An empirical investigation of incompleteness in a large clinical sample of obsessive compulsive disorder

Sibrava, Nicholas J.; Boisseau, Christina L.; Eisen, Jane L.; Mancebo, Maria C.; Rasmussen, Steven A.

doi:10.1016/j.janxdis.2016.05.005

Cited by 31 publications

(20 citation statements)

References 49 publications

(60 reference statements)

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“…Patients with obsessive-compulsive disorder (OCD) suffer from intrusive thoughts, fears, or images (obsessions), with or without ritualized repetitive behaviors (compulsions), which are carried out to reduce the anxiety or discomfort elicited by obsessions or by subjective feelings. Examples include the need to relieve a tactile sensation or achieve a “just right” feeling [1–3]. The lifetime prevalence of OCD in the general population is up to 3% [4].…”

Section: Introductionmentioning

confidence: 99%

Evolution of gamma knife capsulotomy for intractable obsessive-compulsive disorder

et al. 2018

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For more than half a century, stereotactic neurosurgical procedures have been available to treat patients with severe, debilitating symptoms of obsessive-compulsive disorder (OCD) that have proven refractory to extensive, appropriate pharmacological, and psychological treatment. Although reliable predictors of outcome remain elusive, the establishment of narrower selection criteria for neurosurgical candidacy, together with a better understanding of the functional neuroanatomy implicated in OCD, has resulted in improved clinical efficacy for an array of ablative and non-ablative intervention techniques targeting the cingulum, internal capsule, and other limbic regions. It was against this backdrop that gamma knife capsulotomy (GKC) for OCD was developed. In this paper, we review the history of this stereotactic radiosurgical procedure, from its inception to recent advances. We perform a systematic review of the existing literature and also provide a narrative account of the evolution of the procedure, detailing how the procedure has changed over time, and has been shaped by forces of evidence and innovation. As the procedure has evolved and adverse events have decreased considerably, favorable response rates have remained attainable for approximately one-half to two-thirds of individuals treated at experienced centers. A reduction in obsessive-compulsive symptom severity may result not only from direct modulation of OCD neural pathways but also from enhanced efficacy of pharmacological and psychological therapies working in a synergistic fashion with GKC. Possible complications include frontal lobe edema and even the rare formation of delayed radionecrotic cysts. These adverse events have become much less common with new radiation dose and targeting strategies. Detailed neuropsychological assessments from recent studies suggest that cognitive function is not impaired, and in some domains may even improve following treatment. We conclude this review with discussions covering topics essential for further progress of this therapy, including suggestions for future trial design given the unique features of GKC therapy, considerations for optimizing stereotactic targeting and dose planning using biophysical models, and the use of advanced imaging techniques to understand circuitry and predict response. GKC, and in particular its modern variant, gamma ventral capsulotomy, continues to be a reliable treatment option for selected cases of otherwise highly refractory OCD.

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Section: Introductionmentioning

confidence: 99%

Evolution of gamma knife capsulotomy for intractable obsessive-compulsive disorder

et al. 2018

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“…the need to do something "just right" [24,25] . This is related to the notion that OCD patients suffer from a lack of a "stop" signal, thus continuing to act even after task completion [26] .…”

Section: Discussionmentioning

confidence: 99%

Nonfunctional Redundant Acts Characterize OCD, Even in OCD-Unrelated Tasks: A Demonstration in Questionnaire Completion

