Hedging in decision making in disorders of the impulsive-compulsive spectrum

This dissertation comprises three studies that investigated the construct of hedging as a decision making strategy in individuals with Obsessive-Compulsive Disorder (OCD). Hedging refers to the tendency to keep options available when there is a threat of loss of the options that is motivated by the underlying construct of loss aversion (i.e., Prospect Theory). Hedging introduces a behavioural economic approach to the study and understanding of the impact of loss aversion on decision making. Participants played two conditions of the Doors Game (Shin & Ariely, 2004) in which they were instructed to maximize their earnings by tapping three doors in any order: i) constant availability (CA), where all doors remain available; and ii) decreasing availability (DA), where doors fade and disappear if left untapped after a short time (to elicit hedging). In Study One, undergraduates (N = 108) played both the CA and DA conditions and evidence indicates more frequent switching in the DA than the CA condition. There was also a significant negative association between hedging and the cognitive concern subscale of anxiety sensitivity. Study Two examined other psychological correlates of hedging in another undergraduate sample (N = 63) and yielded significant negative associations with the physical component of state anxiety and experience seeking. In Study Three, the results of a comparison of hedging among OCD, Gambling Disorder (GD), and Healthy Control (HC) groups yielded no significant differences. Correlates of hedging, however, differed among the groups and regression analyses suggest that hedging in OCD is negatively predicted by obsessiveness and decisiveness (subscale of the Need for Cognitive Closure; NFC), and positively predicted by experience seeking (subscale of the Sensation Seeking Scale). In the GD group, closed-mindedness (subscale of NFC) positively predicted hedging. In the HC group, fun-seeking (subscale of Behavioral Inhibition and Behavioral Activation Scale) positively predicted hedging. Implications: This work is the first to demonstrate predictors of hedging in OCD using a loss aversion paradigm where evidence suggests that obsessional and motivational drives lead to premature choice selection. Pursuing the loss aversion perspective could significantly advance the decision making research in OCD and in other clinical populations.

Hedging in decision making in disorders of the impulsive-compulsive spectrum

10.32920/ryerson.14655960 ◽

2021 ◽

Author(s):

Syb Pongracic

Keyword(s):

Decision Making ◽

Loss Aversion ◽

Sensation Seeking ◽

Behavioral Activation ◽

Sensitivity Study ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Frequent Switching ◽

Fun Seeking ◽

Using Cognitive-Behavioral Therapy to Treat Obsessive-Compulsive Disorder With Co-Occurring Depression

Journal of Cognitive Psychotherapy ◽

10.1891/0889-8391.33.3.228 ◽

2019 ◽

Vol 33 (3) ◽

pp. 228-241 ◽

Cited By ~ 2

Author(s):

Michael G. Wheaton ◽

Epifania Rita Gallina

Keyword(s):

Cognitive Behavioral Therapy ◽

Behavioral Activation ◽

Behavioral Therapy ◽

Cognitive Behavioral ◽

Future Research ◽

Comorbid Depression ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Many individuals with obsessive-compulsive disorder (OCD) also experience co-occurring depression, which may complicate OCD treatment. Some data suggest that OCD patients with comorbid depression experience less improvement with cognitive-behavioral therapy (CBT), the recommended psychotherapy for OCD. In particular, depression may interfere with an individual's adherence to the tasks of CBT, particularly exposure and response prevention (ERP). However, successful interventions exist for depression within CBT, including both cognitive therapy and behavioral activation, which can be added in treating OCD patients with depression. This article reviews the literature on the impact of comorbid depression on OCD treatment and then describes the treatment of an adult with both conditions. This case history demonstrates how depression-specific interventions can be incorporated into standard ERP to maximize OCD treatment gains. We also review important practice points for treating clinicians and areas for future research.

