scholarly journals Metacognitions in Symptomatic and Remitted Patients with Obsessive Compulsive Disorder: Preliminary Evidence for Metacognitive State and Trait Markers

2020 ◽  
pp. 025371762097529
Author(s):  
Mariyam Bint Meraj ◽  
Shweta Singh ◽  
Sujit K Kar ◽  
Eesha Sharma ◽  
Seema Rani Sarraf

Background: The phenomenon of metacognition is instrumental in the conceptualization and management of obsessive compulsive disorder (OCD). Studies on the comparison between metacognitions in OCD patients and healthy controls or those with other clinical conditions have been conducted. We aimed to compare metacognitions among currently symptomatic OCD (S-OCD) patients, currently remitted OCD patients (R-OCD), and healthy controls (HC). Method: This cross-sectional research was conducted in the Department of Psychiatry of a tertiary care hospital in North India. Purposive sampling method was used to recruit 40 OCD patients, including an equal number of R-OCD and S-OCD patients, and 20 HC matched for age and education. Meta-Cognition Questionnaire and Thought Control Questionnaire were used to assess metacognitive functions. Results: The findings showed a gradient of highest maladaptive metacognitions in the S-OCD group and lowest in HC. In the OCD subgroups, specific metacognitive beliefs (negative beliefs F = 65.52; need to control thoughts F = 61.03) and strategies (worry F = 83.55; low distraction F = 105.61) remained significantly different (P ≤ 0.001) between S-OCD and R-OCD patients. Certain other metacognitions remained consistently more or less stable between S-OCD and R-OCD patients, that is, metacognitive beliefs (cognitive confidence F = 11.43; cognitive self-consciousness F = 37.12) and strategies (punishment F = 17.45; low social control F = 12.89). This finding is further corroborated by positive correlations of severity of OCD with need to control thoughts ( r = 0.66, P < 0.001), negative beliefs ( r = 0.63, P < 0.001), and worry ( r = 0.76, P < 0.001), and negative correlations with distraction ( r = – 0.79, P < 0.001). Conclusion: The study provides preliminary evidence for specific metacognitions distinguished as potential state and trait markers for OCD, which needs to be established on a larger sample using a longitudinal study design.

2021 ◽  
Vol 12 ◽  
Author(s):  
Shin Tae Kim ◽  
Chun Il Park ◽  
Hae Won Kim ◽  
Sumoa Jeon ◽  
Jee In Kang ◽  
...  

Introduction: Metacognitions are considered to be crucial factors for the development and maintenance of pathologic anxiety. The present case–control study aimed to examine how metacognitive beliefs are associated with the diagnostic status and subtypes of obsessive–compulsive disorder (OCD). In addition, we examined the pattern of changes in metacognitive beliefs after a 3-month pharmacological treatment in patients with OCD.Methods: A total of 562 cases with OCD and 236 healthy controls were assessed with the Metacognitions Questionnaire (MCQ) and various measures of OC symptom severity. Multivariate analyses of variance (MANOVAs) with covariates were conducted to explore the relationship between subdimensions of metacognitive beliefs and OCD disease status. In addition, for the OCD patients, Pearson's correlation was performed between baseline MCQ subdimensions and Obsessive–Compulsive Inventory-Revised-Korean subscales (OCI-R-K). Finally, in a subset of drug-free OCD patients (n = 144), the MCQ was reassessed after 3 months of treatment and patterns of changes in subdimensions of the MCQ were examined.Results: Patients with OCD scored significantly higher on the four dimensions of the MCQ. There were significant associations between all MCQ subdimensions and OCI-R-K subscales. In the repeated-measure MANOVA, a significant group (non-responders vs. responders)-by-time interaction effect was found only for the negative beliefs about the uncontrollability and danger of worry (NB) subdimension (F = 10.75; η2 = 0.072; p = 0.001).Conclusion: The presence of dysfunctional metacognitive beliefs in OCD subjects and their association with OCD characteristics suggest that dysfunctional metacognitions may play a crucial role in the pathophysiology of OCD. Improvement of metacognitive beliefs in the NB dimension may be a clinically meaningful correlate of good treatment response in the pharmacological treatment of OCD.


2017 ◽  
Vol 47 (11) ◽  
pp. 1957-1970 ◽  
Author(s):  
A. Yoris ◽  
A. M. García ◽  
L. Traiber ◽  
H. Santamaría-García ◽  
M. Martorell ◽  
...  

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.


2011 ◽  
Vol 26 (S2) ◽  
pp. 977-977 ◽  
Author(s):  
H. Olbrich ◽  
S. Olbrich ◽  
I. Jahn ◽  
U. Hegerl ◽  
K. Stengler

