Dissertationen zum Thema „Compulsive behavior“

This study was designed to explore the nature of compulsive buying behavior with respect to self esteem and money attitude variables. Conjointly, a newly developed screening device, the Compulsive Buying Scale, was used to test its ability to discern compulsive buying tendencies amongst consumers. Comparison was made with participating members of intact compulsive buying help groups and "normal" consumers. Compulsive buyers were found to significantly differ from normal consumers on variables tested. Compulsive buyers were found to have lower self esteem with money attitudes reflecting obsession with money and its perceived power and prestige. Likewise, compulsive buyers differed significantly on the Compulsive Buying Scale adding support to the validity of the scale.

95 leaves.
The area of shame, in psychology, has become increasingly popular in recent years. Despite a great richness of theoretical literature, there is, unfortunately, a dearth of actual research on shame. This study has sought to empirically investigate the relationship between shame and three compulsive behaviours, namely, alcohol dependence, drug dependence and disordered eating. Relations between shame and alcohol dependence, and shame and drug dependence have already been established in the research literature. This study sought to validate these relationships and to extend the research in the area to establish a link between shame and disordered eating. Cook's Internalised Shame Scale was used to assimilate shame, whilst Millon's Clinical Multiaxial Inventory was used to assess drug and alcohol dependence. Disordered eating was assessed by using the Eating Attitudes Test. Pearson's Product Moment Correlations were computed, and regression analyses were conducted, it was found that shame was significantly correlated with alcohol dependence, drug dependence and disordered eating, and that shame predicted 33% of the variation in alcohol dependent behaviour, 36% of the variation in drug dependent behaviour, and 30% of the variation in disordered eating. Within the methodology used it was not possible to establish causality. However, it was possible to contextualise these results within the literature, and suggest possible explanations. From within the literature on shame it was suggested that shame is linked to alcohol abuse and drug abuse as well as to disordered eating, and that the relationship is one of circular causality. Shame is consequent on these behaviours but these behaviours also attempt to reduce shame and are intended to be self soothing, and containing of the uncomfortable feelings attached to an inadequate sense of self. Limitations of the study, and suggestions for future research were examined.
AM2016

Thesis (Ph.D.)--George Mason University, 2009.
Vita: p. 154. Thesis director: Laurence R. Iannaccone. Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Economics. Title from PDF t.p. (viewed June 10, 2009). Includes bibliographical references (p. 144-153). Also issued in print.

The purpose of the present study was to compare the scores of the Beck Depression Inventory, State-Trait Anxiety Inventory, and the Coopersmith Inventory of heterosexual men with compulsive sexual behavior (N = 22), homosexual men with compulsive sexual behavior (N = 19), heterosexual men without compulsive sexual behavior (N = 38), and homosexual men without compulsive sexual behavior (N = 8). The Sex Addiction Screening Test was used to determined placement in a group. Findings revealed men who exhibit compulsive sexual behavior are significantly more depressed, experience lower self-esteem and have higher state anxiety (situational) than controls.

The problem examined in this study was the nature of compulsive purchasing behavior. Three proposed models depicting this behavior as a learned adaptive response to anxiety and/or depression, an addiction, and a personality disorder were introduced and discussed in Chapter I. Background information concerning the areas examined in the models was presented in Chapter II. The research methodology was discussed in Chapter III and the findings of the research presented in Chapter IV. A summary, conclusions, implications, and recommendations were presented in Chapter V.

