There are over three million people in the United States (500,000 of these children) that know the true terror of Obsessive Compulsive Disorder. ONCE AGAIN is a short experimental documentary about the truth of Childhood OCD. Weaving together live action footage, home movies, and animation, the filmmaker tells the story of his childhood struggles with this horrible disorder. In the early nineties, OCD was thought to be a behavioral, almost psychotic disorder. Through mental torture, hospitalization, and humiliation, Once Again shows how John Spottswood Moore eventually won the fight against the disorder to become a champion of his own mind and body. / text

Acceptance and Commitment Therapy is a therapeutic approach that emphasizes the alteration of the relationship one has towards one’s thoughts, rather than attempting to change the content of thoughts. It seeks to promote the awareness of thinking as an ongoing relational process through cognitive defusion techniques. The verbal repetition of thoughts is a technique that has recently been shown in a single-case alternating treatment designs study to significantly reduce the believability and distress associated with self-relevant negative thoughts (Masuda, Hayes, Sackett, & Twohig, 2004). The present study compared the effects of verbal repetition with brief imaginal exposure and no intervention in reducing the believability, distress, and meaningfulness associated with contamination-related thoughts. Individuals with high levels of obsessive-compulsive symptoms identified three distressing contamination-related thoughts and made ratings of belief, distress, and meaningfulness for each thought, using 100-mm visual analogue scales. They were then randomly assigned to receive verbal repetition, imaginal exposure, or no intervention, after which they completed ratings at post-intervention and one-week follow-up. Participants also completed a category membership decision task to determine whether verbal repetition and/or imaginal exposure produces semantic satiation, a temporary loss of the literal meaning of words. Significant reductions in belief, distress, and meaningfulness were observed following verbal repetition at post-intervention and there was some maintenance of these gains one week later. In contrast, no significant reductions were observed at post-intervention following either imaginal exposure or no intervention. However, significant reductions in ratings of belief and distress were observed one week later following imaginal exposure. A semantic satiation effect was observed for only verbal repetition, and although there was no evidence that this effect was associated with reductions in appraisal ratings at post-intervention, there was some indication of a relationship with follow-up appraisal ratings. Implications of these findings are discussed in relation to cognitive-behavioural theories of obsessive-compulsive disorder.

Acceptance and Commitment Therapy is a therapeutic approach that emphasizes the alteration of the relationship one has towards one’s thoughts, rather than attempting to change the content of thoughts. It seeks to promote the awareness of thinking as an ongoing relational process through cognitive defusion techniques. The verbal repetition of thoughts is a technique that has recently been shown in a single-case alternating treatment designs study to significantly reduce the believability and distress associated with self-relevant negative thoughts (Masuda, Hayes, Sackett, & Twohig, 2004). The present study compared the effects of verbal repetition with brief imaginal exposure and no intervention in reducing the believability, distress, and meaningfulness associated with contamination-related thoughts. Individuals with high levels of obsessive-compulsive symptoms identified three distressing contamination-related thoughts and made ratings of belief, distress, and meaningfulness for each thought, using 100-mm visual analogue scales. They were then randomly assigned to receive verbal repetition, imaginal exposure, or no intervention, after which they completed ratings at post-intervention and one-week follow-up. Participants also completed a category membership decision task to determine whether verbal repetition and/or imaginal exposure produces semantic satiation, a temporary loss of the literal meaning of words. Significant reductions in belief, distress, and meaningfulness were observed following verbal repetition at post-intervention and there was some maintenance of these gains one week later. In contrast, no significant reductions were observed at post-intervention following either imaginal exposure or no intervention. However, significant reductions in ratings of belief and distress were observed one week later following imaginal exposure. A semantic satiation effect was observed for only verbal repetition, and although there was no evidence that this effect was associated with reductions in appraisal ratings at post-intervention, there was some indication of a relationship with follow-up appraisal ratings. Implications of these findings are discussed in relation to cognitive-behavioural theories of obsessive-compulsive disorder.

