ResearchPad - obsessive-compulsive-disorder https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Operational method of reliability and content-validity analysis: Taking “trait-symptoms” screening of individuals at high-risk for OCD as an example]]> https://www.researchpad.co/article/elastic_article_13806 A well-designed self-reported scale is highly applicable to current clinical and research practices. However, the problems with the scale method, such as quantitative analysis of content validity and test-retest reliability analysis of state-like variables are yet to be resolved. The main purpose of this paper is to propose an operational method for solving these problems. Additionally, it aims to enhance understanding of the research paradigm for the scale method (excluding criterion-related validity). This paper used a study that involved screening of high-risk groups for OCD (Obsessive-Compulsive Disorder), conducted 5 rounds of tests, and developed scales, reliability, and validity analysis (using sample sizes of 496, 610, 600, 600 and 990). The operational method we propose is practical, feasible, and can be used to develop and validate a scale.

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<![CDATA[Seeking certainty about Intolerance of Uncertainty: Addressing old and new issues through the Intolerance of Uncertainty Scale-Revised]]> https://www.researchpad.co/article/5c6b269bd5eed0c484289d6b

Intolerance of Uncertainty is a trans-diagnostic process that spans a range of emotional disorders and it is usually measured through the Intolerance of Uncertainty Scale-12. The current study aims at investigating some issues in the assessment of Intolerance of Uncertainty (IU) through the Italian Intolerance of Uncertainty Scale-Revised, a measure adapted from the Intolerance of Uncertainty Scale-12 to assess IU across the lifespan. In particular we address the factor structure among a large community sample, measurement invariance across gender, age, and over time, together with reliability and validity of the overall scale and its subscales. The questionnaire was administered to community (N = 761; mean age = 35.86 ± 14.01 years) and undergraduate (N = 163; mean age = 21.16 ± 2.64 years) participants, together with other self-report measures assessing constructs theoretically related to IU. The application of a bifactor model shows that the Italian Intolerance of Uncertainty Scale-Revised possesses a robust general factor, thus supporting the use of the unit-weighted total score of the questionnaire as a measure of the construct. Furthermore, measurement invariance across gender, age, and over time is supported. Finally, the Italian Intolerance of Uncertainty Scale-Revised appears to possess adequate reliability and validity. These findings support the unidimensionality of the measure, a conceptually reasonable result in line with the trans-diagnostic nature of Intolerance of Uncertainty. In addition, this study and comparison with published factor structures of the Intolerance of Uncertainty Scale-12 and of the Intolerance of Uncertainty Scale-Revised identify some issues for the internal structure of the measure. In particular, concern is expressed for the Prospective IU subscale. In light of the promising psychometric properties, the use of the Italian Intolerance of Uncertainty Scale-Revised as a univocal measure is encouraged in both research and clinical practice.

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<![CDATA[Disgust assessment: Factorial structure and psychometric properties of the French version of the Disgust Propension and Sensibility Scale Revised-12]]> https://www.researchpad.co/article/5c58d629d5eed0c4840317c3

The present study examined the internal and external validity of the French version of the 12-item Disgust Propensity and Sensitivity Scale-Revised (DPSS-12) in a nonclinical sample from the general population. Two hundred and eighty-two participants completed the DPSSf-12 questionnaire as well as the Anxiety Sensitivity Index (ASI), Anxiety Trait (STAI B), Obsessional Belief Questionnaire 44 items (OBQ 44), Obsessive Compulsive Inventory-Revised (OCI-R) and Positive and Negative Affect Schedule (PANAS). Confirmatory Factor Analysis supported a 2-factor structure after two sensitivity items were removed. The 10-item scale showed good internal consistency, construct validity and test-retest reliability. These adequate psychometric properties make the DPSSf-10 appropriate for use by researchers and practitioners.

