Cognitive control is central to the phenomenon of intrusive thinking in obsessive-compulsive and related disorders. The current study tested how attempts at cognitive control are impacted by self- vs. other-generated distractor thoughts. Participants (=1913) were randomly assigned to suppress or monitor an intrusive thought and also randomly assigned to: a) self-generate a distractor, b) receive a distractor, or c) receive no distractor guidance. Participants reported subsequent thought recurrences, perceived success and effort keeping the thought out of mind, and positive and negative affect during a one-minute thinking period and a one-minute monitoring period. During the first thinking period only, self-generated distractors resulted in greater perceived control (<.001; during monitoring instructions only) relative to no guidance, and less effort (s<.001) relative to both other conditions. Interestingly, self-generated distractors led to longer duration of recurrences relative to both other conditions (s≤.007). Finally, there were no distractor differences in trajectories of positive and negative affect (s>.10). These findings suggest that the source of distractors may inform when attempts to control intrusive thinking will be helpful versus harmful.
Perceived emotion regulation and emotional distress tolerance in patients with hoarding disorder.
Worden B, Levy HC, Das A … +3 more , Katz BW, Stevens M, Tolin DF
J Obsessive Compuls Relat Disord · 2019 Jul · PMID 32818134 · Full text
Emotional distress tolerance (EDT) and emotion regulation (ER) appear to be highly relevant to hoarding pathology, as excessive saving and/or acquiring may be motivated by emotional avoidance or other attempts to regulat...
Emotional distress tolerance (EDT) and emotion regulation (ER) appear to be highly relevant to hoarding pathology, as excessive saving and/or acquiring may be motivated by emotional avoidance or other attempts to regulate negative affect. While findings with nonclinical samples have suggested and EDT/ER predicts hoarding symptoms, there is little data on clinical samples. The aim of the current study was to examine several self-report measures of EDT and ER in individuals with HD ( = 87) and age-matched nonclinical controls ( = 46), and to explore whether this was predictive of treatment compliance and/or outcome in group CBT for HD. Results suggested that, the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004) total score, DERS goals and awareness subscales, and Intolerance of Uncertainty Scale (IUS; Buhr & Dugas, 2002) were predictive of hoarding severity. However, EDT/ER did not change with treatment, did not mediate treatment outcome, and did not predicted treatment retention, compliance, or outcome. Results suggest that some EDT/ER constructs, such as uncertainty intolerance, difficulty persisting in goal behaviors when upset, and low emotional awareness, may explain significant variance in HD symptoms, although they did not appear to be mechanisms of change in CBT for HD.
Resting-State Functional Connectivity of Supplementary Motor Area Associated with Skin-Picking Symptom Severity.
Huggins AA, Harvey AM, Miskovich TA … +2 more , Lee HJ, Larson CL
J Obsessive Compuls Relat Disord · 2020 Jul · PMID 34650904 · Full text
Pathological skin picking (excoriation) is a relatively common disorder. Although it has been hypothesized to share a similar pathophysiological basis as other obsessive-compulsive (OC) spectrum disorders, to date, littl...
Pathological skin picking (excoriation) is a relatively common disorder. Although it has been hypothesized to share a similar pathophysiological basis as other obsessive-compulsive (OC) spectrum disorders, to date, little work has specifically examined the precise neurobiological mechanisms involved in excoriation. Disruption in functional circuits involving the right inferior frontal gyrus (rIFG) and supplementary motor area (SMA) may be particularly relevant to skin-picking pathology as these regions have been implicated in other OC-spectrum disorders for their roles in response inhibition and voluntary motor action, respectively. To this end, the present study examined the associations between skin-picking symptom severity and resting-state functional connectivity of the rIFG and bilateral SMA. Participants endorsing elevated symptoms of excoriation completed a self-report measure of symptom severity and resting-state functional magnetic resonance imaging scan. Results indicated that symptom severity was associated with weaker connectivity between the SMA and clusters within the orbitofrontal cortex and angular gyrus. Contrary to hypotheses, there were no effects of symptom severity on functional connectivity of the rIFG. Overall, these findings suggest that skin-picking symptom severity may be associated with disruption in higher-order motor networks contributing to deficits in top-down regulation of motor behavior.
