The Structure, Validity, and Specificity of OCD Symptoms

2017 ◽  
pp. 232-259
Author(s):  
David Watson ◽  
Michael W. O’Hara
Keyword(s):  
Logistic Regression ◽  
Scale Development ◽  
Obsessive Compulsive Disorder ◽  
Criterion Validity ◽  
Incremental Validity ◽  
Regression Analyses ◽  
Diagnostic Specificity ◽  
Obsessive Compulsive ◽  
Symptom Dimensions ◽  
Compulsive Disorder

This chapter reviews early attempts to assess obsessive-compulsive disorder (OCD) symptoms, as well as the structural evidence that eventually led to the identification of core, consensual dimensions within the disorder. It then reviews instruments (the Obsessive-Compulsive Inventory; the Schedule of Compulsions, Obsessions, and Pathological Impulses; and the Yale-Brown Obsessive-Compulsive Scale) that have been developed to assess these core symptom dimensions and discusses the validity (including convergent, discriminant, criterion, and incremental validity) and specificity of the scales included in these measures. Three sets of OCD-related items (representing Cleaning, Checking, and Ordering) marked clear, replicable factors in the IDAS-II scale development samples. Indicators of checking and ordering/rituals produced the most impressive results overall, exhibiting the strongest criterion validity, good diagnostic specificity, and significant incremental validity in logistic regression analyses. Washing/cleaning symptoms also showed good diagnostic specificity, but they displayed more moderate criterion validity.

scholarly journals Symmetry Dimension in Obsessive–Compulsive Disorder: Prevalence, Severity and Clinical Correlates

2021 ◽  
Vol 10 (2) ◽  
pp. 274
Author(s):  
Aline P. Vellozo ◽  
Leonardo F. Fontenelle ◽  
Ricardo C. Torresan ◽  
Roseli G. Shavitt ◽  
Ygor A. Ferrão ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Obsessive Compulsive Disorder ◽  
Clinical Sample ◽  
Cross Sectional Study ◽  
Obsessive Compulsive ◽  
Chi Square ◽  
Cross Sectional ◽  
Compulsive Disorder ◽  
Clinical Correlates ◽  
Axis I

Background: Obsessive–compulsive disorder (OCD) is a very heterogeneous condition that frequently includes symptoms of the “symmetry dimension” (i.e., obsessions and/or compulsions of symmetry, ordering, repetition, and counting), along with aggressive, sexual/religious, contamination/cleaning, and hoarding dimensions. Methods: This cross-sectional study aimed to investigate the prevalence, severity, and demographic and clinical correlates of the symmetry dimension among 1001 outpatients from the Brazilian Research Consortium on Obsessive–Compulsive Spectrum Disorders. The main assessment instruments used were the Dimensional Yale–Brown Obsessive–Compulsive Scale, the Yale–Brown Obsessive–Compulsive Scale, the USP-Sensory Phenomena Scale, the Beck Depression and Anxiety Inventories, the Brown Assessment of Beliefs Scale, and the Structured Clinical Interview for DSM-IV Axis I Disorders. Chi-square tests, Fisher’s exact tests, Student’s t-tests, and Mann–Whitney tests were used in the bivariate analyses to compare patients with and without symptoms of the symmetry dimension. Odds ratios (ORs) with confidence intervals and Cohen’s D were also calculated as effect size measures. Finally, a logistic regression was performed to control for confounders. Results: The symmetry dimension was highly prevalent (86.8%) in this large clinical sample and, in the logistic regression, it remained associated with earlier onset of obsessive–compulsive symptoms, insidious onset of compulsions, more severe depressive symptoms, and presence of sensory phenomena. Conclusions: A deeper knowledge about specific OCD dimensions is essential for a better understanding and management of this complex and multifaceted disorder.

Hoarding symptoms and prediction of poor response to limbic system surgery for treatment-refractory obsessive-compulsive disorder

2014 ◽  
Vol 121 (1) ◽  
pp. 123-130 ◽  
Author(s):  
Andre F. Gentil ◽  
Antonio C. Lopes ◽  
Darin D. Dougherty ◽  
Christian Rück ◽  
David Mataix-Cols ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Obsessive Compulsive Disorder ◽  
Limbic System ◽  
Sao Paulo ◽  
Response To Treatment ◽  
São Paulo ◽  
Obsessive Compulsive ◽  
Symptom Dimensions ◽  
Compulsive Disorder ◽  
Treatment Refractory

