Browsing by Subject "Obsessive-compulsive disorder"
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- PublicationOpen AccessA Meta-analytic Study on Executive Function Performance in Children/Adolescents with OCD(Universidad de Murcia. Servicio de Publicaciones, 2022) López Hernández, Paloma; Sánchez Meca, Julio; Rosa Alcázar, Ángel; Rosa Alcázar, Ana IsabelThe main objective of this work was to carry out a meta-analytical study to examine performance in executive functions in children/adolescents with obsessive-compulsive disorder (OCD). Method: A comprehensive literature search from 1984 to September 2021 was con-ducted, selecting a total of 20 published studies comparing executive func-tion outcomes among a group of children and/or adolescents with OCD and a healthy control group. Results: Results showed that the total score on the quality scale of studies ranged between 3 and 8.5 points (on a scale of 0 to 9), with a mean of 6.6. The effect sizes in the different executive func-tions were as follows: Inhibition (d+ = -0.221), Cognitive flexibility (d+ = -0.418), Decision making (d+ = -0.169) and Planning (d+ = -0.319), indicat-ing a lower performance in the OCD groups compared to the healthy con-trol groups. Results were clinically significant in all domains except deci-sion making. Publication bias could only be carried out in flexibility and re-sponse inhibition. Conclusions: OCD patients presented worse executive performance than healthy controls in all functions, highlighting cognitive flexibility and planning. However, results should be interpreted with cau-tion due to the small sample size.
- PublicationOpen AccessA multi-group confirmatory factor analysis of the revised children's anxiety and depression scale (RCADS) in Spain, Chile and Sweden(2022-05-10) Cervin, M.; Veas Iniesta, Alejandro; Piqueras Rodriguez, J. A.; Martínez-gonzález, A. E.; Psicología Evolutiva y de la EducaciónBackground: There is a need for a measure that can be used across countries and cultures to advance cross-cultural research about internalizing mental health symptoms in children and adolescents. The Revised Children’s Anxiety and Depression Scale (RCADS) is a potential candidate, but no study has examined whether its scales are measured similarly in youth populations from different countries. Methods: In this study, we use confirmatory factor analysis (CFA) and multi-group CFA to examine the crosscultural properties of a short and free to use 30-item version of RCADS that assesses social, generalized, panic, and separation anxiety alongside depression and obsessive-compulsive symptoms. We tested the factor structure of RCADS in children and adolescents from Chile, Spain, and Sweden, recruited using different research designs (i.e., school-based studies and an anonymous web survey), and whether the factor structure showed measurement invariance across the three countries. Results: The proposed factor structure of RCADS showed good model/data fit in all three countries and was superior to a unidimensional model in which correlations among scale items were explained by a single broad internalizing factor. Each RCADS subscale showed adequate to excellent internal consistency in all three countries and multi-group CFA supported scalar invariance across the three countries. Limitations: No clinical sample was included. Conclusions: This study provides an important first step in supporting the use of RCADS in cross-cultural research on depression, anxiety and obsessive-compulsive symptoms in children and adolescents, but more work on validity aspects of the scale across cultures is needed.
- PublicationOpen AccessA reliability generalization meta-analysis of the dimensional obsessive-compulsive scale(2021-02) Rubén López-Nicolás; María Rubio-Aparicio; Carmen López-Ibáñez; Julio Sánchez-Meca; López Nicolás, Rubén; Rubio Aparicio, María; López-Ibáñez, Carmen; Sánchez Meca, Julio; Psicología Básica y MetodologíaBackground: The Dimensional Obsessive-Compulsive Scale (DOCS) is a well-established tool for assessing obsessive-compulsive symptomatology. A reliability generalization meta-analysis was conducted to estimate the average reliability of DOCS scores and how reliability estimates vary according to the composition and variability of samples, to identify study characteristics that can explain its variability, and to estimate the reliability induction rate. Method: A literature search produced 86 studies that met the inclusion criteria. Results: For the DOCS total scores, an average alpha coefficient of .925 was found (95% CI [.920,.931]), as well as mean alphas of .881, .905, .913, and .914 for Contamination, Responsibility, Unacceptable Thoughts, and Symmetry subscales, respectively. Moderator analysis showed that internal consistency fell signifi cantly the more clinical and subclinical participants there were in the sample, and the larger the mean score in the sample for the total scores. The most important moderator variables for the subscales were the standard deviation and the mean of the scores. Conclusions: The DOCS scores exhibited excellent internal consistency reliability for both total score and subscale scores and DOCS is suitable both for research and clinical purposes.
