Obsessive-compulsive disorder (OCD) contributes to significant distress and chronic individual and societal impairment (e.g., DuPont et al., 1995; Ruscio et al., 2010). Despite the effectiveness of existing exposure-based therapies, some clients do not achieve symptom reduction or remission (Öst et al., 2015). Thus, identification of the mechanisms of change in treatment and more focused interventions are warranted to improve intervention effectiveness (e.g., Zvolensky et al., 2006). Distress intolerance may be an important but understudied mechanism of change in treatment for OCD. The current study replicated and extended previous findings that were limited by a small sample size (Macatee & Cougle, 2015), lack of focus on OCD specifically (McHugh et al., 2014; Bornovalova et al., 2012; Williams et al., 2013), and the use of non-clinical participants (Cougle et al., 2011; Macatee & Cougle, 2015) by using a residential and intensive outpatient sample of patients diagnosed with OCD. The current study found that reductions in DI accounted for significant improvement in OCD severity beyond changes in biological sex, anxiety change, depression change. Further, reductions in DI significantly contributed to OCD treatment response. Limitations and future directions were discussed.

In this research I explore my Obsessive Compulsive Disorder (OCD) and make manifest equivalent experiences of it through art practice. I investigate my OCD through artistic enactments and test my equivalence of the framework obsessioncompulsion using installation art – an equivalence, which I suggest is a relationship between my embodied perception and my memory. My interpretation of equivalence contains characteristics that arguably align with common emotions of control and doubt, inflated sense of responsibility and fear of disaster, which, I suggest are accessible to an audience other than myself. As such, my artwork proposes that a viewer can experience my equivalence to some degree. I refer to writer David Batchelor's (1997) definition of equivalence as a starting point for this research, and question how my OCD reveals itself through memory and perception, by referring to Richard Shusterman's ideas regarding somaesthetic reflection (2008), Bergson's description of the structure of memory (2004), Paul Ricouer's link between memory and imagination (2006) and Gilles Deleuze's ideas regarding difference and repetition (2013). I also refer to theoretician Estelle Barrett and her ideas regarding “situated knowledge” (2010: 4-5) as a way to frame the subjective and personal nature of my artistic enquiry, regarding my equivalence of OCD. Within this thesis I place emphasis on art practice as a method of research and describe the processes I have used to explore my OCD and make manifest my equivalence. I refer to Clare Bishop’s (2005) phenomenological description of installation art and mimetic engulfment within this process as I consider them methods to reveal my equivalence, by making manifest the relationship between my memory and my perception, both of which are embodied experiences within my OCD. I discuss Ross G. Menzies and Padmal de Silva’s (2004) clinical definitions and descriptions of obsession, compulsion, memory deficit and checking, in addition to phenomenological and pragmatic ideas, regarding memory and perception, as a way to articulate my proposition that equivalence of my OCD is constructed of a interdependent relationship between two embodied experiences, which can be revealed through art practice. My research contributes to new knowledge as it suggests a new way of understanding OCD by employing a multi-disciplined approach to practice-led research.

Studies have shown that aberrant activity in some brain regions involved in the pathology of OCD overlaps similarly with individuals with addiction disorders. The reduced anxiety following a compulsion together with findings of diminished activation in the striatum during reward anticipation proposes a view of OCD being a behavior addiction. To investigate if there are consistent results across studies that support this view a systematic search of the literature was conducted. The keywords in the final search string used were: Obsessive-compulsive disorder, OCD, reward, risk, functional MRI, MRI, fMRI. Databases used for the search were Web of Science and PubMed. The inclusion criteria were studies that compared the neural activity during the anticipation phase of reward between OCD patients and healthy controls. The intervention and brain imaging used in the included studies were the monetary incentive delay task and fMRI. The main data extracted were the alterations in the striatum. Four studies were included in this review with inconsistent results. Three studies did not find any significant difference between OCD and healthy controls and therefore the findings in principle did not support the view of OCD being a behavior addiction. However, differences in study design between studies could be an explanation for the conflicting findings.

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For me, architecture is a service--a way of helping people and the environment--and I wanted my thesis to reflect this idea. This thesis combines human rehabilitation and environmental remediation in order to study how these two types of healing interact. Specifically, the program of the building is a rehabilitation center for Obsessive-Compulsive Disorder (OCD) patients (who stereotypically have an obsession with order and cleanliness). Both the patients and the site are going through the process of healing, but they are doing so in ways that juxtapose each other: while the dirt, plants, and water on the site are made cleaner, the patients are undergoing therapy that helps them understand that it is okay to be "dirtier." This brings into question what the terms "clean" and "dirty" really mean. Through my year-long research into OCD rehabilitation, environmental remediation, and the meaning of dirt, I came across a quotation that summed up this idea within my thesis. It came from the appropriately titled book, Dirt: "A landscape architect's understanding of dirt--as a fertile medium--overturns the term's negative connotations to understand it as explicitly productive." (Born 8) Therefore, my thesis explores dirt's productivity and challenges visitors' and patients' preconceptions of order and disorder. Overall, however, my goal was to create a project that allowed a forgotten, polluted site to be reclaimed by the city and for the patients, through therapy, to reclaim their lives. / Master of Architecture

