Medicine and Health Sciences Commons^™

Sexual Obsessions In A Patient With Schizophrenia, Mohsin Raza, Barbara L. Gracious

HCA Healthcare Journal of Medicine

Obsessive-compulsive symptoms in schizophrenia are often initially unrecognized or missed entirely in the diagnostic process. Sexual obsession is common in patients with schizophrenia. Therefore, identifying sexual obsession early in treatment has significant implications for appropriate multidisciplinary management and prognosis. We report the case of a Hispanic male in his 20s who presented with self-injurious behavior and worsening psychotic symptoms in the context of a recent diagnosis of schizophrenia and without a past diagnosis or historical symptoms of obsessive-compulsive disorder (OCD). This report elucidates the importance of identifying the underlying cause of self-injurious behavior, which in this young man was due …

Bolstering The Effectiveness Of Exposure-Response Prevention In The Treatment Of Obsessive-Compulsive Disorder: Using Self-Compassion As An Adjunctive Intervention, Whitney E. Dyer

DSW Capstone Projects

Individuals suffering with Obsessive-Compulsive Disorder (OCD) face many challenges receiving proper diagnostics and evidence-based treatment. Furthermore, Exposure-Response Prevention (ERP), the empirically supported gold standard approach for targeting OCD, presents its own challenges. Examining the influences of ERP treatment reluctance is paramount to bolstering the effectiveness of outcomes and safeguarding participant adherence and ultimate success. This Capstone highlights the overlooking of addressing shame within traditional ERP protocol and posits a practice application model that supports the adjunctive use of self-compassion, a potent antidote for shame, within the use of ERP. As treatment hesitation is an inhibitor to relief for OCD sufferers, …

Intensive Outpatient Acceptance And Commitment Therapy With Exposure And Response Prevention For Adolescents, Julie M. Petersen, Patricia Zurita Ona, Moorea Blythe, Clara M. Möller, Michael P. Twohig

Psychology Student Research

Intensive treatments for youth obsessive-compulsive disorder (OCD) are important and underresearched. This study used three adolescent cases to assess the preliminary efficacy of an intensive treatment combining acceptance and commitment therapy (ACT) with exposure and response prevention (ERP) for OCD. Participants received intensive treatment for 15 hours per week for three weeks. Assessments were collected at pre-treatment, weekly during treatment, and at posttreatment. All participants ended treatment in the mild range of OCD severity with 32-60% reductions in symptoms. Participants also reported notable improvements in psychological flexibility and ended treatment in the non-clinical range of depression, anxiety, and stress. These …

A Preliminary Examination Of Acceptance And Commitment Therapy (Act) Versus Exposure And Response Prevention (Erp) For Patients With Obsessive-Compulsive Disorder On An Optimal Dose Of Ssris: A Randomized Controlled Trial In Iran, Mehdi Zemestani, Mojgan Salavati, Asrin Seyedolshohadayi, Julie M. Petersen, Clarissa W. Ong, Michael P. Twohig, Ebrahim Ghaderi

Psychology Student Research

This study compared the effects of adding acceptance and commitment therapy (ACT) or exposure and response prevention (ERP) to adults diagnosed with obsessive compulsive disorder (OCD) already on an optimal and stable dose of selective serotonin reuptake inhibitors (SSRIs). Forty adults on SSRIs who were diagnosed with OCD participated in a randomized controlled trial in Iran of 12 individual weekly sessions of either ACT+SSRI, ERP+SSRI, or continued SSRI only. The results showed significant reductions in OCD symptom severity in ACT+SSRI and ERP+SSRI conditions at posttreatment with significantly greater reductions in both conditions compared to SSRI-only at follow-up. Additionally, psychological inflexibility …

The Effectiveness Of Selective Serotonin Reuptake Inhibitors For Treatment Of Obsessive-Compulsive Disorder In Adolescents And Children: A Systematic Review And Meta-Analysis, Vijaya P. Kotapati, Ali M. Khan, Sara Dar, Gulshan Begum, Ramya Bachu, Mahwish Adnan, Aarij Zubair, Rizwan A. Ahmed

School of Medicine Publications and Presentations

Background: Obsessive-compulsive disorder (OCD) is a common behavioral disorder among adolescents and children. The selective serotonin reuptake inhibitors (SSRIs) are the first pharmacological choice for this condition due to mild adverse effect profile.

Objective: This systematic review was performed to evaluate the efficacy of SSRI for OCD in adolescents and children.