Dimensional theoretical models suggest that gambling disorder and eating disorders have two essential shared risk factors: impulsivity and compulsivity. In order to delve into the association between these factors, the main objectives of this thesis were: To study the interaction between different types of impulsivity in gambling and eating disorders. To evaluate the association between impulsivity and DSM-5 criteria used for the diagnosis of gambling disorder, the criterion of illegal acts and the three levels of severity of the disorder. To examine dimensions of compulsivity and the interaction between them and impulsivity levels in the specific case of the gambling disorder. The following conclusions can be drawn: 1) Clinical heterogeneity has been observed, especially taking into account impulsivity levels, between patients with anorexia nervosa of the restrictive subtype and anorexia nervosa of the binge eating/purge subtype. Therefore, the importance of separating the two subtypes of anorexia nervosa is confirmed. 2) Impulsivity and compulsivity can be considered two independent domains in gambling disorder, supporting the dimensional perspective of the impulsive-compulsive spectrum. 3) The multifactorial nature of both domains has been tested. 4) Impulsivity and compulsivity do not contribute to gambling disorder equitably, and impulsivity is more strongly associated with the disorder. 5) All dimensions of impulsivity seem to be interrelated. 6) An association between choice and trait impulsivity has been observed in young patients, corroborating that age is a key factor. 7) Response impulsivity is not significantly associated with the severity of gambling disorder. 8) There is a proven association between impulsivity, gambling disorder, and the commission of criminal acts related to gambling behavior. 9) Impulsive traits may be related to response to treatment for gambling disorder. 10) It was not possible to demonstrate that greater severity was associated with better treatment response, which would question the clinical applicability of DSM-5 criteria.
Los modelos teóricos dimensionales sugieren que el trastorno del juego y los trastornos de la conducta alimentaria tienen dos factores de riesgo compartidos esenciales: impulsividad y compulsividad. Para ahondar en la asociación entre estos factores, los principales objetivos de esta tesis fueron: Estudiar la interacción entre los diferentes tipos de impulsividad en el trastorno de juego y los trastornos de la conducta alimentaria. Evaluar la asociación entre la impulsividad y los criterios del DSM-5 utilizados para el diagnóstico del trastorno del juego, específicamente el criterio de actos ilegales y los tres niveles de gravedad del trastorno. Examinar las dimensiones de la compulsividad y la interacción entre ellas y los niveles de impulsividad en el caso específico del trastorno del juego. Se concluyó: 1) Se ha observado heterogeneidad clínica, especialmente teniendo en cuenta los niveles de impulsividad, entre pacientes con anorexia nerviosa del subtipo restrictivo y anorexia nerviosa del subtipo bulímico-purgativo. Por lo tanto, se confirma la importancia de separar los dos subtipos de anorexia nerviosa. 2) La impulsividad y la compulsividad pueden considerarse dos dominios independientes en el trastorno del juego, apoyando la perspectiva dimensional del espectro impulsivo compulsivo. 3) Se ha comprobado el carácter multifactorial de ambos constructos. 4) La impulsividad y la compulsividad no contribuyen al trastorno del juego de manera equitativa, siendo la impulsividad la más fuertemente asociada al trastorno. 5) Todas las dimensiones de la impulsividad parecen estar interrelacionadas. 6) Se ha observado una asociación entre la impulsividad de elección y la impulsividad rasgo en pacientes jóvenes, corroborando que la edad es un factor esencial. 7) La impulsividad de respuesta no está asociada significativamente con la gravedad del trastorno del juego. 8) Existe una asociación entre la impulsividad, el trastorno del juego y la comisión de delitos relacionados con la conducta de juego. 9) Los rasgos impulsivos están relacionados con la respuesta al tratamiento para el trastorno de juego. 10) No fue posible demostrar que una mayor gravedad estaba asociada con una mejor respuesta al tratamiento, lo que cuestionaría la aplicabilidad clínica de los criterios del DSM-5.

