Rachel Ojserkis’s research while affiliated with Brown University and other places

Obsessive-compulsive (OC) symptoms have been associated with trauma exposure. Although no studies have specified relations between type of trauma and OC symptom presentations, this information may inform personalized care for this complex population. Thus, this study used profile analysis via multidimensional scaling to characterize typical OC symptom profiles in individuals exposed to interpersonal versus noninterpersonal traumas. Profiles were also correlated with self-reported disgust and mental contamination, which have been related to OC symptoms and interpersonal trauma in prior research. The interpersonal trauma group revealed two profiles: (1) Obsessing (high obsessing, low neutralizing), and (2) Ordering (high ordering, low obsessing). The noninterpersonal trauma group showed two profiles: (1) Hoarding/Ordering (high hoarding and ordering, low washing), and (2) Hoarding Only (high hoarding, low ordering). No significant correlations were found between OC profiles and disgust-related constructs. Clinical implications, limitations, and future directions are explored.

Mental contamination (MC), feeling dirty in the absence of a physical contaminant, has been linked to the basic emotion of disgust. Both MC and disgust have been associated with posttraumatic stress (PTS) and obsessive-compulsive (OC) symptoms occurring separately as well as together. However, there is no consensus on the specific ways in which these constructs interact with each other, PTS, or OC symptoms. Thus, this study sought to specify the associations between self-reported MC, disgust constructs, and OC symptoms amongst 250 undergraduates endorsing lifetime traumatic events. Results showed MC to significantly predict OC symptom severity above and beyond the effects of disgust propensity (DP) and disgust sensitivity (DS), controlling for gender, general negative affect, and PTS symptom severity, in both the large trauma-exposed sample and a subgroup (n = 49) endorsing PTS symptoms approximating DSM-5 criteria. Further, DS significantly moderated the strength of the association between DP and MC, controlling for gender, negative affect, PTS symptoms, and OC symptoms, such that higher levels of DS strengthened the conditional effects of DP on MC. These findings suggest that MC predicts OC symptom severity amongst trauma-exposed individuals, and that the interaction of disgust constructs contributes to MC in this population.

Research has suggested that the co-occurrence of PTSD in individuals with OCD is associated with more severe symptoms and less responsivity to empirically supported treatment as compared to individuals with OCD and no history of PTSD. However, much of this work has been limited by non-empirical case report design, cross-sectional and retrospective analyses, or small sample sizes. The current study extended this research by comparing the clinical characteristics of individuals with OCD with and without a lifetime PTSD diagnosis in a large, naturalistic, longitudinal sample over the course of seven years. At baseline, individuals with comorbid lifetime PTSD reported significantly more severe symptoms of OCD (including symptom levels and insight), lower quality of life, and higher rates of comorbid lifetime mood and substance use disorders than participants without lifetime PTSD. Further, individuals with comorbid OCD and lifetime PTSD reported significantly more severe OCD symptoms over the course of seven years than those without lifetime PTSD. These results are largely consistent with the existing literature and support the need to consider PTSD symptoms in the assessment and treatment of OCD.

Body dysmorphic disorder (BDD) is a debilitating clinical condition in which individuals experience severe distress and preoccupation regarding one or more aspects of physical appearance. Body dysmorphic disorder is a complex syndrome that, while classified as a member of the obsessive-compulsive and related disorders (OCRD) category, has a number of distinct features beyond simply an excessive concern with specific body areas. By moving BDD from Somatoform Disorders into the new OCRD section, the recently published fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lent official credence to the conceptualization of BDD that currently dominates the psychological literature - that is, placing BDD along a spectrum of disorders characterized by compulsive and repetitive behaviors. Cognitive-behavior therapy (CBT) is currently the first line treatment for BDD. Cognitive-behavior therapy for BDD typically includes psychoeducation, exposure and response prevention, and cognitive restructuring.

This chapter defines disgust constructs and measurement, outlines the literature on its involvement in psychopathology, and reviews some methods for intervention. According to Rozin and Fallon, a food may elicit disgust based on several factors, including beliefs that ingesting the item will be associated with unpleasant sensory properties, cause bodily harm, or violate a cultural more. Clinically, core disgust has been related to specific phobias, as well as some presentations of obsessive-compulsive disorder. The Disgust Scale-Revised is a 25-item self-report questionnaire that measures disgust propensity, that is, the trait-like quality representing the ease with which one experiences disgust. The Disgust Emotion Scale for Children is a 30-item self-report measure of five domains of disgust among children: animals, injection and blood, mutilation and death, rotting foods, and odors. Behavioral avoidance tasks (BATs) are another way of assessing disgust in research settings.