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<![CDATA[Comprehensive cross-disorder analyses of CNTNAP2 suggest it is unlikely to be a primary risk gene for psychiatric disorders]]> https://www.researchpad.co/article/5c4cc21ed5eed0c484b9fdbe

The contactin-associated protein-like 2 (CNTNAP2) gene is a member of the neurexin superfamily. CNTNAP2 was first implicated in the cortical dysplasia-focal epilepsy (CDFE) syndrome, a recessive disease characterized by intellectual disability, epilepsy, language impairments and autistic features. Associated SNPs and heterozygous deletions in CNTNAP2 were subsequently reported in autism, schizophrenia and other psychiatric or neurological disorders. We aimed to comprehensively examine evidence for the role of CNTNAP2 in susceptibility to psychiatric disorders, by the analysis of multiple classes of genetic variation in large genomic datasets. In this study we used: i) summary statistics from the Psychiatric Genomics Consortium (PGC) GWAS for seven psychiatric disorders; ii) examined all reported CNTNAP2 structural variants in patients and controls; iii) performed cross-disorder analysis of functional or previously associated SNPs; and iv) conducted burden tests for pathogenic rare variants using sequencing data (4,483 ASD and 6,135 schizophrenia cases, and 13,042 controls). The distribution of CNVs across CNTNAP2 in psychiatric cases from previous reports was no different from controls of the database of genomic variants. Gene-based association testing did not implicate common variants in autism, schizophrenia or other psychiatric phenotypes. The association of proposed functional SNPs rs7794745 and rs2710102, reported to influence brain connectivity, was not replicated; nor did predicted functional SNPs yield significant results in meta-analysis across psychiatric disorders at either SNP-level or gene-level. Disrupting CNTNAP2 rare variant burden was not higher in autism or schizophrenia compared to controls. Finally, in a CNV mircroarray study of an extended bipolar disorder family with 5 affected relatives we previously identified a 131kb deletion in CNTNAP2 intron 1, removing a FOXP2 transcription factor binding site. Quantitative-PCR validation and segregation analysis of this CNV revealed imperfect segregation with BD.

This large comprehensive study indicates that CNTNAP2 may not be a robust risk gene for psychiatric phenotypes.

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<![CDATA[Days Out of Role Due to Mental and Physical Conditions: Results from the Singapore Mental Health Study]]> https://www.researchpad.co/article/5989db0aab0ee8fa60bc9c69

Objective

The aim of the current study was to evaluate the relative contributions of mental and physical conditions to days out of role among adults aged 18 years and above in Singapore.

Methods

The Singapore Mental Health Study was a cross-sectional epidemiological survey of a nationally representative sample of residents aged 18 years or older. Diagnosis of mental disorders was established using the Composite International Diagnostic Interview; while chronic physical conditions were established using a checklist. Days out of role were assessed using a WHO Disability Assessment Schedule item. Multivariate regression analyses were used to estimate individual-level and societal-level effects of disorders.

Results

Overall, 8.7% of respondents reported at least one day out of role, with a mean of 5.8 days. The most disabling conditions at the individual level were cancer (118.9 additional days), cardiovascular diseases (93.5), and bipolar disorder (71.0). At the societal level, cardiovascular diseases contributed the highest population attributable risk proportion (45%), followed by cancer (39.3%), and hypertension (13.5%).

Conclusions

Mental and physical conditions are linked to significant losses in productivity for society as well as role disability for individuals, underscoring the need to enhance prevention and intervention efforts to increase overall productivity and improve individual functioning.

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<![CDATA[Evident Exception in Clinical Practice Not Sufficient to Break Traditional Hypothesis]]> https://www.researchpad.co/article/5989dafeab0ee8fa60bc5ac6 ]]> <![CDATA[Increased decision thresholds enhance information gathering performance in juvenile Obsessive-Compulsive Disorder (OCD)]]> https://www.researchpad.co/article/5989db5aab0ee8fa60bdf269

