Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-24T05:31:43.671Z Has data issue: false hasContentIssue false
  • English
  • Français

The place of obsessive–compulsive and related disorders in the compulsive–impulsive spectrum: a cluster-analytic study

Published online by Cambridge University Press:  12 April 2021

Leonardo F. Fontenelle Open the ORCID record for Leonardo F. Fontenelle [Opens in a new window] ,
Louise Destrée ,
Mary-Ellen Brierley ,
Emma M. Thompson ,
Murat Yücel ,
Rico Lee ,
Lucy Albertella Open the ORCID record for Lucy Albertella [Opens in a new window]  and
Sam R. Chamberlain Open the ORCID record for Sam R. Chamberlain [Opens in a new window]
Leonardo F. Fontenelle*
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ) D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
Louise Destrée
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
Mary-Ellen Brierley
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
Emma M. Thompson
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
Murat Yücel
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
Rico Lee
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
Lucy Albertella
Affiliation:
Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
Sam R. Chamberlain
Affiliation:
Department of Psychiatry, University of Southampton; and Department of Psychiatry, University of Cambridge, UK
*
*Author for correspondence: Leonardo F. Fontenelle, MD, PhD Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The extent to which obsessive–compulsive and related disorders (OCRDs) are impulsive, compulsive, or both requires further investigation. We investigated the existence of different clusters in an online nonclinical sample and in which groups DSM-5 OCRDs and other related psychopathological symptoms are best placed.

Methods

Seven hundred and seventy-four adult participants completed online questionnaires including the Cambridge–Chicago Compulsivity Trait Scale (CHI-T), the Barratt Impulsiveness Scale (BIS-15), and a series of DSM-5 OCRDs symptom severity and other psychopathological measures. We used K-means cluster analysis using CHI-T and BIS responses to test three and four factor solutions. Next, we investigated whether different OCRDs symptoms predicted cluster membership using a multinomial regression model.

Results

The best solution identified one “healthy” and three “clinical” clusters (ie, one predominantly “compulsive” group, one predominantly “impulsive” group, and one “mixed”—“compulsive and impulsive group”). A multinomial regression model found obsessive–compulsive, body dysmorphic, and schizotypal symptoms to be associated with the “mixed” and the “compulsive” clusters, and hoarding and emotional symptoms to be related, on a trend level, to the “impulsive” cluster. Additional analysis showed cognitive-perceptual schizotypal symptoms to be associated with the “mixed” but not the “compulsive” group.

Conclusions

Our findings suggest that obsessive–compulsive disorder; body dysmorphic disorder and schizotypal symptoms can be mapped across the “compulsive” and “mixed” clusters of the compulsive–impulsive spectrum. Although there was a trend toward hoarding being associated with the “impulsive” group, trichotillomania, and skin picking disorder symptoms did not clearly fit to the demarcated clusters.

Keywords

Compulsivityimpulsivityobsessive–compulsive disorderbody dysmorphic disorderhoarding disordertrichotillomania
Type
Original Research
Information
CNS Spectrums , Volume 27 , Issue 4 , August 2022 , pp. 486 - 495
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Lucy Albertella and Sam R. Chamberlain shared last authorship.

