Patterns of Reassurance Seeking and Reassurance-Related Behaviours in OCD and Anxiety Disorders

2012 ◽  
Vol 41 (1) ◽  
pp. 1-23 ◽  
Author(s):  
Osamu Kobori ◽  
Paul M. Salkovskis
Keyword(s):  
Panic Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Reliability And Validity ◽  
The Other ◽  
Self Report ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Reassurance Seeking ◽  
Compulsive Disorder

Background: Reassurance seeking is particularly prominent in obsessive-compulsive disorder (OCD) and may be important in OCD maintenance. Aims: This study used a new self-report questionnaire to measure the range of manifestations of reassurance-seeking behaviours, describing their sources from which they seek, frequency, process (how they seek), and consequences (as opposed to triggers and motivations). This study also attempts to identify the degree to which reassurance is specific to OCD as opposed to panic disorder. Method: Reassurance Seeking Questionnaire (ReSQ) was administered to 153 individuals with OCD, 50 individuals with panic disorder with/without agoraphobia, and 52 healthy controls. The reliability and validity of the measure was evaluated and found to be satisfactory. Results: Reassurance seeking was found to be more frequent in both anxiety disorders relative to healthy controls. Individuals diagnosed with OCD were found to seek reassurance more intensely and carefully, and were more likely to employ “self-reassurance” than the other two groups. Conclusions: Further investigation of reassurance will enable better understanding of its role in the maintenance of anxiety disorders in general and OCD in particular.

The inner world of overactive monitoring: neural markers of interoception in obsessive–compulsive disorder

2017 ◽  
Vol 47 (11) ◽  
pp. 1957-1970 ◽  
Author(s):  
A. Yoris ◽  
A. M. García ◽  
L. Traiber ◽  
H. Santamaría-García ◽  
M. Martorell ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Obsessive Compulsive Disorder ◽  
Evoked Potential ◽  
Cognitive Profile ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Inner World ◽  
External Stimuli ◽  
Internal Body

BackgroundObsessive–compulsive disorder (OCD) patients typically overmonitor their own behavior, as shown by symptoms of excessive doubt and checking. Although this is well established for the patients’ relationship with external stimuli in the environment, no study has explored their monitoring of internal body signals, a process known to be affected in anxiety-related syndromes. Here, we explored this issue through a cardiac interoception task that measures sensing of heartbeats. Our aim was to explore key behavioral and electrophysiological aspects of internal-cue monitoring in OCD, while examining their potential distinctiveness in this condition.MethodWe administered a heartbeat detection (HBD) task (with related interoceptive confidence and awareness measures) to three matched groups (OCD patients, panic disorder patients, healthy controls) and recorded ongoing modulations of two task-relevant electrophysiological markers: the heart evoked potential (HEP) and the motor potential (MP).ResultsBehaviorally, OCD patients outperformed controls and panic patients in the HBD task. Moreover, they exhibited greater amplitude modulation of both the HEP and the MP during cardiac interoception. However, they evinced poorer confidence and awareness of their interoceptive skills.ConclusionsConvergent behavioral and electrophysiological data showed that overactive monitoring in OCD extends to the sensing of internal bodily signals. Moreover, this pattern discriminated OCD from panic patients, suggesting a condition-distinctive alteration. Our results highlight the potential of exploring interoceptive processes in the OCD spectrum to better characterize the population's cognitive profile. Finally, these findings may lay new bridges between somatic theories of emotion and cognitive models of OCD.

Intolerance of Uncertainty in OCD

2017 ◽  
Author(s):  
Ryan J. Jacoby ◽  
Jonathan S. Abramowitz
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Daily Life ◽  
Intolerance Of Uncertainty ◽  
Self Report ◽  
Obsessive Compulsive ◽  
Reassurance Seeking ◽  
Compulsive Disorder ◽  
Definition Of ◽  
Behavioral Methods ◽  
Cognitive Construct

Intolerance of uncertainty (IU) is a key cognitive construct in the maintenance of obsessive-compulsive disorder (OCD) symptoms. Whereas most individuals feel “certain-enough” that situations are relatively safe, those with OCD who have elevated IU have difficulty managing the feeling of not knowing “for sure” whether a feared outcome may occur. As a result, they engage in compulsive rituals (e.g., checking, reassurance seeking) with the aim of restoring a sense of certainty. Given the pervasiveness of uncertainty in daily life, these doubts and rituals can lead to heightened daily distress for individuals with OCD. Accordingly, the present chapter reviews the following: (a) a comprehensive definition of IU, (b) the conceptualization of IU as important in the development and maintenance of OCD across various symptom presentations, (c) the measurement of IU using both self-report and behavioral methods, and (d) recommendations for the consideration of IU in OCD treatment.

