Thesis (Ph. D. in Psychology)--Vanderbilt University, Aug. 2007. / Title from title screen. Includes bibliographical references.

An individual who had been diagnosed with Obsessive Compulsive Disorder (OCD) and Schizoaffective Disorder requested assistance with improving his ability to manage symptoms. He had a history of long-term hospitalizations that impacted his placements in residential facilities. He was treated using exposure and response prevention procedures applied to specific rituals pertaining to compulsive bed making, organization, excessive emptying of vacuum canister, excessive hand washing and excessive laundering of clothing. A baseline was established for each ritual by the experimenter exposing the subject to the conditions that "triggered" the rituals. The latency was measured between the presentation of those conditions and the onset of the ritual. During treatment, the subject initiated the same conditions and then refrained from engaging in his rituals for a specific amount of time. Initially, the requested time was the average amount of time he was able to refrain from ritualizing in the baseline sessions. Then, the subject initiated exposure and refrained from the ritual for an increasing amount of time until he was able to refrain for 15 minutes or longer for three ritualistic behaviors. A multiple baseline analysis across rituals indicated that during the course of treatment, over a period of about 4 months, his ability to tolerate the triggers for his rituals was increased to the point that he did not engage in the rituals during the sessions.

Standard methods of assessment for Obsessive-Compulsive Disorder (OCD) involve retrospective report of symptoms over a prior period of interest (e.g., a week, a month, etc.). However, such accounts may be subject to recall biases, leading to inaccurate assessments of symptoms. Recall biases present in two domains of symptom severity (distress and interference) were examined. The following study applied experience-sampling methods (ESM) to OCD symptom assessment. Using a modified form of the Yale-Brown Obsessive Compulsive Scale, twenty-one adults with a primary diagnosis of OCD rated distress and interference of their principle obsession and compulsion four times daily for approximately one week. At the end of the experience-sampling period, participants provided retrospective estimates of distress and interference of principle obsessions and compulsions experienced during the course of the ESM period. Results found that participants retrospectively overestimated OCD ratings, compared to their real-time ratings. Two proposed reasons for such overestimates (peak-end evaluation and symptom variability) were examined though not supported based on current study results. Implications and future directions are discussed.

Misophonia is a decreased sound tolerance condition (DST) that is not yet well-established in the literature. However, the existing research on misophonia shows that it is occurring at substantial levels in the population. The majority of the existing literature has focused on the clinical correlates of misophonia. Although the correlates have been investigated, there is no accepted mechanism behind misophonia etiology or maintenance. The present study examined three hypotheses in order to start to identify potential mechanisms behind misophonia: how emotional predilections are related to the emotional response, how obsessive-compulsive disorder (OCD) symptoms and misophonia are related, and the possibility that the relationship between anxiety sensitivity (AS) and misophonia may be explained in part by the presence of OCD symptoms. Data were collected by Cash (2015) using both undergraduate students (N=451) and community participants (N = 377) using Amazon’s MTurk. Participants completed an online cross-sectional survey assessing for a number of decreased sound tolerance conditions, individual differences variables, and clinical variables. The current study specifically used measures of anxiety sensitivity, OCD, misophonia symptom severity, trait anger, and trait anxiety. Consistent with the literature on state-trait theory, trait emotion was predictive of state levels, such that trait anger was most predictive of an angry misophonic response and trait anxiety was most predictive of an anxious reaction to misophonic stimuli. Misophonia was more strongly related to obsessive than to compulsive components of OCD, consistent with case reports of obsessive thoughts in misophonia. Lastly, OCD symptoms partially mediated the relationship between AS symptom severity and misophonia symptom severity. These results supported our hypotheses, and align with the theorized role of anxiety sensitivity in OCD and in misophonia. Although the data are cross-sectional in nature, and causality cannot be confirmed, the current study provides a strong basis for future research into the mechanisms of misophonia.

No description available.