References

APA. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Arlington, VA: American Psychiatric Publishing Incorporated; 2013.Google Scholar
WHO. International Classification of Diseases 11th Revision. 2020. https://icd.who.int/en. Accessed on March 16, 2021.Google Scholar
Ruscio, AM, Stein, DJ, Chiu, WT, et al. The epidemiology of obsessive–compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15(1):53–63.CrossRefGoogle ScholarPubMed
Postlethwaite, A, Kellett, S, Mataix-Cols, D. Prevalence of hoarding disorder: a systematic review and meta-analysis. J Affect Disord. 2019;256:309–316.CrossRefGoogle ScholarPubMed
Hayes, SL, Storch, EA, Berlanga, L. Skin picking behaviors: an examination of the prevalence and severity in a community sample. J Anxiety Disord. 2009;23(3):314–319.CrossRefGoogle Scholar
Grant, JE, Dougherty, DD, Chamberlain, SR. Prevalence, gender correlates, and co-morbidity of trichotillomania. Psychiatry Res. 2020;288:112948.CrossRefGoogle ScholarPubMed
Buhlmann, U, Glaesmer, H, Mewes, R, et al. Updates on the prevalence of body dysmorphic disorder: a population-based survey. Psychiatry Res. 2010;178(1):171–175.CrossRefGoogle ScholarPubMed
Hollander, E, Doernberg, E, Shavitt, R, et al. The cost and impact of compulsivity: a research perspective. Eur Neuropsychopharmacol. 2016;26(5):800–809.CrossRefGoogle ScholarPubMed
Hollander, E, Wong, CM. Obsessive–compulsive spectrum disorders. J Clin Psychiatry. 1995;56(suppl 4):3–6; discussion 53–55.Google ScholarPubMed
Fineberg, NA, Potenza, MN, Chamberlain, SR, et al. Probing compulsive and impulsive behaviors, from animal models to endophenotypes: a narrative review. Neuropsychopharmacology. 2010;35(3):591–604.CrossRefGoogle ScholarPubMed
Chamberlain, SR, Stochl, J, Redden, SA, et al. Latent traits of impulsivity and compulsivity: toward dimensional psychiatry. Psychol Med. 2018;48(5):810–821.CrossRefGoogle ScholarPubMed
Chamberlain, SR, Tiego, J, Fontenelle, LF, et al. Fractionation of impulsive and compulsive trans-diagnostic phenotypes and their longitudinal associations. Aust N Z J Psychiatry. 2019;53(9):896–907.CrossRefGoogle ScholarPubMed
Romero-Garcia, R, Hook, RW, Tiego, J, et al. Brain micro-architecture and disinhibition: a latent phenotyping study across 33 impulsive and compulsive behaviours. Neuropsychopharmacology. 2021;46(2):423–431.CrossRefGoogle ScholarPubMed
Hook, RW, Grant, JE, Ioannidis, K, et al. Trans-diagnostic measurement of impulsivity and compulsivity: a review of self-report tools. Neurosci Biobehav Rev. 2020.Google ScholarPubMed
Parkes, L, Tiego, J, Aquino, K, et al. Transdiagnostic variations in impulsivity and compulsivity in obsessive–compulsive disorder and gambling disorder correlate with effective connectivity in cortical–striatal–thalamic–cortical circuits. NeuroImage. 2019;202:116070.CrossRefGoogle ScholarPubMed
Fontenelle, LF, Oldenhof, E, Eduarda Moreira-de-Oliveira, M, et al. A transdiagnostic perspective of constructs underlying obsessive–compulsive and related disorders: an international Delphi consensus study. Aust N Z J Psychiatry. 2020;54(7):719–731.CrossRefGoogle Scholar
Yücel, M, Oldenhof, E, Ahmed, SH, et al. A transdiagnostic dimensional approach towards a neuropsychological assessment for addiction: an international Delphi consensus study. Addiction (Abingdon, England). 2019;114(6):1095–1109.CrossRefGoogle Scholar
Evenden, JL. Varieties of impulsivity. Psychopharmacology. 1999;146(4):348–361.CrossRefGoogle ScholarPubMed
