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.

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No description available.

Anemia is a significant public health issue that affects a great number of people in developed and developing countries. The World Health Organization states when the Hb value is/dL in an adult male and/dL in a nonpregnant female, the individual is considered as anemic. Iron deficiency is one of the most common causes of anemia. Inadequate intake of iron, chronic blood loss, and/or a combination of both factors typically lead to iron deficiency anemia. In developed countries, chronic blood loss from gastrointestinal, genitourinary, and gynecological sources are the most common etiologies of iron deficiency anemia. Although there are reports of iron deficiency anemia leading to self-inflicted skin excoriation, there are few cases of chronic blood loss from skin excoriation resulting in severe iron deficiency anemia. We present a 49 year old female with significant past medical history of depression, anxiety and chronic back pain who presented after she was found to have profound anemia with hemoglobin of 4.1g/dl. During interviewing, she denied hematuria, hemoptysis, hematochezia, and had been without menstrual cycles for the past year. Urinalysis was negative for blood as well as two documented negative fecal occult blood tests. Iron studies completed showed severely reduced iron levels. Upon further interviewing, the patient reported a supposedly self-diagnosed keratin disorder. For the past ten years she has been self-treating the keratin disorder by applying topical tretinoin and then wrapping it in saran wrap. She would then peel off areas of skin over multiple areas of her body including all extremities and her face. Multiple pictures of bloody piles of tissue were shown. The patient required 3 units of packed red blood cells and was started on iron supplementation. Gastroenterology was consulted and agreed there was no GI source of her blood loss. Psychiatry further evaluated the patient and diagnosed her with obsessive-compulsive disorder with somatic delusions. The prevalence of anemia among chronic psychiatric patients is more frequent than general population. This coexistence deteriorates the quality of life of the patients, prolongs the psychiatric treatment period, and could even cause an increase in morbidity and mortality. Treatment-related factors, drugs taken, physical conditions, negative lifestyle habits, and nutritional disorders are the reasons for anemia among chronic psychiatric patients. Even though iron deficiency anemia in developed country is most often caused by chronic blood loss from gastrointestinal, genitourinary, and gynecological causes, it is important to evaluate for other factors when none of these are present. Psychiatric causes when warranted from history including somatic delusions from obsessive-compulsive disorder should be considered on the differential when other etiologies are less clear.

Hoarding is characterized by (a) the persistent difficulty discarding personal items; (b) clutter that interferes with living areas; and (c) significant distress or functional impairment. Hoarding symptoms often emerge in childhood and adolescence, yet very few studies on hoarding in this age group exist. Current models of hoarding emphasize impairments in decision-making, yet the literature on decision-making processes in hoarding presents inconsistent findings. Preliminary cognitive studies in adults suggest that hoarding may be associated with deficits in value attribution (the tendency to assign value to personal items). Thus, we propose that the Endowment Effect (EE), in which ownership of an item increases its perceived value, may be informative for the study of hoarding symptoms. This study investigated the EE in youth (children and adolescents) with Obsessive-Compulsive Disorder (OCD) and hoarding symptoms. Given that hoarding involves significant difficulty discarding personal items, we hypothesized that hoarding in youth is associated with a higher EE. Thirty youth participants with a confirmed DSM-5 diagnosis of OCD completed the Endowment Task, a game script of the EE; the Wisconsin Card Sorting Test (WCST), a test of cognitive flexibility; and the Balloon-Analogue Risk Task (BART), a test of risky decision-making. The Children’s Saving Inventory-Parent Version (CSI) was used to measure severity of hoarding symptoms. We divided our sample into thirds based on CSI scores to create a ‘High Hoarding’ group (HH; n=12; mean CSI (S.D.)=30.83 (5.47446)) and a ‘Low Hoarding’ group (LH; n=10; mean CSI (S.D.)=5.00 (3.16228)). The HH group demonstrated a higher average EE than the LH group (average EE, 3.22 and 1.59, respectively). In contrast, no significant between-group differences were found on the WCST and the BART (t=0.901, p=0.378 and t=0.338, p=0.739, respectively). The results of this thesis suggest that psychological ownership plays an important role in the manifestation of hoarding symptoms. Thus, we propose that hoarding might be associated with a specific decision-making deficit related to personal possessions. / Thesis / Master of Science (MSc)

No description available.

The prevalence rate for Obsessive-Compulsive Disorder (OCD) is between 0.8% to 2%. Many of these individuals experience scrupulosity or religious obsessive-compulsive disorder. Although scrupulosity is a salient theme for those who suffer from OCD, there is limited amount of research on scrupulosity across cultures. Research is particularly limited in relation to individuals from Latin American countries, including Mexico. In response to this limitation, the purpose of this study is to determine if there is a significant difference in symptoms of scrupulosity in non-referred samples of college students from the U.S. and Mexico. Results indicated that scrupulosity is a valid and reliable construct in the Mexican sample, not different in structure or intensity relative to an American sample.