Harm avoidance in subjects with obsessive-compulsive disorder and their families

Department of Psychiatry and Psychotherapy, University of Greifswald, Germany.
Journal of Affective Disorders (Impact Factor: 3.38). 05/2008; 107(1-3):265-9. DOI: 10.1016/j.jad.2007.08.017
Source: PubMed


This study investigates the role of harm avoidance (HA) as a possible risk factor in the familiality of obsessive-compulsive disorder (OCD). HA is considered to be a genetically influenced personality trait with an increasingly understood neuroanatomical basis.
75 subjects with OCD from hospital sites and a community sample and their 152 first degree relatives and 75 age and sex matched controls with their 143 first degree relatives were evaluated with structured clinical interviews (DSM-IV). HA was assessed with Cloninger's Tridimensional Personality Questionnaire (TPQ).
Subjects with OCD had higher scores of HA than controls (p<or=0.001). First degree relatives of OCD cases also showed higher HA than relatives of control subjects (p=0.001).These results remained stable when comparing only OCD subjects versus controls (p<or=0.001) and relatives of OCD cases versus relatives of controls (p=0.005) without current comorbid disorders.
The investigation of HA alone does not allow to disentangle the transmission of biological versus psychological factors related to an elevated level of anxiety in families of OCD cases.
This is the first study to extent previous findings of elevated HA in OCD cases to their first degree relatives. Thus, HA may partially mediate the familial risk for OCD.

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    • "Patients with OCD exhibited a pattern that potentially indicated withdrawal tendencies, which were greater than the norm (Ischebeck et al., 2014). These findings are consistent with greater scores on the harm avoidance questionnaire (Ettelt et al., 2008) and enhanced avoidance learning (Endrass, Kloft, Kaufmann, & Kathmann, 2011) in patients with OCD. Lastly, the psychophysiological and neurobiological correlates of conditioned fear extinction in 21 patients with OCD compared with 21 healthy controls were investigated in another study using MRI (Milad et al., 2013). "
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    ABSTRACT: This article will explore recent studies that have identified alterations in brain regions in individuals with obsessive–compulsive disorder (OCD). Specifically, alterations have been found in the cortical surface anatomy, the white matter, the gray matter, the cerebellum, the olfactory-processing structures, the temporal lobe, the prefrontal cortex, and the amygdala. Although some emerging data implicate these brain regions in OCD, the cortico–striatal–thalamic–cortical circuitry remains the prime focus of research. This article will also give an overview of studies that have found different symptom dimensions in individuals with OCD to have distinct neural correlates.
    Brain Mapping An Encyclopedic Reference, Edited by Editor-in-Chief: Arthur W. Toga, 02/2015: chapter Volume 3: Social Cognitive Neuroscience, Cognitive Neuroscience, Clinical Brain Mapping: pages Pages 993–1000; Elsevier Inc.., ISBN: ISBN: 978-0-12-397316-0
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    • "So konnte gezeigt werden, dass sowohl Zwangspatienten als auch deren Angehörige eine erhöhte Prävalenz für die zwanghafte Persönlichkeitsstörung aufweisen (Samuels et al., 2000). Weiterhin wurden für beide Gruppen erhöhte Werte für Neurotizismus (Samuels et al., 2000) und Schadensvermeidung (Ettelt et al., 2008) gefunden. Schadensvermeidung bezeichnet die individuelle Neigung Verhaltensweisen zu hemmen und drückt sich in der Neigung zu Vorsicht, Ängstlichkeit und Pessimismus aus (Cloninger, 1986). "
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    ABSTRACT: Zusammenfassung. Die Zwangsstörung ist eine teilweise genetisch vermittelte psychische Störung, die mit neuropsychologischen Be-einträchtigungen einhergeht. Bisher war die Suche nach den genetischen Ursachen wenig erfolgreich, was an der polygenetischen Über-tragung und an der Heterogenität im klinischen Erscheinungsbild der Zwangsstörung liegen könnte. Die Verwendung des Endophäno-typenkonzepts kann möglicherweise dazu beitragen, diese Probleme zu reduzieren. Endophänotypen sind zustandsunabhängige Marker, die näher an den biologischen Ursachen einer Erkrankung liegen als der klinische Phänotyp und mit einem erhöhten genetischen Risiko für die Erkrankung einhergehen. Die im Bereich der Zwangsstörung existierenden Befunde zu Endophänotypen werden in dem vorlie-genden Artikel diskutiert und Implikationen für zukünftige Studien abgeleitet. Zusammenfassend lässt sich sagen, dass vielversprechende Kandidaten-Endophänotypen in den Bereichen Reaktionshemmung, Handlungsüberwachung und kognitive Flexibilität vorliegen. Abstract. Obsessive-compulsive disorder (OCD) is a heritable condition that is associated with neuropsychological deficits. However, genetic underpinnings are difficult to identify and results have been inconsistent. Reasons for this difficulty may be that multiple genes are involved in the etiology of OCD and that the clinical phenotype of OCD is heterogeneous. The use of cognitive and biological endo-phenotypes was suggested as a resolution to these problems. Endophenotypes are state independent markers that exhibit a closer relation with genetic underpinnings than the clinical phenotype itself. In the current review, we discuss the current state of research on candidate endophenotypes for OCD and consider implications and future directions. In conclusion, several promising candidate endophenotypes for OCD have been identified, namely response inhibition, performance monitoring, and cognitive flexibility.
    Zeitschrift für Psychiatrie Psychologie und Psychotherapie 07/2013; 61(3):155-165. DOI:10.1024/1661-4747/a000154 · 1.99 Impact Factor
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    • "In contrast, the behavioral manifestations of OCD seem to lie on the opposite end of an impulsive–compulsive spectrum (Hollander, 2005). Individuals with OCD exhibit inhibited temperament, avoidance of novel stimuli (Alonso et al., 2008; Coll, Kagan, & Reznick, 1984; Muris, Meesters, & Spinder, 2003; Van Ameringen, Mancini, & Oakman, 1998), increased harm and risk avoidance (Ettelt et al., 2008), and less impulsivity than healthy controls (Fullana et al., 2004a, b; Wu, Clark, & Watson, 2006). We believe that there is a growing convergence of evidence that may, at least in some cases, challenge the diagnostic validity of OCD and ADHD comorbidity. "
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    ABSTRACT: Reported OCD–ADHD comorbidity rates are highly variable and the two disorders are characterized by opposite symptomatology and antithetical pathophysiology. We hypothesized that OCD-related attentional impairment could be misdiagnosed as ADHD symptoms. Thirty adults with OCD, thirty with ADHD, and thirty matched healthy controls (HC) completed disorder-specific measures and an ADHD DSM-IV based questionnaire examining childhood and current symptoms. The ADHD group met significantly more current and childhood ADHD criteria than the other groups. Within the HC and ADHD groups, but not the OCD group, significant positive correlations were found between childhood and current ADHD symptoms. Only within the OCD group, obsessive–compulsive symptoms and ADHD criteria correlated positively. These findings support the predictions of the executive overload model of OCD, suggesting that ADHD-like symptoms in OCD may be a consequence of OCD symptomatology. Clinical implications of a potential misdiagnosis should be considered in light of the probability that stimulant medication exacerbates OCD symptoms. This is particularly important in children, where ADHD diagnosis is based primarily on informant reports.
    Journal of Obsessive-Compulsive and Related Disorders 01/2013; 2(1):53-61. DOI:10.1016/j.jocrd.2012.09.001 · 1.18 Impact Factor
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