Brain Hemispheric Organization, Anxiety, and Psychoses

CNS Spectrums ◽  
2000 ◽  
Vol 5 (9) ◽  
pp. 58-69 ◽  
Author(s):  
Silvana Galderisi ◽  
Armida Mucci ◽  
Mario Maj
Keyword(s):  
Panic Disorder ◽  
Anxiety Disorders ◽  
Psychiatric Disorders ◽  
Obsessive Compulsive Disorder ◽  
Theoretical Models ◽  
Developmental Perspective ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Hemispheric Functioning

AbstractAbnormalities of brain hemispheric organization have been found in a variety of psychiatric disorders. Despite the great amount of data collected and the number of theoretical models elaborated, the role of these abnormalities in the pathogenesis of these disorders remains controversial. This article briefly reviews current concepts of hemispheric functioning, discusses the role of abnormalities of brain hemispheric organization in schizophrenia and in two anxiety disorders (panic disorder and obsessive-compulsive disorder), and outlines a developmental perspective that accounts for the observed abnormalities.

Is Hypochondriasis Related to Obsessive-Compulsive Disorder, Panic Disorder, or Both? An Empirical Evaluation

2008 ◽  
Vol 22 (2) ◽  
pp. 115-127 ◽  
Author(s):  
Brett Deacon ◽  
Jonathan S. Abramowitz
Keyword(s):  
Panic Disorder ◽  
Obsessive Compulsive Disorder ◽  
Cognitive Biases ◽  
Function Analysis ◽  
Intolerance Of Uncertainty ◽  
Panic Attacks ◽  
Self Report ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Body Vigilance

Although hypochondriasis (HC) is considered a somatoform disorder in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision), some authors have pointed out that the symptoms of HC overlap with certain anxiety disorders, namely, panic disorder (PD) and obsessive-compulsive disorder (OCD). Few studies have empirically addressed this overlap. In the present investigation, we used discriminant function analysis to explore how patients with a principal diagnosis of HC, OCD, or PD varied with respect to cardinal symptoms of these disorders (i.e., health anxiety, obsessions and compulsions, and panic-related anxiety and avoidance) and key cognitive biases (i.e., intolerance of uncertainty, anxiety sensitivity, and body vigilance). Fifty treatment-seeking individuals with PD, 21 with OCD, and 23 with HC completed self-report measures of symptoms and cognitions during their clinic visit. Results indicated that whereas individuals with HC experience panic attacks, obsessions, and compulsions, these symptoms are markedly less pronounced than among those with PD and OCD. Conversely, overlaps were found in terms of cognitive biases, with HC patients demonstrating elevated levels of intolerance of uncertainty, body vigilance, and fear of cardiovascular symptoms. Implications for the conceptualization and treatment of HC are discussed.

Panic Attacks and Anxiety Disorders

2020 ◽  
Author(s):  
Curtis Wittmann
Keyword(s):  
Emergency Department ◽  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Stress Disorder ◽  
Acute Stress ◽  
Panic Attacks ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

This review discusses the acute diagnosis and management of panic and anxiety disorders. Anxiety disorders are among the most common psychiatric disorders in the country and are a relatively common cause of presentation to the emergency department. Most anxiety disorders can be conceptualized as fear- or phobia-based disorders, including panic disorder, specific phobia, social phobia, acute stress disorder, posttraumatic stress disorder, and obsessive-compulsive disorder. Each of these disorders is discussed, including prevalence and common clinical presentations. The initial evaluation of patients with a suspected or diagnosed anxiety disorder will be based on their current symptoms. Some patients may be highly agitated and may require deescalation or sedation to perform a reasonable history and physical examination. To achieve this, providers should ensure their own safety first, with attention to the physical layout of the emergency department, ensuring that they are closer to the room exit than the patient (so that they cannot be trapped). The presence of police or security may be necessary to provide optimal care and an appropriate evaluation. Typical treatment of acute exacerbations of anxiety disorders includes medical management, most often benzodiazepines, which can provide immediate relief. Psychiatric consultation may be necessary in certain cases. For most patients, outpatient management rather than inpatient admission will lead to the most effective management of their anxiety.   Key words: anxiety disorder, obsessive-compulsive disorder, panic disorder, phobia, stress disorder This review contains 1 highly rendered figure, 17 tables, and 29 references.

