Obsessions and compulsions

مِن شَرِّ ٱلۡوَسۡوَاسِ ٱلۡخَنَّاسِ

against the harm of the slinking whisperer––

وَكَمۡ أَهۡلَكۡنَا قَبۡلَهُم مِّن قَرۡنٍ هَلۡ تُحِسُّ مِنۡهُم مِّنۡ أَحَدٍ أَوۡ تَسۡمَعُ لَهُمۡ رِكۡزَۢا

How many generations We have destroyed before them! Do you perceive a single one of them now, or hear as much as a whisper

يَوۡمَئِذࣲ يَتَّبِعُونَ ٱلدَّاعِيَ لَا عِوَجَ لَهُۥۖ وَخَشَعَتِ ٱلۡأَصۡوَاتُ لِلرَّحۡمَٰنِ فَلَا تَسۡمَعُ إِلَّا هَمۡسࣰ ا

On that Day, people will follow the summoner from whom there is no escape; every voice will be hushed for the Lord of Mercy; only whispers will be heard

فَوَسۡوَسَ إِلَيۡهِ ٱلشَّيۡطَٰنُ قَالَ يَٰٓـَٔادَمُ هَلۡ أَدُلُّكَ عَلَىٰ شَجَرَةِ ٱلۡخُلۡدِ وَمُلۡكࣲ لَّا يَبۡلَىٰ

But Satan whispered to Adam, saying, ‘Adam, shall I show you the tree of immortality and power that never decays?’

وَلَقَدۡ خَلَقۡنَا ٱلۡإِنسَٰنَ وَنَعۡلَمُ مَا تُوَسۡوِسُ بِهِۦ نَفۡسُهُۥۖ وَنَحۡنُ أَقۡرَبُ إِلَيۡهِ مِنۡ حَبۡلِ ٱلۡوَرِيدِ

We created man––We know what his soul whispers to him: We are closer to him than his jugular vein––

فَوَسۡوَسَ لَهُمَا ٱلشَّيۡطَٰنُ لِيُبۡدِيَ لَهُمَا مَا وُۥرِيَ عَنۡهُمَا مِن سَوۡءَٰتِهِمَا وَقَالَ مَا نَهَىٰكُمَا رَبُّكُمَا عَنۡ هَٰذِهِ ٱلشَّجَرَةِ إِلَّآ أَن تَكُونَا مَلَكَيۡنِ أَوۡ تَكُونَا مِنَ ٱلۡخَٰلِدِينَ

Satan whispered to them so as to expose their nakedness, which had been hidden from them: he said, ‘Your Lord only forbade you this tree to prevent you becoming angels or immortals,’

from the evil of the slinking whisperer Satan — he is referred to by the name of the action waswasa on account of his repeated engaging in it — who slinks away and recoils from the heart whenever God is mentioned

Say: "I seek refuge with the Lord of An-Nas, (1)"The King of An-Nas, (2)"The God of An-Nas, (3)"From the evil of the whisperer who withdraws. (4)"Who whispers in the breasts of An-Nas. (5)"Of Jinn and An-Nas. (6) These are three attributes from the attributes of the Lord, the Mighty and Majestic. They are lordship, sovereignty and divinity. Thus, He is the Lord of everything, the King of everything and the God of everything. All things are created by Him, owned by Him, and subservient to Him. Therefore, He commands whoever is seeking protection to seek refuge with the One Who has these attributes from the evil of the whisperer who withdraws. This (the whisperer) is the devil that is assigned to man. For verily, there is not any of the Children of Adam except that he has a companion that beautifies wicked deeds for him. This devil will go to any lengths to confuse and confound him. The o

Then Satan whispered to them to show them their shameful parts that were hidden from them. This also is a mark of solicitude and a proof of generosity, for they sinned, but He turned it over to Satan's whispering. Then He increased the solicitude. He said, “to show them their shameful parts that were hidden from them.” He said: “He made their pudenda appear to them, but not to others.” They say that afterwards, Adam and Iblis met. Adam said, “You wretch! Do you know what you did to me and what dust you stirred up in my road?” Iblis said, “O Adam, I take it that I took you from the road. Tell me then, who took me from the road?” They also say that both of them turned away from the command, but there is a difference be- tween the two. Adam slipped because of appetite, and Iblis slipped because of pride. Being pride- ful is worse than satisfying appetite. When a sin arises from appetite, th

And how many — in other words many — a generation namely how many a community from among the communities of the past We have destroyed before them for their denial of Our messengers. Can you see can you find so much as one of them or hear from them so much as the faintest sound? No indeed! So just as We destroyed those folk We shall destroy these Meccans.

Then Satan Iblīs whispered to them that he might manifest reveal to them that which was hidden wūriya based on the verbal form fū‘ila and derives from the infinitive al-muwārā to them of their shameful parts. And he said ‘Your Lord prohibited you from this tree only in aversion lest you become angels malakayn may also be read malikayn or become immortals’ in other words that is the necessary consequence of eating from it as is stated in another verse Shall I guide you to the Tree of Immortality and a kingdom that does not waste away? Q. 20120.

