Obsessive-compulsive disorder and its related disorders: a reappraisal of obsessive-compulsive spectrum concepts

Obsessive-compulsive disorder (OCD) is a clinical syndrome whose hallmarks are excessive, anxiety-evoking thoughts and compulsive behaviors that are generally recognized as unreasonable, but which cause significant distress and impairment. When these are the exclusive symptoms, they constitute uncomplicated OCD. OCD may also occur in the context of other neuropsychiatric disorders, most commonly other anxiety and mood disorders. The question remains as to whether these combinations of disorders should be regarded as independent, cooccurring disorders or as different manifestations of an incompletely understood constellation of OCD spectrum disorders with a common etiology. Additional considerations are given here to two potential etiology-based subgroups: (i) an environmentally based group in which OCD occurs following apparent causal events such as streptococcal infections, brain injury, or atypical neuroleptic treatment; and (ii) a genomically based group in which OCD is related to chromosomal anomalies or specific genes. Considering the status of current research, the concept of OCD and OCD-related spectrum conditions seems fluid in 2010, and in need of ongoing reappraisal

Negative Interpretation Bias Connects to Real-World Daily Affect: A Multistudy Approach

Negative interpretation bias, the tendency to appraise ambiguous stimuli as threatening, shapes our emotional lives. Various laboratory tasks, which differ in stimuli features and task procedures, can quantify negative interpretation bias. However, it is unknown whether these tasks globally predict individual differences in real-world negative (NA) and positive (PA) affect. Across two studies, we tested whether different lab-based negative interpretation bias tasks predict daily NA and PA, measured via mobile phone across months. To quantify negative interpretation bias, Study 1 (N = 69) used a verbal, self-referential task whereas Study 2 (N = 110) used a perceptual, emotional image task with faces and scenes. Across tasks, negative interpretation bias was linked to heightened daily NA. However, only negative interpretation bias in response to ambiguous faces was related to decreased daily PA. These results illustrate the ecological validity of negative interpretation bias tasks and highlight converging and unique relationships between distinct tasks and naturalistic emotion

Obsessive-compulsive symptoms, polygenic risk score, and thalamic development in children from the Brazilian High-Risk Cohort for Mental Conditions (BHRCS)

Background: Thalamic volume measures have been linked to obsessive-compulsive disorder (OCD) in children and adolescents. However, it is unclear if alterations in thalamic volumes occur before or after symptom onset and if there is a relation to the presence of sub-clinical obsessive-compulsive symptoms (OCS). Here, we explore the relationship between OCS and the rate of thalamic volume change in a cohort of children and youth at high risk to develop a mental disorder. A secondary aim was to determine if there is a relationship between OCS and the individual’s OCD polygenic risk score (OCD-PRS) and between the rate of thalamic volume change and the OCD-PRS. Methods: The sample included 378 children enrolled in the longitudinal Brazilian High-Risk Cohort for Mental Conditions. Participants were assessed for OCS and the symmetrized percent change (SPC) of thalamic volume across two time-points separated by 3 years, along with the OCD-PRS. Zero-altered negative binomial models were used to analyze the relationship between OCS and thalamic SPC. Multiple linear regressions were used to examine the relationship between thalamic SPC and OCD-PRS. Results: A significant relationship between OCS and the right thalamus SPC (p = 0.042) was found. There was no significant relationship between changes in thalamic volume SPC and OCD-PRS. Conclusions: The findings suggest that changes in the right thalamic volume over the course of 3 years in children may be associated to OCS. Future studies are needed to confirm these results and further characterize the specific nature of OCS symptoms associated with thalamic volumes

Assessment of obsessive-compulsive symptom dimensions: development and evaluation

Although several measures of obsessive-compulsive (OC) symptoms exist, most are limited in that they are not consistent with the most recent empirical findings on the nature and dimensional structure of obsessions and compulsions. In the present research, the authors developed and evaluated a measure called the Dimensional Obsessive-Compulsive Scale (DOCS) to address limitations of existing OC symptom measures. The DOCS is a 20-item measure that assesses the four dimensions of OC symptoms most reliably replicated in previous structural research. Factorial validity of the DOCS was supported by exploratory and confirmatory factor analyses of 3 samples, including individuals with OC disorder, those with other anxiety disorders, and nonclinical individuals. Scores on the DOCS displayed good performance on indices of reliability and validity, as well as sensitivity to treatment and diagnostic sensitivity, and hold promise as a measure of OC symptoms in clinical and research settings

mHealth and technology innovations for anxiety and OC spectrum disorders

Interdisciplinary mobile health (mHealth) technologies and intervention approaches are changing the nature of health research, providing the opportunity to shift from more reactive approaches for patient care to a more proactive stance. As with the larger field of medicine, mHealth and technology‐enhanced approaches in psychiatry and clinical psychology are opening an unparalleled number of avenues to help reduce the risk for psychiatric disease, treat psychological disorders, and increase well‐being of our patients. While promising, this research is characterized by complex challenges across the domains of concept development, initial design and testing, and downstream implementation and scaled‐up dissemination. This Special Issue in the British Journal of Clinical Psychology was designed to highlight the development and implementation of mHealth research in the anxiety and obsessive‐compulsive spectrum disorders. In addition to informing readers about important advances that have been made, the present special issue also draws attention to the myriad challenges that will need to be considered in future research. Three domains relevant for mHealth research are addressed, including a careful consideration of where the research currently stands and what challenges we should prepare for, the adaptation of traditional and adjunctive treatments to mobile or online platforms, and the ability for technology and associated methodological approaches to provide further insight into aetiological investigations

An Experimental Investigation of the Effect of Stress on Saving and Acquiring Behavioral Tendencies: The Role of Distress Tolerance and Negative Urgency

Stress has been implicated as a risk factor for hoarding, although past research has relied on cross-sectional and self-report designs. Using experimental methods and objective hypothetical behavioral hoarding paradigms, we investigated the direct effect of stress on in-the-moment saving and acquiring behavioral tendencies. We also evaluated whether distress tolerance (DT) and negative urgency interacted with stress to predict saving and acquiring behavioral tendencies. A sample of young adults (N=80) completed questionnaires about DT and negative urgency. Participants were randomized to either a psychosocial stressor or nonstressful control task prior to completing two hypothetical behavioral hoarding paradigms. The discarding task asked participants to choose between saving and disposing of items. For the acquiring task, participants completed a computer-simulated shopping spree that measured items acquired. Unexpectedly, participants in the stress condition saved and acquired fewer items than those in the control condition. As hypothesized, stress interacted with DT to predict saving tendencies. The current study should be replicated in a clinical sample. Longitudinal studies are needed to further examine the long-term effect of stress on hoarding. This is the first examination of the direct effect of stress on saving and acquiring tendencies. Although some study hypotheses were not supported, several results are consistent with our predictions and suggest a complex relationship between stress and hoarding. If findings are replicated in a clinical sample, it may be that hoarding patients could benefit from treatments incorporating DT strategies