Along the fringes of Agency: neurodevelopmental account of the obsessive mind

Poletti, Michele; Gebhardt, Eva; Raballo, Andrea

doi:10.1017/s1092852921000560

Cited by 7 publications

(7 citation statements)

References 59 publications

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“…No differences were found in terms of depressive symptoms, ordering/obsessing symptoms, or dysfunctional beliefs. Associations between psychotic vulnerability and greater OCD severity may be explained by a shared neurodevelopmental background of the two disorders, based on aberrant multisensory integration [55]. Whilst de cits in sensory processing play a pivotal role in schizophrenia [56,57], growing evidence indicate a similar pathophysiological mechanism also at work in OCD.…”

Section: Discussionmentioning

confidence: 99%

Psychotic vulnerability and its associations with clinical characteristics in children and adolescents with Obsessive-Compulsive Disorder

Borrelli

Cervin

Ottoni

et al. 2023

Preprint

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Compared to peers, children, and adolescents with Obsessive-Compulsive Disorder (OCD) are at increased risk of developing psychotic disorders. Yet very few studies have examined early indicators of psychosis in pediatric OCD. In the present study, 52 pediatric outpatients (mean age = 15.66 [SD = 2.33], 59.6% girls) with a primary diagnosis of OCD were interviewed using the Schizophrenia Proneness Instrument Child and Adolescent version (SPI-CY), which is a comprehensive clinical interview assessing both Cognitive–Perceptual basic symptoms (COPER) and high-risk criterion Cognitive Disturbances (COGDIS). Associations between COPER/COGDIS symptoms and demographic and clinical characteristics were examined. COPER or COGDIS symptoms were present in 44% of participants, with no significant difference in frequency between girls and boys. Psychotic vulnerability was associated with an earlier age of OCD onset, greater OCD severity, and poorer insight. Further, it was strongly associated with worse psychosocial functioning and explained 22% of unique variance in this variable. Findings suggest that early indicators of psychosis are frequent in pediatric OCD and associated with more severe OCD and poorer functioning. Research examining how psychotic vulnerability in pediatric OCD is associated with short- and long-term outcome is needed.

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Section: Discussionmentioning

confidence: 99%

Psychotic vulnerability and its associations with clinical characteristics in children and adolescents with Obsessive-Compulsive Disorder

Borrelli

Cervin

Ottoni

et al. 2023

Preprint

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“…Therefore, at least in the sensorimotor domain [11], the comparator model of OCD patients is inaccurate in predictions and too sensible in error detection; a persistence individual history of interaction with the surrounding world through this poorly calibrated comparator model may lead to the progressive subjective emergence of SP as NJRE and FInc. In a congruent perspective, it is possible to hypothesize that the obsessive need for order and symmetry (and the related ordering and arranging compulsions) could represent a compensatory attempt to mitigate SP by increasing the sensory predictability of the surrounding world, conferring it a rigidly structured spatial organization [7].…”

Section: Discussionmentioning

confidence: 99%

“…OCD patients' descriptions indicate that SP are passively felt as sensorimotor, quasi-atmospheric perceptions perturbing the normal flow of consciousness. Similarly to obsessions, SP are felt by OCD patients with a reduced SoA [4,6,7], in particular, in relation to the feeling of agency, i.e., the pre-reflective, low-level, and nonconceptual feeling of control over one's own mental contents or actions and their consequences (in comparison with the conscious judgment of agency [13][14][15][16]). Overall, a variety of mental phenomena such as obsessive thoughts and SP precede, trigger, and accompany OCD compulsions (i.e., the ritualistic acts stereotypically performed to mitigate the distress engendered by obsessions).…”

