Ryan J. Jacoby , Abigail Szkutak , Jin Shin , Jennifer Lerner , Sabine Wilhelm
{"title":"Feeling uncertain despite knowing the risk: Patients with OCD (but not controls) experience known and unknown probabilistic decisions as similarly distressing and uncertain","authors":"Ryan J. Jacoby , Abigail Szkutak , Jin Shin , Jennifer Lerner , Sabine Wilhelm","doi":"10.1016/j.jocrd.2023.100842","DOIUrl":"https://doi.org/10.1016/j.jocrd.2023.100842","url":null,"abstract":"<div><p><span>Patients with obsessive compulsive disorder (OCD) present as risk-averse and avoidant of feared stimuli, yet the literature examining risk </span>aversion<span> in OCD is conflicting. One possible explanation is that patients may exhibit aversion only on ambiguous tasks where the likelihood of possible outcomes is unknown. To test this idea, the current study assigned 30 patients with OCD versus 30 non-psychiatric controls (NPC) to conditions of known versus unknown risk (i.e., probabilities) on the Beads Task<span>. Importantly, the task involved real financial stakes. We also examined self-reported intolerance of uncertainty (IU) as a mechanism. Results revealed a significant risk information × group interaction for certainty about the decision. Specifically, while NPCs felt significantly less certain on the unknown risk (versus known risk) task, the OCD group felt uncertain regardless of risk information. Results also revealed a significant main effect of group for distress after deciding, such that the OCD group was more distressed across all task versions compared to NPCs. Elevated trait IU was associated with higher task-related distress. Results indicate that even when patients with OCD are given information about likelihoods, they still feel uncertain and experience distress. Findings have clinical implications for addressing risk aversion and ambiguity/uncertainty in treatment.</span></span></p></div>","PeriodicalId":48902,"journal":{"name":"Journal of Obsessive-Compulsive and Related Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50171401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Haunted by the ghosts of romance past: Investigating retroactive jealousy through the lens of OCD","authors":"Michael A. Osorio, Richard J. McNally","doi":"10.1016/j.jocrd.2023.100849","DOIUrl":"https://doi.org/10.1016/j.jocrd.2023.100849","url":null,"abstract":"","PeriodicalId":48902,"journal":{"name":"Journal of Obsessive-Compulsive and Related Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92019538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rebecca C. Cox , Kelly A. Knowles , Sarah C. Jessup , Alexandra M. Adamis , Bunmi O. Olatunji
{"title":"Psychometric properties of a daily obsessive-compulsive symptom scale for ecological momentary assessment","authors":"Rebecca C. Cox , Kelly A. Knowles , Sarah C. Jessup , Alexandra M. Adamis , Bunmi O. Olatunji","doi":"10.1016/j.jocrd.2023.100840","DOIUrl":"10.1016/j.jocrd.2023.100840","url":null,"abstract":"<div><p><span>Despite growing interest in ecological momentary assessment<span><span> (EMA) in psychopathology and clinical observation of day-to-day fluctuations in obsessive-compulsive disorder (OCD) symptoms, there is not a standardized EMA measure of such symptoms that can guide systematic research. In the absence of such a measure, prior EMA research in OCD has utilized heterogeneous approaches to sampling momentary and daily OCD symptoms, which limits the ability to compare results between studies. The present study sought to examine the </span>psychometric properties of a daily OCD symptom (d-OCS) measure that assesses common OCD symptom themes (e.g., contamination, checking, intrusive thoughts) in a sample of adults with OCD (</span></span><em>n</em> = 20), psychiatric controls (<em>n</em> = 27), and healthy controls (<em>n</em><span> = 27). Participants completed the d-OCS 3 times per day for 1 week. The d-OCS distinguished those with OCD from psychiatric controls and healthy controls. The d-OCS demonstrated good internal consistency, adequate test-retest reliability, and good convergent validity<span>. These findings offer initial psychometric support for the use of the d-OCS in EMA research examining day-to-day fluctuations in symptoms of OCD. Additional investigation is needed to examine the discriminant validity of the d-OCS and generalize these findings to more diverse samples.</span></span></p></div>","PeriodicalId":48902,"journal":{"name":"Journal of Obsessive-Compulsive and Related Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10552676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41177293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle T. Pham , Tiffany A. Campbell , Natalie Dorfman , Laura Torgerson , Kristin Kostick-Quenet , Jennifer Blumenthal-Barby , Eric A. Storch , Gabriel Lázaro-Muñoz