One of the difficulties encountered by therapists working with individuals with obsessive-compulsive (OC) symptoms/disorder is the resistance of OC symptoms to change. A factor that may affect the prognosis for such individuals is the extent to which their symptoms result in positive or negative functional consequences. The current study describes the development, reliability, and validity of a new scale — the Obsessive Compulsive Self-Syntonicity of Symptoms Scale (OCSSSS) - that measures the positive and negative functional consequences of OC symptoms. Items were generated by the principal investigator and major professor after examining the research literature for OC and related disorders. Fifty-four items were generated, which yielded a robust, seven component structure through principal components analysis. Items were rated on a 1-5 Likert scale (1=extremely inconsistent - 5=extremely consistent) with an option of "not applicable" (coded as "0"). Higher scores on the OCSSSS indicated more perceived functional consequences of OC symptoms in an individual's daily life. The sample consisted of 634 students, who responded to an advertisement describing general examples of OC symptoms and who completed several measures online, including: 1) Yale Brown Obsessive Compulsive Scale, Self Report (Y-BOCS-SR); 2)Obsessive Compulsive Inventory Revised (OCI-R); 3) University of Rhode Island Change Assessment (URICA); 4) self-report of frequency of prior/current therapy; evaluation of the effectiveness of prior therapy; evaluation of the expected effectiveness of future therapy; and willingness to participate in future therapy; and 5) social/work adjustment. The OCSSSS was reliable and most items correlated with total score. The OCSSSS's total score and individual component scores were correlated with symptom severity, symptom type, subjective evaluations of treatment experiences, willingness to participate in treatment, avoidance, work and social adjustment, and stage of change. Regression analyses indicated the OCSSSS significantly predicts stage of change, controlling for symptom severity. / Master of Science

No description available.

Doctor of Clinical Psychology / Obsessive-compulsive (OC) symptoms occur in a variety of clinical conditions, but the underlying pathogenesis of these symptoms remains elusive. Few neuropsychological investigations have compared idiopathic Obsessive-Compulsive Disorder (OCD) with patient groups where OC symptoms are acquired. The present study investigated the neuropsychological correlates of OC symptoms in OCD and frontotemporal dementia (FTD), a neurodegenerative illness in which OC symptoms are often acquired. Neuroimaging in OCD has consistently implicated the frontal-striatal-thalamic circuit, particularly the orbitofrontal cortex and basal ganglia. These areas overlap considerably with the sites of cerebral pathology found in FTD. OCD has been associated with a number of neuropsychological deficits, with most consistent findings pointing towards impaired executive function (EF), and less commonly reported deficits in visual memory and visuospatial ability. The neuropsychological hallmark of FTD is deficits in EF. However in both OCD and FTD, the relationship between cognitive deficits and OC symptoms remains unclear. Further, the extent to which OC symptoms are comparable between the groups is ambiguous. Part I of the present study compared 19 OCD subjects to 20 age, education and IQ-matched healthy controls on a battery of neuropsychological tests of all major cognitive domains with emphasis on EF. A measure of Theory of Mind (ToM) thought to be sensitive to orbitofrontal function was also administered. OCD subjects performed worse than controls on a measure of visual memory, visuospatial reasoning and on only one measure of EF. OCD symptom subtypes, as measured by the Obsessive-Compulsive Inventory (OCI), were not correlated with any cognitive deficits. No group differences in ToM were found. It is suggested that prior research has overestimated the severity and significance of EF deficits in OCD. Part II of the study compared 9 FTD participants with 10 matched healthy controls on the same neuropsychological test battery and OC symptom measures. In addition, a measure of compulsive behaviours used in neurological populations was administered to carers. While the incidence of OC symptoms was comparable to reports in previous studies (78%), the OCI was not sensitive in the detection of OC symptoms in FTD. The similarities and differences in OC symptoms between the two patient groups are discussed.

Doctor of Clinical Psychology / Obsessive-compulsive (OC) symptoms occur in a variety of clinical conditions, but the underlying pathogenesis of these symptoms remains elusive. Few neuropsychological investigations have compared idiopathic Obsessive-Compulsive Disorder (OCD) with patient groups where OC symptoms are acquired. The present study investigated the neuropsychological correlates of OC symptoms in OCD and frontotemporal dementia (FTD), a neurodegenerative illness in which OC symptoms are often acquired. Neuroimaging in OCD has consistently implicated the frontal-striatal-thalamic circuit, particularly the orbitofrontal cortex and basal ganglia. These areas overlap considerably with the sites of cerebral pathology found in FTD. OCD has been associated with a number of neuropsychological deficits, with most consistent findings pointing towards impaired executive function (EF), and less commonly reported deficits in visual memory and visuospatial ability. The neuropsychological hallmark of FTD is deficits in EF. However in both OCD and FTD, the relationship between cognitive deficits and OC symptoms remains unclear. Further, the extent to which OC symptoms are comparable between the groups is ambiguous. Part I of the present study compared 19 OCD subjects to 20 age, education and IQ-matched healthy controls on a battery of neuropsychological tests of all major cognitive domains with emphasis on EF. A measure of Theory of Mind (ToM) thought to be sensitive to orbitofrontal function was also administered. OCD subjects performed worse than controls on a measure of visual memory, visuospatial reasoning and on only one measure of EF. OCD symptom subtypes, as measured by the Obsessive-Compulsive Inventory (OCI), were not correlated with any cognitive deficits. No group differences in ToM were found. It is suggested that prior research has overestimated the severity and significance of EF deficits in OCD. Part II of the study compared 9 FTD participants with 10 matched healthy controls on the same neuropsychological test battery and OC symptom measures. In addition, a measure of compulsive behaviours used in neurological populations was administered to carers. While the incidence of OC symptoms was comparable to reports in previous studies (78%), the OCI was not sensitive in the detection of OC symptoms in FTD. The similarities and differences in OC symptoms between the two patient groups are discussed.