Circles: Further Insights into Ocs (Mild-Moderate Obsessive-Compulsive Symptoms)

---

Tormenting Thoughts and Secret Rituals. Everyday Mindfulness for OCD. Being Me with OCD. Coping with Obsessive-Compulsive Disorder. Movers, Dreamers, and Risk-Takers. The Depression of Grief. My Child is Depressed: How Can I Help? Should I Medicate My Child? The Psychobiology of Suicide. Using the Power of Hope to Cope with Dying. The Fog of Paranoia. Heal Your Own Emotional Pain. How to write a great review.

The review must be at least 50 characters long. The title should be at least 4 characters long. Your display name should be at least 2 characters long. At Kobo, we try to ensure that published reviews do not contain rude or profane language, spoilers, or any of our reviewer's personal information. You submitted the following rating and review. We'll publish them on our site once we've reviewed them. Item s unavailable for purchase.

It remains to be seen whether similarly brief but repeated alterations in neural activity could also lead to the development of pathologic plasticity and symptoms in humans. The findings from this study could provide a rationale for investigating whether evidence for similar mechanisms exists in OCD patients. Optogenetically induced increase in perseverative grooming. C 6 days of stimulation led to a progressive increase in grooming 1 h post stimulation. E Progressive increase in evoked firing rate over course of multiple days. Z-scores indicate activity before vs. Modified from Ahmari et al.

Also surprising was the fact that abnormal activity was not directly time-locked to the evolution of abnormal repetitive grooming. Although it is clear that ChR2-mediated stimulation of OFC-VMS circuits was required for the development of abnormal behavior since matched controls did not display the phenotype, the behavioral changes were observed at time points removed from the acute stimulation paradigm.

As discussed above, this is highly suggestive that the evolution of abnormal repetitive behaviors is linked to plasticity originating at OFC-VMS synapses. However, even though it is known that the OFC-VMS node displays electrophysiological changes that parallel the observed behavioral changes, it is possible that the actual causative event s may be localized at a downstream node of the CBGTC network such as the ventral pallidum or anterior thalamus.

Alternatively, the key source of dysfunction may lie in the interaction between plasticity at OFC-VMS synapses and activity alterations within the extended connected neural network, either within or outside of CBGTC circuits. Ongoing experiments in rodents are investigating these questions by combining precise in vivo neural manipulations with sophisticated observational approaches, such as multi-site electrophysiology and in vivo imaging. Further studies will be able to directly assess the effects of optogenetic stimulation at a single site on activity in the entire extended neural network, and identify the key network of nodes responsible for the observed behavioral changes.

In summary, experiments in animals can be an extremely useful complement to human studies for the investigation of neural mechanisms underlying development of pathology relevant to neuropsychiatric illness. Simply put, through these experiments an optogenetic mouse model of OCD was not created. In fact, this approach could be used as a template for dissecting circuit components underlying specific symptoms within a particular disorder, as seen in examination of the diverse features of anxiety by Kim et al.

Thus, animal models can be highly informative, since they provide a valuable tool for: It is important to simultaneously recognize the limitations of animal models and to frame interpretations of the data accordingly. Schedule-induced polydipsia SIP is a ritualized act that neither serves an obvious physiological need nor the overall goal of obtaining food, and can lead to functional impairments associated with excessive fluid intake.

As suggested by Moreno and Flores , consideration of the variables affecting SIP and the neurocircuitry underlying this maladaptive behavior may provide novel insights into OCD. John Falk first reported SIP in He trained food-restricted rats to lever press on a variable interval VI 1-min schedule in daily min sessions. Food delivery depends on a lever press. Thus, the animals have to lever press for food but cannot predict when a lever press will produce food although average food availability is at a frequency of one pellet per min. He observed that shortly after each pellet delivery, the rats frequently drank.

This drinking behavior often lasted so long that pellets made available at short intervals were not earned as rapidly as possible. Most interestingly, drinking was excessive and far beyond physiological need. Rats drank on average more than three times their normal daily fluid intake during the min lever-pressing session. Control rats that received the same number of pellets all at once in a dish and were observed to eat those pellets did not show excessive drinking. SIP has been observed in several species including humans and with different reinforcers.

Instead of SIP, schedule-induced aggression, escape, wheel-running, gnawing and pica eating of non-food objects, e. The generation of SIP depends on the level of food restriction, SIP being less intense or absent in less food-restricted animals. It is not necessary to require an operant response of the animal in order to observe SIP; Falk showed that presenting response-independent food pellets at the same inter-pellet intervals that were used in the VI 1-min schedule described above led to the same level of SIP as that observed when a response was required. Fixed-time FT schedules of response-independent food presentations produce optimal SIP when the inter-pellet interval is 60 s see Moreno and Flores, In general they do.