Towards a Clinically Valid Mechanistic Assessment of Exposure and Response Prevention: Preliminary Utility of an Exposure Learning Tool for Children with OCD.
Kuckertz JM, Piacentini J, Amir N
J Obsessive Compuls Relat Disord · 2020 Apr · PMID 32500008 · Full text
Despite advances in understanding mechanisms underlying fear processes, there remains a significant gap between insights produced via laboratory assessment and concrete tools for harnessing these insights in clinical pra...
Despite advances in understanding mechanisms underlying fear processes, there remains a significant gap between insights produced via laboratory assessment and concrete tools for harnessing these insights in clinical practice. In addressing this gap, researchers would ideally introduce tools that are feasible for patients in clinical practice, easily disseminated to practitioners, and clinically useful. We present pilot data on the Exposure Experience Questionnaire (EEQ), a brief measure designed to assess exposure learning mechanisms. Ten children (ages 8-15) with a primary diagnosis of obsessive-compulsive disorder (OCD) underwent exposure and response prevention in which they completed weekly exposures in clinic and at home. During each exposure, children completed an exposure practice form which included the EEQ. Results suggest the preliminary feasibility and internal consistency of this measure, with comparable utility in clinic and home settings. The EEQ was associated in the expected direction with slope of OCD symptoms, such that greater exposure learning in both clinic and homework exposures predicted improved outcome. Although limited by small sample size, these data support the continued research on the feasibility and utility of the EEQ and suggest that quantifying learning processes following exposure may be a useful addition to mechanistic research in OCD.
The role of ethnic identity in OC symptom dimensions among Asian Americans.
Ching THW, Williams MT
J Obsessive Compuls Relat Disord · 2019 Apr · PMID 32377506 · Full text
Little is known about obsessive-compulsive (OC) symptoms in Asian Americans. Past research has shown elevations in certain symptom dimensions when compared with White Americans, but there have not been any studies on cul...
Little is known about obsessive-compulsive (OC) symptoms in Asian Americans. Past research has shown elevations in certain symptom dimensions when compared with White Americans, but there have not been any studies on cultural mechanisms for these differences. In this study, we examined whether ethnic identity mediated differences in severity of various OC symptom dimensions between Asian and White Americans. A total of 453 participants (79 Asian American, 374 non-Hispanic White) completed measures of ethnic identity and OC symptoms. Separate boostrapped mediation analyses were conducted to determine the indirect (i.e., mediation) effect of ethnoracial group membership on different OC symptom dimensions, via ethnic identity. There was significant evidence of mediation across the majority of OC subscales examined. Asian Americans reported stronger ethnic identity than their White counterparts, which in turn predicted more severe contamination obsessions and washing compulsions, harm-related intrusions, checking, neutralizing, as well as symmetry/ordering symptoms. This study is the first to demonstrate an exacerbating function of ethnic identity for OC symptoms among Asian Americans, contrary to some previous evidence of its protective role for overall mental health among ethnoracial minorities. More research is needed to test and validate hypotheses about why ethnic identity mediated group differences in OC symptoms.
Animal models of OCD-relevant processes: an RDoC perspective.
Pittenger C, Pushkarskaya H, Gruner P
J Obsessive Compuls Relat Disord · 2019 Oct · PMID 32322462 · Full text
Animal models have been invaluable tools in deciphering pathophysiology in many branches of medicine. Their application in the study of complex neuropsychiatric conditions such as obsessive-compulsive disorder (OCD), how...
Animal models have been invaluable tools in deciphering pathophysiology in many branches of medicine. Their application in the study of complex neuropsychiatric conditions such as obsessive-compulsive disorder (OCD), however, raises vexing interpretative challenges. The Research Domain Criteria (RDoC) approach of identifying dimensions of function and dysfunction that cut across syndromic diagnoses provides one potential path forward. We review some of the domains in the current RDoC matrix that may inform our understanding of patients with obsessions and compulsions, and how work in animal model systems is helping us to understand them. We focus on three specific RDoC constructs that may be particularly informative for our understanding of OCD: potential threat, habit, and cognitive control. In each case we review selected recent studies in animal models and their potential contribution to our understanding of OCD, and suggest directions for future research, informed by the animal studies. Such mechanistic work in animal models, in parallel with clinical studies refining our understanding of the relationship between these dimensional constructs and the symptomatology of particular groups of patients, may over time help us to generate a more comprehensive understanding of the pathogenesis and complexity of obsessions and compulsions.