Luigjes, J, Lorenzetti, V, de Haan, S, et al. Defining compulsive behavior. Neuropsychol Rev. 2019;29(1):4–13.CrossRefGoogle ScholarPubMed
Berlin, GS, Hollander, E. Compulsivity, impulsivity, and the DSM-5 process. CNS Spectr. 2014;19(1):62–68.CrossRefGoogle ScholarPubMed
Kogan, CS, Stein, DJ, Rebello, TJ, et al. Accuracy of diagnostic judgments using ICD-11 vs ICD-10 diagnostic guidelines for obsessive–compulsive and related disorders. J Affect Disord. 2020;273:328–340.CrossRefGoogle ScholarPubMed
Chamberlain, SR, Grant, JE. Initial validation of a transdiagnostic compulsivity questionnaire: the Cambridge–Chicago Compulsivity Trait Scale. CNS Spectr. 2018;23(5):340–346.CrossRefGoogle ScholarPubMed
Spinella, M. Normative data and a short form of the Barratt Impulsiveness Scale. Int J Neurosci. 2007;117(3):359–68.CrossRefGoogle Scholar
Stanford, MS, Mathias, CW, Dougherty, DM, et al. Fifty years of the Barratt impulsiveness scale: an update and review. Pers Individ Differ. 2009;47(5):385–395.CrossRefGoogle Scholar
Abramowitz, JS, Deacon, BJ, Olatunji, BO, et al. Assessment of obsessive–compulsive symptom dimensions: development and evaluation of the Dimensional Obsessive–Compulsive Scale. Psychol Assess. 2010;22(1):180–198.CrossRefGoogle ScholarPubMed
Veale, D, Eshkevari, E, Kanakam, N, et al. The Appearance Anxiety Inventory: validation of a process measure in the treatment of body dysmorphic disorder. Behav Cogn Psychother. 2014;42(5):605–616.CrossRefGoogle ScholarPubMed
Tolin, DF, Frost, RO, Steketee, G. A brief interview for assessing compulsive hoarding: the Hoarding Rating Scale-Interview. Psychiatry Res. 2010;178(1):147–152.CrossRefGoogle ScholarPubMed
Tolin, DF, Frost, RO, Steketee, G, et al. The economic and social burden of compulsive hoarding. Psychiatry Res. 2008;160(2):200–211.CrossRefGoogle ScholarPubMed
Keuthen, NJ, O’Sullivan, RL, Ricciardi, JN, et al. The Massachusetts General Hospital (MGH) hairpulling scale: 1. development and factor analyses. Psychother Psychosom. 1995;64(3–4):141–145.CrossRefGoogle ScholarPubMed
Solley, K, Turner, C. Prevalence and correlates of clinically significant body-focused repetitive behaviors in a nonclinical sample. Compr Psychiatry. 2018;86:9–18.CrossRefGoogle Scholar
Snorrason, I, Ólafsson, RP, Flessner, CA, et al. The skin picking scale-revised: factor structure and psychometric properties. J Obsessive Compuls Relat Disord. 2012;1(2):133–137.CrossRefGoogle Scholar
Lovibond, PF, Lovibond, SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335–343.CrossRefGoogle ScholarPubMed
Sinclair, SJ, Siefert, CJ, Slavin-Mulford, JM, et al. Psychometric evaluation and normative data for the depression, anxiety, and stress scales-21 (DASS-21) in a nonclinical sample of U.S. adults. Eval Health Prof. 2012;35(3):259–279.CrossRefGoogle Scholar
Raine, A, Benishay, D. The SPQ-B: a brief screening instrument for schizotypal personality disorder. J Pers Disord. 1995;9(4):346–355.CrossRefGoogle Scholar
Snorrason, I, Beard, C, Peckham, AD, et al. Transdiagnostic dimensions in obsessive–compulsive and related disorders: associations with internalizing and externalizing symptoms. Psychol Med. 2020;1–9. 10.1017/S0033291720000380Google ScholarPubMed
Grant, JE, Potenza, MN. Compulsive aspects of impulse-control disorders. Psychiatr Clin North Am. 2006;29(2):539–551, x.CrossRefGoogle ScholarPubMed