Lesions placed in these structures reduce the development of SIP. Reduced levels of plasma corticosterone and increased levels of prolactin are observed in animals showing SIP and blockade of corticosterone synthesis reduces SIP reviewed by Moreno and Flores, The SIP model appears to have face validity as a compulsive behavior and possibly construct validity based on the involvement of prefrontal cortical and striatal structures in OCD and SIP.

However, the homology of frontal cortical regions in humans and rats remains a topic of discussion. A number of animal models of schizophrenia symptoms have been introduced in recent years reviewed by Jones et al. Results of empirical studies with three of these models suggest that they do.

Before discussing polydipsia in animal models of enhanced SIP, it should be noted that increased drinking has been observed in other animal models of OCD. They observed increased, apparently non-regulatory drinking over days. Excessive drinking was blocked by haloperidol or clomipramine, agents used to treat OCD Amato et al. In this model, polydipsia is only seen in non-water-restricted animals; water-restricted animals instead show decreased drinking following repeated injections of amphetamine or QNP Milella et al. This apparently compulsive-like, non-regulatory behavior was reversed by clomipramine De Carolis et al.

An examination of the relationship of non-regulatory drinking and lever-pressing in these models to polydipsia in the SIP model awaits further study. Sub-chronically treated animals showed an enhanced response to amphetamine when tested a week after the end of injections Jentsch et al. Hawken and colleagues used this model to compare treated and control animals in the SIP paradigm. This observation extends the face validity of the sub-chronic NMDA receptor-blockade model to include increased susceptibility to compulsive behaviors such as polydipsia.

Experimental groups received saline 1. Control groups received the same drug treatments but instead of receiving one food pellet each minute according to the fixed time schedule during daily 2-h sessions, they received pellets in a dish placed next to the feeder cup in the test chamber.

From Hawken et al. Another model that showed enhanced SIP is post-weaning social isolation. Rats are housed singly in clear Plexiglas cages in a colony room where they can see, hear and smell conspecifics but they do not have physical contact with them from the age of weaning postnatal day 21 until the end of testing with testing beginning after at least 5 weeks of social isolation. Post-weaning socially isolated animals show impaired sensorimotor gating, social withdrawal, impaired cognitive flexibility and increased activity in a novel environment Powell and Miyakawa, ; Simpson et al.

Changes in markers for GABA function are also seen in the social isolation model and in schizophrenia Hickey et al. Social isolation rearing in rats presents with increased oxidative stress as well as immune-inflammatory dysregulation Moller et al.

Moreover, disordered redox is also noted in the deer mouse model of OCD Section 4. Animals socially isolated for an equivalent period in adulthood do not show these behavioral changes Geyer and Moghaddam, When post-weaning socially isolated rats were tested for SIP, significantly more drinking was seen compared to age-matched group-housed rats Hawken et al. Results show that behaviors observed in the social isolation model extend to increased susceptibility to a compulsive action. Amphetamine-sensitized rats show increased drinking in the SIP paradigm.

This model involves daily injections of amphetamine, e. These animals show a chronic state of elevated dopaminergic function Lodge and Grace, and neurocognitive deficits that model some of those seen in schizophrenia Castner et al. Hawken and Beninger showed that amphetamine-sensitized rats tested in the SIP paradigm involving intermittent presentations of food pellets as described above drank significantly more than saline-treated controls or controls fed all of the pellets in a dish.

The amphetamine-sensitized rats were given one additional test day following 23 days of SIP testing. On this day, all animals were given all of their food pellets in a dish instead of intermittently throughout the session.

The amphetamine-sensitized group drank significantly more than the saline group. This result suggests that compulsive drinking had become conditioned to cues associated with SIP and may be related to the finding of Ahmari et al. These results with the amphetamine sensitization model are consistent with those from studies using the sub-chronic NMDA receptor blockade or post-weaning social isolation models in showing increased susceptibility to compulsive behavior.

Rats show phenotypic differences in their susceptibility to SIP. Such phenotypic heterogeneity has also been noted in the deer mouse model described in Section 4 Korff et al. Behavioral tasks can be used to identify individual differences in rats and to relate those differences to particular brain circuits. A simple choice task has been used in rats to identify response strategies that are thought to reflect differential reliance on striatal versus hippocampal circuitry.

