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Myth of the pure obsessional type in obsessive--compulsive disorder
Journal article   Peer reviewed

Myth of the pure obsessional type in obsessive--compulsive disorder

Monnica T Williams, Samantha G Farris, Eric Turkheimer, Anthony Pinto, Krystal Ozanick, Martin E Franklin, Michael Liebowitz, H Blair Simpson and Edna B Foa
Depression and anxiety, v 28(6), pp 495-500
Jun 2011
DOI: https://doi.org/10.1002/da.20820
PMID: 21509914
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1002/da.20820View
Published, Version of Record (VoR)Open Access (License Unspecified),  Restricted

Abstract

Adult Ceremonial Behavior Clomipramine - therapeutic use Cognitive Therapy Combined Modality Therapy Female Humans Male Middle Aged Obsessive-Compulsive Disorder - classification Obsessive-Compulsive Disorder - diagnosis Obsessive-Compulsive Disorder - psychology Obsessive-Compulsive Disorder - therapy Personality Assessment Serotonin Uptake Inhibitors - therapeutic use Taboo Thinking
Several studies have identified discrete symptom dimensions in obsessive-compulsive disorder (OCD), derived from factor analyses of the individual items or symptom categories of the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist (YBOCS-SC). This study aims to extend previous work on the relationship between obsessions and compulsions by specifically including mental compulsions and reassurance-seeking. Because these compulsions have traditionally been omitted from prior factor analytic studies, their association to what have been called "pure obsessions" may have been overlooked. Participants (N = 201) were recruited from two multi-site randomized clinical treatment trials for OCD. The YBOCS-SC was used to assess OCD symptoms, as it includes a comprehensive list of obsessions and compulsions, arranged by content category. Each category was given a score based on whether symptoms were present and if the symptom was a primary target of clinical concern, and a factor analysis was conducted. Mental compulsions and reassurance-seeking were considered separate categories for the analysis. Using an orthogonal geomin rotation of 16 YBOCS-SC categories/items, we found a five-factor solution that explained 67% of the total variance. Inspection of items that composed each factor suggests five familiar constructs, with mental compulsions and reassurance-seeking included with sexual, aggressive, and religious obsessions (unacceptable/taboo thoughts). This study suggests that the concept of the "pure obsessional" (e.g., patients with unacceptable/taboo thoughts yet no compulsions) may be a misnomer, as these obsessions were factorially associated with mental compulsions and reassurance-seeking in these samples. These findings may have implications for DSM-5 diagnostic criteria.

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90 citations in Web of Science
99 citations in Scopus

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Collaboration types
Domestic collaboration
Web of Science research areas
Psychiatry
Psychology
Psychology, Clinical
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