{"title":"Clinician perspectives on levels of evidence and oversight for deep brain stimulation for treatment-resistant childhood OCD","authors":"Michelle T. Pham , Tiffany A. Campbell , Natalie Dorfman , Laura Torgerson , Kristin Kostick-Quenet , Jennifer Blumenthal-Barby , Eric A. Storch , Gabriel Lázaro-Muñoz","doi":"10.1016/j.jocrd.2023.100830","DOIUrl":"10.1016/j.jocrd.2023.100830","url":null,"abstract":"<div><p><span>Approximately 10–20% of children with obsessive-compulsive disorder (OCD) have treatment-resistant presentations, and there is likely interest in developing interventions for this patient group, which may include deep brain stimulation<span> (DBS). The World Society for Stereotactic and Functional Neurosurgery has argued that at least two successful </span></span>randomized controlled trials<span> should be available before DBS treatment<span> for a psychiatric disorder is considered “established.” The FDA approved DBS for adults with treatment-resistant OCD under a humanitarian device exemption (HDE) in 2009, which requires that a device be used to manage or treat a condition impacting 8000 or fewer patients annually in the United States. DBS is currently offered to children ages 7 and older with treatment-resistant dystonia under an HDE. Ethical and empirical work are needed to evaluate whether and under what conditions it might be appropriate to offer DBS for treatment-resistant childhood OCD. To address this gap, we report qualitative data from semi-structured interviews with 25 clinicians with expertise in this area. First, we report clinician perspectives on acceptable levels of evidence to offer DBS in this patient population. Second, we describe their perspectives on institutional policies or protocols that might be needed to effectively provide care for this patient population.</span></span></p></div>","PeriodicalId":48902,"journal":{"name":"Journal of Obsessive-Compulsive and Related Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10538479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41154899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"OCD symptoms are related to seeking and relying on external information even in neutral perceptual decisions","authors":"Shachar Ruppin , Ofir Arias , Reuven Dar","doi":"10.1016/j.jocrd.2023.100843","DOIUrl":"https://doi.org/10.1016/j.jocrd.2023.100843","url":null,"abstract":"<div><h3>Introduction</h3><p>Doubt and decision-making difficulties are very common in obsessive-compulsive disorder (OCD). In the present study, we focused on a particular feature of decision-making in OCD – increased information-seeking. Based on the Seeking Proxies for Internal States and the Intolerance for Uncertainty theoretical frameworks, we hypothesized that OCD symptoms will be positively associated with information-seeking, even for neutral perceptual decisions.</p></div><div><h3>Method</h3><p>Fifty-eight UK participants were recruited via Prolific. They performed a perceptual decision-making task and completed questionnaires assessing OCD and associated variables. The perceptual task entailed locating the exact mid-point of a brightness continuum of a specific hue. Upon request, participants could obtain objective hints (purported responses of other participants), although hints incurred time-out penalties.</p></div><div><h3>Results</h3><p>Consistent with our hypothesis, OCD symptom levels predicted how many hints participants requested, even after controlling for anxiety and depression symptoms. Additionally, OCD symptoms were partially related to indecisiveness in the task.</p></div><div><h3>Discussion</h3><p>Our findings suggest that obsessive-compulsive tendencies are related to indecisiveness and to seeking external information even in a neutral context. Moreover, OCD tendencies were related to finding external information desirable enough to justify mildly aversive penalties. This need for clarity and objectivity might account for the development of compulsions despite personal costs.</p></div>","PeriodicalId":48902,"journal":{"name":"Journal of Obsessive-Compulsive and Related Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50171404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer Krafft , Julie M. Petersen , Clarissa W. Ong , Michael P. Twohig , Michael E. Levin