Food-restricted rats were trained in a Y-maze discrimination task where rats always started in one arm and found food in a goal arm that never varied see Fig. On periodic probe trials, they were started in the third arm that was neither the usual start box nor the goal box Fig. Rats that chose the goal arm were identified as relying more on their hippocampus and rats that chose the former start arm were identified as relying more on their striatum Fig. Rats that chose the goal arm are putatively relying on hippocampal learning. Rats that chose the former start arm are putatively relying on the striatum, i.

Y-maze test used to identify different response strategies in rat. During the training phase, food-restricted rats are started in the same arm on each trial and learn to choose the arm baited with a food pellet Reward. On probe test trials, rats are started in the arm that was neither the usual start arm nor the arm where a food pellet was found. At the choice point, a right turn reflects a habit learning striatal strategy and a left turn reflects a place learning hippocampal strategy.

No food reward is provided on probe trials. They found that significantly more rats that developed SIP were those with a habit strategy while more rats that failed to develop SIP had a place strategy. The amphetamine-sensitized and saline control rats from the study by Hawken and Beninger discussed above were also evaluated for response strategy in the Y-maze before being tested for SIP.

Half of the saline control rats used a habit response strategy and half used a place strategy. On the other hand, significantly more of the amphetamine-sensitized rats used a habit strategy suggesting that amphetamine sensitization led to a shift towards a habit strategy Fig. These results reveal that groups of rats that show a greater level of SIP are overrepresented by rats that use a habit strategy. Number of animal that used response habit or place-learning strategies in groups pre-treated for 5 days with amphetamine AMPH; 1.

From Gregory et al.

Frontocortical regions have been implicated in the formation of habits and compulsions Chamberlain et al. The brain has multiple memory systems that may compete for the control of behavior McDonald and White, For example, the hippocampus and striatum are respectively associated with declarative and non-declarative e. When hippocampal function is compromised, as it appears to be in patients with psychogenic polydipsia Goldman, ; Umbricht, , striatal circuits may dominate in the control of behavior. The animal studies discussed above show that a significantly larger proportion of rats showing SIP use striatal response strategies in the Y-maze test.

Amphetamine sensitization leads to a shift towards more animals with a striatal response strategy and more animals that show SIP. Results are consistent with reduced hippocampal function in polydipsia patients and greater control of behavior by striatal circuits. Changes in striatal DA receptor subtypes further implicate this circuit.

Animal models can provide insights into the brain mechanisms of human disorders such as OCD. By investigating SIP, excessive, non-regulatory drinking that resembles compulsive behaviors observed in humans, in animal models it is possible to identify brain regions and circuits that may be involved. Future studies will be able to use these models to identify further details of the brain mechanisms underlying compulsive behavior and new and more effective therapeutics for treating OCD and related disorders. As a naturalistic animal model of OCD, deer mice exhibit two topographies of stereotypy, viz.

The perseverative and seemingly goalless quality of such stereotypy, and that it develops spontaneously, provides face validity for OCD American Psychiatric Association, Heterogeneous distribution within a population of animals see Fig. It therefore implies a genetic basis to its development and possible conservation across generations.

This provides a platform for gene association studies of relevance for modeling OCD genetics. N animals in genetic studies of OCD. The heterogeneous nature of deer mouse stereotypy. From Korff et al. Environmental enrichment partially suppresses the expression of stereotypy, also prompting delayed presentation Hadley et al. Also deer mouse stereotypy appears to be associated with social deficits, is independent of anxiety and presents with symptom heterogeneity with regard to other forms of compulsive-like behavior that has value for studying the obsessive-compulsive interface of OCD Section 4.

As in OCD Evans et al. Deer mouse stereotypy is therefore a useful preparation to extend our knowledge of the phenomenology, genetics, and biological basis of OCD, and its response to treatment. Valuable insights into OCD have been obtained that would have been difficult to obtain from human studies. Differential response of deer mouse stereotypy to chronic fluoxetine and desipramine treatment. Baseline untreated stereotypic activity for each treatment group solid bars is provided for high stereotypic behavior H mice. The number of animals n is shown below the indicated drug treatment.

Locomotor effects following the various drug treatments were minimal data not shown. Striatal concentrations of 5-HT, DA and their associated metabolites do not differ as a function of stereotypy, nor is stereotypy related to altered striatal D 1 and D 2 receptor density Powell et al.

Considering the paradox that deer mouse stereotypy Korff et al. Furthermore, the role of neuronal adaptation in disease re-affirms the importance of using a pathological animal model in drug discovery research as this may provide a better understanding of treatment variability and treatment resistance in OCD see Section 4.