Tvangs- og psykoselidelser er antatt å overlappe på både biologiske og fenomenologiske områder. Det er også funnet at symptomer på psykose og schizotyp lidelse kan predisponere pasienter med OCD for utvikling av psykotiske lidelser og schizotyp lidelse. Dette gjør det relevant å undersøke prevalensen av psykotiske og schizotype symptomer i OCD-populasjonen. Denne studien undersøkte prevalens av psykotiske og schizotype symptomer blant OCD-pasienter uten komorbid psykotisk lidelse (n = 133), en generell pasientgruppe uten psykotiske lidelser (n = 110) og friske kontroller (n = 855). Sammenhengen mellom psykotiske og schizotype symptomer, og tvangssymptomer, behandlingsutfall, samt effekten av psykoterapi for OCD på psykotiske og schizotype symptomer, ble også undersøkt. Resultatene viste at symptomer på psykose og schizotyp lidelse var like tilstede i begge pasientpopulasjonene. Slike symptomer var svakt til moderat korrelert med tvangssymptomer i OCD-utvalget, men denne sammenhengen forsvant ved kontroll for depressive symptomer. Pasienter med høy grad av psykotiske og schizotype symptomer hadde ikke redusert behandlingsrespons når depressive symptomer ble kontrollert for. Psykoterapi for OCD medførte en signifikant reduksjon av tvangsmessige, depressive, psykotiske og schizotype symptomer. Resultatene tyder på at psykotiske og schizotype symptomer er knyttet til flere mentale lidelser og ikke spesifikt til OCD. Høyere nivåer av psykotiske og schizotype symptomer er ikke assosiert med redusert behandlingsrespons blant OCD-pasienter. Det ser ikke ut til at et spesifikt fokus mot psykotiske og schizotype symptomer behøves for at ERP for OCD skal lykkes for denne pasientgruppen.

No description available.

The aim of this study was to explore the differences and similarities between mindfulness and metacognitions, and to investigate how these constructs relate to symptoms of psychiatric disorders. The Five Facet Mindfulness Questionnaire (FFMQ), the Metacognitions Questionnaire 30 (MCQ-30), the Patient Health Questionnaire 9 (PHQ-9), the Generalized Anxiety Disorder Assessment 7 (GAD-7), and the Obsessive-Compulsive Inventory Revised (OCI-R) were administered electronically by the use of social media and online forums, and 224 people completed all five questionnaires. The FFMQ factors of non-judge and awareness were significantly correlated with all of the MCQ factors, while observe, non-react and describe showed weak and varying correlations. Through forward regression analyses the MCQ factors measuring negative metacognitions, uncontrollability and danger and need to control thoughts, was found to be important predictors of symptoms of psychiatric disorders. Awareness and nonreact were found to be the FFMQ factors most important in predicting symptoms of psychiatric disorders. The findings supported both the metacognitive model, and parts of the mindfulness model.

Background: Previous studies have shown that patients with obsessive-compulsive disorder (OCD) have elevated interleukin and chemokine levels in plasma. The purpose of this study was to investigate and validate whether a group of cytokines and chemokines are elevated in a cohort of young adult OCD patients. Methods: A total of 43 patients (11 male/32 female) and 45 controls (15 male/30 female) with OCD were included in the study. The subjects were assessed with the Structured Clinical Interview for DSM-IV Axis I Disorders- Clinical Version or Mini-International Neuropsychiatric Interview. The control group was screened with the Alcohol Use Disorders Identification Test. Proximity extension assay (PEA) was used to measure plasma levels of IL-6, IL-8, MIP-1α, and IL-10. Results: A factor analysis for the cytokines was performed and logistic regression analysis revealed that the cytokines as a group have a significant association for OCD (P=0.031, OR: 2.2) and IL-8 was the cytokine with the highest significance (P=0.007) for the patient group. Conclusion: These findings suggest that this group of cytokines are associated with OCD diagnosis and strengthens previous findings of immune activity in the etiology of OCD. Therefore cytokines and chemokines could have an active role in the etiology of OCD and PEA could be useful in the search for biomarkers.