Patients with obsessive-compulsive disorder (OCD) can be described as cautious and hesitant, manifesting an excessive indecisiveness that hinders efficient decision making. However, excess caution in decision making may also lead to better performance in specific situations where the cost of extended deliberation is small. We compared 16 juvenile OCD patients with 16 matched healthy controls whilst they performed a sequential information gathering task under different external cost conditions. We found that patients with OCD outperformed healthy controls, winning significantly more points. The groups also differed in the number of draws required prior to committing to a decision, but not in decision accuracy. A novel Bayesian computational model revealed that subjective sampling costs arose as a non-linear function of sampling, closely resembling an escalating urgency signal. Group difference in performance was best explained by a later emergence of these subjective costs in the OCD group, also evident in an increased decision threshold. Our findings present a novel computational model and suggest that enhanced information gathering in OCD can be accounted for by a higher decision threshold arising out of an altered perception of costs that, in some specific contexts, may be advantageous.

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<![CDATA[The Relationships between Workaholism and Symptoms of Psychiatric Disorders: A Large-Scale Cross-Sectional Study]]> https://www.researchpad.co/article/5989db34ab0ee8fa60bd26ec

Despite the many number of studies examining workaholism, large-scale studies have been lacking. The present study utilized an open web-based cross-sectional survey assessing symptoms of psychiatric disorders and workaholism among 16,426 workers (Mage = 37.3 years, SD = 11.4, range = 16–75 years). Participants were administered the Adult ADHD Self-Report Scale, the Obsession-Compulsive Inventory-Revised, the Hospital Anxiety and Depression Scale, and the Bergen Work Addiction Scale, along with additional questions examining demographic and work-related variables. Correlations between workaholism and all psychiatric disorder symptoms were positive and significant. Workaholism comprised the dependent variable in a three-step linear multiple hierarchical regression analysis. Basic demographics (age, gender, relationship status, and education) explained 1.2% of the variance in workaholism, whereas work demographics (work status, position, sector, and annual income) explained an additional 5.4% of the variance. Age (inversely) and managerial positions (positively) were of most importance. The psychiatric symptoms (ADHD, OCD, anxiety, and depression) explained 17.0% of the variance. ADHD and anxiety contributed considerably. The prevalence rate of workaholism status was 7.8% of the present sample. In an adjusted logistic regression analysis, all psychiatric symptoms were positively associated with being a workaholic. The independent variables explained between 6.1% and 14.4% in total of the variance in workaholism cases. Although most effect sizes were relatively small, the study’s findings expand our understanding of possible psychiatric predictors of workaholism, and particularly shed new insight into the reality of adult ADHD in work life. The study’s implications, strengths, and shortcomings are also discussed.

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<![CDATA[Altered Fronto-Striatal Fiber Topography and Connectivity in Obsessive-Compulsive Disorder]]> https://www.researchpad.co/article/5989dab9ab0ee8fa60badf42

Fronto-striatal circuits are hypothesized to be involved in the pathophysiology of obsessive-compulsive disorder (OCD). Within this circuitry, ventral frontal regions project fibers to the ventral striatum (VS) and dorsal frontal regions to the dorsal striatum. Resting state fMRI research has shown higher functional connectivity between the orbitofrontal cortex (OFC) and the dorsal part of the VS in OCD patients compared to healthy controls (HC). Therefore, we hypothesized that in OCD the OFC predominantly project fibers to the more dorsal part of the VS, and that the structural connectivity between the OFC and VS is higher compared to HC. A total of 20 non-medicated OCD patients and 20 HC underwent diffusion-weighted imaging. Connectivity-based parcellation analyses were performed with the striatum as seed region and the OFC, dorsolateral prefrontal cortex, and dorsal anterior cingulate cortex as target regions. Obtained connectivity maps for each frontal region of interest (ROI) were normalized into standard space, and Z-component (dorsal–ventral) coordinate of center-of-gravity (COG) were compared between two groups. Probabilistic tractography was performed to investigate diffusion indices of fibers between the striatum and frontal ROIs. COG Z-component coordinates of connectivity maps for OFC ROI were located in the more dorsal part of the VS in OCD patients compared to HC. Fractional anisotropy of fibers between the OFC and the striatum was higher in OCD patients compared to HC. Part of the pathophysiology of OCD might be understood by altered topography and structural connectivity of fibers between the OFC and the striatum.