Considering that DA transmission appears to be unaltered in H mice Powell et al. One such mechanism may involve oxidative stress, evidence of which has been described in OCD Behl et al. Importantly, disturbances in frontal cortical reduced GSH and oxidized GSSG glutathione are correlated with severity of stereotypy in deer mice see Fig. Cortical but not striatal glutathione redox imbalance is correlated with severity of stereotypy in deer mice.

From Guldenpfennig et al. OCD represents a bias in the direct vs. Despite this knowledge, uncertainty prevails as to how DA and 5-HT are co-involved in OCD, especially from a neurotherapeutics point of view. Thus, although D 2 receptor antagonists benefit treatment, a number of studies have failed to demonstrate a hyper-dopaminergic state in OCD Brambilla et al. Further, although direct and indirect acting DA agonists exacerbate obsessive-compulsive OC symptoms, they may also improve such symptoms Denys et al.

A model that presents with behavioral heterogeneity see later in this section and Section 6 would be invaluable in acquiring a deeper understanding of OCD and its treatment. DA pathology likely already exists in a naturalistic pathological animal model but is absent in an acute drug-induced model. The basis for subversive dopaminergic function in deer mice, such as DA-mediated changes in redox balance noted earlier, is a primer for deeper translational research. Severity of stereotypy in deer mice is associated with elevated frontal-cortical not striatal cAMP and reduced PDE4 activity, while chronic fluoxetine significantly reduces both stereotypy and cortical but not striatal cAMP and PDE4 activity in H animals see Fig.

Such concordance between predictive and construct validity is especially significant. Interestingly, the PDE4 inhibitor rolipram decreases methamphetamine-induced stereotypy Iyo et al. OCD animal models are limited in their ability to address the cognitive-obsessive manifestations of OCD.

In order to more closely relate to human OCD American Psychiatric Association, , assessment of co-presenting symptoms of anxiety, social impairment and specific compulsive behaviors has been realized with the deer mouse preparation. This work has demonstrated different behavioral patterns in deer mice that cannot simply be regarded as compulsive repetition and formally establishes a cognitive-psychobiological link in their behavior. When considering the link between stereotypy and social deficits and anxiety, the ventromedial PFC and OFC function as the cortical inputs of the limbic loop, while the caudate functions as the striatal entry point for the associative loop Mannella et al.

This arrangement implicates a possible role for cross-talk between these two pathways in the pathology of OCD. Therefore stereotypy involves motor and limbic elements, making these two parameters and their associated behaviors important targets to be considered in an animal model of OCD.

H deer mice do not present with altered marble burying behavior, a measure of compulsivity or anxiety neophobia , compared to non-stereotypic N mice Wolmarans et al. In fact, all deer mice exhibit a level of inherent burying behavior, thereby dissociating severity of stereotypy with anxiety.

Moreover, a characteristically different within-species form of high burying behavior is evident in certain animals, although neither inherent nor high burying behavior responds to chronic SSRI treatment Wolmarans et al. Despite being a prominent symptom of OCD, social impairment is poorly studied in animals. Higher rates of unemployment, marital discord and financial instability occur among adult OCD patients Kim et al. Furthermore, comorbid OCD and social impairment demonstrate greater OC symptom severity and treatment resistance Alarcon et al.

Finally, greater OCD severity may worsen social impairment and vice versa Rosa et al. Considering children, young OCD sufferers tend to be more socially isolative in scenarios where normal peers may observe their behavior Piacentini et al. Also, a greater tendency of N animals to interact with one another and not with an H animal was observed from before to after chronic SSRI treatment, where such treatment also increased the sociability of H animals towards one another but not towards N animals.

Deer mouse behavior therefore provides a unique insight into the social behavior of OCD patients and their social experiences in the presence of healthy peers. Thus, deer mice not only resemble the compulsive nature of motor repetition, but H behavior is also associated with changes in cognitive ability and emotional perception, as indicated by altered social interactivity and its response to treatment. Nest-building NB behavior forms part of the normal behavioral repertoire of rodents, although differences in NB behavior i.

NB behavior in deer mice is highly variable, with no evident differences as a function of severity of stereotypy Wolmarans et al. However, as described for marble burying behavior above, a sub-population from both H and N cohorts present with large NB behavior. However, in this instance large NB behavior is reversible with chronic SSRI treatment, implying that deer mouse behavior, like human OCD, presents with symptom heterogeneity.

