Content and correlates of checking related to symptoms of obsessive compulsive disorder and generalized anxiety disorder.

In addition to the central role of compulsive behaviors in obsessive compulsive disorder (OCD), recent data have documented the presence of compulsive behaviors in individuals with generalized anxiety disorder (GAD). However, there is a lack of information about potential similarities and differences with regard to the quality, or content, of checking associated with worry and obsessions. The two studies presented herein are an initial step towards gathering this information. Findings of Study 1, from a large unselected undergraduate sample, showed that symptoms of OCD and GAD were both significantly associated with checking behaviors. However, while OCD symptoms were associated with checking related to both objects and interpersonal situations, GAD symptoms were only significantly associated with interpersonal checking. Findings of Study 2, using a separate sample, suggest links between interpersonal checking and features characteristic of GAD, namely emotion regulation difficulties, and between object checking and a cognitive feature of OCD, namely thought-action fusion. In summary, the current studies add to a growing body of literature suggesting that checking may be important in numerous forms of psychopathology, while also suggesting that the nature and function of checking may differ for various symptom profiles.

Development and initial validation of the obsessive belief questionnaire-child version (OBQ-CV).

BACKGROUND: Cognitive models of obsessive-compulsive disorder (OCD) propose that beliefs are important in the etiology and maintenance of OCD and that these beliefs develop during childhood [Neal et al., 1991: Psychol Bull 109:400-410; Rachman, 1997: Behav Res Ther 35:793-802; Cronbach, 1951: Psychometrika 16:297-334]. However, the ability to test these predictions has been hampered by the lack of a standardized measure of OCD-related beliefs for youth. Therefore, this article presents initial data on a youth version of the widely used Obsessive Belief Questionnaire (OBQ) [Bonett, 2002: J Educ Behav Stat 27:335-340]. METHODS: Data examining the psychometric properties of the Obsessive Belief Questionnaire-Child Version (OBQ-CV) are presented from two pediatric OCD samples: a North American (n=29, aged 9-17 years) and a Dutch sample (n=48, aged 8-18 years). RESULTS: Preliminary findings from both samples support the internal consistency, retest reliability, and convergent validity of the OBQ-CV. CONCLUSIONS: Results of this study suggest that the OBQ-CV is a promising tool for examining the role of cognitions in pediatric OCD. Development of the OBQ-CV to augment the existing adult version of the scale creates unique opportunities for investigating the role of cognitions in OCD across the lifespan.

Moving beyond an exclusive focus on harm avoidance in obsessive-compulsive disorder: behavioral validation for the separability of harm avoidance and incompleteness.

There is increasing recognition that symptoms of obsessive-compulsive disorder (OCD) may be associated not only with harm avoidance, but also with sensations of things being incomplete or not "just right." Although preliminary research supports the presence of both harm avoidance and incompleteness in OCD, their validity as separate constructs has not been tested beyond the use of self-report measures. Therefore, the aim of the current study was to behaviorally validate the separability of harm avoidance and incompleteness using an unselected student sample. Consistent with hypotheses, self-reported levels of incompleteness and harm avoidance uniquely predicted participants' ratings of their experiences while performing OCD-relevant behavioral tasks (e.g., washing dirty dishes, arranging books on a bookshelf). Results suggest that harm avoidance is associated with anxiety/nervousness and a desire to prevent harm, whereas incompleteness is linked to feelings of tension/discomfort and a desire to perform tasks perfectly or just right. Theoretical and clinical implications are discussed.

Moving beyond an exclusive focus on harm avoidance in obsessive compulsive disorder: considering the role of incompleteness.

Cognitive-behavioral conceptualizations of obsessive compulsive disorder (OCD) have predominantly viewed compulsions as being motivated by harm avoidance. However, sensations of things being incomplete or not "just right" may also underlie compulsions in OCD. Preliminary research suggests that distinguishing between harm avoidance and incompleteness in OCD may have practical utility, but the research on this topic is very limited to date. The current study further addressed the role of incompleteness in OCD. A confirmatory factor analysis provided evidence for harm avoidance and incompleteness as separate constructs in a student sample. Supporting the benefits of considering incompleteness in addition to harm avoidance, self-reported levels of both constructs were significantly correlated with all domains of OCD symptoms and perfectionism assessed. Further, some evidence for unique relationships was found (e.g., incompleteness with ordering and personally prescribed perfectionism; harm avoidance with obsessing). The role of incompleteness in OCD warrants greater attention.

Affective and neuropsychological correlates of children's rituals and compulsive-like behaviors: continuities and discontinuities with obsessive-compulsive disorder.

This study explored the relations among ritualistic and compulsive-like behavior, fears, and neuropsychological performance in typically developing children between the ages of four and eight years. Forty-two children were administered a battery of neuropsychological tasks assessing response inhibition and set-shifting. Two parent-report questionnaires assessed the intensity of children's fears and compulsive-like behaviors ("just right" perceptions and repetitive behaviors). For younger children (72 months), set-shifting and response inhibition accounted for significant variance in their ritualistic, compulsive-like behaviors. For older children (>72 months), a combination of neuropsychological (response inhibition) and affective (animal fears and social anxiety) factors predicted compulsive-like behaviors. These findings suggest that common neuropsychological mechanisms underlie compulsive, ritualistic behavior exhibited in normal development and in obsessive-compulsive disorder.

Behavioral inhibition and obsessive-compulsive disorder.

Behavioral inhibition is frequently cited as a vulnerability factor for development of anxiety. However, few studies have examined the unique relationship between behavioral inhibition and obsessive-compulsive disorder (OCD). Therefore, the current study addressed the relationship between behavioral inhibition and OCD in a number of ways. In a large unselected student sample, frequency of current OC symptoms was significantly correlated with retrospective self-reports of total levels of childhood behavioral inhibition. In addition, frequency of current OC symptoms was also significantly correlated with both social and nonsocial components of behavioral inhibition. Further, there was evidence for a unique relationship between behavioral inhibition and OC symptoms beyond the relationship of behavioral inhibition and social anxiety. In addition, results showed that reports of childhood levels of behavioral inhibition significantly predicted levels of OCD symptoms in adulthood. Finally, preliminary evidence suggested that behavioral inhibition may be more strongly associated with some types of OC symptoms than others, and that overprotective parenting may moderate the impact of behavioral inhibition on OC symptoms. The current findings suggest the utility of additional research examining the role of behavioral inhibition in the etiology of OCD.