Obsessive-Compulsive Disorder (OCD) is characterised by intrusions into conscious thinking by repetitive, personally abhorrent, absurd and alien thoughts (obsessions) which lead to endless repetitive acts or rehearsal of irrational and sometimes bizarre mental and behavioural rituals (compulsions). Although a number of clinical constructs have been proposed to have a causal influence on OC symptoms, extremely little research exists examining how these constructs are related to each other and, further, how the relationships between these constructs influences each constructs relationship with OC symptoms (e.g. does a given construct have an independent role in influencing OC symptoms or is the constructs influence on OC symptoms being mediated by its influence on another intervening construct or constructs?). In the current thesis, the relationships between 5 clinical constructs were examined, as well as how the pattern of these relationships may affect each constructs influence on OC symptoms. A large questionnaire study suggested that the five constructs are best seen as separate constructs rather than indicators of one underlying construct. Separate experimental studies in which all 5 constructs were manipulated individually suggest that whilst inflated responsibility, intolerance of uncertainty and negative mood, respectively, all causally influence every other construct focused on in this thesis, not just right experiences and as many as can stop rules, respectively, do not casually influence any other construct. Subsequent regression analyses suggest that whilst some constructs directly influence OC symptoms, other constructs influence on OC symptoms are mediated by intervening constructs in the final model, whilst some constructs have little to no influence on OC symptoms when the influence of other constructs in the final model are taken into account. Implications of these findings for existing models of OCD, for studies examining the relationship between multiple constructs and OC symptoms and for the treatment of OCD are discussed.

There is growing research evidence and public concern over the burgeoning of disorders which share common features with substance addictions. In order to investigate the presence and role of addiction features in disorders outside of substance addictions, symptoms of addiction were explored within three addiction groups: alcohol dependence (AD), an established addiction (n = 24); pathological gambling (PG) a disorder with growing empirical support as an addiction (n = 20); and compulsive shopping (CS), a proposed 'novel' addiction(n = 20). Participants were recruited from either the general population, or from the Auckland Salvation Army Bridge residential alcohol and drug treatment programme; Salvation Army Oasis Gambling Service; Pacific Peoples Addiction Service Incorporated; or Te Kahui Hauora O Ngati Koata Trust. Participants completed a battery of self-report measures comprising a demographics questionnaire; Addictive Disorder Questionnaire (ADQ); anxiety and depression subscales of the Symptom Checklist 90 Revised (SCL-90R); Barratt Impulsivity Scale II-r; and substance specific adaptations of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). Three general categories of addiction symptoms: physiological, salience and dyscontrol, were identified as broad aspects of addiction, common across all three groups. Measurable aspects of addiction, including impulsivity, obsessions, anxiety and depression were found to be endorsed similarly across the three addictions, irrespective of the severity of their addiction. Compulsions were found to be higher in the AD group. Higher anxiety was found to be correlated with higher addiction in the behavioural addictions (CS and PG), whereas depression and anxiety were associated with higher addiction severity in the AD group. The results provide support for broadening addiction diagnostic definitions, to be more encompassing of the psychological and physiological experiences of each symptom; and developing different diagnostic categories for non-substance addictions that reflect the severity of the addiction. Results also provide evidence for developmental phases of addiction, from an early 'hedonistic' impulsive phase, to a compulsive phase, in which increased dyscontrol, mood and anxiety, marks the severity of the addiction.

The purpose of this study was twofold: (1) to determine the relationships between social media, fashion interest and fast fashion involvement and whether these psychographic variables affect propensity for compulsive clothing buying and (2) to determine whether a relationship exists between compulsive buying and propensity toward hoarding. Data was collected through consumer panel from Qualtrix. Screener questions ensured that all respondents were adult females with an interest in fashion. Responses yielded 232 usable surveys, which were analyzed using SPSS software. Social media was found to be positively related to fashion interest, fast fashion involvement, and compulsive clothing buying. Compulsive clothing buying was found to be positively related to all three compulsive clothes hoarding symptoms: clothing clutter disorganization, clothing acquisition, and difficulty discarding clothing.