Obsessive-compulsive disorder (OCD) is associated with substantial impairment across a number of life domains. Recently increased interest has been focused on the bi-directional relationship between OCD and family processes, particularly a subset of family reactions to OCD symptoms that are termed "accommodation." Accommodation consists of any changes in family members' behavior aimed at preventing or reducing the patient's rituals or their distress related to OCD symptoms. For example, family members may provide patients with supplies they need to ritualize (e.g., extra soap), or may engage in rituals themselves (e.g., excessive washing). Previous research has indicated high levels of accommodation are associated with more severe OCD symptoms and functional impairment on the part of patients, and may interfere with the first line psychosocial treatment for OCD, a form of cognitive behavior therapy (CBT) consisting of exposure (to cues provoking obsessions) and ritual prevention (ERP). Thus, the aims of this research project were to develop and test a brief intervention focused on reducing accommodation in the family members of adult OCD patients with the aim of facilitating the implementation of ERP. Eighteen patient and family member dyads participated in the study. All patients received a course of standard individual ERP for OCD. Family members were randomized to either the intervention group or a control group that did not receive any intervention. The goals of the two-session intervention were to identify current accommodation behaviors and provide alternative ways of responding to OCD symptoms. Patients and family members were assessed at baseline and regularly throughout the 25-week study. Results revealed that the intervention successfully reduced accommodation with a large effect size. Patients whose family members received the intervention showed greater levels of symptom reduction than patients whose family members had not. Hierarchical regression analyses revealed that change in family accommodation from baseline accounted for a significant amount of variance in later OCD symptoms. These results suggest that this intervention successfully enhanced the outcomes of standard CBT including ERP for adults with OCD. The findings support further exploration of this intervention in larger samples and in other diagnostic groups where accommodation is likely to occur.

Obsessive compulsive disorder (OCD) is an illness that significantly reduces the quality of life of those affected by the disorder. Current and past research has established a relationship between an authoritarian parenting style and the development of OCD. There is an absence of research regarding the influence of parenting styles on the development of different subtypes of OCD. This study examined the relationship of Baumrind's parenting styles (permissive, authoritarian, and restrictive) as gathered from participant answers on the Parenting Behavior Questionnaire and the OCD subtypes (contamination, harm, unwanted thoughts, and symmetry) as gathered from participant answers to the Dimensional Obsessive Compulsive Scale. Participants were 140 members of OCD Foundations within the United States, between the ages of 18 and 69, who self-selected to take the online survey that was linked to them by an e-mail from the foundations. A one-way between subjects ANOVA showed no significant difference between the 3 parenting styles and the 4 subtypes of OCD. Future studies should use a clinical sample that isolates participants for the specific diagnosed OCD subtypes. This isolation would eliminate the limitation of this study that had participants answering questions across all subtypes, regardless of their diagnosis. This study may impact social change by furthering the discussion of how parenting and OCD may be related, thus helping scholars, educators, and other professionals to be more proactive in guiding parents when raising their children.

Obsessive-compulsive disorder (OCD) is relatively common (Ruscio, Stein, Chiu, & Kessler, 2010) and leads to significant functional impairment (World Health Organization, 2001). Research suggests that exposure and response prevention (EX/RP) is efficacious for reducing OCD symptoms (NICE, 2006); however, standard outpatient EX/RP does not effectively alleviate symptom severity among a substantial proportion of OCD patients (Abramowitz, 2006). Intensive EX/RP programs have been developed to address the needs of treatment-refractory OCD patients (Veale et al., 2016). While evidence from effectiveness studies suggests that intensive EX/RP programs lead to significant reductions in OCD symptom severity, a portion of patients do not demonstrate improvement in response to intensive treatment (e.g., Björgvinsson, Hart, et al., 2013; Boschen, Drummond, & Pillay, 2008). These findings underscore the need to identify reliable predictors of OCD patient response to intensive EX/RP to help target clinical and research efforts toward improving treatment outcomes for those least likely to respond to current treatment modalities. Therefore, the proposed study evaluated distinct trajectories of OCD symptom change across six-weeks of intensive treatment and examined factors that predict membership in those trajectory groups. Results suggested that three latent subgroups of OCD patients emerged with one demonstrating symptom relapse during intensive treatment. Further, OCD symptom severity was the only baseline factor that predicted latent-class membership. Implications and future directions of research are discussed.

No description available.

No description available.