Verily, those who believe and work deeds of righteousness, the Most Gracious will bestow love for them (96)So, We have made this easy in your own tongue, only that you may give glad tidings to those who have Taqwa, and warn with it the people that are Ludda (97)And how many a generation before them have We destroyed! Can you find a single one of them or hear even a whisper of them (98) Allah places Love of the Righteous People in the Hearts Allah, the Exalted, informs about His believing servants, who work righteous deeds – deeds that He is pleased with because they are in accordance with the legislation of Muhammad ﷺ – that He plants love for them in the hearts of His righteous servants. This is something that is absolutely necessary and there is no avoiding it. This has been reported in authentic Hadiths of the Messenger of Allah ﷺ in various different ways. Imam Ahmad recorded that

حَدَّثَنَا عَبْدُ اللَّهِ بْنُ يُوسُفَ، أَخْبَرَنَا مَالِكٌ، عَنْ يَحْيَى بْنِ سَعِيدٍ، عَنْ عَبْدِ الرَّحْمَنِ الأَعْرَجِ، عَنْ عَبْدِ اللَّهِ ابْنِ بُحَيْنَةَ ـ رضى الله عنه ـ أَنَّهُ قَالَ إِنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم قَامَ مِنِ اثْنَتَيْنِ مِنَ الظُّهْرِ لَمْ يَجْلِسْ بَيْنَهُمَا، فَلَمَّا قَضَى صَلاَتَهُ سَجَدَ سَجْدَتَيْنِ ثُمَّ سَلَّمَ بَعْدَ ذَلِكَ‏.‏

Narrated `Abdullah bin Buhaina:Allah's Messenger (ﷺ) got up after the second rak`a of the Zuhr prayer without sitting in between (the second and the third rak`at). When he finished the prayer he performed two prostrations (of Sahu) and then finished the prayer with Taslim

حَدَّثَنَا أَبُو الْوَلِيدِ، حَدَّثَنَا شُعْبَةُ، عَنِ الْحَكَمِ، عَنْ إِبْرَاهِيمَ، عَنْ عَلْقَمَةَ، عَنْ عَبْدِ اللَّهِ ـ رضى الله عنه ـ أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم صَلَّى الظُّهْرَ خَمْسًا فَقِيلَ لَهُ أَزِيدَ فِي الصَّلاَةِ فَقَالَ ‏ "‏ وَمَا ذَاكَ ‏"‏‏.‏ قَالَ صَلَّيْتَ خَمْسًا‏.‏ فَسَجَدَ سَجْدَتَيْنِ بَعْدَ مَا سَلَّمَ‏.‏

Narrated' `Abdullah:Once Allah's Messenger (ﷺ) offered five rak`at in the Zuhr prayer, and somebody asked him whether there was some increase in the prayer. Allah's Messenger (ﷺ) said, "What is that?" He said, "You have offered five rak`at." So Allah's Messenger (ﷺ) performed two prostrations of Sahu after Taslim

أَخْبَرَنَا سُلَيْمَانُ بْنُ دَاوُدَ، وَالْحَارِثُ بْنُ مِسْكِينٍ، قِرَاءَةً عَلَيْهِ وَأَنَا أَسْمَعُ، عَنِ ابْنِ وَهْبٍ، عَنْ عَمْرِو بْنِ الْحَارِثِ، عَنْ بُكَيْرٍ، أَنَّ أَبَا السَّائِبِ، حَدَّثَهُ أَنَّهُ، سَمِعَ أَبَا هُرَيْرَةَ، يَقُولُ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏‏ "‏‏ لاَ يَغْتَسِلْ أَحَدُكُمْ فِي الْمَاءِ الدَّائِمِ وَهُوَ جُنُبٌ ‏‏"‏‏ ‏‏.‏‏

Abu Hurairah said:"The Messenger of Allah (ﷺ) said: 'None of you should perform ghusl in standing water while he is Junub

أَخْبَرَنَا مُحَمَّدُ بْنُ حَاتِمٍ، قَالَ حَدَّثَنَا حِبَّانُ، قَالَ حَدَّثَنَا عَبْدُ اللَّهِ، عَنْ مَعْمَرٍ، عَنْ هَمَّامِ بْنِ مُنَبِّهٍ، عَنْ أَبِي هُرَيْرَةَ، عَنِ النَّبِيِّ صلى الله عليه وسلم قَالَ ‏‏ "‏‏ لاَ يَبُولَنَّ الرَّجُلُ فِي الْمَاءِ الدَّائِمِ ثُمَّ يَغْتَسِلُ مِنْهُ أَوْ يَتَوَضَّأُ ‏‏"‏‏ ‏‏.‏‏

It was narrated from Abu Hurairah that the Messenger of Allah (ﷺ) said:"None of you should urinate into standing water and then perform Ghusl or Wudu' with it