Deer mouse behavior therefore resembles the inter-patient differences in OC phenomenology in that normal non-pathological viz. N and aberrant viz. OC; H stereotypical behavior is present. Moreover, different forms of OC phenotypes viz. Different psychological constructs of OC behavior are thus presented, with stereotypy resembling motor-associated compulsive behavior and aberrant NB reflecting a cognitive foundation in that it implicates a reason for compulsivity, i.

The latter would involve thoughtfulness in the expression of OC behavior. Deer mouse stereotypy is a promising model for research into the neurobiology and behavior of OCD, as well as a platform for novel drug discovery and research into the genetics of OCD. It has provided confirmatory facts about OCD phenomenology, as well as new knowledge pertaining to its neurobiology and treatment.

The notion that the transformation in behavior induced by chronic treatment with the DA agonist QNP could serve as an animal model of OCD arose by serendipity, during the course of research with animal models of psychosis. Specifically, experimental attempts to obtain from the behavior of QNP rats evidence of a psychotic state—expected from the DA hypothesis of schizophrenia Carlsson, ; Willner, —did not yield the predicted result of disorganized activity Szechtman et al.

To translate this impression into an experimental framework, Szechtman and colleagues followed Reed who argued that the structure of OCD symptoms, rather than their content, is more clinically relevant and revealing of mechanisms. Hence, they searched for the spatiotemporal structure of OCD compulsions in the clinical literature and derived from it the following set of salient features of compulsive checking: They translated those features into a set of objective criteria by identifying specific tests and quantifiable dependent variables that indexed those criteria and showed that QNP-treated rats met the stated criteria for compulsive checking Ben Pazi et al.

Thus, because the spatiotemporal structure of QNP-induced behavior matched the salient features of OCD checking in the human, it was proposed that the QNP preparation constitutes an animal model of OCD compulsions and compulsive checking in particular Szechtman et al. A comprehensive description of the logic and details of this model has been reviewed Eilam and Szechtman, b ; Szechtman et al.

The standard protocol to induce compulsive checking is a dose of QNP every 3—4 days 0. Control rats receive an injection of saline. The open field is a large table without walls 1. The open field is divided virtually into 25 locales Fig. Evidence for compulsive checking requires the presence of a significant difference between the QNP- and saline-treated rats on all 4 criteria measures, as shown in Fig.

In essence, in the QNP sensitization model, compulsive checking is manifested by exaggerated preoccupation with one location in the environment, to which the animal returns repeatedly Fig. Experimental set-up and test for compulsive checking. The open field apparatus with 4 objects on it. Subdivision of the open field into 25 places.

The software algorithm assigns the positions of x,y coordinates of a stop within these locales. Test for compulsive checking on the 8th injection of quinpirole 0. Rats are said to show compulsive checking behavior when their performance is significantly different from saline controls on all 4 measures: Modified from Alkhatib et al.

First, it is open to a rich and sophisticated analysis of the behaviors that constitute the observable symptoms of the disorder. Indeed, the approach and methods developed to analyse compulsive checking in the rat were successfully applied to the analysis of rituals in OCD patients see Section 7. Second, the model measures spontaneous behavior in an open-ended situation where there are no explicit rewards or contingencies. This simulates the condition which challenges OCD patients; namely, how to behave in situations of uncertainty where the environment does not dictate the optimal response Boyer and Bergstrom, ; Cavedini et al.

Because in the QNP model compulsive checking is characterized as an entire set of dependent measures, the question whether compulsive behavior is a unitary whole can be addressed by the method of nervous system fractionation Teitelbaum, , ; Teitelbaum and Pellis, ; Teitelbaum and Stricker, That is, if compulsive checking behavior is a unitary whole, then a lesion should affect the entire set as one entity. However, if the phenomenon is comprised of discrete functional components then a lesion in a specific part of the brain should affect some components and not others, in essence fractionating the phenomenon into components.

Two such lesion studies Dvorkin et al. In a study by Dvorkin et al. Tellingly, as shown in Fig. These effects were evident on measures of checking behavior in saline-treated rats blue colored bars; left bar cluster ; the pertinent effects are indicated by the graph bar having a solid fill. Performance on criteria measures of compulsive checking behavior shown by groups of rats with lesion to the basolateral amygdala BLA , nucleus accumbens core NAc , orbital frontal cortex OFC or sham lesion. Blue bars represent groups with chronic saline treatment left cluster of each panel and red bars represent groups with chronic quinpirole treatment right cluster of bars of each panel.