Methods: Search terms were entered into PubMed, PsycINFO, Scopus, CINAHL, and Google Scholar. The included studies were randomized, placebo-controlled trials of SSRIs conducted in populations of children and adolescents younger than 18 years. Change from baseline Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), end-treatment CY-BOCS with respective SD, and response and …

Susceptibility Of Mental Disorders: Examining The Comorbidity Of Seasonal Affective Disorder, Nathaniel Wasden

Student Works

This literature review examines the symptoms, theorized causes, and comorbidity of seasonal affective disorder (SAD). Although causes of SAD remain unknown, researchers have observed a common pattern of vitamin D deficiency among patients with SAD. The importance of vitamin D in regulating serotonergic activity has been well documented, including the positive correlation between decreased serotonin levels and increased depressive symptoms. For more than 30 years, researchers have hypothesized that decreased serotonin activity is linked to symptoms of SAD. Furthermore, patients with other mental disorders, including depression, bipolarity, obsessive-compulsive disorder, etc. are likely to experience aggravation of symptoms during peak SAD …

A Contemporary Psychometric Evaluation Of The Obsessive Compulsive Inventory-Revised (Oci-R), Bethany M. Wootton, Gretchen J. Diefenbach, Laura B. Bragdon, Gail Steketee, Randy O. Frost, David F. Tolin

Psychology: Faculty Publications

Traditionally, hoarding symptoms were coded under obsessive-compulsive disorder (OCD), however, in DSM-5 hoarding symptoms are classified as a new independent diagnosis, hoarding disorder (HD). This change will likely have a considerable impact on the self-report scales that assess symptoms of OCD, since these scales often include items measuring symptoms of hoarding. This study evaluated the psychometric properties of one of the most commonly used self-report measures of OCD symptoms, the Obsessive-Compulsive Inventory-Revised (OCI-R), in a sample of 474 individuals with either OCD (n = 118), HD (n = 201), or no current or past psychiatric disorders (n = 155). Participants …

Hoarding Behaviour In An Italian Non-Clinical Sample, Francesco Bulli, Gabriele Melli, Claudia Carraresi, Eleonora Stopani, Alberto Pertusa, Randy O. Frost

Psychology: Faculty Publications

Background: Hoarding is associated with significant impairment. Although traditionally considered as a symptom of obsessive-compulsive disorder (OCD), some authors have proposed that pathological hoarding could be considered as a stand alone condition. The prevalence of pathological hoarding behaviour has been shown to be high in some countries, but little is known about the prevalence and correlates of hoarding in the non-clinical population in Italy. Method: We studied the prevalence of self-reported hoarding behaviour using the Italian version of the Saving Inventory-Revised, as well as the association between hoarding and various clinical correlates, including obsessive-compulsive symptoms, compulsive buying, anxiety, and depression. …

A Multitrait-Multimethod Matrix Investigation Of Hoarding, Joseph F. Meyer, Randy O. Frost, Timothy A. Brown, Gail Steketee, David F. Tolin

Psychology: Faculty Publications

Hoarding is a serious and potentially life-threatening mental health problem that, until recently, was considered a subtype of OCD. However, recent research suggests it is distinct and more prevalent than OCD. Three key defining features have emerged in factor analytic studies of hoarding scales: excessive acquisition, difficulty discarding, and excessive clutter. Covariation among these defining features has received limited attention. The primary aim of the current study was to examine the role of the three key features in defining hoarding disorder. Convergent and discriminant validity of the three hoarding factors were examined in a multitrait-multimethod matrix. A secondary aim was …

Lamotrigine Augmentation Of Serotonin Reuptake Inhibitors In Severe And Long-Term Treatment-Resistant Obsessive-Compulsive Disorder, Manuel Arrojo-Romero, María Tajes Alonso, Jose De Leon

Psychiatry Faculty Publications

The treatment recommendations in obsessive-compulsive disorder (OCD) after lack of response to selective serotonin reuptake inhibitors (SSRIs) include augmentation with other drugs, particularly clomipramine, a more potent serotonin reuptake inhibitor (SRI), or antipsychotics. We present two cases of response to lamotrigine augmentation in treatment-refractory OCD; each received multiple SRI trials over a >10-year period. The first patient had eleven years of treatment with multiple combinations including clomipramine and SSRIs. She had a >50% decrease of Y-BOCS (from 29 to 14) by augmenting paroxetine (60 mg/day) with lamotrigine (100 mg/day). The second patient had 22 years of treatment with multiple combinations, …

An Exploration Of Comorbid Symptoms And Clinical Correlates Of Clinically Significant Hoarding Symptoms, Brian J. Hall, David F. Tolin, Randy O. Frost, Gail Steketee

Psychology: Faculty Publications

Background Hoarding disorder (HD) is currently being considered for inclusion in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), yet remains poorly understood. Consensus is building that hoarding may constitute a separate disorder, although comorbidity remains high and complicates the diagnostic picture. The purpose of this investigation was to explore patterns of comorbidity among people who engage in hoarding behavior in order to better understand its clinical presentation and phenomenology. Methods Data were collected from a large internet sample (N = 363) of people who self-identified as having hoarding problems, met criteria for clinically significant hoarding, and …

Recruitment Of African Americans For Obsessive Compulsive Disorder Treatment Research, Georgia Michalopoulou, Pamela Falzarano, David Rosenberg