Exploring the Role of Dissociation Dimensions in Obsessive Compulsive Disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S496-S496
Author(s):  
A. Pozza ◽  
N. Giaquinta ◽  
D. Dèttore
Keyword(s):  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Future Studies ◽  
Compulsive Disorder ◽  
Dissociative Experiences ◽  
Dissociative Amnesia ◽  
Competing Interest

IntroductionIn the last decade, accumulating evidence has been produced on the role of dissociation in Obsessive Compulsive Disorder (OCD). Understanding which dissociation dimensions are specific to OCD could suggest the integration of therapeutic strategies for dissociation in the treatment of patients with OCD.ObjectivesThe current study explored the role of dissociation in a sample of patients with OCD, patients with anxiety disorders and healthy controls with the aim to understand which dissociation dimensions could be specific to OCD.MethodOne hundred seventy-one participants were included in the study (56% females, mean age = 35.96, SD = 12.61), of which 52 were patients with primary OCD, 59 were patients with Anxiety Disorders (AD), and 60 were healthy controls. The Dissociative Experiences Scale (DES), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Yale-Brown Obsessive Compulsive Scale (Y-BOCS) were administered.ResultsPatients with OCD had significantly higher dissociative amnesia symptoms than patients with AD and health controls (F = 6.08, P < 0.01) and higher depersonalization/derealization symptoms than healthy controls but not than patients with AD. Patients with OCD did not report significantly higher dissociative absorption than healthy controls and patients with AD.ConclusionsStrategies targeting dissociative amnesia and depersonalization/derealization symptoms in OCD are discussed. Future studies should examine which OCD subtypes are more strongly associated to dissociation dimensions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Reassurance-seeking behaviour, intolerance of uncertainty, and neurocognitive functioning in obsessive-compulsive disorder

2021 ◽  
Author(s):  
Erin Orr
Keyword(s):  
Decision Making ◽  
Obsessive Compulsive Disorder ◽  
Psychological Symptoms ◽  
Intolerance Of Uncertainty ◽  
Future Research ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Reassurance Seeking ◽  
Targeted Interventions ◽  
Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a psychological condition involving excessive reassurance-seeking (ERS), or repeated questioning of others about something perceived as threatening; low cognitive confidence; and intolerance of uncertainty (IU; Cougle et al., 2012; Nedeljkovic et al., 2009; Parrish, 2009). Relationships between these symptoms and several domains of cognitive functioning were examined in the present study. Thirty-five OCD patients and 34 healthy controls completed a battery of psychological questionnaires and neurocognitive measures. Results indicated that OCD patients reported greater levels of ERS than healthy controls in three different situations. Furthermore, significant relationships were identified between: (1) decision-related ERS and decision-making impairment, (2) cognitive confidence and decision-related ERS, and (3) a particular form of IU, inhibitory IU, and decision-making impairment. These findings are important, as these psychological symptoms are associated with negative outcomes. The relationships identified provide an important foundation for future research and the development of targeted interventions for these symptoms.

scholarly journals Preliminary Analysis of the Factor Structure, Reliability and Validity of an Obsessive-Compulsive Disorder Screening Tool for Use with Adults in Malaysia

2019 ◽  
Vol 16 (23) ◽  
pp. 4763 ◽  
Author(s):  
Normah Che Din ◽  
Liana Mohd Nawi ◽  
Shazli Ezzat Ghazali ◽  
Mahadir Ahmad ◽  
Norhayati Ibrahim ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Factor Structure ◽  
Screening Tool ◽  
High Reliability ◽  
Reliability And Validity ◽  
Self Report ◽  
Future Research ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Structure Reliability

This is a preliminary study to examine the factor structure, reliability, and validity of an obsessive-compulsive disorder (OCD) screening tool for use in the Malaysian setting. A total of 199 Malaysian adults were recruited for this study. After cleaning and normalizing the data, 190 samples were left to be analyzed. Principle component analysis using varimax rotation was then performed to examine various factors derived from psychometric tools commonly used to assess OCD patients. The screening tool exhibited three factors that fit the description of obsessions and compulsions from the Diagnostic and Statistical Manual of Mental Disorders—5th Edition (DSM 5), as well as other common symptoms that co-morbid with OCD. The labels given to the three factors were: Severity of Compulsions, Severity of Obsessions, and Symptoms of Depression and Anxiety. Reliability analysis showed high reliability with a Cronbach’s alpha of 0.94, whereas convergent validity of the tool with the Yale Brown Obsessive-compulsive Scale—Self Report demonstrated good validity of r = 0.829. The three-factor model explained 68.91% of the total variance. Subsequent studies should focus on OCD factors that are culturally unique in the Malaysian context. Future research may also use online technology, which is cost-efficient and accessible, to further enhance the screening tool.

