Obsessive Compulsive Disorder (OCD) has been linked to a dysmorphic construction of self that is closely tied to mental illness (Bhar & Kyrios, 2007). Although associations have been found, no study has determined the impact of OCD on one's self-perception, to better understand how to resolve patients' dysmorphic construction and fear of oneself. College students (N = 410; M = 20.60, SD = 4.27) completed an anonymous online survey for course credit. The survey consisted of a demographic questionnaire, the Obsessive-Compulsive Inventory-Revised (Foa et al., 2002), theEgo-Dystonicity Questionnaire (Purdon et al., 2007), and the Self-concept Identity Measure (Kaufman et al., 2019). To determine if scores on the Obsessive-Compulsive Inventory would predict scores on the Identity Measure and if the Ego-Dystonicity scale would account for a greater percentage of the variation in Identity subscale scores than Obsessing scores alone, multiple regression analyses were utilized. Results suggest that although, symptoms of OCD were useful in predicting variance all of the identity subscales, ego-dystonicity appeared to be particularly useful for establishing incremental validity in the prediction of the lack of identity subscale. Implications for intervention and prevention efforts in regard to the effects of OCD on identity will be discussed.

Obsessive-Compulsive Disorder (OCD) is a debilitating, chronic neuropsychiatric disorder estimated to effect approximately 1-2% of the Canadian population. Our understanding of the pathophysiological mechanisms involved in OCD is unclear, as evidenced by the moderate response associated with treatments targeting these putative pathways. As such, there is a need to explore novel mechanisms of disease. Recent research has focused on the gut-brain axis and highlighted the potential role of the gut microbiota in psychiatric conditions. Further, the role of inflammation is also gaining traction in psychiatric research. This thesis investigates the role of these commensal gut bacteria in OCD, by examining stool samples of unmedicated, non-depressed OCD outpatients and healthy community controls. Given that systemic inflammation is a suggested pathway by which gut bacteria effect behaviour, morning levels of C-reactive protein (CRP), interleukin-6 (IL-6) and tumor-necrosis factors-α (TNF-α) were also examined. To our knowledge, this thesis is the first investigation of the gut microbiome in OCD. This thesis describes: (1) a critical review of the literature developing a theoretical basis for a role of microbial dysbiosis in OCD; that (2) three specific genera and species richness/diversity are lower in OCD patients compared to controls; (3) mean CRP, but not IL-6 and TNF-α, is elevated in this sample of OCD patients; and (4) gastrointestinal symptom severity and prevalence of irritable bowel syndrome is higher in OCD. Taken together, this thesis is the first study to provide evidence for microbial dysbiosis in OCD. Although systemic inflammation may not mediate the relationship between reduced diversity and OCD symptomatology, these results provide evidence for mild systemic inflammation. Further gastrointestinal and psychiatric symptom severity are positively correlated, but not specific to patients with IBS. These results suggest the gut microbiome may be a potential pathway of interest for future OCD research, clinical implications are also made. / Thesis / Doctor of Philosophy (PhD)