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<![CDATA[Authors' Reply]]> https://www.researchpad.co/article/5989daefab0ee8fa60bc08f6 ]]> <![CDATA[Deep Brain Stimulation of Medial Dorsal and Ventral Anterior Nucleus of the Thalamus in OCD: A Retrospective Case Series]]> https://www.researchpad.co/article/5989da90ab0ee8fa60b9fac6

Background

The current notion that cortico-striato-thalamo-cortical circuits are involved in the pathophysiology of obsessive-compulsive disorder (OCD) has instigated the search for the most suitable target for deep brain stimulation (DBS). However, despite extensive research, uncertainty about the ideal target remains with many structures being underexplored. The aim of this report is to address a new target for DBS, the medial dorsal (MD) and the ventral anterior (VA) nucleus of the thalamus, which has thus far received little attention in the treatment of OCD.

Methods

In this retrospective trial, four patients (three female, one male) aged 31–48 years, suffering from therapy-refractory OCD underwent high-frequency DBS of the MD and VA. In two patients (de novo group) the thalamus was chosen as a primary target for DBS, whereas in two patients (rescue DBS group) lead implantation was performed in a rescue DBS attempt following unsuccessful primary stimulation.

Results

Continuous thalamic stimulation yielded no significant improvement in OCD symptom severity. Over the course of thalamic DBS symptoms improved in only one patient who showed “partial response” on the Yale-Brown Obsessive Compulsive (Y-BOCS) Scale. Beck Depression Inventory scores dropped by around 46% in the de novo group; anxiety symptoms improved by up to 34%. In the de novo DBS group no effect of DBS on anxiety and mood was observable.

Conclusion

MD/VA-DBS yielded no adequate alleviation of therapy-refractory OCD, the overall strategy in targeting MD/VA as described in this paper can thus not be recommended in DBS for OCD. The magnocellular portion of MD (MDMC), however, might prove a promising target in the treatment of mood related and anxiety disorders.

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<![CDATA[D-cycloserine augmentation of behavior therapy for anxiety and obsessive-compulsive disorders: A meta-analysis]]> https://www.researchpad.co/article/5989db50ab0ee8fa60bdbf24

Objective

The present meta-analysis investigates whether the antibiotic D-cycloserine (DCS), a partial agonist at the glutamatergic N-methyl-D-aspartate receptor, can augment the effect of behavior therapy in humans with anxiety and obsessive-compulsive disorders.

Method

A keyword-based computer search was conducted using common electronic databases. Only studies investigating the effect of DCS in humans with anxiety and obsessive-compulsive disorders were included, resulting in 23 studies with a combined sample size of 1314 patients. Effect sizes were coded as Hedges’ g and SMCC, the latter also incorporating differences in pre-treatment values. Bayesian multilevel meta-analysis was applied to take dependencies of effect sizes obtained from the same study into account.

Results

While previous meta-analyses found small to moderate improvements, the current results including the most recent research indicate that the overall effect of DCS is very small and almost indistinguishable from zero (g = -0.12, CI = [-0.27, 0.02]; SMCC = -0.10, CI = [-0.29, 0.07]). Slightly larger effects were found for social anxious patients. Further, study quality and year of publication were relevant moderators, with higher quality / more recent studies reported smaller effects of DCS.

Conclusions

These findings raise the question of the usefulness of DCS as an augmentation of exposure therapy for anxiety and obsessive-compulsive disorders. At least, it seems to be less promising than initially thought. The fact that study quality was inversely related to the reported effect sizes underlines the importance of high quality primary research in order to avoid over-estimation of treatment effects in clinical psychology.

