The Centrality of Doubting and Checking in the Network Structure of Obsessive-Compulsive Symptom Dimensions in Youth.

OBJECTIVE: 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 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, having strong connections to 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.

[Sluggish cognitive tempo: an updated review]. / Tempo cognitivo lento: una revision actualizada.

INTRODUCTION: The study of sluggish cognitive tempo (SCT) arose largely from research carried out on attention deficit hyperactivity disorder (ADHD). This construct is defined by a range of behavioural symptoms such as the appearance of drowsiness, daydreaming, physical hypoactivity, little initiative, lethargy and apathy. DEVELOPMENT: The construct of SCT is reviewed by means of recently published papers on its clinical characteristics, associated symptoms, evaluation, prevalence, aetiology, comorbidity, neuropsychological profiles and treatment. The latest studies propose that SCT should be understood as a cluster of symptoms that is distinct from ADHD. Although there is no clear consensus on the matter, the evidence is becoming increasingly more consistent and endows SCT with a high degree of external validity, associating it with internalising symptoms. CONCLUSIONS: We believe the different subtypes of ADHD must be grounded in attentional conceptual models. Hence, the attentional guidance network would be related with SCT, the vigilance or sustained attention network would be linked with the inattentive subtype of ADHD, and executive attention would be involved in the combined subtype of ADHD. The evidence obtained to date, including this review, supports the idea that SCT is an attention disorder distinct from ADHD but, like any dimensional disorder, it can overlap with it in around half the cases.

TITLE: Tempo cognitivo lento: una revision actualizada.Introduccion. El estudio del tempo cognitivo lento (TCL) surgio en gran parte de las investigaciones del trastorno por deficit de atencion/hiperactividad (TDAH). Este constructo se define con una gama de sintomas conductuales, como apariencia de somnolencia, soñar despierto, hipoactividad fisica, pobre iniciativa, letargo y apatia. Desarrollo. Se revisa el constructo de TCL a traves de articulos recientemente publicados al respecto sobre caracteristicas clinicas, sintomas asociados, evaluacion, prevalencia, etiologia, comorbilidad, perfiles neuropsicologicos y tratamiento. Los trabajos mas actuales proponen entender el TCL como un cluster de sintomas distintivo del TDAH. Aunque no hay un consenso claro, los datos son cada vez mas consistentes y dotan de gran validez externa al TCL, asociandolo con sintomas internalizantes. Conclusiones. Consideramos necesario anclar los diferentes subtipos de TDAH en modelos conceptuales atencionales. Asi, la red de orientacion atencional se relacionaria con el TCL, la red de vigilancia o atencion sostenida con el TDAH subtipo inatento, y la atencion ejecutiva seria la implicada en el TDAH subtipo combinado. La evidencia hasta la fecha, incluyendo esta revision, apoya la idea de que el TCL es un trastorno de atencion diferenciado del TDAH, pero que, como cualquier trastorno dimensional, puede solaparse con el aproximadamente en la mitad de los casos.