It is of crucial importance to identify and disseminate effective treatments for paediatric obsessive-compulsive disorder (OCD). OCD is time-consuming and distressing, and can substantially disable functioning at school, at home, and with peers (Piacentini, 2003). Children who do not receive treatment are at risk of psychological difficulties in adulthood, including continued OCD, clinical anxiety and depression, personality disorders, and social maladjustment (Wewetzer et al., 2001). Two-thirds of adult cases of OCD develop in childhood, and adults with OCD have lower employment, poorer academic achievement, and lower marital rates compared to non-OCD adults (Hollander et al., 1996; Koran, 2000; Lensi et al., 1996; Steketee, 1993). The distressing nature of OCD in childhood, accompanying psychosocial impairment and risk of future psychopathology, underscore the need to identify effective treatments. The primary aim of this thesis was to expand knowledge of evidence-based treatments for paediatric OCD. A mixed-methodology approach was employed to examine key issues in this area. The first study used meta-analytic methodology to determine the evidence supporting available treatments for paediatric OCD. An extensive literature search revealed over 100 published reports of treatments, encompassing a broad array of theoretical approaches and treatment strategies. Examples of treatments used for paediatric OCD included psychodynamic therapy, pharmacotherapy, cognitive-behavioural therapy (CBT), hypnosis, family therapy, immunotherapy, and homeopathy. / Study 1 comprised the first known meta-analysis of randomised, controlled treatment trials (RCTs) for paediatric OCD. Included studies were limited to RCTs as they are the most scientifically valid means for determining treatment efficacy and provide a more accurate estimate of treatment effect by removing error variance associated with confounding variables. The literature search identified 13 RCTs containing 10 pharmacotherapy to control comparisons (N = 1016) and 5 CBT to control comparisons (N = 161). Random effects modelling yielded statistically significant pooled effect size (ES) estimates for pharmacotherapy (ES = 0.48, 95% CI = 0.36 to 0.61, p < .00001) and CBT (ES = 1.45, 95% CI = 0.68 to 2.22, p =.002). The results support the efficacy of CBT and pharmacotherapy, and confirm these approaches as the only two evidence-based treatments for paediatric OCD. Implications and suggestions for future research are discussed. The effectiveness of CBT provided impetus to further examine this treatment. Group CBT is an understudied treatment modality among children with OCD. It was hypothesised that group CBT would possess efficacy because of the effectiveness of individual CBT for children with OCD, the demonstrated effectiveness of group CBT among adults with OCD, the practical and therapeutic advantages afforded by a group treatment approach, and the embeddedness of the approach in robust psychological theory. The aim of the second study was to evaluate the efficacy of group CBT. The study comprised the largest known conducted randomised, placebo-controlled trial of group CBT for paediatric OCD. / Twenty-two children and adolescents with a primary diagnosis of OCD were randomly assigned to a 12-week program of group CBT or a credible psychological placebo. Children were assessed at baseline, end of treatment, and at 1 month follow-up. Outcome measures included the Children’s Yale-Brown Obsessive-Compulsive Scale, global measures of OCD severity, Children’s Depression Inventory, and parent- and child-rated measures of psychosocial functioning. An intention-to-treat analysis revealed that children in the group CBT condition had statistically significantly lower levels of symptomatology at posttreatment and follow-up compared to children in the placebo condition. Analysis of clinical significance showed that 91% of children that received CBT were ‘recovered’ or ‘improved’ at follow-up, whereas 73% of children in the placebo condition were ‘unchanged’. Effect size analysis using Cohen’s d derived an effect of 1.14 and 1.20 at posttreatment and follow-up, respectively. These effects are comparable to results from studies of individual CBT. This study supported group CBT as an effective treatment modality for paediatric OCD and demonstrated that the effect extends beyond placebo and nonspecific treatment factors. In addition to treatment efficacy, the inherent worth of a treatment lies in its adoption by the relevant clinical population. Children with OCD are known to be secretive and embarrassed about symptoms, and there is often a long delay between onset of symptoms and treatment-seeking (Simonds & Elliot, 2001). An important observation during the course of conducting the RCT was that a high rate (39%) of eligible families declined participation. / This led to the question, "What barriers prevent participation in group CBT for paediatric OCD?" Qualitative methodology was employed to address this research question. Eligible families that had declined participation in the RCT were contacted and invited to participate in semi-structured interviews that explored reasons for non-participation and positive and negative perceptions of group CBT. The average time between non-participation and interview was 1.33 years (SD = 3 months). Data were collected from nine families and thematic analysis methodology was utilised to identify emergent themes. Failure to participate was predicted by practical and attitudinal barriers. Practical barriers included a lack of time, distance, severity of OCD symptoms, financial, and child physical health. Attitudinal barriers included child embarrassment about OCD symptoms, child belief that therapy would be ineffective, fear of the social aspect of the group, lack of previous success with psychology, lack of trust in strangers, parental concern about the structure of the group, denial of a problem, and ‘not being ready for it’. Attitudinal barriers more frequently predicted treatment non-participation. Positive and negative perceptions of this treatment modality were informative. Parents showed no differences in preference for individual or group CBT. An important finding was that 56% of the children had not received treatment since parental expression of interest in the group CBT program. Application of the findings to methods that promote service utilisation is discussed.