- PublicationOpen AccessCognitive flexibility and response inhibition in patients with Obsessive-Compulsive Disorder and Generalized Anxiety Disorder(Elsevier, 2020) Rosa-Alcázar, Angel; Olivares-Olivares, Pablo; Martínez-Esparza, Inma; Parada-Navas, Jose Luis; Rosa-Alcázar, Ana Isabel; Olivares-Rodríguez, José; Personalidad, Evaluación y Tratamiento PsicológicosBackground/Objective: The main aim of this study was to analyze differences in inhibition and cognitive flexibility, taking into account some variables that may influence results (non verbal reasoning, depression, anxiety, intolerance of uncertainty, comorbidity, medication consump- tion). Method: The participants were 95 adults aged 17-61 years old (M = 33.48, SD = 11.13), primary (most severe) Generalized Anxiety Disorder or Obsessive-Compulsive Disorder and a healthy control group. Neuropsychological neasures were completed using computerized Wisconsin Card Sorting Test, Stroop Color Word Test and Go/NoGo Task. Results: Clinical groups presented worse results in cognitive flexibility to the control group. The obsessive-compulsive group showed worse scores in flexibility than the generalized anxiety group, once non-verbal reasoning and tolerance to uncertainty were controlled. Comorbidity and medication use did not affect results in the obsessive compulsive group but did however influence the generalized anxiety group. Conclusions: Cognitive flexibility could be included treatment in the treatment of obsessive- compulsive disorder and generalized anxiety disorder.
- PublicationOpen AccessCoping strategies in obsessive-compulsive patients during Covid-19 lockdown(Elsevier, 2021) Rosa-Alcázar, Angel; Garcia-Hernández, M. Dolores; Parada-Navas, José Luis; Olivares-Olivares, Pablo; Martínez-Murillo, Sergio; Rosa-Alcázar, Ana Isabel; Personalidad, Evaluación y Tratamiento PsicológicosBackground/Objective: The main aim of this study was to compare coping strategies in obsessive-compulsive disorder (OCD) patients and a healthy control group during COVID-19 lockdown and to analyze the relationship with some variables which may influence results (depression, anxiety, comorbidity, subtype of obsession-compulsion). Method: There were 237 participants, 122 OCD and 115 healthy controls, aged 17-61 years old (M = 33.48, SD = 11.13). Results: Groups showed differences in the use of some adaptive strategies (positive reinterpre- tation, acceptance, humor) and maladaptive (denial, self-blame). Within obsessive-compulsive group, comorbidity affected the greater use of inappropriate strategies (denial, substance abuse and self-blame) while type of obsession-compulsion did not influence use. Anxiety and depres- sion levels were related to the use of less adaptive strategies. Conclusions: These findings strengthen the need for training in the use of effective and adaptive coping strategies, making it necessary to improve clinical follow-up of these patients. It is relevant to be in contact with healthcare professionals, review medication and observe the anxiety and depression levels.