Reducing the Social Stigma Associated with Obsessive Compulsive Disorder: A Controlled Trial of an Intervention Program in a Turkish Community Sample

Journal of Evidence-Based Psychotherapies ◽

10.24193/jebp.2020.2.14 ◽

2020 ◽

Vol 20 (2) ◽

pp. 101-120

Author(s):

Ayça Aktaç Gürbüz ◽

Orçun YORULMAZ ◽

Gülşah DURNA

Keyword(s):

Intervention Program ◽

Controlled Trial ◽

Community Sample ◽

Case Vignette ◽

Control Group ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Significant Difference ◽

Scientific research into the reduction of stigmatization, particularly related to specific problems such as Obsessive-Compulsive Disorder (OCD), is scarce. In the present study, we examine the impact of a video-based antistigma intervention program for OCD in a pretest-posttest control group research. After being randomly assigned to either an intervention (n= 101) or control group (n= 96), the participants reported their attitudes on a hypothetical case vignette before and after OCD vs. Multiple Sclerosis (MS) videos, and again six months later as a follow up assessment. The mixed design analyses for the group comparisons indicated that although there was no significant difference in the measures of the control group, the participants watching the anti-stigma OCD video, in which the focus was psychoeducation and interaction strategies, reported significantly lower scores on social distances and negative beliefs for the case vignettes they read, and this difference was maintained six months later. Then, the present results indicate the effectiveness of our anti-stigma intervention program for OCD. Interventions to reduce stigmatization can also be viewed as effective tools for changing the attitudes of people toward OCD, although further research and applications are needed related to specific disorders if a longlasting impact is to be achieved.

Pupil with Obsessive-Compulsive Disorder

Lifelong Learning ◽

10.11118/lifele201707027 ◽

2017 ◽

Vol 7 (2) ◽

pp. 7-25

Author(s):

Karolina Diallo

Keyword(s):

School Performance ◽

School Environment ◽

Detrimental Effect ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

The Past ◽

And Performance ◽

Pupil with Obsessive-Compulsive Disorder. Over the past twenty years childhood OCD has received more attention than any other anxiety disorder that occurs in the childhood. The increasing interest and research in this area have led to increasing number of diagnoses of OCD in children and adolescents, which affects both specialists and teachers. Depending on the severity of symptoms OCD has a detrimental effect upon child's school performance, which can lead almost to the impossibility to concentrate on school and associated duties. This article is devoted to the obsessive-compulsive disorder and its specifics in children, focusing on the impact of this disorder on behaviour, experience and performance of the child in the school environment. It mentions how important is the role of the teacher in whose class the pupil with this diagnosis is and it points out that it is necessary to increase teachers' competence to identify children with OCD symptoms, to take the disease into the account, to adapt the course of teaching and to introduce such measures that could help children reduce the anxiety and maintain (or increase) the school performance within and in accordance with the school regulations and curriculum.

Sex Differences in Anxiety Disorders

The Oxford Handbook of Evolutionary Psychology and Behavioral Endocrinology ◽

10.1093/oxfordhb/9780190649739.013.21 ◽

2019 ◽

pp. 404-432

Author(s):

Teresa A. Piggott ◽

Alexandra N. Duran ◽

Isha Jalnapurkar ◽

Tyler Kimm ◽

Stephanie Linscheid ◽

...

Keyword(s):

Sex Differences ◽

Anxiety Disorder ◽

Anxiety Disorders ◽

Stress Disorder ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Considerable Research ◽

Psychosocial Influences ◽

Psychiatric Conditions ◽

Women are more likely than men to meet lifetime criteria for an anxiety disorder. Moreover, anxiety is a risk factor for the development of other psychiatric conditions, including major depression. Numerous studies have identified evidence of sex differences in anxiety disorders, and there is considerable research concerning factors that may contribute to vulnerability for anxiety in females. In addition to psychosocial influences, biological components such as the female reproductive hormone cycle have also been implicated. Although psychotropic medication is more likely to be prescribed to women, there is little controlled data available concerning sex differences in the efficacy and/or tolerability of pharmacotherapy in anxiety disorders. This chapter provides an overview of the impact of gender in the epidemiology, phenomenology, course, and treatment response in generalized anxiety disorder (GAD), social anxiety disorder (SAD), posttraumatic stress disorder (PTSD), panic disorder (PD), and obsessive-compulsive disorder (OCD).

