Effects of Insight With Obsessive Beliefs and Metacognition Appraisal On Symptoms’ Severity Among Patients With Obsessive Compulsive Disorder

Background: Obsessive Compulsive Disorder (OCD) is among the top ten devastating mental disorders. Psychiatric nurses have significant roles in its diagnosis and management. Aim of the study: to investigate the effects of insight with obsessive beliefs and metacognition appraisal on the severity of symptoms among patients with OCD. Subjects and methods: This case-control study was conducted in the outpatient clinics at El Maamoura Mental Health Hospital. It included 69 OCD patients recruited from the setting, and 69 age- and gender-matched healthy controls. A self-administered questionnaire Yale Brown OCD Scale, Overvalued Ideas Scale (OVIS), and Metacognitions Questionnaire (MCQ-30) was used in data collection. The fieldwork was from October 2020 to March 2021. Results: Most patients were diagnosed with OCD at <30 years age (78.3%), and 39.1% tried self-management. OCD patients’ scores of Yale Brown, OVIS, and MCQ-30 were significantly higher than controls (p<0.001). A significant positive correlation was found between Yale Brown severity and OVIS insight scores (r=0.459). The multivariate analysis revealed that OVIS score is the strongest independent positive predictor of the Yale Brown severity score, while good family relations is a negative predictor. As for the MCQ-30, the control thoughts score was a positive predictor, and the self-consciousness score a negative predictor. Conclusion and recommendations: OCD patients have poorer insight and more maladaptive metacognitive beliefs in comparison with healthy controls. Although poor insight has a significant negative impact on OCD severity, the effects of metacognition still need further research. The study recommends training programs to improve the insight of OCD patients. Further research addressing the role of metacognition in OCD is warranted.

Validation of the Arabic version of the Dusseldorf Orthorexia Scale (DOS) among Lebanese adolescents

Background Orthorexia Nervosa (ON) is defined as a pathological preoccupation characterized by obsessive beliefs and compulsive behaviors regarding 'pure' eating behaviors. Many scales have been established and display good results regarding reliability and validity measures, including but not limited to ORTO-R (revised version of ORTO-15), Eating Habits Questionnaire, Teruel Orthorexia Scale (TOS) and the Düsseldorf Orthorexia Scale (DOS). Among these, the DOS seems to be a promising measure for multiple reasons. The current paper aims to validate the DOS, a measure of ON, in a non-Western population of Lebanese adolescents. Methods This was a cross-sectional designed study, conducted between May and June 2020, which enrolled 555 adolescents (15–18 years old; 75.7% females). Due the coronavirus pandemic outbreak, the data were gathered through snowball sampling using an online questionnaire. The DOS, TOS and ORTO-R scales were used in this study to screen for orthorexic tendencies and behaviors. Results We tested four competing structural models of the DOS assessing its factorial validity. The results of the current investigation revealed that the one-factorial model is the best one to represent the structure of the questionnaire. We provided evidence for validity for the DOS through demonstrating that it correlates significantly with other measures of orthorexic behaviours (Teruel Orthorexia Scale and ORTO-R). Finally, we have gathered evidence that the orthorexic behaviours as measured by DOS are not associated with age (r = −.02; p = .589), household crowding index (r = .02; p = .578), and Body Mass Index (r = .04; p = .297). Yet, females as compared to males achieved higher scores (M = 20.07, SD = 6.38 vs M = 18.29, SD = 6.37; p = .005; d = .28). Conclusion The Arabic version of the DOS seems to be a structurally valid and internally consistent questionnaire measuring orthorexic eating behavior in a sample of Lebanese adolescents. This tool may be useful for psychologists, psychiatrists, dietitians and other clinicians in the assessment and the treatment of the multidimensional nature of ON.

