Historically, treatment of obsessive-compulsive disorder (OCD) has focused on anxiety regarding t... more Historically, treatment of obsessive-compulsive disorder (OCD) has focused on anxiety regarding the potential of something bad happening. Therefore, cognitive-behavioral therapies (CBT) for OCD have emphasized altering the perceived connection between intrusions and performing a compulsion aimed at preventing the negative outcome and reducing anxiety. However, there is increasing recognition that some OCD symptoms are not related to anxiety regarding negative outcomes, but are motivated by a desire to reduce a sensation that things are incomplete or not just right. Thischapter presents the case of a 9-year-old girl with OCD related to both harm avoidance and not-just-right experiences (NJREs). Discussion of her NJRE-related symptoms is emphasized. Initial experiences suggest that patients with NJRE-related symptoms can benefit from CBT when the NJREs are recognized and incorporated into the case conceptualization and treatment.
Journal of Psychopathology and Behavioral Assessment, Oct 30, 2008
Hoarding has historically been conceptualized as a symptom of Obsessive Compulsive Disorder (OCD)... more Hoarding has historically been conceptualized as a symptom of Obsessive Compulsive Disorder (OCD); however, data demonstrate important differences between hoarding and OC symptoms (for discussion, see Grisham et al. Anxiety Disorders, 19, 767‑779. 2005). Hoarding has also been observed in disorders besides OCD, including specific Impulse Control Disorders (ICDs; e.g., kleptomania, trichotillomania, pathological gambling, compulsive buying). Therefore, the current study
Journal of Behavior Therapy and Experimental Psychiatry, Mar 1, 2016
Obsessive-compulsive (OC) symptoms and repetitive negative thinking (RNT) are associated with poo... more Obsessive-compulsive (OC) symptoms and repetitive negative thinking (RNT) are associated with poor inhibitory control. Sleep disruptions may partially mediate these relations and/or act as a "second hit" to individuals with OC symptoms and RNT. Models including habitual (past month) hours slept and bedtimes were tested. We employed a go/no-go task that allowed us to examine the relation between sleep and inhibition with various task contingencies. Sixty-seven unselected individuals were recruited from the participant pool at a public university. Bias-corrected bootstrap estimates did not show that sleep disruption mediated the relation between OC symptoms and response inhibition nor the relation between RNT and response inhibition. Multiple linear regression analyses found significant interactions between hours slept and OC symptom severity and between RNT and hours slept to predict poor response inhibition. Hours slept significantly negatively predicted commission errors when OC symptoms and RNT levels were relatively heightened but not when OC symptoms and RNT levels were relatively low. These effects were present in blocks where task contingencies were designed to shape a no-go bias. No significant relations were found with habitual bedtimes. The cross-sectional study design precludes testing the temporal precedence of symptoms in the "second hit" model. The unselected sample also limits generalization to clinical samples. These findings support a "second hit" model of interaction between sleep disruption and perseverative thoughts and behaviors. Further research on the mechanisms of the relation between sleep disruption and perseverative thought symptoms (OC and RNT) is warranted.
Individuals with obsessive-compulsive disorder (OCD) often report compulsions aimed at reducing f... more Individuals with obsessive-compulsive disorder (OCD) often report compulsions aimed at reducing feelings of something not being just right or sensations of incompleteness. Research using self-report questionnaires has demonstrated a link between not just right experiences (NJREs) and OCD symptoms (Behav. Res. Therapy 41 (2003) 681; Anxiety, 1 (1995) 208). Extending previous work, this paper presents experimental and self-monitoring data on NJREs in an undergraduate sample. NJREs produced distress and urges to change something, but feared consequences were rare. Stronger responses were found for naturally occurring self-monitored NJREs compared to NJREs elicited in the laboratory. Several significant relationships were found between features of NJREs and OC symptoms and constructs theoretically related to OCD (e.g., responsibility, incompleteness), but no significant relationships were found between features of NJREs and non-OCD-related constructs (worry, depressive symptoms, social anxiety). Further consideration of NJREs will be useful in improving our understanding of the phenomenology, neurobiological substrates, and treatment, of OCD.
There is increasing recognition of an important interplay between psychiatric disorders and sleep... more There is increasing recognition of an important interplay between psychiatric disorders and sleep. Clinical observations and several empirical studies have shown that later bedtimes are associated with obsessive-compulsive disorder (OCD). This study examined the relation of delayed bedtimes (DBs) and symptoms of OCD. Two hundred and sixty-six undergraduates completed a battery of questionnaires assessing sleep patterns, mood, and obsessive-compulsive (OC) symptoms. Results showed that participants with DBs reported increased rates of OC symptoms, as compared with non-DB participants. Further, this relation remained significant when controlling for negative affect. Additional work examining the interplay between sleep and OC symptoms is warranted.