Journal of Health Disparities Research and Practice

A systematic review of recruitment approaches was conducted as a step towards creating a culturally sensitive approach to enhance participation of African Americans into our Obsessive Compulsive Disorder (OCD) treatment research. From this review, a recruitment plan providing a collaborative partnership between the African American community and the clinical investigators was adopted. We sought to increase participation in OCD research by developing culturally sensitive educational materials, implementing strategies such as recruiter ethnic match, encouraging individuals to participate by a pastor, and providing education in the community that attempted to decrease stigmatization of mental illness and target cultural suspicion of institutional …

Ocd As A Dynamical Disease And The Familial Context Of Ritual Rigidity: A Nonlinear Dynamics Perspective, Robert W. Bond

Dissertations (1934 -)

Comparatively few studies of obsessive compulsive disorder (OCD) have addressed the interpersonal dynamical patterns within families that could exacerbate or quell symptom severity in the ill relatives or hypothesize other roles for familial variables. Furthermore, the extant studies have relied primarily upon linear models. Methodological limitations of linear models, such as assuming that change occurs as the result of unidirectional influences and that the scores obtained for each variable are independent of each other are at variance with temporal, dynamic phenomena and have restricted the empirical investigations of the dynamics of OCD.

The current study investigated whether OCD could be …

A Brief Interview For Assessing Compulsive Hoarding: The Hoarding Rating Scale-Interview, David F. Tolin, Randy O. Frost, Gail Steketee

Psychology: Faculty Publications

This article describes the development and validation of the Hoarding Rating Scale-Interview (HRS-I), a brief (5-10 min) five-item semi-structured interview that assesses the features of compulsive hoarding (clutter, difficulty discarding, acquisition, distress and impairment). Trained interviewers administered the HRS-I to 136 adults (73 compulsive hoarding, 19 OCD, 44 non-clinical controls) along with a battery of self-report measures. An initial assessment was conducted in the clinic, and a second assessment was conducted in participants' homes. The HRS-I showed high internal consistency and reliability across time and context. The HRS-I clearly differentiated hoarding and non-hoarding participants, and was strongly associated with other …

The Economic And Social Burden Of Compulsive Hoarding, David F. Tolin, Randy O. Frost, Gail Steketee, Krista D. Gray, Kristin E. Fitch

Psychology: Faculty Publications

The aim of the present study was to determine the economic and social burden of compulsive hoarding in a large sample of individuals with self-identified hoarding, as well as a separate sample of family members of individuals who hoard. Self-identified hoarding participants (N = 864, 94% female, 65% met research criteria for clinically relevant compulsive hoarding) and family informants (N = 655, 58% described a relative who appeared to meet research criteria for compulsive hoarding), completed an internet survey. Questions were derived in part from those used in the National Comorbidity Survey (NCS), and when possible, hoarding participants were compared …

Family Burden Of Compulsive Hoarding: Results Of An Internet Survey, David F. Tolin, Randy O. Frost, Gail Steketee, Kristin E. Fitch

Psychology: Faculty Publications

Compulsive hoarding, the acquisition of and failure to discard large numbers of possessions, is associated with substantial health risk, impairment in functioning, and economic burden. Despite clear indications that hoarding has a detrimental effect on people living with or near someone with a hoarding problem, no empirical research has examined these harmful effects. The aim of the present study was to examine the burden of hoarding on family members. Six hundred sixty-five family informants who reported having a family member or friend with hoarding behaviors completed an internet-based survey. Living with an individual who hoards during childhood was associated with …

Love-Variant: The Wakin-Vo I. D. R. Model Of Limerence, Albert H. Wakin, Duyen B. Vo

Psychology Faculty Publications

The purpose of the current paper is to 1) propose the Wakin-Vo I.D.R model of limerence and 2) establish grounds for the scientific query of limerence. Limerence is an involuntary interpersonal state that involves intrusive, obsessive, and compulsive thoughts, feelings, and behaviors that are contingent on perceived emotional reciprocation from the object of interest. The model that the authors propose holds that although limerence resembles normative love, it is a state that is necessarily negative, problematic, and impairing, with clinical implications. The model frames limerence as consisting of three functional components: initiating force, driving forces, and resultant forces. Parallels between …

An Open Trial Of Cognitive-Behavioral Therapy For Compulsive Hoarding, David F. Tolin, Randy O. Frost, Gail Steketee

Psychology: Faculty Publications

The aim of the present study was to provide preliminary data on the efficacy of a new cognitive-behavioral treatment (CBT) for compulsive hoarding. Fourteen adults with compulsive hoarding (10 treatment completers) were seen in two specialty CBT clinics. Participants were included if they met research criteria for compulsive hoarding according to a semistructured interview, were age 18 or above, considered hoarding their main psychiatric problem, and were not receiving mental health treatment. Patients received 26 individual sessions of CBT, including frequent home visits, over a 7-12 month period between December 2003-February 2005. Primary outcome measures were the Saving Inventory-Revised (SI-R), …