Solid fill bars in top row show effect of NAc lesion on frequency of checking and length of check while those in the bottom row show effect of OFC lesion on recurrence of checking and stops before checking. Modified from Dvorkin et al. For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article. When it is analyzed whether the split into the two subsets reveals a meaningful subdivision, it becomes apparent that the measures in the top and bottom rows of Fig. That is, NAc lesions affected measures indicative of the amount of checking behavior, whereas OFC lesions affected indices of staying away from checking.

Consistent with the literature as to the function of NAc, Dvorkin et al. Similarly, they suggested that a second component is the focus or concentration on the task of checking.

Following the proposition that the appropriateness of analysis ought to be confirmed with a synthesis of the behavior from its parts Teitelbaum, ; Teitelbaum and Pellis, , Szechtman and colleagues sought to re-synthesize compulsive checking from the identified components, without using QNP.

In a study by Tucci et al. To reconstitute focus, the employed treatment was a low dose of the 5-HT 1A receptor agonist 8-hydroxy di- n -propylamino tetralin hydrochloride DPAT 0. NAc core lesion and the other one was Drug saline vs. As shown in Fig. Performance on criteria measures for compulsive checking behavior shown by groups of sham controls and NAc core lesion rats treated with saline or DPAT. From Tucci et al. Indeed, analysis revealed that performance of QNP-induced checking is characterized by yet another attribute, which sets compulsive behavior apart from normal motivation: However, QNP-induced checking behavior is characterized by a very abbreviated period of time after a bout of checking before the start of another checking bout see Fig.

Duration of negative feedback signal as measured by time to next checking bout in rats treated chronically with saline blue open circles and quinpirole red solid squares during the course of treatment to induce compulsive checking. From Dvorkin et al. For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article. Remarkably, this hypothesis brings the work with rats into the framework of the security motivation theory of OCD Szechtman and Woody, ; Woody and Szechtman, that originated in a separate and independent line of research Szechtman et al.

It does so because the rat work raises the question what particular motivation has checking behavior as its output, an answer contained in the security motivation theory of OCD Szechtman and Woody, ; Woody and Szechtman, Specifically, it had been proposed that there exists a special motivation—Security Motivation—evolved to handle the uncertainties of potential threats, and that a dysfunction in security motivation produces OCD Szechtman and Woody, ; Woody and Szechtman, The notion of a special motivation for potential danger was based on clinical literature that the domain of most OCD thoughts and behaviors is safety and security Reed, and on evidence from ethological and ecological literatures that animals show speciestypical behaviors for assessing various domains of potential harm, including potential threats related to predation and disease e.

These considerations suggested that a security motivation system would produce not only the urge to engage with cues of potential danger but produce also speciestypical precaution and preventive responses such as checking or washing Hinds et al.

Tell a friend about this book...

Accordingly, it was theorized that OCD symptoms emerge if there is a malfunction that prevents the normal de-activation of security motivation because preoccupation with issues of potential danger would continue, driving repeated performance of security-related behaviors such as checking or washing and the associated thoughts and ideas characteristic of OCD Szechtman et al. Recent experimental support for this theory has come from studies showing that in individuals with OCD, performance of precautionary behaviors is indeed deficient in turning off an activated security motivation Hinds et al.

Moreover, the neuroanatomical structures associated with the component behaviors of the compulsive checking system are common elements of the CBGTC circuit implicated in OCD and have been proposed as the neural circuit of the security motivation system Szechtman et al. The reviewed decomposition of compulsive checking behavior in the rat into functional components and the characterization of compulsive checking as highly motivated performance but without apparent satiation, provides strikingly convergent support from an animal model for the security motivation theory of OCD Szechtman and Woody, ; Woody and Szechtman, In concordance with the existence of a heterogeneous group of patients, OCD patients do not show consistent responsiveness to treatment, as some patients respond well whereas others show partial or no response.

In other words, the capacity of a treatment strategy to modulate specific pathophysiological disease substrates may not suffice as an efficient treatment for all OCD patients due to the existence of endophenotypes entailing a specific neurobiological substrate of behavior. And this staying mindful, and then just saying what is actually going on right now, just seems to make a lot more sense to me.

Well, I notice that this is definitely a very good way. Maybe even the only one that exists that could really help. For this patient, information and discussion about the nature of the mind and thoughts were of particular interest. Realizing that having sudden unpleasant, intrusive thoughts is a common phenomenon known not just to patients with OCD but to most people, meant a great relief to him and made it easier for him to observe his obsessions without judging himself for their occurrence. Accordingly, he tried to mindfully watch obsessive thoughts come and go, to make them out as obsessions and then to bring his attention back to the present moment.