أَخْبَرَنَا أَبُو عَبْدِ الرَّحْمَنِ، أَحْمَدُ بْنُ شُعَيْبٍ قَالَ أَنْبَأَنَا عَمْرُو بْنُ عَلِيٍّ، قَالَ حَدَّثَنَا أَبُو عَاصِمٍ، قَالَ حَدَّثَنَا ابْنُ أَبِي ذِئْبٍ، قَالَ حَدَّثَنِي أَسِيدُ بْنُ أَبِي أَسِيدٍ، عَنْ مُعَاذِ بْنِ عَبْدِ اللَّهِ، عَنْ أَبِيهِ، قَالَ أَصَابَنَا طَشٌّ وَظُلْمَةٌ فَانْتَظَرْنَا رَسُولَ اللَّهِ صلى الله عليه وسلم لِيُصَلِّيَ بِنَا ثُمَّ ذَكَرَ كَلاَمًا مَعْنَاهُ فَخَرَجَ رَسُولُ اللَّهِ صلى الله عليه وسلم لِيُصَلِّيَ بِنَا فَقَالَ ‏"‏ قُلْ ‏"‏ ‏.‏ فَقُلْتُ مَا أَقُولُ قَالَ ‏"‏ ‏{‏ قُلْ هُوَ اللَّهُ أَحَدٌ ‏}‏ وَالْمُعَوِّذَتَيْنِ حِينَ تُمْسِي وَحِينَ تُصْبِحُ ثَلاَثًا يَكْفِيكَ كُلَّ شَىْءٍ ‏"‏ ‏.‏

It was narrated from Mu'adh bin 'Abdullah that his father said:"It was raining and dark, and we were waiting for the Messenger of Allah [SAW] to lead us in prayer. Then the Messenger of Allah [SAW] came out to lead us in prayer and he said: 'Say.' I said: 'What should I say?' He said: 'Say: He is Allah, (the) One and Al-Mu'awwadhatain in the evening and in the morning, three times, and that will suffice you against everything

أَخْبَرَنَا مُحَمَّدُ بْنُ عَلِيٍّ، قَالَ حَدَّثَنِي الْقَعْنَبِيُّ، عَنْ عَبْدِ الْعَزِيزِ، عَنْ عَبْدِ اللَّهِ بْنِ سُلَيْمَانَ، عَنْ مُعَاذِ بْنِ عَبْدِ اللَّهِ بْنِ خُبَيْبٍ، عَنْ أَبِيهِ، عَنْ عُقْبَةَ بْنِ عَامِرٍ الْجُهَنِيِّ، قَالَ بَيْنَا أَنَا أَقُودُ، بِرَسُولِ اللَّهِ صلى الله عليه وسلم رَاحِلَتَهُ فِي غَزْوَةٍ إِذْ قَالَ ‏"‏ يَا عُقْبَةُ قُلْ ‏"‏ ‏.‏ فَاسْتَمَعْتُ ثُمَّ قَالَ ‏"‏ يَا عُقْبَةُ قُلْ ‏"‏ ‏.‏ فَاسْتَمَعْتُ فَقَالَهَا الثَّالِثَةَ فَقُلْتُ مَا أَقُولُ فَقَالَ ‏"‏ ‏{‏ قُلْ هُوَ اللَّهُ أَحَدٌ ‏}‏ ‏"‏ ‏.‏ فَقَرَأَ السُّورَةَ حَتَّى خَتَمَهَا ثُمَّ قَرَأَ ‏{‏ قُلْ أَعُوذُ بِرَبِّ الْفَلَقِ ‏}‏ وَقَرَأْتُ مَعَهُ حَتَّى خَتَمَهَا ثُمَّ قَرَأَ ‏{‏ قُلْ أَعُوذُ بِرَبِّ النَّاسِ ‏}‏ فَقَرَأْتُ مَعَهُ حَتَّى خَتَمَهَا ثُمَّ قَالَ ‏"‏ مَا تَعَوَّذَ بِمِثْلِهِنَّ أَحَدٌ ‏"‏ ‏.‏

It was narrated that 'Uqbah bin 'Amir Al-Juhani said:"While I was leading the Messenger of Allah [SAW] on his mount on a military campaign, he said: 'O 'Uqbah, say!' I listened, then he said: 'O 'Uqbah, say!' I listened, then he said it a third time. I said: 'What should I say?' He said: 'Say: He is Allah, (the) One...' and he recited the Surah to the end. Then he recited: 'Say: I seek refuge with (Allah) the Lord of the daybreak...' and I recited it with him until the end. Then he recited: 'Say: I seek refuge with (Allah) the Lord of mankind...' and I recited it with him until the end. Then he said: 'No one ever sought refuge (with Allah) by means of anything like them

فإن كان يؤذيه ذلك فليرش عليه الماء حتى يقوى في نفسه ذلك ولا يتسلط عليه الشيطان بالوسواس

ولم يجدوا إلا الوسواس والكراهة له ولا يمكن أن يقال أراد بصريح الإيمان الوسوسة فلم يبق إلا حمله على الكراهة المساوقة للوسوسة والرياء وإن كان عظيما فهو دون الوسوسة في حق الله تعالى فإذا اندفع ضرر الأعظم بالكراهة فبأن يندفع بها ضرر الأصغر أولى وكذلك يروى عن النبي صلى الله عليه وسلم في حديث ابن عباس أنه قال الحمد لله الذي رد كيد الشيطان إلى الوسوسة + حديث ابن عباس الحمد لله الذي رد كيد الشيطان إلى الوسوسة أخرجه أبو داود والنسائي في اليوم والليلة بلفظ كيده

| بيان تسلط الشيطان على القلب بالوساوس ومعنى الوسوسة وسبب غلبتها

وكان بعضهم يخفف الصلاة خيفة الوسواس وروى أن عمار بن ياسر صلى صلاة فأخفها فقيل له خففت يا أبا اليقظان فقال هل رأيتموني نقصت من حدودها شيئا قالوا لا قال إني بادرت سهو الشيطان إن رسول الله صلى الله عليه وسلم قال إن العبد ليصلي الصلاة لا يكتب له نصفها ولا ثلثها ولا ربعها ولا خمسها ولا سدسها ولا عشرها وكان يقول إنما يكتب للعبد من صلاته ما عقل منها + حديث إن عمار بن ياسر صلى فأخفها فقيل له خففت يا أبا اليقظان الحديث @QB@ وفيه @QE@ إن العبد ليصلي صلاة لا يكتب له نصفها ولا ثلثها إلى آخره أخرجه أحمد بإسناد صحيح وتقدم المرفوع عنه وهو عند أبي داود والنسائي + ويقال إن طلحة والزبير وطائفة من الصحابة رضي الله عنهم كانوا أخف الناس صلاة وقالوا نبادر بها وسوسة الشيطان