Tyrimas buvo atliekamas Lietuvos sveikatos mokslų universiteto, Veterinarijos akademijos, Stambiųjų gyvulių klinikoje. Pasirinktas tyrimo objektas, šlubuojančių arklių kulno sąnarys; metodika pirminis klinikinis tyrimas bei rentgenologinis tyrimas. Tiriamoji arklių grupė buvo sudaryta iš arklių, kurie buvo pasirinkti atsitiktiniu būdu. Įvairių veislių, lyčių ir amžiaus. Arklių kulno sąnarys yra vienas iš judamojo aparato – sudėtingas mechanizmas. Sudarytas iš kelių kaulų junginio ir sudaro vienaašį sudėtinį sąnarį (sraigtinis/sudėtinis). Blauzdikaulio, kulnies ir pėdos kaulų junginys. Šis sudėtinis judamasis mechanizmas dažnai paveikiamas Osteochondritis dissecans patologijos, kuris kelia arkliams skausmingą diskomforto jausmą ir gyvulys į šį dirgiklį atsako šlubavimu. Arklių kulno sąnario Osteochondritis dissecans dažniausiai diagnozuojamas sportiniams žirgams (56,53 proc.) dėl neadekvataus gyvulio jėgų išnaudojimo arba spartaus kumeliuko augimo ir nesubalansuoto jam tinkamo raciono. Taip pat nustatyta, jog kulno sąnario OCD diagnozuojama eržilams/kastratams (75 proc.) daugiau, nei kumelėms (25 proc.). Tyrimo metu paaiškėjo, jog kulno sąnario OCD pažeidimai lokalizavosi tiek pas eržilus/kastratus, tiek kumeles, daugiausiai kairiajame kulno sąnaryje (58,33 proc.), o dešinės kulno sąnario kojos pažeidimų aptikta procentine išraiška mažiau (33,33 proc.). / The study was conducted in Lithuanian University of Health Sciences, Veterinary Academy, Large Animal Clinic. The selected object of research was lame horse hock joint; method - initial clinical examination and radiographic analysis. The exploratory group of equines consisted of horses which were selected incidentally: various breeds, genders and age. Horse hock joint is one of the apparatus of locomotion which is a complex mechanism. It is composed of a compound of several bones to form a one-axis composite joint (screw/composite). It consists of combination of tibia, hock and foot bones. This complex locomotor mechanism is often affected by the pathology of Osteochondritis dissecans which causes painful feeling of discomfort for horses and consequently, they respond to this irritant by lameness. Horse Osteochondritis dissecans most often is diagnosed for racing and sports horses (56.53 percent) due to inadequate exploitation of animal strength, rapid growth of foal and improper diet. It was also found that OCD was diagnosed in stallions/geldings (75 percent) more than in mares (25 percent). The study revealed that OCD lesions localized to both stallions/geldings and mares, mostly on the left hock joint (58.33 percent), while the lesions of hock joint of the right leg were detected by a percentage less (33.33 percent).

There has been an abundance of studies that have adopted positivist approaches, employing quantitative methods, to research OCD 'symptoms' and their underlying neurobiology and neurochemistry. There appears to be a lack of research investigating how OCD is experienced by those living with the diagnosis, and in particular the experiences of young people diagnosed with OCD. Ten young people, aged 14-17 years old, with a diagnosis of OCD were recruited from Child and Adolescent Mental Health Services (CAMHS). The young people were interviewed and a Thematic Analysis (TA) was used to analyse data. Four themes were developed through the analysis. The first theme 'Traumatic and stressful life events' found that 9 out of the 10 participants experienced at least one of the following three life events just prior to the development of their OCD: 'Hostility in the family', 'Illness and death', 'Bullying and friendlessness'. Four subthemes, 'Lack of understanding of the behaviour', 'Being secretive', 'I thought I was going crazy', and 'Feeling different', provided a richer understanding to the theme 'Responses to signs of OCD'. The four subthemes 'Feeling "right"', 'I was taking on all the responsibility', 'It's ruined everything', 'Everyday life is now in my bedroom' explored the third theme 'The battle of living with OCD'. The last theme 'Ambivalent relationship to help' described the conflict that most participants had over exposure therapy and accommodation of their OCD. Lastly, most participants felt the long waiting time for help was frustrating. The theme is fully explored by the following three subthemes: 'Conflicts of exposure therapy', 'Conflicts about accommodation of the OCD', and 'Frustrations of long waiting lists'. The themes that emerged may provide important information for clinicians and the implications of the research findings are discussed. The strengths and limitations of the study are noted and there are suggestions for future research.

No description available.

