An investigation of doubt in obsessive–compulsive disorder

Jack Samuels, O. Joseph Bienvenu, Janice Krasnow, Ying Wang, Marco A. Grados, Bernadette Cullen, Fernando S. Goes, Brion Maher, Benjamin D. Greenberg, Nicole C. McLaughlin, Steven A. Rasmussen, Abby J. Fyer, James A. Knowles, Paul Nestadt, James T. McCracken, John Piacentini, Dan Geller, David L. Pauls, S. Evelyn Stewart, Dennis L. Murphy & 5 others Yin Yao Shugart, Vidya Kamath, Arnold Bakker, Mark A. Riddle, Gerald Nestadt

Research output: Contribution to journalArticle

Abstract

Background Clinicians have long considered doubt to be a fundamental characteristic of obsessive–compulsive disorder (OCD). However, the clinical relevance of doubt in OCD has not been addressed. Methods Participants included 1182 adults with OCD who had participated in family and genetic studies of OCD. We used a clinical measure of the severity of doubt, categorized as none, mild, moderate, severe, or extreme. We evaluated the relationship between doubt and OCD clinical features, Axis I disorders, personality and personality disorder dimensions, impairment, and treatment response. Results The severity of doubt was inversely related to the age at onset of OCD symptoms. Doubt was strongly related to the number of checking symptoms and, to a lesser extent, to the numbers of contamination/cleaning and hoarding symptoms. Doubt also was related to the lifetime prevalence of recurrent major depression and generalized anxiety disorder; to the numbers of avoidant, dependent, and obsessive–compulsive personality disorder traits; and to neuroticism and introversion. Moreover, doubt was strongly associated with global impairment and poor response to cognitive behavioral treatment (CBT), even adjusting for OCD severity and other correlates of doubt. Conclusions Doubt is associated with important clinical features of OCD, including impairment and cognitive–behavioral treatment response.

Original languageEnglish (US)
Pages (from-to)117-124
Number of pages8
JournalComprehensive Psychiatry
Volume75
DOIs
StatePublished - May 1 2017

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Obsessive-Compulsive Disorder
Compulsive Personality Disorder
Personality Disorders
Obsessive Hoarding
Anxiety Disorders
Age of Onset
Depression
Introversion (Psychology)

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

An investigation of doubt in obsessive–compulsive disorder. / Samuels, Jack; Bienvenu, O. Joseph; Krasnow, Janice; Wang, Ying; Grados, Marco A.; Cullen, Bernadette; Goes, Fernando S.; Maher, Brion; Greenberg, Benjamin D.; McLaughlin, Nicole C.; Rasmussen, Steven A.; Fyer, Abby J.; Knowles, James A.; Nestadt, Paul; McCracken, James T.; Piacentini, John; Geller, Dan; Pauls, David L.; Stewart, S. Evelyn; Murphy, Dennis L.; Shugart, Yin Yao; Kamath, Vidya; Bakker, Arnold; Riddle, Mark A.; Nestadt, Gerald.

In: Comprehensive Psychiatry, Vol. 75, 01.05.2017, p. 117-124.

Research output: Contribution to journalArticle

Samuels, J, Bienvenu, OJ, Krasnow, J, Wang, Y, Grados, MA, Cullen, B, Goes, FS, Maher, B, Greenberg, BD, McLaughlin, NC, Rasmussen, SA, Fyer, AJ, Knowles, JA, Nestadt, P, McCracken, JT, Piacentini, J, Geller, D, Pauls, DL, Stewart, SE, Murphy, DL, Shugart, YY, Kamath, V, Bakker, A, Riddle, MA & Nestadt, G 2017, 'An investigation of doubt in obsessive–compulsive disorder' Comprehensive Psychiatry, vol 75, pp. 117-124. DOI: 10.1016/j.comppsych.2017.03.004

Samuels, Jack; Bienvenu, O. Joseph; Krasnow, Janice; Wang, Ying; Grados, Marco A.; Cullen, Bernadette; Goes, Fernando S.; Maher, Brion; Greenberg, Benjamin D.; McLaughlin, Nicole C.; Rasmussen, Steven A.; Fyer, Abby J.; Knowles, James A.; Nestadt, Paul; McCracken, James T.; Piacentini, John; Geller, Dan; Pauls, David L.; Stewart, S. Evelyn; Murphy, Dennis L.; Shugart, Yin Yao; Kamath, Vidya; Bakker, Arnold; Riddle, Mark A.; Nestadt, Gerald / An investigation of doubt in obsessive–compulsive disorder.