{"title":"Making space: A randomized waitlist-controlled trial of an acceptance and commitment therapy website for hoarding","authors":"Jennifer Krafft , Julie M. Petersen , Clarissa W. Ong , Michael P. Twohig , Michael E. Levin","doi":"10.1016/j.jocrd.2023.100846","DOIUrl":"https://doi.org/10.1016/j.jocrd.2023.100846","url":null,"abstract":"<div><h3>Background</h3><p><span>Hoarding disorder<span> causes significant impairment, but existing treatments have notable barriers to access and do not target several psychological processes that may contribute to hoarding. Therefore, this study evaluated an </span></span>acceptance and commitment therapy (ACT) self-help website for hoarding with minimal coaching in a randomized waitlist-controlled trial to evaluate initial feasibility and efficacy.</p></div><div><h3>Methods</h3><p>Participants were 73 U.S.-based adults with clinically significant hoarding symptoms. The website comprised 16 self-help sessions to be completed over 8 weeks. Measures were taken at baseline, posttreatment, and 1-month follow-up.</p></div><div><h3>Results</h3><p>Multilevel models indicated that the ACT condition improved significantly more than waitlist on hoarding symptom severity (the primary outcome; β = 0.74, Holm-corrected <em>p</em> = .01) as well as secondary outcomes (e.g., functional impairment, well-being, and progress toward personal values, Holm-corrected <em>p</em>s < .05). Rates of reliable (34.61%) and clinically significant (11.54%) change at posttreatment were limited, with no significant differences between groups. Responses indicated that this intervention was acceptable, credible, and easy to use, although adherence could be further improved.</p></div><div><h3>Conclusions</h3><p>Overall, results suggest that an ACT self-help program for hoarding can be acceptable and efficacious. Limitations include a predominantly White and female sample and the lack of an active control condition.</p></div>","PeriodicalId":48902,"journal":{"name":"Journal of Obsessive-Compulsive and Related Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92019536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michael G. Wheaton , Benjamin Rosenfield , David Rosenfield , Rachel Marsh , Edna B. Foa , H. Blair Simpson
{"title":"Predictors of EX/RP alone versus EX/RP with medication for adults with OCD: Does medication status moderate outcomes?","authors":"Michael G. Wheaton , Benjamin Rosenfield , David Rosenfield , Rachel Marsh , Edna B. Foa , H. Blair Simpson","doi":"10.1016/j.jocrd.2023.100850","DOIUrl":"https://doi.org/10.1016/j.jocrd.2023.100850","url":null,"abstract":"<div><p>Exposure and response prevention (EX/RP) can be delivered as monotherapy or to augment serotonin reuptake inhibitors (SRIs). While both options are considered effective OCD treatments, responses are heterogenous. Substantial work has investigated EX/RP predictors to account for this variability, with mixed findings. Little research has studied whether EX/RP predictors may differ in medicated versus non-medicated samples (i.e., medication status as a moderator). We pooled data from two clinical trials conducted concurrently in the same specialty OCD clinic. One enrolled patients who were on stable SRI doses (EX/RP as SRI augmentation, n = 58) while the other enrolled non-medicated patients (EX/RP monotherapy, n = 38). Both trials used the same manualized EX/RP protocol and blinded independent evaluators. LASSO regression derived predictors and moderators of outcome. Improvement did not significantly differ between the EX/RP alone group and the SRI + EX/RP group. In both groups, higher baseline OCD severity and worse quality of life predicted poorer outcome. OCPD traits moderated results: Patients with more severe OCPD traits had better outcomes from EX/RP monotherapy than those receiving EX/RP with SRIs. Patient adherence to EX/RP homework mediated the associations between the baseline variables and outcome. The effect of OCPD traits on outcome warrants future study to improve care.</p></div>","PeriodicalId":48902,"journal":{"name":"Journal of Obsessive-Compulsive and Related Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92019537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jana Hansmeier , Cornelia Exner , R. Porrmann , K. Schumacher , Jakob Fink-Lamotte
{"title":"Exploring the link between thought-action fusion and symptom-based shame in obsessive-compulsive disorder","authors":"Jana Hansmeier , Cornelia Exner , R. Porrmann , K. Schumacher , Jakob Fink-Lamotte","doi":"10.1016/j.jocrd.2023.100848","DOIUrl":"https://doi.org/10.1016/j.jocrd.2023.100848","url":null,"abstract":"<div><p>The emotion of shame has been found to be closely related to obsessive-compulsive disorder (OCD). Thought-action fusion (TAF) might explain this relationship, but its causal role with regard to symptom-based shame is unclear. There is growing evidence showing that the metacognitive intervention of detached mindfulness (DM) helps to prevent the development of TAF and thereby shame. The current study investigates, (1) if a TAF induction condition with violent content increases shame compared to a control induction condition with neutral content in randomized nonclinical participants with heightened OCD symptoms (<em>n</em> = 88), and (2) if a subsequent brief DM intervention shows a preventive effect for developing shame compared to a control condition about mnemonic techniques. An ANOVA showed that shame in participants of the TAF induction significantly increased compared to the control condition. In a second ANOVA, the DM intervention failed to show a preventive effect on developing TAF and shame in a following TAF induction experiment compared to the control condition. The present findings suggest the importance of TAF beliefs for the development of shame. A more intense DM intervention or additional (meta-)cognitive interventions might be necessary to prevent the development of shame.