Obsessive-compulsive disorder (OCD), with a prevalence of 1-2 %, frequently leads a chronic course. Persons with OCD are often reluctant to seek help and, if they do, their OCD is often missed. This is unfortunate, since active treatment may substantially improve social function and quality of life. Serotonin reuptake inhibitors (SRIs) have welldocumented efficacy in OCD, but delayed response may be problematic. Methods to predict response have been lacking. Because SRIs are effective, pathophysiological research on OCD has focussed on serotonin. However, no clear aberrations of serotonin have been found, thus other mechanisms ought to be involved. Our aims were to facilitate clinical detection and assessment of OCD, to search for biochemical correlates of response and side-effects in SRI treatment of OCD and to identify any possible involvement of oxytocin in the pathophysiology of OCD. In study I, we tested in 402 psychiatric out-patients the psychometric properties of a concise rating scale, “Brief Obsessive Compulsive Scale” (BOCS). BOCS was shown to be easy to use and have excellent discriminant validity in relation to other common psychiatric diagnoses. Studies II-V were based on 36 OCD patients from a randomised controlled trial of paroxetine, clomipramine or placebo. In study II, contrary to expectation, we found that the change (decrease) of serotonin in whole blood was most pronounced in non-responders to SRI. This is likely to reflect inflammatory influence on platelet turnover rather than serotonergic processes within the central nervous system. In studies IV-V, we found relations between changes of oxytocin in plasma and the anti-obsessive response, and between oxytocin and the SRI related delay of orgasm, respectively. In both cases, the relation to central oxytocinergic mechanisms is unclear. In males, delayed orgasm predicted anti-obsessive response.

Eye Movement Desensitization and Reprocessing, EMDR, is a new clinical treatment shown to be effective for victims of trauma. EMDR is a time efficient, comprehensive methodology backed by positive, controlled research, for the treatment of disturbing experiences that underlie many pathologies. An eight phase treatment approach that includes using eye movements or other left-right stimulation, EMDR helps victims of trauma reprocess disturbing thoughts and memories. The purpose of this research project was to describe and explore the utilization of EMDR by licensed clinical social workers who were registered as members of the National Association of Social Workers.

Syftet med den aktuella studien var att undersöka hur variablerna passion och ångest förhåller sig till varandra samt undersöka om situationen idrottare befinner sig i (träning eller match) har betydelse för dessa samband. I studien deltog 112 idrottare i åldrarna 15–34 år (M=20.2, SD=4.3) från tio olika idrottsföreningar i Halland. Deltagarna mättes en gång inför träning och en gång inför match. Resultatet visade att det förelåg ett negativt signifikant samband mellan harmonisk passion och ångest inför träning (r = -.19, p <.05) och match (r = -.32, p <.01) samt att det inte förelåg ett positivt signifikant samband mellan tvångsmässig passion och ångest inför träning (r = .16, p >.05) och match (r = .07, p >.05). Resultatet visade även att situationen hade en signifikant effekt på deltagarnas upplevda ångest (p <.01). Vidare visade resultatet att det fanns en signifikant skillnad i upplevd ångest mellan de två formerna av passion (p <.01). Däremot förelåg det ingen signifikant interaktionseffekt mellan de två olika formerna av passion och de två olika situationerna i upplevd ångest (p >.05). Baserat på studiens resultat, framhävs vikten av en harmonisk passion då denna verkar vara en mer hälsosam väg till idrottslig prestation. / The purpose of this study was to investigate how the variables passion and anxiety relate to each other, as well as investigate if the type of situation athletes are exposed to (practice vs. game) is of significance for this relation. In the study, 112 athletes between 15-34 years of age (M=20.2, SD=4.3) from ten different sports associations in Halland participated. The participants were measured once right before a practice and once right before a game. The results showed that there was a negative significant correlation between harmonious passion and anxiety prior to practice (r = -.19, p <.05) and game situation (r = -32, p <.01), but showed no positive significant correlation between obsessive passion and anxiety prior to practice (r = .16, p >.05) and game situation (r = .07, p >.05). Furthermore, the results showed that the type of situation had a significant effect on the level of anxiety among the participants (p <.01). The results also showed that there was a significant difference in levels of anxiety depending on the type of passion (p <.01). However, there appeared to be no significant interaction effect between the two groups of passion and the level of anxiety depending on the situation (p >.05). Based on the results of the study, a harmonious passion is desirable, since this seems to be a healthier road toward athletic performance.