وقد كره السلف بيع السيف في وقت الفتنة خيفة أن يشتريه ظالم فهذا ورع فوق الأول والكراهية فيه أخف ويليه ما هو مبالغة ويكاد يلتحق بالوسواس وهو قول جماعة أنه لا تجوز معاملة الفلاحين بآلات الحارث لأنهم يستعينون بها على الحراثة ويبيعون الطعام من الظلمة ولا يباع منهم البقر والفدان وآلات الحرث وهذا ورع الوسوسة إذ ينجر إلى أن لا يباع من الفلاح طعام لأنه يتقوى به على الحراثة ولا يسقي من الماء العام لذلك وينتهي هذا حد التنطع المنهي عنه وكل متوجه إلى شيء على قصد خير لا بد وأن يسرف إن لم يذمه العلم المحقق وربما يقدم على ما يكون بدعة في الدين ليستضر الناس بعده بها وهو يظن أنه مشغول بالخير ولهذا قال صلى الله عليه وسلم فضل العالم على العابد كفضلي على أدنى رجل من أصحابي +

وقالت فرقة الوسوسة والذكر يتساوقان في الدوام على القلب تساوقا لا ينقطع وكما أن الإنسان قد يرى بعينيه شيئين في حالة واحدة فكذلك القلب قد يكون مجرى لشيئين فقد قال صلى الله عليه وسلم ما من عبد إلا وله أربعة أعين عينان في رأسه يبصر بهما أمر دنياه وعينان في قلبه يبصر بهما أمر دينه + حديث ما من عبد إلا وله أربعة أعين عينان في رأسه يبصر بهما أمر دنياه وعينان في قلبه يبصر بهما أمر دينه أخرجه أبو منصور الديلمي في مسند الفردوس من حديث معاذ بلفظ الآخرة مكان دينه وفيه الحسين بن أحمد بن محمد الهروي السماخي الحافظ كذبه الحاكم والآفة منه وإلى هذا ذهب المحاسبي والصحيح عندنا أن كل هذه المذاهب صحيحة ولكن كلها قاصرة عن الإحاطة بأصناف الوسواس وإنما نظر كل واحد منهم إلى صنف واحد من الوسواس فأخبر عنه

Etiology of obsessions and compulsions: a meta-analysis and narrative review of twin studies.: The relative importance of genetic and environmental factors in the etiology of obsessive-compulsive (OC) symptoms is unclear. Cognitive-behavioral models propose that shared environment (e.g., parenting style) is important. Family segregation studies suggest that nonadditive genetic factors may be involved. To investigate the etiology of OC symptoms, a meta-analysis was conducted of 37 twin samples from 14 studies, supplemented by a narrative review. Results indicated that in terms of mean effe

Is cyberchondria a new transdiagnostic digital compulsive syndrome? A systematic review of the evidence.: Background: Cyberchondria (CYB) has been described relatively recently as a behaviour characterized by excessive online searching for medical information that is associated with increasing levels of health anxiety. Although CYB has received some attention from researchers, there is no consensus about many of its aspects. Aims: We describe one of the first reported cases of a treatment-seeking patient with CYB. We review the published literature on the definition of CYB, its assessment, epidemiol

Family and couple integrated cognitive-behavioural therapy for adults with OCD: A meta-analysis.: Background: Integrating family into the treatment of obsessive-compulsive disorder (OCD) is standard in pediatric populations; however, in adult populations, patients are typically treated independent of their family. Yet, there is compelling evidence to suggest that family members exacerbate OCD symptoms, and thus there is a strong rationale for integrating family members into the treatment of adult OCD. The present meta-analysis examined whether family treatment is effective for OCD in adult p

Effects of exercise on obsessive-compulsive disorder symptoms: a systematic review and meta-analysis.: Objective: This systematic review and meta-analysis assessed the efficacy of exercise in reducing OCD symptoms. Methods: We searched PubMed, Cochrane Central Register of Controlled Trials, MEDLINE, Scopus and grey literature until March 2022. The study was preregistered at Prospero (CRD42021283931). We included randomised controlled and pre-post trials assessing physical activity as an intervention for OCD. Risk of bias was assessed using the Cochrane ROBINS-I tool and the RoB2 tool. Results: Th

Associations between perfectionism and symptoms of anxiety, obsessive-compulsive disorder and depression in young people: a meta-analysis.: Perfectionism is a transdiagnostic process contributing to the onset and maintenance of anxiety, obsessive-compulsive disorder (OCD) and depression. The aim of this systematic review and meta-analysis was to examine the association between perfectionism, and symptoms of anxiety, OCD and depression among young people aged 6-24 years. A systematic literature search retrieved a total of 4,927 articles, with 121 studies included (Mpooled age = ~17.70 years). Perfectionistic concerns demonstrated sig