The pivotal role of inflated responsibility beliefs in the maintenance and treatment of obsessive-compulsive disorder (OCD) has been clearly demonstrated (Rachman, 1993; Salkovskis, 1998; Shafran, 1997; van Oppen & Arntz, 1994). Yet little is known about the origins of these beliefs, their contribution to a sense of inflated responsibility or the symptoms of OCD, or the contribution of personality to inflated responsibility and to OCD, The aims of this thesis were to investigate a model of the inter-relationships among the personality dimensions of neuroticism and psychoticism, inflated responsibility and OCD, and the origins of inflated responsibility to inflated responsibility and to OCD. In order to achieve these aims, a scale was developed to assess the origins of inflated responsibility based upon the five pathways proposed by Salkovskis, Shafran, Rachman, and Freeston (1999) and the additional domains of guilt, vigilance and thought-action fusion (Shafran, Thordarson, & Rachman, 1996; Shafran, Watkins & Charman, 1996; Tallis, 1994). Eighty-four participants with OCD (age M = 43.36) and 74 control participants (age M =37.14) volunteered to participate in the two studies of this thesis. The aim of Study 1 was to develop and validate a measure of the Origins of Inflated Responsibility (OIR). The results of the first study yielded a 25-ttem scale, the Origins of Inflated Responsibility Questionnaire (OIRQ) with five independent factors: responsibility, strictness, protection from responsibility, critical incidents, and peer blame which demonstrated both internal reliability and temporal stability over a 2-week period. In Study 2, participants also completed the Responsibility Attitudes Scale (Salkovskis, Wroe, Gledhill, Morrison, Forrester, Richards, ct al. (2000) (a measure of inflated responsibility), the Padua Inventory (Sanavio, 1988) (to measure of the symptoms of OCD)y and the Eysenck Personality Inventory-Revised (Eysenck & Eysenck, 1991). Multivariatc Analysis of Variance revealed that the OCD group scored higher on all variables than the control group except for strictness where the groups were not different, and psychoticism where the OCD group scored lower. A series of Multiple Regression analyses revealed that both group and the OIR contributed to inflated responsibility (R2 = .56). When all variables, OIR, inflated responsibility and neuroticism were entered as predictors of OCD, 60% of the variance in OCD was explained however, 49% of the variance was shared by the independent variables suggesting the presence of some underlying construct. Structural Equation Modelling, where all the constructs in the model were examined simultaneously, revealed that neuroticism contributed to the OIR, inflated responsibility and OCD. The OIR were also significant predictors of inflated responsibility and indirectly through inflated responsibility predictive of OCD. The OIR also directly predicted OCD and when the total effects are considered, their contribution was greater than the total effect for inflated responsibility alone. The results of these studies provide good support for the origins of inflated responsibility proposed by Salkovskis et al. (1999), as measured by the OIRQ developed for use in the current thesis. The results also support the contribution of inflated responsibility and neuroticism, as well as the OIR, to OCD, The large amount of variance shared by the OIR, inflated responsibility and neuroticism suggest that there might be some underlying construct, perhaps of a biopsychosocial nature, that requires further investigation for its role in the onset and maintenance of OCD. The clinical relevance of these findings is discussed in terms of early prevention strategies and interventions.

An individual who had been diagnosed with Obsessive Compulsive Disorder (OCD) and Schizoaffective Disorder requested assistance with improving his ability to manage symptoms. He had a history of long-term hospitalizations that impacted his placements in residential facilities. He was treated using exposure and response prevention procedures applied to specific rituals pertaining to compulsive bed making, organization, excessive emptying of vacuum canister, excessive hand washing and excessive laundering of clothing. A baseline was established for each ritual by the experimenter exposing the subject to the conditions that "triggered" the rituals. The latency was measured between the presentation of those conditions and the onset of the ritual. During treatment, the subject initiated the same conditions and then refrained from engaging in his rituals for a specific amount of time. Initially, the requested time was the average amount of time he was able to refrain from ritualizing in the baseline sessions. Then, the subject initiated exposure and refrained from the ritual for an increasing amount of time until he was able to refrain for 15 minutes or longer for three ritualistic behaviors. A multiple baseline analysis across rituals indicated that during the course of treatment, over a period of about 4 months, his ability to tolerate the triggers for his rituals was increased to the point that he did not engage in the rituals during the sessions.