Section: Towards a Phenomenological Modelmentioning

confidence: 99%

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Neurodevelopmental Antecedents and Sensory Phenomena in Obsessive Compulsive Disorder: A Systematic Review Supporting a Phenomenological-Developmental Model

et al. 2022

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Background: The majority of models on obsessive compulsive disorder (OCD) endorse a top-down perspective on the cognitive mechanisms underlying OCD functioning and maintenance, whereas a bottom-up perspective is rarely pursued. Objectives: The aim of the study was to review the empirical literature on sensory phenomena (SP) and neurodevelopmental antecedents of OCD, which could support the conceptualization of an alternative, bottom-up perspective integrating neurodevelopmental and phenomenological levels of analysis on OCD. Methods: A systematic review according to PRISMA guidelines was performed in PubMed/MEDLINE, PsycInfo, the Cochrane Library, and Excerpta Medica Database (EMBASE) and focused on SP and “neurodevelopmental antecedents” (operationalized in early risk factors, neuroimaging signs, neurological soft signs, and sensory responsivity). The time interval was from inception up to March 31, 2022. Results: From the search in electronic databases, 48 studies were retained and reviewed. SP are highly prevalent in OCD patients and overrepresented in comparison with healthy controls. Similarly, OCD patients also present a higher prevalence of early environmental adversities and sensorimotor alterations in terms of neurological soft signs and sensory over-responsivity in the tactile and acoustic domains; additional findings included hypogyrification signs at neuroimaging. Both sensorimotor alterations and SP are associated with tic-related manifestations and poorer insight in OCD patients. Conclusions: On the ground of established common subjective experience of SP and premorbid neurodevelopmental features, we hypothesized an explanatory model for OCD, which considers the possible pathophysiological role for altered corollary discharge and enhanced error detection in the neurodevelopment of SP and obsessions. SP may represent the subjective experiential resonance of an individual history of persistently inaccurate sensory predictions, whereas accompanying manifestations, such as the obsessive need for order and symmetry, may represent a compensatory attempt to mitigate SP. This neurodevelopmental-phenomenological bottom-up model, describing a dimensional gradient of sensorimotor alterations and related subjective experiences, may contribute to explain the dimensional affinity between OCD and schizophrenia spectrum disorders. Furthermore, this model could be useful for the early detection of subjects at higher risk of OCD.

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“…anxiety and depression as aspects of prodromal delusional mood) and others being more typical of nonpsychotic disorders [14]. As we will discuss later, recent research suggests that the current notion of obsession likewise could encompass several subtypes of phenomena potentially associated with different diagnostic groups and clinical trajectories [15].…”

Section: Obsessive-compulsive Symptoms In At-risk Mental State For Ps...mentioning

confidence: 99%

Obsessive-compulsive symptoms in the schizophrenia-spectrum: current developments in psychopathology research

Rasmussen

Raballo

2023

Current Opinion in Psychiatry

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Purpose of reviewSchizophrenia-spectrum disorders (SSD) frequently involve symptoms that usually are ascribed to nonpsychotic disorder spectra, such as obsessive-compulsive symptoms (OCS). These symptoms can cause differential diagnostic challenges, particularly in early illness stages, and must be considered in treatment planning. In this review, we provide an overview of recent literature within the field of OCS in SSD, with a focus on psychopathology research.Recent findingsOCS are seen in approximately a quarter of patients with SSD or at-risk mental state of psychosis. They are associated with more severe clinical features and specific temporal patterns of OCS may be linked with different clinical trajectories. However, the current definitions of OCS have been criticized for their overinclusive nature, which is a limiting step for differential diagnosis and more precise prognostic stratification. Specific phenomenological features, including a link with experiential anomalies (disorders of basic self), have been suggested to provide clinically relevant distinctions.SummaryThe presence of OCS in SSD is associated with more severe clinical features and invites a higher clinical attention and perspectival monitoring. Some findings suggest that more fine-grained psychopathological distinctions might be a viable clinical and research strategy to advance the field in the direction of precision psychiatry.

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Along the fringes of Agency: neurodevelopmental account of the obsessive mind

Cited by 7 publications

References 59 publications

Psychotic vulnerability and its associations with clinical characteristics in children and adolescents with Obsessive-Compulsive Disorder

Psychotic vulnerability and its associations with clinical characteristics in children and adolescents with Obsessive-Compulsive Disorder

Neurodevelopmental Antecedents and Sensory Phenomena in Obsessive Compulsive Disorder: A Systematic Review Supporting a Phenomenological-Developmental Model

Obsessive-compulsive symptoms in the schizophrenia-spectrum: current developments in psychopathology research

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