Service-user efforts to maintain their wellbeing during and after successful withdrawal from antipsychotic medication

Therapeutic Advances in Psychopharmacology ◽

10.1177/2045125321989133 ◽

2021 ◽

Vol 11 ◽

pp. 204512532198913

Author(s):

Miriam Larsen-Barr ◽

Fred Seymour

Keyword(s):

Antipsychotic Medication ◽

Online Survey ◽

Structured Interviews ◽

Obsessive Compulsive ◽

Convenience Sample ◽

Internal Resources ◽

Compulsive Disorder ◽

What Works ◽

Systemic Factors ◽

Background: It is well-known that attempting antipsychotic withdrawal can be a fraught process, with a high risk of relapse that often leads people to resume the medication. Nonetheless, there is a group of people who appear to be able to discontinue successfully. Relatively little is known about how people do this. Methods: A convenience sample of adults who had stopped taking antipsychotic medication for more than a year were recruited to participate in semi-structured interviews through an anonymous online survey that investigated antipsychotic medication experiences in New Zealand. Thematic analysis explored participant descriptions of their efforts to maintain their wellbeing during and after the withdrawal process. Results: Of the seven women who volunteered to participate, six reported bipolar disorder diagnoses and one reported diagnoses of obsessive compulsive disorder and depression. The women reported successfully discontinuing antipsychotics for 1.25–25 years; six followed a gradual withdrawal method and had support to prepare for and manage this. Participants defined wellbeing in terms of their ability to manage the impact of any difficulties faced rather than their ability to prevent them entirely, and saw this as something that evolved over time. They described managing the process and maintaining their wellbeing afterwards by ‘understanding myself and my needs’, ‘finding what works for me’ and ‘connecting with support’. Sub-themes expand on the way in which they did this. For example, ‘finding what works for me’ included using a tool-box of strategies to flexibly meet their needs, practicing acceptance, drawing on persistence and curiosity and creating positive life experiences. Conclusion: This is a small, qualitative study and results should be interpreted with caution. This sample shows it is possible for people who experience mania and psychosis to successfully discontinue antipsychotics and safely manage the impact of any symptoms that emerge as a result of the withdrawal process or other life stressors that arise afterwards. Findings suggest internal resources and systemic factors play a role in the outcomes observed among people who attempt to stop taking antipsychotics and a preoccupation with avoiding relapse may be counterproductive to these efforts. Professionals can play a valuable role in facilitating change.

Experiences of Mental Distress during COVID-19: Thematic Analysis of Discussion Forum Posts for Anxiety, Depression, and Obsessive-Compulsive Disorder

Illness Crisis & Loss ◽

10.1177/10541373211023951 ◽

2021 ◽

pp. 105413732110239

Author(s):

G. Brewer ◽

L. Centifanti ◽

J. Castro Caicedo ◽

G. Huxley ◽

C. Peddie ◽

...

Keyword(s):

Mental Distress ◽

Psychological Impact ◽

Discussion Forum ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Care Workers ◽

Positive Experiences ◽

Anxiety Depression ◽

The psychological impact of the COVID-19 pandemic on coronavirus patients, health care workers, and the general population is clear. Relatively few studies have, however, considered the impact of the pandemic on those with pre-existing mental health conditions. Therefore, the present study investigates the personal experiences of those with anxiety, depression, and obsessive-compulsive disorder during COVID-19. We conducted a qualitative study utilising Reddit discussion forum posts. We conducted three separate thematic analyses from 130 posts in subreddit forums aimed for people identifying with anxiety, depression, and obsessive-compulsive disorder. We identified a number of similar discussion forum themes (e.g., COVID-19 intensifying symptoms and a lack of social support), as well as themes that were unique to each forum type (e.g., hyperawareness and positive experiences during the pandemic). Findings should guide future practice and the support provided to those living with mental distress.