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<![CDATA[Heightened Olfactory Sensitivity in Young Females with Recent-Onset Anorexia Nervosa and Recovered Individuals]]> https://www.researchpad.co/article/5989daa9ab0ee8fa60ba894b

Introduction

Olfaction may be related to food restriction and weight loss. However, reports regarding olfactory function in individuals with anorexia nervosa (AN) have been inconclusive.

Objective

Characterize olfactory sensitivity and identification in female adolescents and young adults with first-episode AN and young females recovered from AN.

Methods

We used the Sniffin’ Sticks Odor Threshold Test and Odor Identification Test to assess 43 participants with first-episode AN, 27 recovered participants, and 39 control participants. Participants completed the Importance of Olfaction questionnaire, the Beck Youth Inventory and the Eating Disorder Inventory. We also conducted a psychiatric diagnostic interview and the Autism Diagnostic Observation Schedule with participants.

Results

Both clinical groups showed heightened olfactory sensitivity. After excluding participants with depression, participants with first-episode AN identified more odors than recovered participants.

Conclusion

Heightened olfactory sensitivity in AN may be independent of clinical status, whereas only individuals with current AN and without depression show more accurate odor identification.

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<![CDATA[Why Did the FDA Approve These Advertisements?]]> https://www.researchpad.co/article/5989da09ab0ee8fa60b77119 ]]> <![CDATA[Factor Structure, Reliability, and Validity of the Japanese Version of the Disgust Propensity and Sensitivity Scale-Revised]]> https://www.researchpad.co/article/5989d9f3ab0ee8fa60b6f09b

The Disgust Propensity and Sensitivity Scale-Revised is one of the most widely used measures of individual differences for the emotion of disgust. It consists of 2 subscales: disgust propensity and disgust sensitivity. This study examined the factor structure, reliability, and validity of the Japanese version of the revised Disgust Propensity and Sensitivity Scale. Japanese participants (N = 1067) completed the scale as well as the Padua Inventory, Anxiety Sensitivity Index, State-Trait Anxiety Inventory, and Positive and Negative Affective Schedule. The participants were divided into 3 samples: Sample 1 (n = 481, mean age = 23.05, 186 males and 295 females); Sample 2 (n = 492, mean age = 20.27, 243 males and 249 females); and Sample 3 (n = 94, mean age = 22.68, 35 males and 58 females). We combined Samples 1 and 2 (n = 973, mean age = 21.66, 429 males and 544 females), and then created 2 subsamples to ensure the mutual independence of the samples used for two different factor analyses: subsample 1 (n = 486, mean age = 21.86, 199 male and 287 female) for exploratory factor analysis and subsample 2 (n = 487, mean age = 21.40, 230 male and 257 female) for confirmatory factor analysis. We examined test-retest reliability using Sample 3, and construct validity using Samples 1, 2, and the combined sample. Exploratory and confirmatory factor analyses revealed that the item-factor structure of the Japanese Disgust Propensity and Sensitivity Scale-Revised was identical to the English version. Moreover, the scale showed good internal consistency, test-retest reliability, and construct validity for empirical support as provided by correlational analyses. Results revealed adequate psychometric properties of the scale. This study provided the first examples of empirical support for the DPSS-R-J.

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<![CDATA[Use of Selective Serotonin Reuptake Inhibitors and Risks of Stroke in Patients with Obsessive Compulsive Disorder: A Population-Based Study]]> https://www.researchpad.co/article/5989db28ab0ee8fa60bd0c66

Background

Previous research has suggested a link between antidepressants use and the development of cerebrovascular events, but there has never been any study investigating the risk of stroke in obsessive-compulsive disorder (OCD) patients treated with a selective serotonin reuptake inhibitor (SSRI).

Methods

A retrospective observational cohort study was conducted using data from the National Health Insurance Database of Taiwan between the year of 2001 and 2009. A total of 527 OCD patients with 412 subjects in the SSRI use group and 115 in the non SSRI use group were included. Multivariable Cox proportional-hazards models were used to explore the associations between SSRI use and the occurrence of stroke, controlling for age, gender, concomitant medications, and comorbid medical illnesses.