- PublicationOpen AccessLongitudinal course of obsessive-compulsive symptoms during the COVID-19 pandemic: A systematic review of three years of prospective cohort studies(Giovanni Fioriti Editore s.r.l., 2023) Pugi, Daniele; Loren Angelo, Nicole; Ragucci, Federica; Garcia-Hernandez, Maria Dolores; Rosa-Alcázar, Ana Isabel; Pozza, Andrea; Personalidad, Evaluación y Tratamiento PsicológicosObjective: During the pandemic, there has been a slight increase in obsessive- compulsive symptoms in both clinical and non-clinical samples. Three years after the pandemic, we conducted the first systematic review of prospective cohort studies assessing temporal changes in obsessive-compulsive symptoms and their extent in both patients with obsessive-compulsive disorder (OCD) and community samples, regardless of age or socio-cultural background, during any phase of the pandemic. Method: Prospective cohort studies were included if validated self-report questionnaires or standardized interviews for obsessive-compulsive symptoms were used. Studies that enrolled OCD patients were included if OCD was diagnosed before the outbreak of the pandemic. The following were our exclusion criteria: cross- sectional and case-control studies, single case studies, editorials, commentaries, and reviews. Studies assessing the effectiveness of an intervention were excluded. Results: 15 studies were included. Overall, studies showed a small upsurge in obsessive-compulsive symptoms, especially washing/contamination symptoms, during the coronavirus outbreak. The severity of symptoms seemed to follow the pattern of restriction measures and the increase in the number of COVID-19 cases. Conclusions: Factors contributing to the worsening of obsessive-compulsive symptoms during the pandemic were discussed.
- PublicationOpen AccessMindfulness-based psychotherapy in patients with obsessive-compulsive disorder: a meta-analytical Study(Elsevier, 2022-07-12) Riquelme Marín, Antonio; Rosa Alcázar, Ana Isabel; Ortigosa Quiles, Juan Manuel; Personalidad, Evaluación y Tratamiento Psicológicos; Facultad de Psicología y LogopediaBackground/Objective: Obsessive compulsive disorder is a disorder of special relevance in mental health, however, not all patients respond adequately to traditional intervention systems. The present work aims to study the usefulness of mindfulness-based interventions in patients with obsessive compulsive disorder. Method: An exhaustive search of the literature between 1996 and 2021 allowed us to locate 11 published articles. The effect size was the pretest-posttest standardized mean change calculated for obsession-compulsion, as well as depression symptoms and conscious coping. Results: he results showed mean effect sizes for mindfulness in the reduction of obsessive-compulsive symptoms (d + = 0.648) and, to a lesser extent, depression (d + = 0.417) and the improvement in Mindfull coping (d + = 0.509). There was no significant decrease in effect size when mindfulness was applied in patients with residual symptoms from previous treatments. Conclusions: These results are promising regarding the usefulness of the application of intervention programs based on mindfulness in people with obsessive compulsive disorder, both as an alternative option and as a complementary treatment to more traditional intervention formats.
- PublicationOpen AccessPredictors of Parental Accommodation and Response Treatment in Young Children With Obsessive-Compulsive Disorder(Frontiers, 2021) Rosa-Alcázar, Angel; Rosa-Alcázar, Ana Isabel; Parada-Navas, José Luis; Olivares-Olivares, Pablo; Rosa-Alcázar, Encarnación; Personalidad, Evaluación y Tratamiento PsicológicosBackground: Cognitive–behavioral family-based treatment (CBFT) is the treatment standard in very young children with obsessive–compulsive disorder (OCD), which includes the same core components of cognitive–behavioral therapy (CBT) with significant family involvement. Although the latter reports high rates of remission, some children do not improve with treatments. Therefore, it is necessary to identify possible moderating variables such as comorbidity, severity of disorder, years of onset, parental anxiety, and parental accommodation. This study has two main aims: (1) to propose a predictive model on family accommodation (father and mother), taking into account variables related to the children (severity of obsessive–compulsive responses, internalizing and externalizing symptoms, and comorbidity) and with the parents before intervention (worry, accommodation of one parental member over the other) and (2) to examine the mediating role of externalizing symptoms and mother’s accommodation in the relation between initial severity and improvement of severity of obsessive–compulsive responses in children aged 5–8 years. Methods: Participants comprised 56 children with OCD [mean = 6.61 (SD = 0.76)] and their parents; 79% of the sample was men. Treatment was implemented by two clinicians specialized in OCD (>15 years of experience). Clinicians were trained to administer CBT protocol in the same way. They were doctors of clinical psychology and researchers at the OCD. Results: Mother’s accommodation was associated with child variables (Child Behavior Checklist–Externalizing and Initial Severity, Children’s Yale–Brown Obsessive–Compulsive Scale). Father’s accommodation could be explained by parent variables (mother’s accommodation and worry). Simple mediation model tested using the SPSS macro PROCESS supported the relation of the initial severity of symptoms with that following intervention, through the simple indirect effect of externalizing symptoms of the child. Conclusions: Comorbidities with externalizing symptoms, father’s worry, and mother’s accommodation were variables that should be controlled in treatment of pediatric OCD.