A woman affected by dirt- and blood- related obsessions as well as washing and cleaning compulsions explained that being mindful leads to a decreased occurrence of obsessions:. And then, everything else is not important in that moment. I just go shopping and focus on that. If I really put myself into that, then there is not much space for other things.

Furthermore, the patients reported an increased willingness to tolerate even unpleasant emotions when performing mindfulness meditation. Three participants reported that feelings such as sadness and pain occurred during the body scan. All of them stated that they had been able to let these feelings surface without trying to change them or get rid of them. Four participants reported that MBCT had taught them to live more actively in the present moment. Consequently, they perceived a reduced tendency to ruminate and worry as well as an increased ability to engage in pleasant activities and to value these experiences.

One patient noted that whilst MBCT had not helped her to reduce her obsessions and compulsions, she experienced herself as reacting calmer even in difficult situations, more capable to accept her OCD as a part of her life and as being able to enjoy her life despite her struggle with OCD. Last but not least, some participants specifically used mindfulness exercises before going to bed and reported a positive impact on their sleep.

Three participants reported that OCD symptoms considerably interfered with their mindfulness practice during and beyond the sessions. By the end of the course, however, she noticed that considerably fewer counting compulsions occurred during the sessions. She reported that during the eight weeks it had become easier for her to restrain herself from engaging in rituals, though she was still afflicted with several obsessive concerns. Another participant suffered from extensive mental compulsive rituals. More precisely, he felt the urge to mentally repeat everything that he or others had said.

Three patients found it especially challenging to use mindfulness techniques such as the three-minute breathing space as a skill in difficult situations related to OCD. One participant explained that he experienced his compulsions as a highly automatized behavior — he repeatedly caught himself in the act, becoming aware then that he had not been able to mindfully notice an obsessive urge before engaging in a compulsive ritual. Three more participants found the mismatch between their wish to get rid of their OCD as fast as possible and mindfulness being a long-term process troubling.

Adding to this is that mindfulness initially does not appear goal-oriented. One participant phrased it this way:. One somehow always expects something to happen immediately. Rather, it just happens automatically. And you have to be patient there, with yourself. Of a total of twelve treatment completers, four attended all eight MBCT sessions, five missed one session and three missed two.

Two participants indicated that they had practiced mindfulness outside the sessions six to seven times per week. Five participants reported that they had practiced four to five times and the five remaining participants had practiced two to three times.

There was a problem providing the content you requested

Concerning the ratings of satisfaction, the three-minute-breathing space received the most favorable ratings: Eight patients found the body scan very or quite helpful, seven said this about the sitting meditation and four about the yoga exercises. The results of the present pilot study provide preliminary evidence that patients with OCD find aspects of MBCT acceptable and beneficial. Changes within eight weeks included a perceived decline of obsessive compulsive symptoms, living more actively in the present moment, an increased ability to allow unpleasant emotions, a calmer attitude in everyday life and towards OCD as well as improved mood and sleep.

One participant repeatedly became aware of unpleasant emotional and physical states during the body scan. However, as he stated, this was not a purely undesired outcome, as he tried to embrace these states as opportunities to relate differently to unpleasant feelings and sensations.

He reported that the body scan sometimes even brought to light inner struggles that had been rather unconscious. This helped him clarify problems he was currently dealing with. MBCT was originally designed as a relapse prevention for patients in remission from major depressive disorder, that is, for participants who are not presently symptomatic.

Our findings suggest that patients with acute OCD, despite various reported difficulties, can also benefit from the approach. Several participants suggested continuing the program after the eight sessions, and pointed out possible difficulties in implementing mindfulness in everyday life without guidance and feedback. Deeper knowledge about particular treatment components might in turn allow revisions of the treatment manual, e. The qualitative reports as well as the ratings of satisfaction indicated that our participants especially valued the three-minute breathing space.

Obsessive-compulsive disorder: Insights from animal models - Europe PMC Article - Europe PMC

This resulted in a heightened ability to regulate compulsive behavior, whereas prior to MBCT, compulsions had been perceived as rather uncontrollable. This may be due to an improved self-regulation of attention, resulting in a being more aware of internal events, for example recognizing compulsive urges at an earlier stage and b being more able to purposefully redirect attention, e. Another component of MBCT that our participants perceived as helpful was the acceptance of private experiences and self-acceptance.

The patients reported that after MBCT, they were able to handle their emotions more flexibly and with an increased willingness to experience unpleasant states. This seems especially relevant for patients with OCD since obsessive-compulsive symptoms frequently serve as processes that regulate unpleasant emotions [ 29 ]. The accepting attitude did not exclusively relate to emotions: Some participants also reported that they had learned to relate to their obsessions in a different way, e.