El trastorn obsessivocompulsiu (TOC) es caracteritza per la presència de pensaments, imatges o impulsos intrusos i egodistònics que provoquen ansietat (obsessions) i que generalment porten a la realització de conductes repetitives amb l'objectiu de disminuir-la (compulsions). Estudis clínics han demostrat que el TOC no és un trastorn homogeni. S'han descrit diferències significatives en característiques clíniques del trastorn, com el contingut de les obsessions i les compulsions, la comorbilitat o la resposta al tractament, que han donat lloc a que diversos autors suggereixin diferents classificacions per al trastorn. L'etiologia del TOC, que encaixa en el model etiopatològic d'interacció gen-ambient acceptat per a la majoria de trastorns psiquiàtrics, inclou l'alteració dels circuits cerebrals corticoestriatals com a substrat neurobiològic més acceptat. De tota manera, encara que els estudis de neuroimatge han descrit de forma consistent alteracions a nivell estructural i funcional en els pacients amb TOC, els treballs que han intentat descriure les alteracions sotjacents als diferents subtipus clínics suggerits han reportat resultats poc consistents. En aquesta tesi, s'intenta aprofundir en el coneixement de la neurobiologia del TOC i descriure possibles característiques de neuroimatge estructural i funcional comuns a subgrups de pacients que s'han descrit homogenis a nivell clínic. D'aquesta manera, aquestes alteracions podrien constituir possibles marcadors de neuroimatge per aquests subgrups. Amb aquest objectiu, s'han portat a terme quatre treballs. En els tres primers, s'ha realitzat una anàlisi de ressonància magnètica (RM) estructural de les alteracions en el volum regional de substància grisa cerebral (SG) associada a tres propostes de classificació dels pacients, definides prèviament a nivell clínic. Així, s'ha comparat la distribució regional de SG entre els pacients amb obsessions autògenes i reactives, d'acord al model proposat per Lee & Kwon, entre aquells pacients que presenten o no fenòmens sensorials com a part de la seva simptomatologia obsessivocompulsiva i entre els pacients que refereixen algun factor vital estressant associat a l'inici del trastorn i aquells que no. Per altra banda, en el quart treball, ens hem proposat aprofundir en els correlats neurals sotjacents al model clínic multidimensional del TOC, el més estès tant a nivell clínic com d'investigació, mitjançant un estudi de la connectivitat funcional corticoestriatal durant un paradigma de provocació de símptomes. En resum, els resultats obtinguts permeten concloure que la classificació dels pacients en funció de les característiques de les seves obsessions (en autògenes i reactives), la presència de fenòmens sensorials precedint o acompanyant les compulsions, o la presència o absència d'algun antecedent vital estressant previ a l'inici del trastorn, s'associa a diferències específiques en la distribució regional de SG analitzada mitjançant RM estructural, involucrant sobretot estructures de tipus sensorimotor. Així mateix, l'expressió clínica del TOC estaria mediada per alteracions específiques en la connectivitat corticoestriatal, i alhora modulada, amb un grau d'especificitat variable, per la inducció de símptomes obsessivocompulsius. Així doncs, els resultat obtinguts reforcen la idea de que l'heterogeneïtat clínica observada en la pràctica diària podria tenir una traducció a nivell neural. Aquest accent en el caràcter biològic de la variabilitat fenotípica del TOC enllaça amb algunes perspectives a curt i mitjà termini. Per exemple, el plantejament d'estudis longitudinals, l'avaluació de diferents escenaris d'estrès sobre el desenvolupament de la simptomatologia obsessivocompulsiva, la caracterització àmplia dels pacients a nivell clínic però també cognitiu i neuropsicològic mitjançant protocols el més homogenis possibles entre grups de recerca, així com el coneixement de les estructures i circuits cerebrals implicats en manifestacions clíniques concretes ens haurien de permetre aconseguir una major personalització dels abordatges terapèutics. Alhora, es podria plantejar, en possibles assaigs clínics futurs, l'actuació sobre aquestes determinades regions o circuits cerebrals a través de teràpies físiques poc invasives com l'estimulació cerebral profunda, l'estimulació magnètica transcranial, l'estimulació per corrent elèctrica directa transcranial, o bé tècniques com la neuroretroalimentació en temps real mitjançant RM funcional.
Obsessive compulsive disorder (OCD) is characterized by the presence of intrusive, egodystonic and anxiogenic thoughts or images (obsessions) and/or ritualized behaviors or mental acts (compulsions), performed to relieve such anxiety. Clinical studies have described a high heterogeneity for the disorder in terms of the content of the obsessions and compulsions, comorbidity or treatment response. Based on such variability, several authors have suggested different classifications for OCD. Although neuroimaging studies have consistently reported structural and functional brain alterations in OCD patients, mostly involving cortico-striatal regions and circuits, attempts to describe neural alterations associated to the OCD subgroups already described at a clinical level, have reported less consistent results. In this doctoral thesis, we aim to describe common structural and functional neuroimaging characteristics in clinically homogeneous subgroups. In this way, these alterations could be considered as neuroimaging biomarkers for such subgroups. With this objective, we developed four studies. In three, structural magnetic resonance analyses were performed to assess regional brain gray matter (GM) volume alterations associated with three different clinical classifications for the disorder. We compared the regional GM distribution between OCD-patient subgroups according to the presence of autogenous or reactive obsessions, sensory phenomena symptoms preceding or accompanying compulsions and stressful life events at the disorder's onset. On the other hand, in the fourth study, we tried to assess the neural correlates of the clinical multidimensional model of OCD, the most extensively used model at a clinical and research levels, via a functional connectivity study during a symptom provoking paradigm. In sum, our results suggest that the classification of the patients based on the content of their obsessions, the presence of sensory phenomena or the presence of any stressful life events as a trigger of the disorder are associated with specific differences in the GM distribution, mostly involving sensorimotor structures. Moreover, OCD clinical expression may be mediated by specific alterations in cortico-striatal connectivity, that in turn could be modulated, with a variable degree of specificity, by the induction of OCD symptoms.