A Network Analysis of Hoarding Symptoms, Saving and Acquiring Motives, and Comorbidity.
Timpano KR, Bainter SA, Goodman ZT … +3 more , Tolin DF, Steketee G, Frost RO
J Obsessive Compuls Relat Disord · 2020 Apr · PMID 36212770 · Full text
Hoarding disorder is marked by strong attachments to everyday objects, extreme difficulties discarding, and impairing levels of clutter. We examined the associations between hoarding symptoms and associated clinical feat...
Hoarding disorder is marked by strong attachments to everyday objects, extreme difficulties discarding, and impairing levels of clutter. We examined the associations between hoarding symptoms and associated clinical features using network analysis in a large sample of individuals with established hoarding disorder (n=217) and matched healthy controls (n=130). Network nodes included the three core features of hoarding (difficulties discarding, clutter, and acquiring), along with comorbid symptoms, impairment, and saving and acquiring motives. Models showed hoarding and comorbid symptoms as separate syndromes. Healthy and patient networks differed significantly in both global network strength and structure. For the hoarding patient network, the comorbidity and hoarding clusters were connected by acquiring and anxiety, which served as bridge symptoms. Clutter was the only hoarding node associated with impairment. Hoarding beliefs were not central to the model, and only difficulties discarding was associated with saving and acquiring motives, including emotional attachment and wastefulness beliefs. Our findings indicate that the network approach to mental disorders provides a new and complementary way to improve our understanding of the etiological model of hoarding, and may present novel hypotheses to examine in treatment development research.
Clinician-reported barriers to using exposure with response prevention in the treatment of paediatric obsessive-compulsive disorder.
Keleher J, Jassi A, Krebs G
J Obsessive Compuls Relat Disord · 2020 Jan · PMID 32140386 · Full text
Exposure techniques are underutilised in the treatment of anxiety disorders in routine practice, but little is known about the use of exposure with response prevention (ERP) for OCD, particularly in youth. The current st...
Exposure techniques are underutilised in the treatment of anxiety disorders in routine practice, but little is known about the use of exposure with response prevention (ERP) for OCD, particularly in youth. The current study aimed to examine the utilisation of ERP for paediatric OCD via an anonymous online survey completed by clinicians ( = 107). Specifically, we explored the association of clinician characteristics and OCD symptom subtypes with ERP use, as well as clinician-reported barriers to ERP implementation. The majority of clinicians reported commonly using ERP when treating youth with OCD, and rates of ERP use were highest among clinical psychologists. Clinician-held negative beliefs about exposure were significantly associated with lower ERP use. Additionally, clinicians reported being less likely to use ERP to treat hoarding symptoms and taboo obsessions, compared to other OCD symptom subtypes. The most commonly endorsed barriers to successful ERP implementation were aspects of the phenomenology of OCD (e.g. covert compulsions, frequently changing rituals) as opposed to general barriers (e.g. insufficient time during sessions). Overall, our findings suggest that OCD presents unique challenges for clinicians delivering exposure-based therapy. Training should address these OCD-specific obstacles in order to promote dissemination of ERP for youth with OCD.
Pediatric OCD in the era of RDoC.
Garnaat SL, Conelea CA, McLaughlin NCR … +1 more , Benito K
J Obsessive Compuls Relat Disord · 2019 Oct · PMID 32042574 · Full text
The NIMH Research Domain Criteria (RDoC) initiative was established with the goal of developing an alternative research classification to further research efforts in mental health. While RDoC acknowledges that constructs...
The NIMH Research Domain Criteria (RDoC) initiative was established with the goal of developing an alternative research classification to further research efforts in mental health. While RDoC acknowledges that constructs should be considered within a developmental framework, developmental considerations have not yet been well integrated within the existing RDoC matrix. In this paper, we consider RDoC in relation to pediatric OCD, a paradigmatic example of a neuropsychiatric disorder that often has onset in childhood but is also present across the lifespan. We discuss three RDoC subdomains with relevance to OCD as exemplars, providing for each construct a brief review of normative developmental changes, the state of construct-relevant research in pediatric OCD, and challenges and limitations related to developmental considerations within each subdomain. Finally, we conclude with a brief discussion of how RDoC may continue to evolve with regard to developmental considerations in order to further research in pediatric OCD.