Mental contamination (MC), feeling dirty in the absence of a physical contaminant, has been linked to the basic emotion of disgust. Both MC and disgust have been associated with posttraumatic stress (PTS) and obsessive-compulsive (OC) symptoms occurring separately as well as together. However, there is no consensus on the specific ways in which these constructs interact with each other, PTS, or OC symptoms. Thus, this study sought to specify the associations between self-reported MC, disgust constructs, and OC symptoms amongst 250 undergraduates endorsing lifetime traumatic events. Results showed MC to significantly predict OC symptom severity above and beyond the effects of disgust propensity (DP) and disgust sensitivity (DS), controlling for gender, general negative affect, and PTS symptom severity, in both the large trauma-exposed sample and a subgroup (n=49) endorsing PTS symptoms approximating DSM-5 criteria. Further, DS significantly moderated the strength of the association between DP and MC, controlling for gender, negative affect, PTS symptoms, and OC symptoms, such that higher levels of DS strengthened the conditional effects of DP on MC. These findings suggest that MC predicts OC symptom severity amongst trauma-exposed individuals, and that the interaction of disgust constructs contributes to MC in this population.

Many patients with bulimia nervosa (BN) also meet criteria for a lifetime alcohol use disorder (AUD). In order to understand possible mechanisms contributing to the co-occurrence and perpetuation of these disorders, this study investigated the importance of impulsivity and test meal intake among patients with BN by comparing women with BN only (n = 18), BN and current/past AUDs (n = 13), and healthy controls (n = 12). All participants completed assessments of eating disorder symptoms, frequency of alcohol use, binge eating, and purging via questionnaires and semi-structured interviews over two sessions. Measures of impulsivity consisted of computerized and self-report measures, and laboratory test meals. Significant differences between individuals with BN with/without comorbid AUDs were not found for test meal intake, impulsivity measures, or self-reported psychological symptoms. As hypothesized, compared to healthy controls, individuals with BN had significantly higher scores on two subscales and the total score of the Barratt Impulsiveness Scale, a trait measure of impulsivity, and consumed significantly more calories in the binge instruction meal. Total Barratt Impulsiveness Scale scores were also significantly related to kcal consumed during the laboratory test meal when individuals were instructed to binge eat (BN groups). Data from this study add to the existing literature implicating impulsivity in the psychopathology of disorders of binge eating, including BN, and also support the use of laboratory meals as a symptom-specific measure of this trait in eating disorder populations.

Obsessive–compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) frequently co-occur. However, the shared features of these conditions have been under-examined. Evaluation of the common aspects of posttraumatic and obsessive–compulsive (OC) symptoms could improve treatment responsivity for individuals with comorbid PTSD and OCD, for whom outcome is typically poorer than for those with either disorder alone. This study examined intolerance of uncertainty, inflated responsibility, and a global measure of posttraumatic cognitions as potential shared cognitive constructs that moderate distress associated with OC symptoms. A total of 211 undergraduate students reporting significant trauma histories participated. All participants completed measures of obsessive–compulsive symptoms and beliefs, as well as posttraumatic cognitions. Results indicated that posttraumatic cognitions moderated the relationship between inflated responsibility and intolerance of uncertainty, which in turn predicted all domains of obsessive–compulsive symptom distress (all βs > 0.41, all zs > 3.44). Further, posttraumatic cognitions alone significantly predicting OC symptoms related to doubting, obsessions, and neutralizing. These findings suggest that shared cognitive constructs play a role in co-occurring posttraumatic stress and OC symptoms, and thus may be a relevant treatment target when these disorders present simultaneously.

La asco, además del miedo, es un estado emocional prominente asociado con la evitación de estímulos perturbadores. Aunque la mayoría de la investigación se ha llevado a cabo en relación con el trastorno obsesivo-compulsivo (TOC), datos recientes han implicado la asco en la etiología de trastornos de ansiedad en general. Se ha demostrado que la disminución de la asco es clave para la reducción de los síntomas en personas con TOC. Sin embargo, son escasos los trabajos que exploren si estas intervenciones son eficaces en trastornos de ansiedad en la infancia con componentes prominentes de asco. Este estudio examinó cómo la propensión a la asco en niños con trastornos de ansiedad responde a la terapia cognitivo-conductual (TCC) con énfasis en la exposición. Cuarenta y un niños de 7 a 17 años, con trastornos de ansiedad, fueron evaluados en la propensión a la asco y tratados semanalmente con TCC intensiva. Se encontró que los niveles de asco disminuyeron tras el tratamiento en todos los diagnósticos de trastorno de ansiedad, siendo los niños con TOC primario los que mostraron reducciones significativamente mayores. Se discuten las implicaciones clínicas y sugerencias para futuras investigaciones sobre el tratamiento de la asco en relación con los trastornos de ansiedad infantil.