The most common method of diagnosing Obsessive-Compulsive Disorder is the Yale-Brown Obsessive Compulsive Scale, which measures the severity of symptoms without regard to compulsions. However, this scale is limited to only considering the quantifiable time and energy lost to compulsions. Conversely, current systems of brain imaging arrest mobility and thus make it virtually impossible to observe compulsions at all, focusing instead on neurological responses to external stimuli. There is little research which merges both approaches, to consider the neuro-physiological effects of obsessions as well as the physical response through compulsions. As such, this research is focused on developing a model of compulsivity based upon neurological chemical pathways. The objective is to develop a model which would predict, given a set of environmental parameters, the probability of an individual with OCD performing compulsive behavior and the prevalence of such behavior. By applying this concept to a neural system known as the worry circuit, a computer program was composed and simulations run by this program suggest that the likelihood of compulsive behavior can be predicted using a function of the number of compulsions performed previously. In this model, each neurological agent in the worry circuit, represented by an automaton, has a certain probability of reacting to a stimulus and moving into one of two distinct excited states. Based on the final state of the automaton, the agent will send excitatory or inhibitory signals to surrounding agents, which also have a certain probability of changing states. If the final agent within the cycle shifts into an excited state, the subject will perform a compulsion. These results may be considered preliminary, given the sample size of the case study and the primitive nature of the model.