Designing the Relationship Obsessive-Compulsive Inventory (ROCI) Based on Iranian Culture and Evaluation of Its Psychometric Properties

Objective: The purpose of the present study was to evaluate the factor structure, validity, and reliability of the revised Relationship Obsessive-Compulsive Inventory (ROCI), with emphasis on Iranian culture. Method: The statistical sample consisted of 341 married students studying in Tehran universities in the academic year 2018-2019, who were selected by available sampling method. The New ROCI, Obsessive-Compulsive Inventory-Revised (OCI-R), Obsessive Beliefs Questionnaire (OBQ), Depression, Anxiety and Stress Scale (DASS), Dyadic Adjustment Scale (DAS), and Relationship beliefs inventory (RBI) were the tools of the present study. Results: The Content Validity Index (CVI) and Content Validity Ratio (CVR) of the new ROCI were good. Also, there was a significant and negative correlation between all subscales and the total score of the new ROCI with all subscales and the total score of the DAS, and there was also a significant positive correlation between the subscales and the total score of the new ROCI with the subscales and the total score of OBQ, OCI-R, RBI, and DASS. Also, the two factor model explained 54.50% of the variance in the new ROCI. Furthermore, all of the confirmatory factor analysis indices of the new ROCI were better than the original ROCI. The results of test-retest correlation of the factor one and two of ROCI were 0.85 and 0.78, respectively. Also, the Cronbach's alpha of the factor one and two of ROCI were 0.60 and 0.74, respectively. Conclusion: In general, it can be said that the new ROCI was different from the original ROCI, and the new ROCI had better indicators than the original ROCI.

Distinct clinical manifestations of obsessive-compulsive disorder are associated with cortical thickness alteration

Background: Although brain structural changes have been reported in patients with obsessive-compulsive disorder (OCD), results from previous studies have been inconsistent. A growing number of studies have focused on obsessive beliefs and impulsivity which could be involved in the occurrence and maintenance of OCD symptoms. The present study aimed to examine whether there are distinct brain structural changes in patients with different OCD subgroups. Methods: Eighty-nine patients with OCD and 42 healthy controls were recruited to undergo structural magnetic resonance imaging brain scan. OCD patients were classified into subgroups according to scores of the Obsessive Belief Questionnaire (OBQ-44) and the Barratt Impulsiveness Scale (BIS-11) using cluster analysis. Group comparisons in cortical thickness and subcortical volumes between all OCD patients and healthy controls, as well as between subgroups of OCD patients and healthy controls, were carried out. Results: OCD patients with more obsessive beliefs and attentional impulsivity (OCD_OB_AT) had reduced cortical thickness at the inferior parietal gyrus, the superior and middle temporal gyrus and the insula compared with OCD patients with higher score on the non-planning impulsivity (OCD_NP, corrected p < 0.05). The whole group of OCD patients and both subgroups showed reduced cortical thickness at the superior parietal gyrus compared with controls (uncorrected p < 0.01, number of vertices > 100). Conclusion: Our results suggest that apart from distinct phenomenology, there are distinct neural correlates of different OCD subgroups based on obsessive beliefs and impulsivity. These neural correlates may have clinical significance and should be considered in future research.

Executive Functioning and Clinical Variables in Patients with Obsessive-Compulsive Disorder

Background: Cognitive flexibility, response inhibition, and working memory are considered the main mechanisms responsible for executive control. This study examined differences in cognitive flexibility, inhibition, and working memory in patients with obsessive–compulsive disorder (OCD) relative to a control group. Method: A total of 62 obsessive-compulsive participants (OCD = 32; healthy control = 32) aged between 17 and 56 years old (M = 33.16, SD = 9.23) were administered the computerized Wisconsin Card Sorting Test, Stroop Color–Word Test, Go/No-Go Task, Digit Test, and Corsi Block Test. Clinician-rated and self-reported obsessive–compulsive symptom severity, and anxiety, depression, and obsessive beliefs were evaluated. Results: The control group performed better than the OCD group in tasks involving cognitive flexibility, inhibition, and visuospatial working memory. Anxiety and obsessive beliefs influenced the participants’ performance on inhibition and working memory tasks. Similarly, comorbidity also influenced inhibition and working memory. In addition, the use of pharmacotherapy and the degree of OCD symptom severity influenced verbal working memory. Conclusions: Cognitive flexibility, inhibition, and visuospatial working memory deficits may be endophenotypes of OCD but require further examination for specificity. OCD severity, comorbidity patterns, anxiety, and obsessive beliefs may influence performance.