Controlled scientific research into obsessive-compulsive disorder (OCD) in adulthood has considerably progressed over the past two decades; however, current research into childhood OCD is still in its infancy by comparison. As a result, current psychological conceptualisations of OCD during childhood, including approaches to treatment, are almost entirely based on adult models of the disorder. Previous research however, examining the clinical phenomenology of OCD has provided some evidence that OCD might be associated with different clinical correlates at different stages of development. In particular, there appears to be a bimodal distribution in terms of the age of onset of the disorder, a male predominance during childhood and adolescence compared to adulthood, stronger familial aggregation of OCD in early onset cases, and differences in the types of symptoms and the patterns of comorbidity across age groups. The first study aimed to assess the developmental continuity in clinical correlates of OCD across 3 distinct age groups, including; children (n = 40), adolescents (n = 44) and adults (n = 41). It was hypothesised that the sample of children would be predominantly male, and would have a higher familial aggregation of OCD and/or anxiety/depression in first-degree relatives. It was further hypothesised that there would be significant age-related differences in terms of specific symptoms, patterns of comorbidity, OCD severity, functional impairment, and level of insight and distress. The results of this study supported the developmental heterogeneity hypothesis, with significant differences occurring across age groups on a number of clinical features of OCD including age at onset, symptoms experienced, comorbidity, severity, insight and impairment. The recognition of developmental differences in clinical features of OCD will assist in the accurate assessment and diagnosis of the disorder, and will allow for refinement of current treatment strategies to ensure treatments effectively target features of the disorder as it presents at different developmental stages. While the cognitive theory of OCD is one of the most widely accepted accounts of the maintenance of the disorder in adults, no study to date has systematically evaluated this theory across children, adolescents and adults with the disorder. Until empirical investigation examines the applicability of this theory to children and adolescents, we know very little about the cognitive processes associated with OCD during childhood or adolescence. The second study investigated developmental differences in the cognitive processing of threat in a sample of children (n = 34), adolescents (n = 39) and adults (n = 38) with OCD. Using an idiographic assessment approach, as well as self-report questionnaires, this study evaluated cognitive appraisals of responsibility, probability, severity, thought-action fusion (TAF), thought-suppression, self-doubt and cognitive control. It was hypothesised that there would be age related differences in reported responsibility for harm, probability of harm, severity of harm, thought suppression, TAF, self-doubt and cognitive control. Results demonstrated that children with OCD reported experiencing fewer intrusive thoughts, which were less distressing and less uncontrollable than those experienced by adolescents and adults with OCD. Furthermore, responsibility attitudes, probability biases and thought suppression strategies were significantly higher in adolescents and adults with OCD, compared to children. Cognitive processes of TAF, perceived severity of harm, self-doubt and cognitive control were found to be comparable across age groups. These findings suggest that some cognitive biases associated with OCD in adults, are in fact also associated with OCD during childhood and adolescence, however there remains some discontinuity across specific cognitive processes. For a developmentally sensitive theory of OCD, further investigation is clearly warranted into other possible age related maintenance factors of this disorder. Implications of these 2 empirical investigations are highlighted and directions for future research are discussed.