Object Recent findings have suggested a correlation between obsessive-compulsive disorder (OCD) symptom dimensions and clinical outcome after limbic system surgery for treatment-refractory patients. Based on previous evidence that the hoarding dimension is associated with worse outcome in conventional treatments, and may have a neural substrate distinct from OCD, the authors examined a large sample of patients undergoing limbic surgery (40 with capsulotomy, 37 with cingulotomy) and investigated if symptom dimensions, in particular hoarding, could influence treatment outcome. Methods Data from 77 patients from 3 different research centers at São Paulo (n = 17), Boston (n = 37), and Stockholm (n = 23) were analyzed. Dimensional Yale-Brown Obsessive Compulsive Scale (Y-BOCS; São Paulo) or Y-BOCS Symptom Checklist scores (Boston and Stockholm) were used to code the presence of 4 well-established symptom dimensions: forbidden thoughts, contamination/cleaning, symmetry/order, and hoarding. Reductions in YBOCS scores determined clinical outcome. Results Mean Y-BOCS scores decreased 34.2% after surgery (95% CI 27.2%–41.3%), with a mean follow-up of 68.1 months. Patients with hoarding symptoms had a worse response to treatment (mean Y-BOCS decrease of 22.7% ± 25.9% vs 41.6% ± 32.2%, respectively; p = 0.006), with no significant effect of surgical modality (capsulotomy vs cingulotomy). Patients with forbidden thoughts apparently also had a worse response to treatment, but this effect was dependent upon the co-occurrence of the hoarding dimension. Only the negative influence of the hoarding dimension remained when an ANOVA model was performed, which also controlled for preoperative symptom severity. Conclusions The presence of hoarding symptoms prior to surgery was associated with worse clinical outcome after the interventions. Patients with OCD under consideration for ablative surgery should be carefully screened for hoarding symptoms or comorbid hoarding disorder. For these patients, the potentially reduced benefits of surgery need to be carefully considered against potential risks.

Does GRIN2B gene influence obsessive-compulsive disorder risk, symptom dimensions and treatment response?

2018 ◽  
Vol 31 ◽  
pp. 150-151 ◽  
Author(s):  
Biju Viswanath ◽  
Reshma Jabeen Taj MJ ◽  
Ravi Kumar Nadella ◽  
Tulika Shukla ◽  
Madhuri H. Nanjundaswamy ◽  
...  
Keyword(s):  
Treatment Response ◽  
Obsessive Compulsive Disorder ◽  
Obsessive Compulsive ◽  
Symptom Dimensions ◽  
Compulsive Disorder ◽  
Risk Symptom ◽  
Disorder Risk

scholarly journals Criterion Validity of the Yale-Brown Obsessive-Compulsive Scale Second Edition for Diagnosis of Obsessive-Compulsive Disorder in Adults

2018 ◽  
Vol 9 ◽  
Author(s):  
Pedro Castro-Rodrigues ◽  
Marta Camacho ◽  
Sílvia Almeida ◽  
Mónica Marinho ◽  
Catarina Soares ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Criterion Validity ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

scholarly journals Amygdala activation and symptom dimensions in obsessive–compulsive disorder

2014 ◽  
Vol 204 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Esther Via ◽  
Narcís Cardoner ◽  
Jesús Pujol ◽  
Pino Alonso ◽  
Marina López-Solà ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Obsessive Compulsive ◽  
Cross Sectional ◽  
Symptom Dimensions ◽  
Compulsive Disorder ◽  
Amygdala Activation ◽  
Fearful Faces ◽  
Fmri Study ◽  
Fear And Anxiety ◽  
Emotional Face

BackgroundDespite knowledge of amygdala involvement in fear and anxiety, its contribution to the pathophysiology of obsessive–compulsive disorder (OCD) remains controversial. In the context of neuroimaging studies, it seems likely that the heterogeneity of the disorder might have contributed to a lack of consistent findings.AimsTo assess the influence of OCD symptom dimensions on amygdala responses to a well-validated emotional face-matching paradigm.MethodCross-sectional functional magnetic resonance imaging (fMRI) study of 67 patients with OCD and 67 age-, gender- and education-level matched healthy controls.ResultsThe severity of aggression/checking and sexual/religious symptom dimensions were significantly associated with heightened amygdala activation in those with OCD when responding to fearful faces, whereas no such correlations were seen for other symptom dimensions.ConclusionsAmygdala functional alterations in OCD appear to be specifically modulated by symptom dimensions whose origins may be more closely linked to putative amygdala-centric processes, such as abnormal fear processing.

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