Background. Feelings of doubt and perseverative behaviours are key symptoms of obsessive–compulsive disorder (OCD) and have been linked to hyperactive error and conflict signals in the brain. While enhanced neural correlates of error monitoring have been robustly shown, far less is known about conflict processing and adaptation in OCD. Method. We examined event-related potentials during conflict processing in 70 patients with OCD and 70 matched healthy comparison participants, focusing on the stimulus-locked N2 elicited in a flanker task. Conflict adaptation was evaluated by analysing sequential adjustments in N2 and behaviour, i.e. current conflict effects as a function of preceding conflict. Results. Patients with OCD showed enhanced N2 amplitudes compared with healthy controls. Further, patients showed stronger conflict adaptation effects on reaction times and N2 amplitude. Thus, the effect of previous compatibility was larger in patients than in healthy participants as indicated by greater N2 adjustments in change trials (i.e. iC, cI). As a result of stronger conflict adaptation in patients, N2 amplitudes were comparable between groups in incompatible trials following incompatible trials. Conclusions. Larger N2 amplitudes and greater conflict adaptation in OCD point to enhanced conflict monitoring leading to increased recruitment of cognitive control in patients. This was most pronounced in change trials and was associated with stronger conflict adjustment in N2 and behaviour. Thus, hyperactive conflict monitoring in OCD may be beneficial in situations that require a high amount of control to resolve conflict, but may also reflect an effortful process that is linked to distress and symptoms of OCD.

The diploma thesis is focused on orthorexia nervosa in connection with OCD. Theoretical part contains introduction, diagnostic criteria and methods of measuring. Increasing attention is given to risk groups and factors, which can affect the development of both disorders. Moreover, treatment options and comparison with other mental disorders are presented. The last part of theoretical part is focused on athletes in fitness centers, which are research subjects in the practical part of the thesis. The main goal of practical part is to find out connection between orthorexia nervosa and OCD in selected group of respondents (N=203). Main research survey has quantitative design. The ORTO-15 and Obsessive - Compulsive Inventory (OCI) surveys are used. Statistical analysis shows statistically significant correlation between orthorexia symptoms and obsessive - compulsive disorder symptoms. There is not any significant correlation between orthorexia and training frequency. However, there is statistically significant correlation between orthorexia symptoms and training frequency. The results also show that the occurrence of orthorexia is not sex-linked. Interviews with some responders have been added to research survey (N = 6). The gathered data were processed open coding and presented card unloading...

The diploma thesis is focused on orthorexia nervosa in connection with OCD. Theoretical part contains introduction, diagnostic criteria and methods of measuring. Increasing attention is given to risk groups and factors, which can affect the development of both disorders. Moreover, treatment options and comparison with other mental disorders are presented. The last part of theoretical part is focused on athletes in fitness centers, which are research subjects in the practical part of the thesis. The main goal of practical part is to find out connection between orthorexia nervosa and OCD in selected group of respondents (N=203). Main research survey has quantitative design. The ORTO-15 and Obsessive - Compulsive Inventory (OCI) surveys are used. Statistical analysis shows statistically significant correlation between orthorexia symptoms and obsessive - compulsive disorder symptoms. There is not any significant correlation between orthorexia and training frequency. However, there is statistically significant correlation between orthorexia symptoms and training frequency. The results also show that the occurrence of orthorexia is not sex-linked. Interviews with some responders have been added to research survey (N = 6). The gathered data were processed open coding and presented card unloading...

The objective of this licentiate thesis is to investigatearchitectural experience and creation in virtual space and itsrepresentational problems. The thesis comprises three articlespublished during the years 2001-2003, and a website,www.arch.kth.se/~zimm. The articles investigate architecture as a transgressivestate between the virtual worlds of imagination and thedomestic interior, introducing obsessive dreambuilding as amethod of negotiating material fictions in real space. The mainrepresentative of this kind of architectural activity is thefictional character Baron des Esseintes in Joris-KarlHuysmans´ novel À Rebours (1884). Together with thearchitectural transformations created by the architect Sir JohnSoane and the artists Kurt Schwitters and Gregor Schneider, theprojects share and develop the theme of extreme individualityand explore the architectural imagination at work in the mindof the obsessive dreambuilder. These architects of parallelrealities create operative fields of artificiality andimagination, where architectural space splits into differentontological states, providing fields for observation ofperceptional and representational problems. <b>Keywords:</b>Architecture, Against Nature/À Rebours,Artifice, Artificiality, Domestic interior, Dream, Experience,Fiction, Hypertext, Huysmans, Imagination, Individuality,Interactivity, Interface, Obsession, Obsessive dreambuilding,Perception, Representation, Schwitters, Schneider, Soane,Symbolism, Virtual Reality / NR 20140805

