Childhood obsessive-compulsive traits in anorexia nervosa patients, their unaffected sisters and healthy controls: a retrospective study.

Although there is evidence that childhood perfectionistic traits predate the onset of eating disorders, few studies to date have examined the prevalence and clinical correlates of these traits in patients with anorexia nervosa (AN) and their unaffected sisters. The aim of this work was to study the prevalence of childhood obsessive-compulsive traits in patients with lifetime AN, their unaffected sisters and healthy women. A total of 116 AN patients, 32 healthy sisters and 119 controls were assessed by the EATATE Interview to assess traits such as perfectionism, inflexibility, rule-bound traits, drive for order and symmetry, and excessive doubt and cautiousness. Both self-report and maternal reports were collected. AN patients reported more childhood obsessive-compulsive traits than their healthy sisters and controls. In contrast, no differences between healthy controls and unaffected sisters emerged. In patients with AN, a dose-response relationship was found between the number of childhood obsessive-compulsive traits and psychopathology, including body image distortion, thus indicating that these traits are an important feature to be considered in assessing and treating eating disorders.

Examining the momentary relationships between body checking and eating disorder symptoms in women with anorexia nervosa.

Body checking is common among individuals with anorexia nervosa (AN) and increases risk for dietary restriction. However, no study has examined whether body checking increases the immediate risk for engaging in other harmful weight loss behaviors, or whether this relationship is moderated by person-level traits. The current study utilized ecological momentary assessment (EMA) to examine whether (a) body checking predicted rapid use of weight loss behaviors, and (b) whether eating-related obsessionality/compulsivity moderated this relationship. Women with full or subthreshold anorexia nervosa (N = 118) completed a measure of eating-related obsessionality/compulsivity at baseline, followed by a 14-day EMA protocol during which they reported on body checking and weight loss behaviors (i.e., exercise, self-induced vomiting, laxative use, skipping meals, and increasing fluid intake). In a series of generalized linear mixed models, within-person effects indicated that momentary body checking significantly predicted subsequent meal skipping and using fluids to curb appetite. Between-person effects indicated that individuals who engage in more frequent body checking also engage in a higher frequency of self-induced vomiting, meal skipping, and use of fluids to curb appetite. An individual's degree of eating-related obsessionality/compulsivity did not moderate any of these relationships. Findings highlight body checking as an immediate precursor of dangerous weight loss behaviors among individuals with AN, and underscore the need for clinicians to address body checking during treatment.

Clinical validation of the parent-report Toronto Obsessive-Compulsive Scale (TOCS): A pediatric open-source rating scale.

Background: There is a need to develop a multipurpose obsessive-compulsive disorder (OCD) measure that is useful for cross disorder research and as a reliable clinical rating scale. The current study examined the psychometric properties and established clinical cutoffs for the parent-report version of the Toronto Obsessive-Compulsive Scale (TOCS), a 21-item rating scale of obsessive-compulsive traits. Method: Participants ranged in age from 6 to 21 years old and had a primary diagnosis of OCD (n = 350, 50% female), attention-deficit/hyperactivity disorder (ADHD) (n = 820, 25% female), autism spectrum disorder (ASD) (n = 794, 22% female), or were typically developing controls (n = 391, 51% female). Confirmatory factor analyses, internal consistency reliability, and convergent and divergent validity of the TOCS were examined in the OCD group. Using various scoring approaches, receiver operating characteristic (ROC) analyses were used to establish a clinical cut-off by splitting the OCD group into a discovery sample (166 OCD cases, 164 controls) and a validation sample (184 OCD cases, 227 controls). Classification accuracy and TOCS scores were compared across OCD, ADHD, and ASD groups. Results: The psychometric properties of the TOCS were confirmed. ROC analyses across TOCS scoring approaches in the discovery sample indicated excellent diagnostic discrimination (AUC ≥0.95, sensitivity 77%-92%, specificity 92%-98%). Established cutoffs, when applied in the independent validation sample of OCD cases and controls, showed an overall classification accuracy of 85%-90%. The TOCS total score and symptom count showed good discrimination of OCD from ADHD (AUC ≥0.86) and ASD (AUC ≥0.81). The OCD group scored significantly higher on all TOCS dimensions (except Hoarding) than the ADHD and ASD groups. Conclusion: The TOCS is a reliable and valid rating scale with strong sensitivity and specificity in discriminating OCD cases from controls, as well as from ASD and ADHD. It is a quantitative OCD measure with important clinical and research applications, with particular relevance for cross disorder phenotyping and population-based studies.

Schizotypal and obsessive-compulsive traits: Co-occurrence rate and relationship with executive function, emotion experience, and emotion expressivity in college students.