In: Comprehensive Psychiatry, Vol. 75, 01.05.2017, p. 117-124.

Research output: Contribution to journalArticle

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abstract = "Background Clinicians have long considered doubt to be a fundamental characteristic of obsessive–compulsive disorder (OCD). However, the clinical relevance of doubt in OCD has not been addressed. Methods Participants included 1182 adults with OCD who had participated in family and genetic studies of OCD. We used a clinical measure of the severity of doubt, categorized as none, mild, moderate, severe, or extreme. We evaluated the relationship between doubt and OCD clinical features, Axis I disorders, personality and personality disorder dimensions, impairment, and treatment response. Results The severity of doubt was inversely related to the age at onset of OCD symptoms. Doubt was strongly related to the number of checking symptoms and, to a lesser extent, to the numbers of contamination/cleaning and hoarding symptoms. Doubt also was related to the lifetime prevalence of recurrent major depression and generalized anxiety disorder; to the numbers of avoidant, dependent, and obsessive–compulsive personality disorder traits; and to neuroticism and introversion. Moreover, doubt was strongly associated with global impairment and poor response to cognitive behavioral treatment (CBT), even adjusting for OCD severity and other correlates of doubt. Conclusions Doubt is associated with important clinical features of OCD, including impairment and cognitive–behavioral treatment response.",
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AU - Bienvenu,O. Joseph

AU - Krasnow,Janice

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AU - Grados,Marco A.

AU - Cullen,Bernadette

AU - Goes,Fernando S.

AU - Maher,Brion

AU - Greenberg,Benjamin D.

AU - McLaughlin,Nicole C.

AU - Rasmussen,Steven A.

AU - Fyer,Abby J.

AU - Knowles,James A.

AU - Nestadt,Paul

AU - McCracken,James T.

AU - Piacentini,John

AU - Geller,Dan

AU - Pauls,David L.

AU - Stewart,S. Evelyn

AU - Murphy,Dennis L.

AU - Shugart,Yin Yao

AU - Kamath,Vidya

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N2 - Background Clinicians have long considered doubt to be a fundamental characteristic of obsessive–compulsive disorder (OCD). However, the clinical relevance of doubt in OCD has not been addressed. Methods Participants included 1182 adults with OCD who had participated in family and genetic studies of OCD. We used a clinical measure of the severity of doubt, categorized as none, mild, moderate, severe, or extreme. We evaluated the relationship between doubt and OCD clinical features, Axis I disorders, personality and personality disorder dimensions, impairment, and treatment response. Results The severity of doubt was inversely related to the age at onset of OCD symptoms. Doubt was strongly related to the number of checking symptoms and, to a lesser extent, to the numbers of contamination/cleaning and hoarding symptoms. Doubt also was related to the lifetime prevalence of recurrent major depression and generalized anxiety disorder; to the numbers of avoidant, dependent, and obsessive–compulsive personality disorder traits; and to neuroticism and introversion. Moreover, doubt was strongly associated with global impairment and poor response to cognitive behavioral treatment (CBT), even adjusting for OCD severity and other correlates of doubt. Conclusions Doubt is associated with important clinical features of OCD, including impairment and cognitive–behavioral treatment response.

AB - Background Clinicians have long considered doubt to be a fundamental characteristic of obsessive–compulsive disorder (OCD). However, the clinical relevance of doubt in OCD has not been addressed. Methods Participants included 1182 adults with OCD who had participated in family and genetic studies of OCD. We used a clinical measure of the severity of doubt, categorized as none, mild, moderate, severe, or extreme. We evaluated the relationship between doubt and OCD clinical features, Axis I disorders, personality and personality disorder dimensions, impairment, and treatment response. Results The severity of doubt was inversely related to the age at onset of OCD symptoms. Doubt was strongly related to the number of checking symptoms and, to a lesser extent, to the numbers of contamination/cleaning and hoarding symptoms. Doubt also was related to the lifetime prevalence of recurrent major depression and generalized anxiety disorder; to the numbers of avoidant, dependent, and obsessive–compulsive personality disorder traits; and to neuroticism and introversion. Moreover, doubt was strongly associated with global impairment and poor response to cognitive behavioral treatment (CBT), even adjusting for OCD severity and other correlates of doubt. Conclusions Doubt is associated with important clinical features of OCD, including impairment and cognitive–behavioral treatment response.

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