Quality of Life in Patients with Hoarding Disorder.
Tolin DF, Das A, Hallion LS … +3 more , Levy HC, Wootton BM, Stevens MC
J Obsessive Compuls Relat Disord · 2019 Apr · PMID 31595215 · Full text
The aim of this study was to investigate health-related quality of life (QoL) in patients with hoarding disorder (HD). Fifty-four patients with a primary diagnosis of HD, and 24 age- and sex-matched healthy control (HC)...
The aim of this study was to investigate health-related quality of life (QoL) in patients with hoarding disorder (HD). Fifty-four patients with a primary diagnosis of HD, and 24 age- and sex-matched healthy control (HC) participants, completed a battery of questionnaires including the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), Saving Inventory-Revised, and Depression, Anxiety, Stress Scales. Compared to HC participants, those with HD reported poorer health-related QoL across all domains of the SF-36. When controlling for comorbid affective symptoms, HD participants scored lower than did HC participants in the QoL domains of social functioning, emotional well-being, role limitations due to emotional problems, vitality, and general health. HD symptom severity predicted, beyond the effects of affective symptoms, lower QoL in social functioning, emotional well-being, role limitations due to emotional problems, vitality, and general health.
Is perfectionism a risk factor for adolescent body dysmorphic symptoms? Evidence for a prospective association.
Krebs G, Quinn R, Jassi A
J Obsessive Compuls Relat Disord · 2019 Jul · PMID 31534902 · Full text
The current study tested the hypothesis that perfectionism is a risk factor for the development of body dysmorphic disorder (BDD), as proposed by prevailing cognitive behavioural models. School students aged 14-16 years...
The current study tested the hypothesis that perfectionism is a risk factor for the development of body dysmorphic disorder (BDD), as proposed by prevailing cognitive behavioural models. School students aged 14-16 years completed questionnaires 6 months apart (Time 1: = 302; Time 2: = 68) assessing perfectionism, BDD symptoms, and anxiety and depression. Robust regression models tested concurrent and prospective associations between perfectionism and BDD symptoms, with and without adjustment for coexisting anxiety and depression. Total perfectionism was positively associated with concurrent BDD symptoms, even when controlling for coexisting anxiety and depression. Moreover, total perfectionism predicted changes in BDD symptoms between Time 1 and Time 2. Examination of perfectionism subscales indicated that only self-oriented perfectionism, not socially-prescribed perfectionism, predicted BDD symptoms concurrently and prospectively while controlling for coexisting psychopathology. This study provides preliminary evidence for self-oriented perfectionism being a risk factor for the development of BDD in youth. If replicated, these findings could highlight the potential value of targeting self-oriented perfectionism in prevention and early intervention programs for BDD.
Disgust sensitivity mediates the effects of race on contamination aversion.
George JR, Pittenger C, Kelmendi B … +2 more , Lohr JM, Adams TG
J Obsessive Compuls Relat Disord · 2018 Oct · PMID 31341759 · Full text
African Americans report greater contamination aversion than European Americans. Few studies have attempted to identify potential causes for this elevated contamination aversion, though existing research and theory sugge...
African Americans report greater contamination aversion than European Americans. Few studies have attempted to identify potential causes for this elevated contamination aversion, though existing research and theory suggests this may be partly due to concomitant heightened disgust sensitivity. The present study examined the relations between race, disgust sensitivity, and contamination aversion among African and European Americans. A convenience sample of fourhundred and twenty-nine participants completed the Disgust Scale - Revised (DS-R) and the Padua Inventory - Revised (PI-R). African Americans endorsed greater disgust sensitivity (DS-R total) - particularly on the core and contamination subscales of the DS-R - and scored higher on the contamination subscale of the PI-R (but not on other subscales) than European Americans. Mediational analyses revealed a significant total effect of race on contamination aversion and a significant indirect effect of race on contamination aversion through disgust sensitivity; the direct effect of race on contamination aversion remained significant even after controlling for race. These findings suggest that elevated contamination aversions among African Americans may be partly due to elevated disgust sensitivity. If confirmed with larger and clinical samples, and more robust experimental methods, this relationship may prove to have implications for the treatment of contamination-based obsessive-compulsive disorder (OCD) among African Americans.