Decision-making under uncertainty in obsessive–compulsive disorder

Journal of Psychiatric Research ◽

10.1016/j.jpsychires.2015.08.011 ◽

2015 ◽

Vol 69 ◽

pp. 166-173 ◽

Cited By ~ 30

Author(s):

Helen Pushkarskaya ◽

David Tolin ◽

Lital Ruderman ◽

Ariel Kirshenbaum ◽

J. MacLaren Kelly ◽

...

Keyword(s):

Decision Making ◽

Decision Making Under Uncertainty ◽

Obsessive Compulsive ◽

Compulsive Disorder

Further evidence of a dissociation between decision-making under ambiguity and decision-making under risk in obsessive–compulsive disorder

Journal of Affective Disorders ◽

10.1016/j.jad.2015.01.060 ◽

2015 ◽

Vol 176 ◽

pp. 118-124 ◽

Cited By ~ 28

Author(s):

Hae Won Kim ◽

Jee In Kang ◽

Kee Namkoong ◽

Kyungun Jhung ◽

Ra Yeon Ha ◽

...

Keyword(s):

Decision Making ◽

Decision Making Under Risk ◽

Obsessive Compulsive ◽

Compulsive Disorder

How New Technologies Can Improve Prediction, Assessment, and Intervention in Obsessive-Compulsive Disorder (e-OCD): Review

JMIR Mental Health ◽

10.2196/11643 ◽

2019 ◽

Vol 6 (12) ◽

pp. e11643 ◽

Cited By ~ 3

Author(s):

Florian Ferreri ◽

Alexis Bourla ◽

Charles-Siegfried Peretti ◽

Tomoyuki Segawa ◽

Nemat Jaafari ◽

...

Keyword(s):

Machine Learning ◽

Virtual Reality ◽

New Technologies ◽

Assessment Tools ◽

Clinical Practices ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Pubmed Database ◽

Background New technologies are set to profoundly change the way we understand and manage psychiatric disorders, including obsessive-compulsive disorder (OCD). Developments in imaging and biomarkers, along with medical informatics, may well allow for better assessments and interventions in the future. Recent advances in the concept of digital phenotype, which involves using computerized measurement tools to capture the characteristics of a given psychiatric disorder, is one paradigmatic example. Objective The impact of new technologies on health professionals’ practice in OCD care remains to be determined. Recent developments could disrupt not just their clinical practices, but also their beliefs, ethics, and representations, even going so far as to question their professional culture. This study aimed to conduct an extensive review of new technologies in OCD. Methods We conducted the review by looking for titles in the PubMed database up to December 2017 that contained the following terms: [Obsessive] AND [Smartphone] OR [phone] OR [Internet] OR [Device] OR [Wearable] OR [Mobile] OR [Machine learning] OR [Artificial] OR [Biofeedback] OR [Neurofeedback] OR [Momentary] OR [Computerized] OR [Heart rate variability] OR [actigraphy] OR [actimetry] OR [digital] OR [virtual reality] OR [Tele] OR [video]. Results We analyzed 364 articles, of which 62 were included. Our review was divided into 3 parts: prediction, assessment (including diagnosis, screening, and monitoring), and intervention. Conclusions The review showed that the place of connected objects, machine learning, and remote monitoring has yet to be defined in OCD. Smartphone assessment apps and the Web Screening Questionnaire demonstrated good sensitivity and adequate specificity for detecting OCD symptoms when compared with a full-length structured clinical interview. The ecological momentary assessment procedure may also represent a worthy addition to the current suite of assessment tools. In the field of intervention, CBT supported by smartphone, internet, or computer may not be more effective than that delivered by a qualified practitioner, but it is easy to use, well accepted by patients, reproducible, and cost-effective. Finally, new technologies are enabling the development of new therapies, including biofeedback and virtual reality, which focus on the learning of coping skills. For them to be used, these tools must be properly explained and tailored to individual physician and patient profiles.