Distinct Subcortical Volume Alterations in Pediatric and Adult OCD: A Worldwide Meta- and Mega-Analysis.: Objective: Structural brain imaging studies in obsessive-compulsive disorder (OCD) have produced inconsistent findings. This may be partially due to limited statistical power from relatively small samples and clinical heterogeneity related to variation in illness profile and developmental stage. To address these limitations, the authors conducted meta- and mega-analyses of data from OCD sites worldwide. Method: T1 images from 1,830 OCD patients and 1,759 control subjects were analyzed, using coo

PDI-4A: an augmented provisional screening instrument assessing 5 additional common anxiety-related diagnoses in adult primary care patients.

Patients with nonpsychotic mental health and emotional problems are commonly seen by primary care physicians. The objective of this study was to expand the Provisional Diagnostic Instrument-4 (PDI-4) to include a short self-report screen for 5 common anxiety-related diagnoses: panic attack (PA), social phobia (SP), obsessive-compulsive disorder (OCD), hypochondriasis, and post-traumatic stress disorder (PTSD). Primary care patients (N = 343) were originally evaluated with a self-report screen comprised of 85 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition symptom-based candidate questions, then interviewed by a trained rater for Structured Clinical Interview Research Version (SCID)/Adult ADHD Clinician Diagnostic Scale version 1.2 (ACDS) assessment and diagnosis. Responses to screening questions were used to calculate sensitivity and specificity for an SCID diagnosi…

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The relationship between resilience and levels of anxiety, depression, and obsessive-compulsive symptoms in adolescents.

Objective: Mental health problems affect approximately 20% of adolescents. Traditionally, the principal focus has been on vulnerability and risk factors and less on protective factors. The study, therefore, explores the relation between frequent psychiatric symptoms and resilience factors among older adolescents. Method: The Resilience Scale for Adolescents (READ) was completed by 307 Norwegian high school students (M = 16.4 years) along with the Depression Anxiety Stress Scales, and the Obsessive-Compulsive Inventory-Revised. Results: Higher resilience scores predicted lower scores on levels of depression, anxiety, stress and obsessive-compulsive symptoms after controlling for age and gender. Conclusion: This study provides further evidence that it may be fruitful for clinicians and researchers to attend to resilience factors in relation to psychological symptoms among older adolescents…

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The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication.

Despite significant advances in the study of obsessive-compulsive disorder (OCD), important questions remain about the disorder's public health significance, appropriate diagnostic classification, and clinical heterogeneity. These issues were explored using data from the National Comorbidity Survey Replication, a nationally representative survey of US adults. A subsample of 2073 respondents was assessed for lifetime Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV) OCD. More than one quarter of respondents reported experiencing obsessions or compulsions at some time in their lives. While conditional probability of OCD was strongly associated with the number of obsessions and compulsions reported, only small proportions of respondents met full DSM-IV criteria for lifetime (2.3%) or 12-month (1.2%) OCD. OCD is associated with substantial comorbidity, not only with anx…

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Long-term follow-up of patients with obsessive-compulsive disorder treated by anterior capsulotomy: a neuropsychological study.

Background: For treatment-refractory Obsessive-Compulsive-Disorder (OCD) patients, anterior capsulotomy is a potential therapy. We investigated what kinds of cognitive deficits treatment-refractory patients have and how anterior capsulotomy modifies their clinical and cognitive profiles. Methods: Ten treatment-refractory OCD patients were examined in two groups (operated and non-operated) with 5 participants in each group, matched for symptom severity, gender, age and education. The operated group was treated with anterior capsulotomy; the non-operated group was treated only with pharmaco- and psychotherapy. The Yale-Brown Obsessive-Compulsive Rating Scale (Y-BOCS) was used to measure OCD symptoms, and ten neuropsychological tests were used to measure cognitive functioning. Results: In the operated group, the score of Y-BOCS score significantly decreased during the two-year follow-up per…

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Shame- and guilt-proneness: relationships with anxiety disorder symptoms in a clinical sample.

Researchers postulate that both shame and guilt are emotions important to anxiety disorders. Extant data, however, indicate that guilt-proneness shares non-significant relationships with psychopathology symptoms after controlling for shame-proneness. To further investigate the relevance of shame and guilt to the anxiety disorders domain, the current study examined associations between shame- and guilt-proneness and anxiety disorder symptoms using data from patients (N=124) with primary anxiety disorder diagnoses. Results indicated that only symptoms of social anxiety disorder (SAD) and generalized anxiety disorder (GAD) shared significant relations with shame-proneness after controlling for other types of anxiety disorder symptoms, depression symptoms, and guilt-proneness. Further, changes in shame-proneness during treatment were found to share significant relations with changes in obses…

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The generalized anxiety spectrum: prevalence, onset, course and outcome.