Results

A total of nineteen OCD patients were diagnosed with new onset of stroke during the follow-up period including six cases in the SSRI group and thirteen in the non SSRI use group. SSRI use was demonstrated to be associated with a decreased risk of stroke (hazard ratio [HR] = 0.30; 95% confidence interval [CI] = 0.10–0.86, P = 0.02). The increase in age-related risk of strokes was 2.55 per decade (HR = 2.55; 95% CI = 1.74–3.75, P<0.001). Alternatively, sex, concomitant use of aspirin and non-steroidal anti-inflammatory drugs, and comorbidities with angina pectoris, diabetes mellitus, hypertension, and hyperlipidemia were not found to be associated with an increased risk for stroke in OCD patients.

Conclusions

Our study showed that SSRI use was associated with decreased risk of stroke in OCD patients. Further investigation into the possible biological mechanisms underlying the relationship between stroke and SSRI use in OCD patients is warranted.

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<![CDATA[Community-Based Learning in a Time of Conflict]]> https://www.researchpad.co/article/5989da87ab0ee8fa60b9c947 ]]> <![CDATA[Should Industry Speak the Loudest in Informing the Public on Medical Matters?]]> https://www.researchpad.co/article/5989da7eab0ee8fa60b99974 ]]> <![CDATA[“On My Own, but Not Alone” - Adolescents’ Experiences of Internet-Delivered Cognitive Behavior Therapy for Obsessive-Compulsive Disorder]]> https://www.researchpad.co/article/5989db38ab0ee8fa60bd3fde

Introduction

Childhood Obsessive-Compulsive Disorder (OCD) is a prevalent and impairing condition that can be effectively treated with Cognitive Behavior Therapy (CBT). However, a majority of children and adolescents do not have access to CBT. Internet-delivered CBT (ICBT) has been suggested as a way to increase availability to effective psychological treatments. Yet, the research on ICBT in children and adolescents has been lagging behind significantly both when it comes to quantitative as well as qualitative studies. The aim of the current study was to describe the experience of ICBT in adolescents with OCD.

Method

Eight adolescents with OCD that had received ICBT were interviewed with qualitative methodology regarding their experiences of the intervention. Data was summarized into thematic categories.

Results

Two overarching themes were identified, autonomy and support, each consisting of three primary themes (self-efficacy, flexibility, secure self-disclosure and clinician support, parental support, identification/normalization, respectively).

Conclusions

The experiential hierarchical model that was identified in this study is, in part, transferrable to previous research. In addition, it highlights the need of further study of important process variables of ICBT in young patient populations.

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<![CDATA[Integrating Genetic, Neuropsychological and Neuroimaging Data to Model Early-Onset Obsessive Compulsive Disorder Severity]]> https://www.researchpad.co/article/5989da08ab0ee8fa60b76b69

We propose an integrative approach that combines structural magnetic resonance imaging data (MRI), diffusion tensor imaging data (DTI), neuropsychological data, and genetic data to predict early-onset obsessive compulsive disorder (OCD) severity. From a cohort of 87 patients, 56 with complete information were used in the present analysis. First, we performed a multivariate genetic association analysis of OCD severity with 266 genetic polymorphisms. This association analysis was used to select and prioritize the SNPs that would be included in the model. Second, we split the sample into a training set (N = 38) and a validation set (N = 18). Third, entropy-based measures of information gain were used for feature selection with the training subset. Fourth, the selected features were fed into two supervised methods of class prediction based on machine learning, using the leave-one-out procedure with the training set. Finally, the resulting model was validated with the validation set. Nine variables were used for the creation of the OCD severity predictor, including six genetic polymorphisms and three variables from the neuropsychological data. The developed model classified child and adolescent patients with OCD by disease severity with an accuracy of 0.90 in the testing set and 0.70 in the validation sample. Above its clinical applicability, the combination of particular neuropsychological, neuroimaging, and genetic characteristics could enhance our understanding of the neurobiological basis of the disorder.

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