Empirical findings suggest that there is an overlap between schizophrenia and obsessive-compulsive disorder (OCD). These disorders also have a high comorbidity rate. However, little is known about the impact of co-occurring schizotypal and obsessive-compulsive traits on executive function, emotion experience, and emotion expressivity in the normal population. The present study examined the prevalence of coexisting schizotypal and obsessive-compulsive traits and the relationship between these two traits in a sample of healthy college students. We also conducted a moderation analysis to explore the effect of these two type of traits on executive function, emotion experience, and emotion expressivity. We recruited 3,319 participants to complete the Schizotypal Personality Questionnaire (SPQ) and the Obsessive-Compulsive Inventory - Revised (OCI-R). A subset of them (n = 575) also completed the Chinese versions of the Dysexecutive Questionnaire (DEX), the Temporal Experience of Pleasure Scale (TEPS), and the Emotional Expressivity Scale (EES). We found that the prevalence of co-occurring schizotypal and OCD traits was 3.33%. All the subscales of the SPQ and the OCI-R significantly correlated with each other. Both traits had a negative impact on executive function and emotion expressivity. The interaction between the disorganization dimension of schizotypal traits and OCD traits had a significant effect on executive function, but not emotion experience or emotion expressivity. This study was limited by its cross-sectional design and recruitment of only college students. These findings suggest that there is an approximately 3% rate of co-occurring schizotypal and obsessive-compulsive traits in a healthy college student sample. The interaction between these two types of traits may influence executive function.

Altered default mode network functional connectivity in individuals with co-occurrence of schizotypy and obsessive-compulsive traits.

In this study, we examined differences in resting-state functional connectivity between sub-regions of the Default Mode Network (DMN) and whole brain voxels in 22 individuals with high schizo-obsessive traits (SOT), 30 with high schizotypal traits (SCT) alone, 20 with high obsessive-compulsive traits (OCT) alone and 30 with low trait scores (LT). We found that the SOT group showed the most reduced functional connectivity within the DMN compared with the other groups. The SOT group also showed increased connectivity between the DMN and the Salience Network, and between the DMN and the Auditory Network compared with the LT group. The SCT group exhibited increased connectivity between the DMN and the Salience Network, and between the DMN and the Executive Control Network (ECN) compared with the LT group. The OCT group exhibited decreased connectivity within the DMN, between the DMN and the Salience Network, and between the DMN and the ECN compared with the LT group. These findings highlight different changes in DMN-related functional connectivity associated with high SOT, SCT and OCT traits and may provide insight into the dysfunctional brain networks in the early stage of schizophrenia spectrum disorders.

Comparing Two Short Forms of the Hewitt-Flett Multidimensional Perfectionism Scale.

Hewitt and Flett's 45-item Multidimensional Perfectionism Scale is a widely used instrument to assess self-oriented, other-oriented, and socially prescribed perfectionism. With 45 items, it is not overly lengthy, but there are situations where a short form is useful. Analyzing data from four samples, this article compares two frequently used 15-item short forms of the Multidimensional Perfectionism Scale-Cox et al.'s and Hewitt et al.'s-by examining to what degree their scores replicate the original version's correlations with various personality characteristics (e.g., traits, social goals, personal/interpersonal orientations). Regarding self-oriented and socially prescribed perfectionism, both short forms performed well. Regarding other-oriented perfectionism, however, Cox et al.'s short form (exclusively composed of negatively worded items) performed less well than Hewitt et al.'s (which contains no negatively worded items). It is recommended that researchers use Hewitt et al.'s short form to assess other-oriented perfectionism rather than Cox et al.'s.

The Toronto Obsessive-Compulsive Scale: Psychometrics of a Dimensional Measure of Obsessive-Compulsive Traits.

OBJECTIVE: To describe the Toronto Obsessive-Compulsive Scale (TOCS), a novel 21-item parent- or self-report questionnaire that covers wide variation in obsessive-compulsive (OC) traits, and to evaluate its psychometric properties in a community-based pediatric sample. METHOD: The TOCS was completed for 16,718 children and adolescents between the ages of 6 and 17 years in a community setting. Internal consistency, convergent validity with the Obsessive-Compulsive Scale of the Child Behaviour Checklist (CBCL-OCS), divergent validity with the Strengths and Weaknesses of ADHD (Attention-Deficit/Hyperactivity Disorder) Symptoms and Normal Behaviour Rating Scale (SWAN), interrater reliability, as well as sensitivity and specificity of the TOCS were assessed. RESULTS: The internal consistency of the 21 TOCS items was excellent (Cronbach's α = 0.94). TOCS was moderately correlated with the CBCL-OCS (Spearman correlation = 0.51) and poorly correlated with the SWAN (Pearson correlation = 0.02). Sensitivity and specificity analyses indicated that a TOCS total score of greater than 0 successfully discriminated community-reported obsessive-compulsive disorder (OCD) cases from noncases. OC traits were continuously distributed both at the total score and dimensional level in our pediatric community sample. CONCLUSION: TOCS is a multidimensional measure of OC traits in children and adolescents with sound psychometric properties. TOCS reveals that OC traits are common and continuously distributed in a community sample. TOCS may be a useful measure for studies of the characteristics and etiology of OC traits.