Intolerance of uncertainty in hoarding disorder.
Castriotta N, Dozier ME, Taylor CT … +2 more , Mayes T, Ayers CR
J Obsessive Compuls Relat Disord · 2019 Apr · PMID 32670782 · Full text
BACKGROUND: Intolerance of uncertainty (IU) has been proposed as a transdiagnostic risk and maintenance factor underlying various forms of psychopathology. Few studies, however, have examined IU in hoarding disorder (HD)...
BACKGROUND: Intolerance of uncertainty (IU) has been proposed as a transdiagnostic risk and maintenance factor underlying various forms of psychopathology. Few studies, however, have examined IU in hoarding disorder (HD)-a condition characterized by excessive urges to acquire and difficulties discarding possessions-core symptoms that may be fueled by inflated IU. We examined cross-sectional relationships between IU and different symptom facets of HD, controlling for anxiety and depression severity, and explored whether pre-treatment levels of IU predicted response to exposure-based treatment for HD. METHOD: Fifty-seven individuals seeking treatment for HD completed baseline measures of hoarding symptoms, IU, anxiety and depression. Participants then completed 26 sessions of group exposure-based treatment for HD with or without compensatory cognitive training. Hoarding symptoms were assessed following the final treatment session to index treatment response. RESULTS: IU was positively and significantly associated with greater urges to acquire and greater difficulties discarding possessions, beyond shared variance accounted for by anxiety and depression. IU was not significantly related to clutter symptom severity. Higher pre-treatment IU predicted increased odds of treatment non-response. CONCLUSIONS: Elevated IU is associated with specific hoarding symptom clusters and may be an important target for HD treatment.
Predictors of treatment outcome and attrition in adults with hoarding disorder.
Ayers CR, Pittman JOE, Davidson EJ … +3 more , Dozier ME, Mayes TL, Almklov E
J Obsessive Compuls Relat Disord · 2018 Aug · PMID 32670783 · Full text
While a number of hoarding disorder-specific therapeutic interventions have been developed over recent years, hoarding disorder (HD) remains difficult to treat. The purpose of this investigation is to inform HD treatment...
While a number of hoarding disorder-specific therapeutic interventions have been developed over recent years, hoarding disorder (HD) remains difficult to treat. The purpose of this investigation is to inform HD treatment efforts by examining factors that influence treatment attrition and treatment response. Secondary data analysis of baseline and post-treatment data from two previously published psychotherapy treatment studies for hoarding were performed to identify predictors of hoarding symptom improvement and treatment attrition in 106 adults with HD. No demographic variables were associated with symptom improvement or treatment attrition. However, higher levels of avoidant coping (i.e., self-distraction combined with behavioral disengagement) significantly predicted symptom improvement. The maintenance stage of change along with high readiness for change also significantly predicted symptom improvement. Participants who dropped from treatment had significantly higher baseline levels of denial and clutter, both of which independently predicted treatment attrition. The findings from this study suggest that emotion-related constructs, such as managing stress and motivation for change, may play an important role in patients' response to and participation in HD treatment.
Demographic and health-related correlates of obsessive-compulsive symptoms among African Americans.
Williams MT, Taylor RJ, Himle JA … +1 more , Chatters LM
J Obsessive Compuls Relat Disord · 2017 Jul · PMID 30079297 · Full text
This study examined the correlates of the symptoms of obsessive-compulsive disorder (OCD) among a nationally-representative sample of African American adults ( = 3,570). Demographic and several self-rated health variable...
This study examined the correlates of the symptoms of obsessive-compulsive disorder (OCD) among a nationally-representative sample of African American adults ( = 3,570). Demographic and several self-rated health variables were examined. Although only 1.6% of the sample met DSM-IV diagnostic criteria for OCD, a sizeable proportion of the sample reported compulsions (12.5%) and obsessions (15.3%). Material hardship was positively associated with nearly all measured symptoms of OCD and fewer years of educational attainment was related to greater compulsive symptoms. Self-rated mental health was related to both compulsions and obsessions, and self-rated physical health was associated with counting and repeating compulsions. Implications and areas for further research with African Americans are discussed, including improving access to care for those most in need of services.
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