In der vorliegenden Dissertation wurden die Folgen einer SPRED2-Defizienz in einem Knockout Mausmodell untersucht. Dabei wurde insbesondere die mögliche Verbindung zur Zwangsstörung, einer psychiatrischen Erkrankung beleuchtet. Das SPRED2-Protein kommt im menschlichen Körper in zahlreichen Geweben vor, besonders im Hirn wurde eine ubiquitäre Expression nachgewiesen und ein Zusammenhang mit der Neurogenese und neuronaler Differenzierung vermutet. Seine regulatorische Funktion besteht in einer inhibitorischen Wirkung auf den BDNF/TrkB-ERK-Signalweg, welcher u.a. für die Transkription neuronaler Gene verantwortlich ist. Die verwendeten SPRED2-defizienten Mäuse wurden durch Insertion eines Gene-Trap Vektors in das Spred2-Gen generiert. Die Insertion verhindert letztendlich die korrekte Translation des Proteins. Von der durch weitere Verpaarung entstehenden SPRED2-Knockout Mauslinie wurden ausschließlich männliche Tiere verwendet. Im Rahmen einer SPRED2-KO-Studie von der AG Schuh des Physiologischen Instituts der Universität Würzburg, die u.a. die Entgleisung der HHNA mit resultierendem erhöhten Stresshormonspiegel und eine Dysregulation des Mineralhaushaltshormons Aldosteron zeigte, wurden bei den Versuchstieren zwanghafte Verhaltensmuster beobachtet. Daraufhin wurden elektrophysiologische Messungen durchgeführt, die auf eine Anomalie in der synaptischen Übertragung zwischen Thalamus und Amygdala hindeuteten. Erhöhte Effizienz und Erregbarkeit der amygdaloiden Neuronen führten zu der morphologischen Untersuchung, die im Rahmen dieser Arbeit durchgeführt wurden. Da die Afferenzen des Thalamus vorwiegend in den lateralen Kern der Amygdala projizieren, wurde zunächst dieser betrachtet. Ziel der Untersuchung war es, Erkenntnisse darüber zu erlangen, ob der Knockout des SPRED2-Proteins in Mäusen zu einer veränderten Morphologie der Neuronen der lateralen Amygdala führt. Falls dies der Fall sein sollte, könnte damit zumindest ansatzweise das zwanghafte Verhalten der SPRED2-defizienten Mäusen erklärt werden. Die Hirne der Versuchstiere wurden nach der Golgi-Cox-Imprägnierung nach Glaser und Van der Loos und der Einbettung in Celloidin in 150 μm dicke Scheiben geschnitten und anschließend mithilfe eines Hellfeld-Mikroskops und des Neurolucida-Systems analysiert. Quantitativ erfasst und analysiert wurden pyramidale Klasse 1-Neuronen der lateralen Amygdala inklusive absoluter Anzahl und Dichte der Spines an ihren Dendriten. Die Untersuchung zeigte bei SPRED2-KO-Mäusen eine signifikante Erhöhung der mittleren Länge des apikalen Dendriten in Branch order 3 und eine tendenzielle Erhöhung der Gesamtzahl der Spines an den Dendriten in Branch order 1-3 gegenüber den Wildtyp-Mäusen. Daraus lässt sich folgern, dass ein Knockout des SPRED2-Proteins sich auf die Morphologie der Neuronen der lateralen Amygdala auswirkt. Die erhöhte mittlere Länge des apikalen Dendriten in Branch order 3 und die tendenziell erhöhte Spine-Anzahl korrelieren mit der gesteigerten synaptischen Übertragung und Erregbarkeit an amygdaloiden pyramidalen Neuronen. Auf molekularer Ebene kann die Hyperaktivität der lateralen Amygdala als Folge der fehlenden Inhibition des BDNF/TrkB-ERK-Signalwegs und der dadurch veränderten Expression zahlreicher synaptischer Proteine diskutiert werden. Die veränderte Morphologie der Neuronen in der lateralen Amygdala kann eine Ursache für das zwanghafte Verhalten der Mäuse sein, jedoch ist anzunehmen, dass Zwangsstörungen nicht bloß eine monokausale Ursache haben. Diese Arbeit identifiziert SPRED2 als neuen Regulator der Morphologie und Aktivität von Synapsen und die Amygdala als wichtige Hirnregion bei der Entstehung von Zwangsstörungen. SPRED2 ist somit ein vielversprechender Angriffspunkt für andere und spezifischere Untersuchungen der Hirnfunktion und eine potenzielle genetische Ursache für weitere neurologische Erkrankungen. / In this present dissertation, the consequences of SPRED2-deficiency in a knockout mouse model have been investigated. In particular, the possible connection to the obsessive-compulsive disorder was examined. The SPRED2 protein is found in many tissues in the human body. Especially in the brain, ubiquitous expression was found and a connection to neurogenesis and neuronal differentiation was suspected. Its regulatory function is an inhibitory effect to the BDNF/TrkB-ERK signaling pathway, which amongst others is responsible for the transcription of neuronal genes. The SPRED2-deficient mice used were generated by insertion of a gene trap vector into the Spred2 gene. The insertion ultimately prevents the correct translation of the protein. From the SPRED2 knockout mouse line only male animals were used. As part of a SPRED2-KO study by AG Schuh of the Physiological Institute of the University of Würzburg, which showed, inter alia, the derailment of HHNA resulting in increased stress hormone levels and a dysregulation of the mineral household hormone aldosterone, obsessive behaviors were observed in the experimental animals. Subsequently, electrophysiological measurements were performed indicating an abnormality in synaptic transmission between thalamus and amygdala. Increased efficiency and excitability of the amygdaloid neurons led to the morphological investigation, which were accomplished in the context of this work. Since the afferents of the thalamus predominantly project into the lateral nucleus of the amygdala, it was first considered. The aim of the study was to find out if the knockout of the SPRED2 protein in mice leads to an altered morphology of neurons of the lateral amygdala. If so, it could at least somewhat explain the compulsive behavior of SPRED2-deficient mice. The brains of the test animals were cut into 150 μm slices and, after Golgi-Cox impregnation according to Glaser and Van der Loos, embedded in celloidin and then analyzed using a bright field microscope and the Neurolucida system. Quantitatively, pyramidal class 1 neurons of the lateral amygdala were recorded and analyzed, including the absolute number and density of the spines at their dendrites. The study showed a significant increase in the mean length of the apical dendrites in branch order 3 in SPRED2-KO mice and a tendency to increase the total number of spines on the dendrites in branch order 1-3 compared to the wild-type mice. It can be concluded that a knockout of the SPRED2 protein affects the morphology of the neurons of the lateral amygdala. The increased mean length of the apical dendrites in branch order 3 and the tendency to increased spine counts correlate with the increased synaptic transmission and excitability of amygdaloid pyramidal neurons. At the molecular level, the hyperactivity of the lateral amygdala may be discussed as a consequence of the lack of inhibition of the BDNF/TrkB-ERK pathway and the resulting altered expression of numerous synaptic proteins. The altered morphology of the neurons in the lateral amygdala may be a cause of the compulsive behavior of the mice, but it can be assumed that obsessive-compulsive disorder does not merely have a monocausal cause. This work identifies SPRED2 as a new regulator of morphology and activity of synapses and the amygdala as an important brain region in the development of obsessive-compulsive disorder. SPRED2 is thus a promising target for other and more specific studies of brain function and a potential genetic cause for other neurological disorders.