Neurophysiological hyperactivation of cortical and subcortical brain areas has been reported in obsessive-compulsive disorder (OCD) using functional imaging techniques and electroencephalography (EEG). Also sleep disturbances and delayed sleep phases have been associated with OCD symptomatology. However, vigilance regulation in OCD during the transition phase from wakefulness to sleep onset remains unclear. Therefore the aim of this study was to analyze EEG-source estimates and EEG vigilance regulation in OCD patients in comparison to healthy controls.A 15 minute resting EEG was recorded in 30 unmedicated OCD patients and 30 healthy, age and gender matched controls. EEG power source estimates of the whole time series were computed by exact Low Resolution Brain Electromagnetic Tomography (eLORETA). Each consecutive one second EEG-segment was classified into one out of seven EEG-vigilance stages (0, A1, A2, A3, B1, B2/3, C) using Vigilance Algorithm Leipzig (VIGALL). The eLORETA analysis (log of F-ratios, p < 0.05, corrected for multiple comparison) revealed significantly increased delta power in the right superior frontal gyrus for OCD patients in comparison to healthy controls. Vigilance analysis yielded significantly increased amounts of high vigilance stage A2 (Mann-Whitney test, p < 0.001, corrected for multiple comparison) for OCD patients.This study repeated findings of altered EEG-power in frontal areas in OCD patients. Alterations of EEG-vigilance regulation were found with increased amounts of high vigilance stage A2. This is in line with a hypothesis of cortical hyperactivation in OCD. The value of EEG-vigilance as a possible biological marker for e.g. treatment response should be focus of further studies.


2021 ◽  
Author(s):  
Long Long Chen ◽  
Oskar Flygare ◽  
John Wallert ◽  
Jesper Enander ◽  
Volen Ivanov ◽  
...  

Objective: To assess executive functions in patients with Body Dysmorphic Disorder (BDD) and Obsessive-Compulsive Disorder (OCD) compared with healthy controls. Methods: Adults diagnosed with BDD (n=26) or OCD (n=29) according to DSM-5, and healthy controls (n=28) underwent validated and computerized neuropsychological tests; spatial working memory (SWM), Intra- extra dimensional set shifting (IED) and Stop signal task (SST), from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Test performance was compared between groups, and correlated to standardized symptom severity of BDD and OCD. Significance level was set to p<0.05. Results: There were no statistically significant between-group differences on key outcome measures in SWM, IED, or SST. There was a weak positive correlation between symptom severity and test errors on SWM and IED in both OCD and BDD groups; increased clinical severity were associated with more errors in these tests. Further, there was a negative correlation between symptom severity and SST in the BDD group. Conclusions: Patients with BDD or OCD did not differ from healthy control subjects in terms of test performance, however there were several statistically significant correlations between symptom severity and performance in those with BDD or OCD. More studies on EF in BDD and OCD are required to elucidate if there are differences in EF between these two disorders.


2021 ◽  
Author(s):  
Yanrong Wang ◽  
Shaohua Chang ◽  
Xiaomin Ma ◽  
Jiying Li ◽  
Ruixia Zhang ◽  
...  

Abstract We examined the relationship between facial morphological features and clinical characteristics of adolescents with obsessive-compulsive disorder (OCD). The enrolled study sample comprised 40 adolescents diagnosed with OCD using the Obsessive Compulsive Inventory Child Version (OCI-CV) and 38 healthy controls (HCs). Facial photos, 21 facial diameters, and nine facial angles were collected using image software. In males, lower lip red height was significantly lower in OCD patients than in HCs (P < 0.05); no significant differences were observed in other facial indicators (all P > 0.05). In females, the nasolabial angle was smaller in OCD patients than in HCs (P < 0.05); no significant differences were observed in other facial indicators (all P > 0.05). The difference in lower lip red height between the OCD group and HC group was positively correlated with mental neutralization symptoms (r = 0.401, P < 0.05). Our findings highlight the relationship between facial and clinical characteristics in OCD patients.


2020 ◽  
Vol 33 (2) ◽  
pp. e100180
Author(s):  
Eram Ansari ◽  
Sudha Mishra ◽  
Adarsh Tripathi ◽  
Sujita Kumar Kar ◽  
Pronob Kumar Dalal

BackgroundPatients suffering from psychiatric disorders tend to stigmatise themselves which had been linked to poor adherence to treatment.AimsThe aim of the present study was to study internalised stigma and medication adherence and to assess the relationship between them in patients with obsessive compulsive disorder (OCD).MethodsA cross-sectional study was conducted on 112 patients diagnosed with OCD who were attending the Out-patient's department at Department of Psychiatry of a tertiary care hospital in North India. Internalised stigma and current medication adherence were assessed with Internalized Stigma of Mental Illness Scale (ISMI) and Medication Adherence Rating Scale, respectively. Yale-Brown Obsessive Compulsive Scale was used to assess the current severity of OCD symptoms. Sociodemographic and clinical details were also obtained from the patients by using a semistructured sociodemographic proforma.ResultsMost of the patients reported moderate level of internalised stigma with a mean ISMI score of 77.98 (10.82). Most of the patients were compliant while 41.96% reported poor medication adherence. Internalised stigma was negatively correlated with the current medication adherence. Current severity of OCD symptoms also showed a significant positive correlation with internalised stigma and a significant negative correlation with medication adherence.ConclusionHigh levels of internalised stigma were associated with lower adherence to treatment which suggests that internalised stigma may be a very important factor influencing medication adherence in patients with OCD.


2020 ◽  
Vol 237 (10) ◽  
pp. 3117-3123
Author(s):  
Christine Lochner ◽  
Samuel R. Chamberlain ◽  
Martin Kidd ◽  
Lian Taljaard ◽  
Naomi A. Fineberg ◽  
...  

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