Background: Generalized anxiety disorder (GAD) is generally considered to be a chronic condition, waxing and waning in severity; however prospective investigation of the course of GAD in community samples is lacking. This study seeks to fill that gap, by identifying the whole spectrum of generalized anxiety syndromes, sub-typing them according to their duration and frequency of occurrence, and evaluating their long-term course and outcome in the community. Method: The prospective Zurich Study assessed psychiatric and somatic syndromes in a community sample of young adults (N = 591) (aged 20 years at first interview) by six interviews over a period of 20 years (1979-1999). GAD syndromes were defined by DSM-III symptom criteria without applying any exclusion criteria. A spectrum of generalized anxiety was defined by duration: 6 months (DSM-IV), 1 month (DSM-III), < or = 2 weeks (with weekl…

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The role of the brain-derived neurotrophic factor (BDNF) val66met variant in the phenotypic expression of obsessive-compulsive disorder (OCD).

Evidence suggests that the Val66Met variant of the brain-derived neurotrophic factor (BDNF) gene may play a role in the etiology of Obsessive-Compulsive Disorder (OCD). In this study, the role of the BDNF Val66Met variant in the etiology and the phenotypic expression of OCD is investigated. Associations between the BDNF Val66Met variant and OCD, obsessive-compulsive symptom dimensions, Yale-Brown Obsessive Compulsive Scale (YBOCS) severity scores, age of onset and family history of obsessive-compulsive symptoms were assessed. The BDNF Val66Met variant was genotyped in 419 patients with sub-/clinical OCD and 650 controls. No differences in allele or genotype frequency were observed between cases and controls. In females with OCD, the Met66Met genotype was associated with later age of onset and a trend for a negative family history, whereas the Val66Val genotype was associated with a trend…

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Obsessive-compulsive disorder.

Obsessive-compulsive disorder is a severe and disabling clinical condition that usually arises in late adolescence or early adulthood and, if left untreated, has a chronic course. Whether this disorder should be classified as an anxiety disorder or in a group of putative obsessive-compulsive-related disorders is still a matter of debate. Biological models of obsessive-compulsive disorder propose anomalies in the serotonin pathway and dysfunctional circuits in the orbito-striatal area and dorsolateral prefrontal cortex. Support for these models is mixed and they do not account for the symptomatic heterogeneity of the disorder. The cognitive-behavioural model of obsessive-compulsive disorder, which has some empirical support but does not fully explain the disorder, emphasises the importance of dysfunctional beliefs in individuals affected. Both biological and cognitive models have led to e…

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Using computerized adaptive testing to reduce the burden of mental health assessment.

Objective: This study investigated the combination of item response theory and computerized adaptive testing (CAT) for psychiatric measurement as a means of reducing the burden of research and clinical assessments. Methods: Data were from 800 participants in outpatient treatment for a mood or anxiety disorder; they completed 616 items of the 626-item Mood and Anxiety Spectrum Scales (MASS) at two times. The first administration was used to design and evaluate a CAT version of the MASS by using post hoc simulation. The second confirmed the functioning of CAT in live testing. Results: Tests of competing models based on item response theory supported the scale's bifactor structure, consisting of a primary dimension and four group factors (mood, panic-agoraphobia, obsessive-compulsive, and social phobia). Both simulated and live CAT showed a 95% average reduction (585 items) in items adminis…

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Perfectionism in depression, obsessive-compulsive disorder and eating disorders.

High levels of perfectionism have been observed in major depression, anxiety disorders and eating disorders. Though few studies have compared levels of perfectionism across these disorders, there is reason to believe that different dimensions of perfectionism may be involved in eating disorders than in depression or anxiety [Bardone-Cone, A. M. et al. (2007). Perfectionism and eating disorders: Current status and future directions. Clinical Psychology Review, 27, 84-405]. The present study compared patients with major depression, obsessive-compulsive disorder, and eating disorders on dimensions of perfectionism. Concern over Mistakes was elevated in each of the patient groups while Pure Personal Standards was only elevated in the eating disorder sample. Doubts about Actions was elevated in both patients with obsessive-compulsive disorder and eating disorders, but not in depressed patient…

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The evolution of deep brain stimulation for neuropsychiatric disorders.

Deep brain stimulation (DBS) is the most focal method for stimulating the human brain. In contrast to lesions, DBS is nonablative, with the advantages of reversibility and adjustability. Thus, therapeutic effectiveness can be enhanced and stimulation-related side effects minimized during long-term patient management. While DBS is an approved adjunct therapy for severe, medication-refractory movement disorders, it remains investigational in neuropsychiatry. However, experience to date, though limited, suggests that DBS may offer a degree of hope to patients with severe and treatment-resistant neuropsychiatric illness. Thus far, work in obsessive-compulsive disorder (OCD), the first psychiatric condition studied using modern DBS devices, has shown consistently positive results across multiple small-scale studies. Work in treatment-resistant Major Depressive Disorder (MDD) also suggests the…

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A pilot study of vagus nerve stimulation (VNS) for treatment-resistant anxiety disorders.

Background: Vagus nerve stimulation (VNS) is an effective anticonvulsant device and has shown antidepressant effects in chronic treatment resistant depression. Because the vagus nerve sends information to brain regions important in anxiety regulation (locus coeruleus, orbitofrontal cortex, insula, hippocampus and amygdala), this pathway might be involved in perceiving or manifesting various somatic and cognitive symptoms that characterize anxiety disorders. On the basis of this reasoning and reports of anxiolytic effects of VNS in patients treated for epilepsy and depression, we organized an open-label pilot acute trial of adjunctive VNS on top of stable medications, followed by long-term follow-up, to assess the safety and potential efficacy of VNS for patients with treatment resistant anxiety disorders. Methods: Eleven adult outpatients with treatment resistant obsessive-compulsive dis…

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Symptom overlap between autism spectrum disorder, generalized social anxiety disorder and obsessive-compulsive disorder in adults: a preliminary case-controlled study.