Anxiety is adaptive and plays an important role in keeping us safe. However, when anxiety becomes... more Anxiety is adaptive and plays an important role in keeping us safe. However, when anxiety becomes too extreme, it can cause significant disruptions and distress. Understanding the mechanisms underlying excessive anxiety and how to best treat it is a priority for researchers and clinicians. There is increasing recognition that disruptions in the amount and timing of sleep are associated with anxiety symptoms and characteristics. In the current paper, we explore the intersections between sleep, circadian rhythms, and anxiety. First, we review accumulating evidence that anxiety is associated with disruptions in sleep and circadian rhythms in both clinical and nonclinical samples and across ages. Next, we discuss the data linking sleep disruptions with anxiety-related traits (anxiety sensitivity, neuroticism, and perfectionism) and patterns of cognition and emotion. Finally, potential treatment implications are highlighted. Overall, these data suggest that delineating the role of disruptions in the amount and timing of sleep holds promise for improving the lives of individuals with heightened anxiety.
ABSTRACT Higher levels of repetitive negative thinking (RNT; a perseverative and abstract focus o... more ABSTRACT Higher levels of repetitive negative thinking (RNT; a perseverative and abstract focus on negative aspects of one's experience) are associated with reduced sleep duration. This information is already informing theory and clinical practice. However, we are not aware of any studies examining the relation between RNT and the timing of sleep. We examined both disorder specific measures of RNT and a transdiagnostic measure of the RNT process in relation to sleep duration and timing in a sample of 100 unselected undergraduates. Replicating prior findings, shorter sleep duration was cross-sectionally associated with more rumination and delayed sleep timing was associated with more obsessive-compulsive symptoms. Further, extending this prior work, the transdiagnostic measure of RNT was associated with shorter sleep duration and delayed sleep timing. Individuals who endorsed a preference for later sleep and activity times also reported more RNT. These findings suggest that RNT may be uniquely related to both sleep duration and timing.
Historically, treatment of obsessive-compulsive disorder (OCD) has focused on anxiety regarding t... more Historically, treatment of obsessive-compulsive disorder (OCD) has focused on anxiety regarding the potential of something bad happening. Therefore, cognitive-behavioral therapies (CBT) for OCD have emphasized altering the perceived connection between intrusions and performing a compulsion aimed at preventing the negative outcome and reducing anxiety. However, there is increasing recognition that some OCD symptoms are not related to anxiety regarding negative outcomes, but are motivated by a desire to reduce a sensation that things are incomplete or not just right. Thischapter presents the case of a 9-year-old girl with OCD related to both harm avoidance and not-just-right experiences (NJREs). Discussion of her NJRE-related symptoms is emphasized. Initial experiences suggest that patients with NJRE-related symptoms can benefit from CBT when the NJREs are recognized and incorporated into the case conceptualization and treatment.
Journal of Psychopathology and Behavioral Assessment, Oct 30, 2008
Hoarding has historically been conceptualized as a symptom of Obsessive Compulsive Disorder (OCD)... more Hoarding has historically been conceptualized as a symptom of Obsessive Compulsive Disorder (OCD); however, data demonstrate important differences between hoarding and OC symptoms (for discussion, see Grisham et al. Anxiety Disorders, 19, 767‑779. 2005). Hoarding has also been observed in disorders besides OCD, including specific Impulse Control Disorders (ICDs; e.g., kleptomania, trichotillomania, pathological gambling, compulsive buying). Therefore, the current study
Journal of Behavior Therapy and Experimental Psychiatry, Mar 1, 2016
Obsessive-compulsive (OC) symptoms and repetitive negative thinking (RNT) are associated with poo... more Obsessive-compulsive (OC) symptoms and repetitive negative thinking (RNT) are associated with poor inhibitory control. Sleep disruptions may partially mediate these relations and/or act as a "second hit" to individuals with OC symptoms and RNT. Models including habitual (past month) hours slept and bedtimes were tested. We employed a go/no-go task that allowed us to examine the relation between sleep and inhibition with various task contingencies. Sixty-seven unselected individuals were recruited from the participant pool at a public university. Bias-corrected bootstrap estimates did not show that sleep disruption mediated the relation between OC symptoms and response inhibition nor the relation between RNT and response inhibition. Multiple linear regression analyses found significant interactions between hours slept and OC symptom severity and between RNT and hours slept to predict poor response inhibition. Hours slept significantly negatively predicted commission errors when OC symptoms and RNT levels were relatively heightened but not when OC symptoms and RNT levels were relatively low. These effects were present in blocks where task contingencies were designed to shape a no-go bias. No significant relations were found with habitual bedtimes. The cross-sectional study design precludes testing the temporal precedence of symptoms in the "second hit" model. The unselected sample also limits generalization to clinical samples. These findings support a "second hit" model of interaction between sleep disruption and perseverative thoughts and behaviors. Further research on the mechanisms of the relation between sleep disruption and perseverative thought symptoms (OC and RNT) is warranted.