Comorbidity with Axis I Anxiety Disorders in Remitted Psychotic Patients 1 Year After Hospitalization

CNS Spectrums ◽  
2007 ◽  
Vol 12 (12) ◽  
pp. 913-919 ◽  
Author(s):  
Antonio Ciapparelli ◽  
Rosemma Paggini ◽  
Donatella Marazziti ◽  
Claudia Carmassi ◽  
Maria Bianchi ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Rating Scale ◽  
Severity Of Illness ◽  
Psychotic Symptoms ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Comorbid Anxiety ◽  
Axis I

ABSTRACTIntroductionComorbid anxiety disorders are frequently encountered in psychoses and mainly assessed during the hospitalization.MethodsComorbidity was investigated in 98 patients with schizophrenia, schizoaffective, or bipolar disorder, previously hospitalized for psychotic symptoms. Assessments, including Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Brief Psychiatric Rating Scale, and Clinical Global Impressions Scale, were performed during hospitalization (t0) and subsequently in a phase of remission (t1). Comorbidity was assessed at t1 only.ResultsOne or more comorbid anxiety diagnoses were made in 46 (46.9%) patients. Of these, 15 (32.6%) received multiple anxiety diagnoses, while 31 (67.4%) single anxiety diagnoses. Schizophrenic patients had a rate of social anxiety disorder (SAD) higher (P<.05) than the others. Patients assessed with panic disorder or with obsessive-compulsive disorder at t1 showed significantly greater severity of illness at t0; patients with SAD demonstrated greater severity at t1. No significant differences in the rates of individual anxiety disorders were found in patients treated with typical or atypical antipsychotics or with both.ConclusionAnxiety disorders, particularly obsessive-compulsive disorder, panic disorder and SAD, seem to be frequently comorbid in remitted psychotic patients; SAD would be more prevalent in schizophrenia and might negatively impact the course of the illness.

Unpacking the role of self-reported compulsivity and impulsivity in obsessive-compulsive disorder

CNS Spectrums ◽  
2017 ◽  
Vol 23 (1) ◽  
pp. 51-58 ◽  
Author(s):  
Luisa Prochazkova ◽  
Linden Parkes ◽  
Andrew Dawson ◽  
George Youssef ◽  
Gabriela M. Ferreira ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Principal Component ◽  
Self Report ◽  
Clinical Severity ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Novel Treatment ◽  
Final Group

ObjectiveWe aimed to determine whether individuals with obsessive-compulsive disorder (OCD) and demographically matched healthy individuals can be clustered into distinct clinical subtypes based on dimensional measures of their self-reported compulsivity (OBQ–44 and IUS–12) and impulsivity (UPPS–P).MethodsParticipants (n=217) were 103 patients with a clinical diagnosis of OCD; 79 individuals from the community who were “OCD-likely” according to self-report (Obsessive-Compulsive Inventory–Revised scores equal or greater than 21); and 35 healthy controls. All data were collected between 2013 and 2015 using self-report measures that assessed different aspects of compulsivity and impulsivity. Principal component analysis revealed two components broadly representing an individual's level of compulsivity and impulsivity. Unsupervised clustering grouped participants into four subgroups, each representing one part of an orthogonal compulsive-impulsive phenotype.ResultsClustering converged to yield four subgroups: one group low on both compulsivity and impulsivity, comprised mostly of healthy controls and demonstrating the lowest OCD symptom severity; two groups showing roughly equal clinical severity, but with opposing drivers (i.e., high compulsivity and low impulsivity, and vice versa); and a final group high on both compulsivity and impulsivity and recording the highest clinical severity. Notably, the largest cluster of individuals with OCD was characterized by high impulsivity and low compulsivity. Our results suggest thatbothimpulsivity and compulsivity mediate obsessive-compulsive symptomatology.ConclusionsIndividuals with OCD can be clustered into distinct subtypes based on measures of compulsivity and impulsivity, with the latter being found to be one of the more defining characteristics of the disorder. These dimensions may serve as viable and novel treatment targets.

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