Amitai

Arnon²,

Shaham³

et al. 2017

Psychopathology

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Background: Ethological methods used to analyze human obsessive-compulsive disorder (OCD) rituals demonstrated excess of unnecessary repetitions as well as irrelevant, idiosyncratic acts (additions) compared to normal activity. A question that still remains is whether these well-known repetitions and additions are manifested in behaviors unrelated to the OCD rituals. Our objectives were to: (1) assess whether OCD-related repetitions and additions as found in previous studies also affect the patients' activity of filling out questionnaires and (2) evaluate the specificity of these behaviors to OCD as opposed to other anxiety disorders and healthy controls. Sampling and Methods: Several standardized disorder-specific self-report questionnaires were used in order to assess the patient's psychopathologies. The style of filling-out these questionnaires by OCD and non-OCD anxiety outpatients and normal controls was analyzed. Four categories were used: omissions, repetitions, corrections, and additions. Results: The OCD group scored significantly higher on the number of additions as compared with both the anxiety group and the nonclinical group, and significantly higher on the number of corrections and repetitions as compared with the nonclinical group. Conclusions: The hallmarks of OCD, repetitions and additions, are manifested not only in the patient's rituals and thoughts, but in apparently “neutral” tasks that do not a priori involve the intrusive thoughts, urges, and images typical of obsessive-compulsive behavior. Additions seem to be more specific to OCD than repetitions. These two executive faults impede routine functionality of OCD patients in tasks related and unrelated to their rituals. Our study delineates simple, observable behavioral characteristics that distinguish between OCD and non-OCD anxiety patients as well as healthy individuals. These symptomatic behaviors may offer a clue to personality traits or deficits in executive functions that possibly play a part in the pathophysiology of OCD. Our results are an additional indication that nonfunctionality in obsessive-compulsive behavior deserves full attention for a better understanding of the psychopathological mechanisms of OCD.

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“…In Übereinstimmung mit dieser Hypothese sind überwie-gend NJRE-motivierte Betroffene perfektionistischer als überwie-gend schadensvermeidungsmotivierte [Summerfeldt et al, 2001]. Zudem gibt es Hinweise darauf, dass Erstere neben Perfektionismus zusätzliche zwanghafte Persönlichkeitszüge aufweisen, entweder im Sinne eines noch normalen «gewissenhaften Persönlichkeitsstils» oder auch extremisiert im Sinne einer zwanghaften Persönlichkeits-störung [Summerfeldt, , 2007[Summerfeldt, , 2008Sibrava et al, 2016].…”

Section: Theoretische Einordnung Der Unvollständigkeits-phänomeneunclassified

Aktueller Forschungsstand zum Unvollständigkeitserleben bei Zwangsstörungen

Ecker

Gönner²

2017

Verhaltenstherapie

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In der vorliegenden Arbeit wird ein Überblick über den Forschungsstand zum Unvollständigkeitserleben bei Menschen mit Zwängen gegeben. Empirische Daten zur phänomenologischen Differenzierung zwischen selbstbezogenem Unvollständigkeitserleben (SU) und Nicht-genau-richtig-Erleben («not-just-right experiences»; NJREs) werden vorgestellt. Erhebungsinstrumente und Befunde zur Auftretenshäufigkeit, zur Assoziation mit unterschiedlichen symptombasierten Subtypen und mit der Schwere der Zwänge sowie zur Spezifität von NJREs für Zwänge werden skizziert. Überlegungen und Befunde zur theoretischen Einordnung von Unvollständigkeitsphänomenen werden zusammengefasst (SU als zwangsspezifische Form von Depersonalisation/Derealisation mit «Zwei-Bühnen-Modell» als ätiologischer Hypothese; NJREs als empfindungsbasierter Perfektionismus mit Bezug zu zwanghaften Persönlichkeitsmerkmalen und Ticstörungen und mit vermuteter neurobiologischer Basis). Bislang fehlen Studien zur Evaluation auf unvollständigkeitsbetonte Zwänge zugeschnittener Modifikationen kognitiv-verhaltenstherapeutischer Verfahren.

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An empirical investigation of incompleteness in a large clinical sample of obsessive compulsive disorder

Cited by 31 publications

References 49 publications

Evolution of gamma knife capsulotomy for intractable obsessive-compulsive disorder

Evolution of gamma knife capsulotomy for intractable obsessive-compulsive disorder

Nonfunctional Redundant Acts Characterize OCD, Even in OCD-Unrelated Tasks: A Demonstration in Questionnaire Completion

Aktueller Forschungsstand zum Unvollständigkeitserleben bei Zwangsstörungen

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