Whereas MBCT and the meta-cognitive therapy MCT , which has also recently been applied to patients with OCD [ 30 ], share the objective of changing the attitude towards private experiences rather than their content, acceptance, self-acceptance and the non-judging attitude are more specific for mindfulness and MBCT.

In our sample, the acceptance-focused elements of MBCT were perceived as beneficial. This finding appears plausible from a theoretical point of view, as OC symptoms have been linked to pathological guilt [ 31 ] and shame-proneness [ 32 ]. Thus, we recommend that future MBCT protocols for patients with OCD highlight the three-minute breathing space, self-acceptance and the acceptance of private events.

Comparing our results to findings on subjective experiences of patients with mood disorders who underwent MBCT, we found several parallels.

Loading...

As in our study, they point out that the program was felt to be too short. Interestingly, other researchers chose longer intervals between the end of the program and the interviews, allowing for an exploration of medium-and long-term effects of mindfulness training. Finucane and Mercer [ 6 ] report that the program helped two of their participants to return to work. It cannot be ruled out that mindfulness training elicits these changes only in patients with mood disorders and not in OCD patients; however, it seems reasonable that changes in social relationships and work life are fairly long-term effects that were not addressed by our short-term approach.

Findings by Williams et al. They report that patients benefited from mindfulness training through understanding and breaking their health anxiety circles, accompanied by a decrease in automatically reacting to bodily sensations and anxious thoughts. This closely resembles reports from OCD patients in our study who were better able to interrupt dysfunctional stimulus—response-chains. Our results show the same effects. Similar to our sample, the twelve patients in the study by Bevan et al. The authors focused on the comparison of an intense form of CBT to a weekly format and did not explicitly focus on treatment components that were perceived as helpful or difficult.

Therefore, only limited comparisons to our results are possible. Our study has several strengths, but also clear limitations. Against this background and considering the explorative character of our research questions, a qualitative methodology appeared appropriate. To support these findings with more objective data, clinician ratings of OCD severity, depressive symptoms and global level of functioning were recorded at baseline, post and 6 months follow-up.

These results will be reported elsewhere. In our analysis, we adhered to quality criteria defined by Mayring [ 26 ]: Data analysis followed a systematic rule-governed procedure involving a team of researchers, thus ensuring a certain degree of inter-subjectivity of our findings. However, qualitative methodology remains a rather subjective approach, reflecting the experiences of the studied subjects only, and is prone to researcher bias. Interpretability and generalizability of the reported findings are further limited by the lack of a control group, the small sample size and the unbalanced gender ratio.

The fact that interviews were conducted directly after the course limits our statements to a short-term perspective, lacking information about long-lasting effects of mindfulness training in OCD. However, scheduling interviews directly after the course probably precluded memory bias.

Psychology

In summary, we showed that MBCT can be applied to OCD patients experienced with exposure and response prevention, that patients report various benefits and experience no major harmful outcomes. However, our study provides only preliminary results, leaving open a number of questions to be considered in the future. First, randomized controlled trials with larger sample sizes are needed to evaluate the efficacy of MBCT in OCD and specify the effects of the program in comparison to active control groups.

Consequently, and due to the pilot character of our study, no reliable statements can be made as to whether MBCT should best be delivered as a complementary treatment to patients who do not or only partially respond to ERP, as an add-on for patients who undergo ERP at the same time, as a preparation to ERP for patients who are reluctant to engage in ERP, or as a stand-alone treatment. Second, the outcome variables that appropriately and fully capture the changes elicited by MBCT need to be determined.

Our findings suggest that mindfulness training may not only help alleviate OCD symptoms, but may lead to benefits beyond symptom reduction. This implicates that further research on mindfulness treatment in OCD should not be limited to measures of symptom severity. It should additionally, in a more holistic approach, address further outcome measures such as the quality of life as well as possible mediating variables such as an accepting attitude, the self-regulation of attention, and meta-cognitive beliefs. CN has received speaker honoraria from Servier and has served as a scientific advisor for Novartis.

EH acquired and analyzed the data and drafted the manuscript.

• Nanofabrication Handbook
• The Dolls (The Cousin Connection Book 1)
• Composing Ethnography: Alternative Forms of Qualitative Writing (Ethnographic Alternatives)
• Fragile but Strong
• Scraped Knees
• Hugo Chávez et Álvaro Uribe ou la force des mots: Deux discours pour gouverner (Recherches Amériques latines) (French Edition)
• The Surreal Reich