Background: Obsessive-compulsive disorder (OCD) and social anxiety disorder (SAD) frequently co-occur in persons with autism spectrum disorder (ASD). We studied which features distinguish 'pure' anxiety disordered patients from those with co-morbid ASD. Method: In a case-controlled design in which groups were matched for age, sex and educational level, patients with OCD or SAD and co-morbid ASD were compared with patients with 'pure' (i.e. without ASD) OCD, with 'pure' SAD and a control group, using the Autism Questionnaire (AQ), Yale-Brown Obsessive-Compulsive Scales, Liebowitz Social Anxiety Scale, Beck Anxiety Inventory and questions on egodystonia of OC behaviors. Results: No between patient group differences were found on social or general anxiety measures. The AQ subscales communication problems and lack of imagination discriminated best between patients with comorbid ASD and the o…

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Four-factor structure of obsessive-compulsive disorder symptoms in children, adolescents, and adults.

Objective: To determine whether the four-factor category-based obsessive-compulsive disorder (OCD) symptom structure from a previous confirmatory factor analysis (CFA) may be appropriately used in child, adolescent, and adult groups. Symptom dimensions are increasingly used as quantitative traits in genetic, neuroimaging, and treatment studies of OCD across all ages. Identification of a category-based OCD symptom dimension structure that is validated for use across child, adolescent, and adult age groups is necessary to guide ongoing translational research. Method: Four OCD samples comprising 356 individuals were divided into child, adolescent, and adult groups. The fit of the only CFA-defined four-factor model was compared across these independent age group samples. Multiple-group CFA using maximum likelihood estimation assessed adequacy of fit comparing unconstrained and measurement we…

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Influences of hormone-based contraception on depressive symptoms in premenopausal women with major depression.

Objective: Hormone-based contraceptives affect mood in healthy women or in women with premenstrual dysphoric disorder (PMDD). No study has yet examined their association with mood in women with major depressive disorder (MDD). The purpose of this study was to determine whether estrogen-progestin combination or progestin-only contraceptives are associated with depression severity, function and quality of life, or general medical or psychiatric comorbidity in women with MDD. Methods: This analysis focused on a large population of female outpatients less than 40 years of age with non-psychotic MDD who were treated in 18 primary and 23 psychiatric care settings across the US, using data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Baseline demographic and clinical information was gathered and compared between three groups based on hormonal use: combination …

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Principal components analysis of obsessive-compulsive disorder symptoms in children and adolescents.

Background: Obsessive-compulsive disorder (OCD) has a broadly diverse clinical expression that may reflect etiologic heterogeneity. Several adult studies have identified consistent symptom dimensions of OCD. The purpose of this study was to conduct an exploratory principal components analysis of obsessive-compulsive (OC) symptoms in children and adolescents with OCD to identify improved phenotypes for future studies. Methods: This study examined lifetime occurrence of OC symptoms included in the 13 symptom categories of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Principal components analysis with promax rotation was performed on 231 children and adolescents with OCD and compared with results of similar adult studies. Results: A four-factor solution emerged explaining 59.8% of symptom variance characterized by 1) …

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Shared executive dysfunctions in unaffected relatives of patients with autism and obsessive-compulsive disorder.

Background: Executive dysfunctions have been studied as a potential endophenotype associated with the genetic basis of autism. Given that recent findings from clinical and molecular genetic studies suggest that autism and obsessive-compulsive disorder (OCD) could share a common pattern of heritability, we assessed executive functions as a possible common cognitive endophenotype in unaffected family members of individuals with either autism or OCD. Methods: Five tests assessing executive functions (Tower of London, verbal fluency, design fluency, trail making and association fluency) were proposed to 58 unaffected first-degree relatives (parents and siblings) of probands with autism and 64 unaffected first-degree relatives of OCD patients. Results were compared with those of 47 healthy controls matched for age, sex, and level of education. Results: In the Tower of London test, both groups…

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Obsessive-compulsive disorder: prevalence, comorbidity, impact, and help-seeking in the British National Psychiatric Morbidity Survey of 2000.

Objective: There is little information about obsessive-compulsive disorder in large representative community samples. The authors aimed to establish obsessive-compulsive disorder prevalence and its clinical typology among adults in private households in Great Britain and to obtain generalizable estimates of impairment and help-seeking. Method: Data from the British National Psychiatric Morbidity Survey of 2000, comprising 8,580 individuals, were analyzed using appropriate measurements. The study compared individuals with obsessive-compulsive disorder, individuals with other neurotic disorders, and a non-neurotic comparison group. ICD-10 diagnoses were derived from the Clinical Interview Schedule-Revised. Results: The authors identified 114 individuals (74 women, 40 men) with obsessive-compulsive disorder, with a weighted 1-month prevalence of 1.1%. Most individuals (55%) in the obsessive…

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Female hormones affect symptom severity in obsessive-compulsive disorder.