Individuals with obsessive-compulsive disorder (OCD) often report compulsions aimed at reducing f... more Individuals with obsessive-compulsive disorder (OCD) often report compulsions aimed at reducing feelings of something not being just right or sensations of incompleteness. Research using self-report questionnaires has demonstrated a link between not just right experiences (NJREs) and OCD symptoms (Behav. Res. Therapy 41 (2003) 681; Anxiety, 1 (1995) 208). Extending previous work, this paper presents experimental and self-monitoring data on NJREs in an undergraduate sample. NJREs produced distress and urges to change something, but feared consequences were rare. Stronger responses were found for naturally occurring self-monitored NJREs compared to NJREs elicited in the laboratory. Several significant relationships were found between features of NJREs and OC symptoms and constructs theoretically related to OCD (e.g., responsibility, incompleteness), but no significant relationships were found between features of NJREs and non-OCD-related constructs (worry, depressive symptoms, social anxiety). Further consideration of NJREs will be useful in improving our understanding of the phenomenology, neurobiological substrates, and treatment, of OCD.
There is increasing recognition of an important interplay between psychiatric disorders and sleep... more There is increasing recognition of an important interplay between psychiatric disorders and sleep. Clinical observations and several empirical studies have shown that later bedtimes are associated with obsessive-compulsive disorder (OCD). This study examined the relation of delayed bedtimes (DBs) and symptoms of OCD. Two hundred and sixty-six undergraduates completed a battery of questionnaires assessing sleep patterns, mood, and obsessive-compulsive (OC) symptoms. Results showed that participants with DBs reported increased rates of OC symptoms, as compared with non-DB participants. Further, this relation remained significant when controlling for negative affect. Additional work examining the interplay between sleep and OC symptoms is warranted.
Anxiety is adaptive and plays an important role in keeping us safe. However, when anxiety becomes... more Anxiety is adaptive and plays an important role in keeping us safe. However, when anxiety becomes too extreme, it can cause significant disruptions and distress. Understanding the mechanisms underlying excessive anxiety and how to best treat it is a priority for researchers and clinicians. There is increasing recognition that disruptions in the amount and timing of sleep are associated with anxiety symptoms and characteristics. In the current paper, we explore the intersections between sleep, circadian rhythms, and anxiety. First, we review accumulating evidence that anxiety is associated with disruptions in sleep and circadian rhythms in both clinical and nonclinical samples and across ages. Next, we discuss the data linking sleep disruptions with anxiety-related traits (anxiety sensitivity, neuroticism, and perfectionism) and patterns of cognition and emotion. Finally, potential treatment implications are highlighted. Overall, these data suggest that delineating the role of disruptions in the amount and timing of sleep holds promise for improving the lives of individuals with heightened anxiety.
ABSTRACT Higher levels of repetitive negative thinking (RNT; a perseverative and abstract focus o... more ABSTRACT Higher levels of repetitive negative thinking (RNT; a perseverative and abstract focus on negative aspects of one's experience) are associated with reduced sleep duration. This information is already informing theory and clinical practice. However, we are not aware of any studies examining the relation between RNT and the timing of sleep. We examined both disorder specific measures of RNT and a transdiagnostic measure of the RNT process in relation to sleep duration and timing in a sample of 100 unselected undergraduates. Replicating prior findings, shorter sleep duration was cross-sectionally associated with more rumination and delayed sleep timing was associated with more obsessive-compulsive symptoms. Further, extending this prior work, the transdiagnostic measure of RNT was associated with shorter sleep duration and delayed sleep timing. Individuals who endorsed a preference for later sleep and activity times also reported more RNT. These findings suggest that RNT may be uniquely related to both sleep duration and timing.
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