This thesis deals with the complications that brings obsessive-compulsive disorder (OCD) school-age children in the family and school life. It consists of two parts - theoretical and practical. The theoretical part is divided into the seven chapters and is drawn from the knowledge of professional literature and Internet sources. This section consists of basic information about OCD, the etiology, diagnosis, treatment options. The last three chapters deal with the consequences of obsessive-compulsive disorder and problems that OCD brings to family and school life. The practical part is an empirical investigation dealing with the main objective of the work, which is based on an analysis of complications that brings obsessive-compulsive disorder of school-age children in the family and school life. Survey results was achieved through open, axial and selective coding, which allowed delineation create grounded theory. It was found that OCD manifests in childhood and brings negative consequences not only for family but also for the school life of the child, especially in the form of disturbed domestic atmosphere and the inability to concentrate on teaching.

<p>Den vård som har starkast evidens vid behandling av tvångssyndrom, Obsessive Compulsive Disorder (OCD), är kognitiv beteendeterapi (KBT), innehållande exponering och responsprevention. Idag är tillgången till denna vård begränsad främst på grund av för få behandlare. Tidigare forskning pekar på att personer med OCD kan bli hjälpta av mindre terapeutintensiva behandlingar. Att leverera vård stegvis med ökande behandlingsintensitet; Stepped Care, kan vara ett sätt att öka tillgängligheten av KBT. Denna pilotstudie har undersökt Stepped Care för OCD i form av tre steg, på Ångestenheten, Karolinska Universitetssjukhuset. Det primära syftet har varit att bidra till kunskapsinsamlingen kring Stepped Care vid OCD. Sammanlagt 19 vuxna patienter ingår i pilotstudien. 8 blev förbättrade efter självhjälp, 5 efter gruppbehandling, 2 efter individualterapi samt 4 bortfall. Av dessa behöll 7 av självhjälps-, 3 av grupp- och ingen av individualpatienterna sina framsteg vid en uppföljning 12 veckor efter avslutad behandling. Totalt tog behandlingen 244 terapeuttimmar i anspråk, vilket är mer än en halvering mot traditionell individualbehandling. Resultaten tyder på att Stepped Care är ett intressant alternativ för att effektivisera och öka tillgängligheten av vård för OCD-patienter.</p>