</p></div>","PeriodicalId":48902,"journal":{"name":"Journal of Obsessive-Compulsive and Related Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92042677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amanda N. Belanger , Kiara R. Timpano , Goi Khia Eng , Laura B. Bragdon , Emily R. Stern
{"title":"Associations between suicidality and interoception in obsessive-compulsive disorder","authors":"Amanda N. Belanger , Kiara R. Timpano , Goi Khia Eng , Laura B. Bragdon , Emily R. Stern","doi":"10.1016/j.jocrd.2023.100844","DOIUrl":"https://doi.org/10.1016/j.jocrd.2023.100844","url":null,"abstract":"<div><h3>Background</h3><p>Individuals with obsessive-compulsive disorder (OCD) are at increased risk for suicide. One potential risk factor is interoceptive sensibility (IS), which is one's subjective experience of bodily sensations. The current study examined the relationship between IS and current suicidal ideation and lifetime history of suicide attempt, controlling for relevant covariates.</p></div><div><h3>Methods</h3><p>Participants (<em>N</em> = 145) were a clinical sample of individuals with OCD from the New York City area. A clinical rater administered a diagnostic interview and an OCD severity assessment, and participants completed questionnaires about demographics, IS, and suicidality.</p></div><div><h3>Results</h3><p>Current suicidal ideation was associated with reduced trusting of the body, and lifetime history of suicide attempt was related to greater general awareness of sensation. These associations remained significant after controlling for covariates.</p></div><div><h3>Conclusions</h3><p>These results suggest that specific facets of IS may be associated with specific domains of suicidality. Decreased body trusting may represent a feeling of disconnection from the body that facilitates desire for death. Increased noticing of bodily sensations may lead to greater mental pain, which could interact with deficits in emotion regulation to increase risk for suicide attempt. Further research on the relationships between IS and suicidality in OCD is warranted.</p></div>","PeriodicalId":48902,"journal":{"name":"Journal of Obsessive-Compulsive and Related Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50171402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Applying a drift diffusion model to test the effect of oxytocin on attentional biases in body dysmorphic disorder","authors":"Gillian Grennan, Yuchen Zhao, Angela Fang","doi":"10.1016/j.jocrd.2023.100841","DOIUrl":"https://doi.org/10.1016/j.jocrd.2023.100841","url":null,"abstract":"<div><p><span>Individuals with body dysmorphic disorder (BDD) display selective attentional biases to threat. Oxytocin is an endogenous </span>neuropeptide<span> proposed to modulate attentional salience in social contexts. We conducted a secondary analysis applying drift diffusion modeling (DDM) to test whether individuals with BDD would display an attentional bias to threat, and whether oxytocin would modulate this bias. Eighteen participants with BDD and 15 healthy controls received an oxytocin or placebo nasal spray during two study visits, in randomized order, and completed a modified spatial cueing paradigm. DDM successfully parsed distinct task components demonstrating a selective attentional bias to disgust versus neutral faces in BDD compared to controls in the placebo condition, and a main effect of oxytocin on exacerbating this bias across participants. There were no effects using mean reaction time measures. DDM may reveal insights about attentional biases by utilizing trial-wise information. Oxytocin may exacerbate attentional biases to threat in BDD.</span></p></div><div><h3>General scientific summary</h3><p>Drift diffusion modeling successfully parsed distinct components of a modified spatial cueing task that assessed attentional biases in those with body dysmorphic disorder (BDD) and healthy controls that were missed in conventional analyses using mean reaction time measures. Individuals with BDD displayed an attentional preference for disgust versus neutral faces in the placebo condition, and oxytocin exacerbated this attentional bias.</p></div>","PeriodicalId":48902,"journal":{"name":"Journal of Obsessive-Compulsive and Related Disorders","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50171403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}