Introduction: Family-focused cognitive behavioural therapy (FFCBT) is emphasized as an approach to optimize treatment outcomes for early-onset obsessive-compulsive disorder (OCD). Parental engagement is critical to successful treatment. However, few studies have examined how to promote parental engagement during FFCBT. Additionally, from a parental perspective, there is a limited understanding of factors that influence parental engagement throughout treatment, including the role of nurses. Aims: To determine (i) how parents experience and understand their engagement in FFCBT provided for their child with early-onset OCD in community or outpatient mental health programs, and (ii) how parents describe the role of nurses related to parental engagement during the treatment process. Methods: This study used an interpretive description approach. Semi-structured interviews were completed with parents (n = 17) recruited from community or outpatient children’s mental health programs in the Hamilton Region of Southwestern Ontario. Treatment provider interviews (n = 9) augmented the data collected from parents’ perceptions of their engagement and the role of nurses during FFCBT. Interviews were analyzed using Braun and Clark’s (2006) thematic analysis process. Results: A conceptualized model was constructed to display and communicate the individual, interpersonal, and contextual influences identified by parents and treatment providers. These influences facilitated or inhibited parental engagement during treatment across distinct phases, levels, and stages of engagement. Six distinct nursing roles were identified that promoted parental engagement throughout treatment. / Dissertation / Doctor of Philosophy (PhD) / Without effective treatment, pediatric obsessive-compulsive disorder (OCD) can interfere with childhood development. Early-onset OCD is a unique subtype of the disorder involving pediatric patients with symptoms that present before the age of 10 years. Family-focused cognitive behavioural therapy (FFCBT) emphasizing parental involvement is commonly used to treat pediatric OCD. However, parental engagement during FFCBT, including nurses’ roles, is poorly understood. This study aimed to increase knowledge about parental engagement during FFCBT for children with early-onset OCD receiving treatment in community programs. Data analysis of parent and treatment provider interviews identified various factors and how nurses influenced parental engagement during FFCBT. A model was made to display how these factors helped or hindered parental engagement during treatment and how nurses promoted engagement across three distinct phases. This new knowledge informed recommendations to promote parental engagement for treatment providers, improve service development and delivery, and strengthen nursing education.

Behavior therapy of obsessive-compulsive disorder (OCD) aims to reduce avoidance, rituals, and discomfort in OCD-relevant situations. The Behavioral Avoidance Test (BAT) measures these behavior-related outcomes in individually challenging OCD-related situations. The association of the BAT with OCD severity measures and its relevance for treatment outcome is, however, still unclear. The current study investigates with a retrospective analysis of a subsample of a pilot study, (1) if reactions on the BAT are related to OCD severity measures in an OCD sample (n = 28), (2) if treatment with two variants of cognitive-behavior therapy (exposure and response prevention vs. metacognitive therapy) changes the BAT scores and (3) if these changes as well as pretreatment BAT avoidance are relevant for OCD treatment outcome as measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Participants rated avoidance, ritual, and discomfort in three individually challenging OCD-related situations before and after therapy. For one of these situations, BAT dimensions were rated by the therapist and an independent rater in addition to the patients’ ratings. Correlational analyses found significant correlations between BAT discomfort and OCD severity measures like the Y-BOCS. A repeated measures ANOVA with pre- and posttest scores showed that all three BAT dimensions significantly decreased during both treatments. Hierarchical regression analyses (controlling for Y-BOCS pretest scores) revealed that changes in BAT discomfort as well as pretreatment BAT avoidance scores predicted the Y-BOCS posttest score. These findings suggest that the BAT is a distinct measure of behavior-related outcomes partly being relevant for OCD treatment outcome.

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