Grassi, G, Pallanti, S, Righi, L, et al. Think twice: impulsivity and decision making in obsessive–compulsive disorder. J Behav Addict. 2015;4(4):263–272.CrossRefGoogle ScholarPubMed
Matsunaga, H, Kiriike, N, Matsui, T, et al. Impulsive disorders in Japanese adult patients with obsessive–compulsive disorder. Compr Psychiatry. 2005;46(1):43–49.CrossRefGoogle ScholarPubMed
Prochazkova, L, Parkes, L, Dawson, A, et al. Unpacking the role of self-reported compulsivity and impulsivity in obsessive–compulsive disorder. CNS Spectr. 2018;23(1):51–58.CrossRefGoogle ScholarPubMed
Abramovitch, A, McKay, D. Behavioral impulsivity in obsessive–compulsive disorder. J Behav Addict. 2016;5(3):395–397.CrossRefGoogle ScholarPubMed
Fontenelle, LF, Mendlowicz, MV, Versiani, M. Impulse control disorders in patients with obsessive–compulsive disorder. Psychiatry Clin Neurosci. 2005;59(1):30–37.CrossRefGoogle ScholarPubMed
Frydman, I, Mattos, P, de Oliveira-Souza, R, et al. Self-reported and neurocognitive impulsivity in obsessive–compulsive disorder. Compr Psychiatry. 2020;97:152155.CrossRefGoogle ScholarPubMed
Grant, JE, Mancebo, MC, Eisen, JL, et al. Impulse-control disorders in children and adolescents with obsessive–compulsive disorder. Psychiatry Res. 2010;175(1–2):109–113.CrossRefGoogle ScholarPubMed
Grant, JE, Mancebo, MC, Pinto, A, et al. Impulse control disorders in adults with obsessive compulsive disorder. J Psychiatr Res. 2006;40(6):494–501.CrossRefGoogle ScholarPubMed
Kashyap, H, Fontenelle, LF, Miguel, EC, et al. “Impulsive compulsivity” in obsessive–compulsive disorder: a phenotypic marker of patients with poor clinical outcome. J Psychiatr Res. 2012;46(9):1146–1152.CrossRefGoogle ScholarPubMed
Stein, DJ, Hollander, E, Simeon, D, et al. Impulsivity scores in patients with obsessive–compulsive disorder. J Nerv Ment Dis. 1994;182(4):240–241.CrossRefGoogle ScholarPubMed
Grant, JE, Lust, K, Chamberlain, SR. Body dysmorphic disorder and its relationship to sexuality, impulsivity, and addiction. Psychiatry Res. 2019;273:260–265.CrossRefGoogle ScholarPubMed
Grant, JE, Redden, SA, Leppink, EW, et al. Skin picking disorder with co-occurring body dysmorphic disorder. Body Image. 2015;15:44–48.CrossRefGoogle ScholarPubMed
Grant, JE, Menard, W, Pagano, ME, et al. Substance use disorders in individuals with body dysmorphic disorder. J Clin Psychiatry. 2005;66(3):309–316; quiz 404–305.CrossRefGoogle ScholarPubMed
Jefferies-Sewell, K, Chamberlain, SR, Fineberg, NA, et al. Cognitive dysfunction in body dysmorphic disorder: new implications for nosological systems and neurobiological models. CNS Spectr. 2017;22(1):51–60.CrossRefGoogle ScholarPubMed
Angelakis, I, Gooding, PA, Panagioti, M. Suicidality in body dysmorphic disorder (BDD): a systematic review with meta-analysis. Clin Psychol Rev. 2016;49:55–66.CrossRefGoogle ScholarPubMed
Rosell, DR, Futterman, SE, McMaster, A, et al. Schizotypal personality disorder: a current review. Curr Psychiatry Rep. 2014;16(7):452CrossRefGoogle ScholarPubMed
Morein-Zamir, S, Kasese, M, Chamberlain, S, et al. Elevated levels of hoarding in ADHD: a special link with inattention. 2020. 10.1101/2020.06.09.20126490CrossRefGoogle Scholar
Grant, JE, Menard, W, Phillips, KA. Pathological skin picking in individuals with body dysmorphic disorder. Gen Hosp Psychiatry. 2006;28(6):487–493.CrossRefGoogle ScholarPubMed
Supplementary material: File

Fontenelle et al. supplementary material

Appendix

Download Fontenelle et al. supplementary material(File)
File 63.8 KB