- PublicationOpen AccessResponse inhibition, cognitive flexibility and working memory in obsessive-compulsive disorder, generalized anxiety disorder and social anxiety disorder(MDPI, 2021) Rosa-Alcázar, Ana Isabel; Rosa-Alcázar, Ángel; Martínez-Esparza, Inmaculada C.; Storch, Eric A.; Olivares-Olivares, Pablo J.; Personalidad, Evaluación y Tratamiento PsicológicosAbstract: This study analyzed response inhibition, cognitive flexibility and working memory in three groups of patients diagnosed with obsessive-compulsive disorder, social anxiety disorder and generalized anxiety disorder, considering some variables that may influence results (nonverbal reasoning, comorbidity, use of pharmacotherapy). Neuropsychological measures were completed using a computerized Wisconsin card sorting test, Stroop color word test, go/no-go task, digits and Corsi. Significant differences were obtained among groups in cognitive flexibility and working memory variables. The obsessive-compulsive disorder (OCD) group showed the worst results. The social anxiety disorder group obtained greater effect sizes in visuospatial memory. However, significant differences between groups in visuospatial memory were no longer present when nonverbal reasoning was controlled. Comorbidity influenced interference in the OCD and generalized anxiety disorder (GAD) groups. In addition, the executive functions were differently influenced by the level of obsessions and anxiety, and the use of pharmacotherapy. Study limitations include a non-random selection of participants, modest sample size and design type (cross-sectional). The OCD group showed the worst results in flexibility cognitive and verbal working memory. Comorbidity, use of pharmacotherapy and level anxiety and obsessions were variables influencing the performance of executive functions.
PublicationRestrictedSystematic Review and Meta-Analysis: An Empirical Approach to Defining Treatment Response and Remission in Pediatric Obsessive-Compulsive Disorder(Elsevier, 2022) Farhat, Luis C.; Vattimo, Edoardo F. Q.; Ramakrishnan, Divya; Levine, Jessica L.S.; Johnson, Jessica A.; Artukoglu, Bekir B.; Landeros-Weisenberger, Angeli; Asbahr, Fernando R.; Cepeda, Sandra L.; Comer, Jonathan S.; Fatori, Daniel; Franklin, Martin E.; Freeman, Jennifer B.; Geller, Daniel A.; Goodman, Wayne K.; Heyman, Isobel; Ivarsson, Tord; Lenhard, Fabian; Lewin, Adam B.; Li, Fenghua; Merlo, Lisa J.; Mohsenabadi, Hamid; Peris, Tara S.; Piacentini, John; Rosa-Alcázar, Ana Isabel; Rosa-Alcázar, Ángel; Rozenman, Michelle; Sapyta, Jeffrey J.; Serlachius, Eva; Shabani, Mohammad J.; Shavitt, Roseli G.; Small, Brent J.; Skarphedinsson, Gudmundur; Swedo, Susan E.; Thomsen, Per Hove; Turner, Cynthia; Weidle, Bernhard; Euripides C., Miguel; Storch, Eric A.; Mataix-Cols, David; Bloch, Michael H.; Grant, Paul J.; Personalidad, Evaluación y Tratamiento PsicológicosObjective: A lack of universal definitions for response and remission in pediatric obsessive- compulsive disorder (OCD) has hampered the comparability of results across trials. To address this problem, we conducted an individual participant data diagnostic test accuracy meta-analysis to evaluate the discriminative ability of the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) in determining response and remission. We also aimed to generate empirically derived cutoffs on the CY-BOCS for these outcomes. Method: A systematic review of PubMed, PsycINFO, Embase and CENTRAL identified 5,401 references, 42 randomized controlled clinical trials (RCTs) were considered eligible and 21 provided data for inclusion (N 1,234). A score ≤ 2 in the Clinical Global Impressions Improvement and Severity scales were chosen to define response and remission, respectively. A two-stage random-effects meta-analysis model was established. The area under the curve (AUC) and the Youden Index were computed to indicate the discriminative ability of the CY-BOCS and to guide for the optimal cutoff, respectively. Results: The CY-BOCS had sufficient discriminative ability to determine response (AUC 0.89) and remission (AUC 0.92). The optimal cutoff for response was a ≥ 35% reduction from baseline to posttreatment (sensitivity [95% CI] 83.9 [83.7, 84.1]; specificity [95% CI] 81.7 [81.5, 81.9]). The optimal cutoff for remission was a posttreatment raw score ≤ 12 (sensitivity [95% CI] 82.0 [81.8, 82.2]; specificity [95% CI] 84.6 [84.4, 84.8]). Conclusion: Meta-analysis identified empirically optimal cutoffs on the CY-BOCS to determine response and remission in pediatric OCD RCTs. Systematic adoption of standardized operational definitions for response and remission will improve comparability across trials for pediatric OCD.- PublicationOpen AccessThe Centrality of Doubting and Checking in the Network Structure of Obsessive-Compulsive Symptom Dimensions in Youth(Elsevier, 2020) Cervin, Matti; Perrin, Sean; Olsson, Elin; Aspvall , Kristina; Geller, Daniel A.; Wilhelm, Sabine; McGuire, Joseph; Lázaro, Luisa; Martínez-González, Agustin E.; Barcaccia, Barbara; Pozza, Andrea; Goodman, Wayne K.; Murphy, Tanya K.; Seçer, Ismail; Piqueras, José A.; Rodríguez Jiménez, Tiscar; Godoy, Antonio; Rosa-Alcázar, Ana Isabel; Rosa-Alcázar, Ángel; Ruiz-García, Beatriz M.; Storch, Eric A.; Mataix-Cols, David; Personalidad, Evaluación y Tratamiento PsicológicosObjective: Obsessive-compulsive disorder (OCD) is a heterogeneous condition with well- established symptom dimensions across the lifespan. The objective of the present study was to use network analysis to investigate the internal structure and central features of these dimensions in unselected schoolchildren and in children with OCD.Method: We estimated the network structure of OCD symptom dimensions in 6,991 schoolchildren and 704 children diagnosed with OCD from 18 sites across 6 countries. All participants completed the Obsessive-Compulsive Inventory—Child Version. Results: In both the school-based and clinic-based samples, the OCD dimensions formed an interconnected network with doubting/checking emerging as a highly central node, that is, exerting strong influence over other symptom dimensions in the network. The centrality of the doubting/ checking dimension was consistent across countries, sexes, age groups, clinical status, and tic disorder comorbidity. Network differences were observed for age and sex in the school-based but not the clinic-based samples. Conclusion: The centrality of doubting/checking in the network structure of childhood OCD adds to classic and recent conceptualizations of the disorder in which the important role of doubt in disorder severity and maintenance is highlighted. The present results suggest that doubting/ checking is a potentially important target for further research into the etiology and treatment of childhood OCD.