The objective of drinking water treatment is to provide water which is free of pathogens, is chemically and biologically stable, and is of good aesthetic quality. Natural organic matter (NOM) is present in all natural waters and can make meeting these goals more challenging. Not only does it undergo adverse reactions with disinfectants such as chlorine, it also impacts the biological stability of water within the distribution system and contributes to undesirable aesthetic qualities such as taste and odour. NOM has also been implicated in membrane fouling, which continues to be a significant operational problem preventing wider implementation of this process. Due to its highly variable heterogeneous nature, NOM can be difficult to characterize in terms of its specific composition, however recent analytical advancements are allowing for a better understanding of its behaviour in water treatment. Two promising tools for NOM characterization include Liquid Chromatography Organic Carbon Detection (LC-OCD) and Fluorescence Excitation Emission Matrix (FEEM) analyses. In this research both techniques were applied to samples taken from five full scale facilities in Ontario, Canada over all four seasons. The source waters for these treatment locations consisted of both river (Grand River, Ottawa River) and Great Lake waters (Lake Huron, Lake Erie, Lake Ontario), and an additional raw source (Saugeen River) was also monitored. The plants all employed granular media filtration, but had differences including enhanced coagulation, ozonation, biofiltration and sand ballasted flocculation. Other relevant water quality parameters were also monitored (TOC, DOC, UV254, pH, conductivity etc.) as well as plant operating conditions (dosages, flows, filter run times etc.) to investigate their impact on removal of specific NOM fractions. Four of the waters (Grand River, Ottawa River, Lake Erie and Lake Ontario) were selected based on the initial survey due to their NOM composition, for bench scale ultrafiltration (UF) membrane fouling experiments. The experiments were run at constant flux for a period of five days, with an automated permeation cycle and backwash. The impact of biopolymers on hydraulically reversible and irreversible fouling was of specific interest. Important seasonal trends were identified for all waters, with biopolymer content increasing at higher temperatures. Useful comparisons could also be made between different treatment processes including conventional and enhanced coagulation. The enhanced process while significantly improving the removal of humic substances, was not beneficial in terms of biopolymer removal, suggesting a different removal mechanism for these two fractions. The removal of low molecular weight ozonation by-products during full scale biofiltration was well demonstrated, and other fractions (building blocks, biopolymers) had varying degrees of removal, which was more dependent on temperature. Principle component analysis (PCA), an advanced multivariate statistical method, was successfully applied to a FEEM data set containing five different waters at varying degrees of treatment. Three principle components related to humic-like, protein-like and particulate/colloidal material were identified, and served as useful complementary information to the LC-OCD results. The humic-like component was found to have relatively good correlation to the humic fraction from LC-OCD analysis, with some deviation in the post-ozonation samples (which underwent greater structural changes not captured by LC-OCD). The biopolymer fraction was shown to have good correlation to hydraulically reversible membrane fouling across all four waters. The same could not be said for hydraulically irreversible fouling for which a combined fouling layer (with particulate and colloidal material) is hypothesized. This research provides those working in the water treatment sector with greater insight into NOM behaviour during various levels of treatment. As biopolymers were demonstrated to impact hydraulically reversible fouling (relatively independent of water quality), their removal prior to membrane filtration could significantly extend operational cycles by extending time between backwashes, thereby reducing energy requirements. As biopolymers are also suspected in forming a combined fouling layer, their removal can potentially minimize chemical cleaning requirements (and extend the life cycle of the membranes). The removal of biopolymers through coagulation was well demonstrated. Biofiltration is also expected to perform well as a membrane pre-treatment due its ability to remove biopolymers and particulate/colloidal matter. The ability of biofiltration to control biological re-growth in the distribution system (by removing low molecular weight biodegradable products) was also shown using LC-OCD and FEEM analysis.

A growing literature suggests that individuals repeatedly check in part because they lack confidence in their memories for previously-completed actions. It has also been hypothesized that the cognitive distrust demonstrated by individuals with OCD extends beyond memory to related factors such as attention and perception; however, the relation between distrust in attention, perception and memory has yet to be examined. The present study examined the extent to which distrust in attention and perception relate to memory distrust and compulsive checking in participants ranging in OCD symptom severity. A measure of distrust in attention and perception was developed for this purpose. Initial psychometric results indicated that distrust in attention and perception can be measured reliably and that it is related to previously-established metacognitive factors (e.g., distrust in memory) and OCD-relevant beliefs (e.g., inflated sense of responsibility). Importantly, the present results also indicated that distrust in attention and perception contributed to checking symptoms beyond memory distrust, baseline negative mood and neuroticism, and previously-established OCD beliefs (i.e., inflated sense of responsibility). Taken together, these findings suggest that distrust in attention and perception may be an important mechanism in the persistence of compulsive checking.

A growing literature suggests that individuals repeatedly check in part because they lack confidence in their memories for previously-completed actions. It has also been hypothesized that the cognitive distrust demonstrated by individuals with OCD extends beyond memory to related factors such as attention and perception; however, the relation between distrust in attention, perception and memory has yet to be examined. The present study examined the extent to which distrust in attention and perception relate to memory distrust and compulsive checking in participants ranging in OCD symptom severity. A measure of distrust in attention and perception was developed for this purpose. Initial psychometric results indicated that distrust in attention and perception can be measured reliably and that it is related to previously-established metacognitive factors (e.g., distrust in memory) and OCD-relevant beliefs (e.g., inflated sense of responsibility). Importantly, the present results also indicated that distrust in attention and perception contributed to checking symptoms beyond memory distrust, baseline negative mood and neuroticism, and previously-established OCD beliefs (i.e., inflated sense of responsibility). Taken together, these findings suggest that distrust in attention and perception may be an important mechanism in the persistence of compulsive checking.