There is circumstantial evidence that reproductive events can influence symptom severity of obsessive-compulsive disorder (OCD). We sent self-report questionnaires to 350 female outpatients with OCD to examine the relationship between the menstrual cycle, pregnancy, menopause, hormonal contraceptives, selective serotonin reuptake inhibitors and symptom severity of OCD. Yale-Brown Obsessive-Compulsive Scale scores were used at three serial time points during the menstrual cycle to assess symptom severity. One hundred and one out of 350 questionnaires (29%) were returned and completed. Forty-nine patients reported an exacerbation of OCD symptoms during the premenstrual period, nine during the menopause and 17 patients during pregnancy, whereas 11 patients mentioned improvement of OCD symptoms during pregnancy. Premenstrual dysphoric disorder could only partly explain a premenstrual exacerb…

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Increasing willingness to experience obsessions: acceptance and commitment therapy as a treatment for obsessive-compulsive disorder.

This study evaluated the effectiveness of an 8-session Acceptance and Commitment Therapy for OCD intervention in a nonconcurrent multiple-baseline, across-participants design. Results on self-reported compulsions showed that the intervention produced clinically significant reductions in compulsions by the end of treatment for all participants, with results maintained at 3-month follow-up. Self-monitoring was supported with similar decreases in scores on standardized measures of OCD. Positive changes in anxiety and depression were found for all participants as well as expected process changes in the form of decreased experiential avoidance, believability of obsessions, and need to respond to obsessions. All participants found the treatment to be highly acceptable. Implications and future directions are discussed.

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Examining the links between spiritual struggles and symptoms of psychopathology in a national sample.

The present study investigated the relationship between spiritual struggles and various types of psychopathology symptoms in individuals who had and had not suffered from a recent illness. Participants completed self-report measures of religious variables and symptoms of psychopathology. Spiritual struggles were assessed by a measure of negative religious coping. As predicted, negative religious coping was significantly linked to various forms of psychopathology, including anxiety, phobic anxiety, depression, paranoid ideation, obsessive-compulsiveness, and somatization, after controlling for demographic and religious variables. In addition, the relationship between negative religious coping and anxiety and phobic anxiety was stronger for individuals who had experienced a recent illness. These results have implications for assessments and interventions targeting spiritual struggles, espe…

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Obsessive-compulsive disorder symptom dimensions show specific relationships to psychiatric comorbidity.

The goals of this study were to examine relationships among symptom categories in obsessive-compulsive disorder (OCD), to establish OCD symptom dimensions by factor- and cluster-analytic analyses, and to explore associations between OCD symptom dimensions and comorbid neuropsychiatric conditions. A total of 317 OCD participants underwent a systematic diagnostic interview using the Structured Clinical Interview for DSM-IV. OCD symptoms assessed by the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist (N=169) and by the Thoughts and Behaviors Inventory (N=275) were subjected to factor and cluster analyses. An identical four-factor solution emerged in two different data sets from overlapping samples, in agreement with most smaller factor-analytic studies employing the YBOCS checklist alone. The cluster analysis confirmed the four-factor solution and provided additional information on …

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Cluster analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive disorder: clinical and genetic correlates.

Background: Comorbidity of certain obsessive-compulsive spectrum disorders (OCSDs; such as Tourette's disorder) in obsessive-compulsive disorder (OCD) may serve to define important OCD subtypes characterized by differing phenomenology and neurobiological mechanisms. Comorbidity of the putative OCSDs in OCD has, however, not often been systematically investigated. Methods: The Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , Axis I Disorders-Patient Version as well as a Structured Clinical Interview for Putative OCSDs (SCID-OCSD) were administered to 210 adult patients with OCD (N = 210, 102 men and 108 women; mean age, 35.7 +/- 13.3). A subset of Caucasian subjects (with OCD, n = 171; control subjects, n = 168), including subjects from the genetically homogeneous Afrikaner population (with OCD, n = 77; control subjects, n = 144), w…

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Pastoral theory and practice in the team approach to treatment of scrupulosity as a component of obsessive compulsive disorder.

The statistical estimates of the prevalence of Obsessive Compulsive Disorder (OCD) in the general population have increased dramatically in recent years. "Blasphemous" obsessions and religious compulsions dominate the clinical picture of many sufferers of OCD. Freud proposed that religion might be a contributing factor for many patients with mental illness. He hedged, however, that observation--something that many of his followers have not done. Others have noted the pathoplasticity of strict religious upbringing and images of God as vindictive or otherwise harsh. Only recently--since the 1970s--has much clinical attention been focused on this disorder by the other disciplines within the mental health community. The church, however, is ahead of the curve in diagnosis and treatment of scrupulosity. It has long been a concern for pastoral counselors--particularly pre-Vatican II Roman Catho…

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A roadmap to rumination: a review of the definition, assessment, and conceptualization of this multifaceted construct.

Rumination has been widely studied and is a crucial component in the study of cognitive vulnerabilities to depression. However, rumination means different things in the context of different theories, and has not been uniformly defined or measured. This article aims to review models of rumination, as well as the various ways in which it is assessed. The models are compared and contrasted with respect to several important dimensions of rumination. Guidelines to consider in the selection of a model and measure of rumination are presented, and suggestions for the conceptualization of rumination are offered. In addition, rumination's relation to other similar constructs is evaluated. Finally, future directions for the study of ruminative phenomena are presented. It is hoped that this article will be a useful guide to those interested in studying the multi-faceted construct of rumination.

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