The high prevalence of compulsive-like behaviours in normal childhood suggests that these behaviours may play an important role in development. Furthermore, the similarities between the typical compulsive behaviours of childhood and the clinically significant behaviours that characterise Obsessive Compulsive Disorder (OCD) suggest that these two phenotypes may share similar neuropsychological profiles. In this study, two theories are investigated; one, that the neuropsychological deficits attributed to the pathogenesis of OCD also play a role in the manifestation of typical compulsive behaviours of childhood. Two, that compulsive behaviour supports the advancement of adaptive behaviour.
The participants were 48 elementary school children (19 males) between the ages of 72 and 152 months (M= 106.5, SD = 24.49). Parents rated the frequency of typical compulsive behaviour on the Childhood Routines Inventory (CRI; Evans et al., 1997). Adaptive behaviour was assessed with the Vineland Adaptive Behavior Scales---Survey Form (VABS; Sparrow, Balla, & Cicchetti, 1984). The measure of set shifting was the manual 64-card version of the Wisconsin Card Sort Task (WCST; Kongs, Thompson, Iverson, & Heaton, 1981). Response inhibition was tested with the Conners' Continuous Performance Test (CPT; Conners, 2000) and the Tapping Test (Diamond & Taylor, 1996). Stepwise multiple regressions were performed to examine the relationships amongst variables of interest. The participants were later divided into three groups (seven years and younger, seven to ten years, ten years and older) to examine relationships by age. Adaptive behaviour and response inhibition were predictive of levels of typical compulsive behaviour across the age range. Together, coping skills and play and leisure skills as assessed on the VABS emerged as the most important predictors of the repetitive compulsive behaviours. Response latency on the tapping task was the strongest predictor of increased levels of just right compulsive behaviour. Set shifting did not predict levels of compulsive behaviour although positive correlations were found in the youngest group. Overall, the data support the notions that clinical OCD and the typical compulsive and ritualistic behaviour of childhood share similar neuropsychological profiles, and that compulsive behaviour in childhood supports the development of increasingly advanced adaptive behaviour.

In the past two decades, a considerable amount of research has been carried out on the phenomenon of excessive Internet use, variously termed Internet addiction, Internet dependency and problematic Internet use. Despite this, there is still little agreement as to what constitutes this phenomenon, whether it should be considered a clinical disorder or not and what leads to this excessive or maladaptive use. The terminology used in this study is that of Problematic Internet Use (PIU). Several theoretical models have been proposed in the understanding of PIU including personality models, operant conditioning models, social cognitive and cognitive behavioural models (Davis, 2001; LaRose, lin & Eastin, 2003; Young, 1999). A proposed gap in the literature is the lack of studies exploring participant experiences of problematic Internet use. It is for this reason that this study aimed at exploring the experiences of a small sample of individuals with self-identified problematic Internet use. The implications of this phenomenological data for the above-mentioned theoretical models were then reviewed. This study used an Interpretative Phenomenological Analysis (IPA) approach in exploring these aims. A sample of four participants was selected through purposive sampling techniques. Four major themes emerged from the analysis namely: Escapism, Social Insecurity and Validation, Perfectionism and Control. These experiences of participants were also explored in terms of the conceptual models reviewed in order to compare how closely they related to participant experiences. A strong inter-relationship was found between the four themes mentioned above. The Internet appeared to provide a sense of control and validation to these individuals while simultaneously rendering them unable to maintain control of their Internet usage in relation to this. This sense of control was experienced through an escape from negative emotions, offline obligations and at times a dissatisfactory position in reality. Of the four models reviewed, the Social Cognitive model proposed by LaRose et al. (2003) appeared to offer the most relevant understanding of PIU to participant experiences. The presence of maladaptive cognitions also appeared to feature strongly as an underlying factor in participants' PIU, as theorised by cognitive behavioural models (Davis, 2001; Young, 1999) Finally recommendations are made for further more detailed exploration of PIU using interpretative, experiential methods.

Thesis (M.S.) -- Central Connecticut State University, 2008.
Thesis advisor: Damon Mitchell. "... in partial fulfillment of the requirements for the degree of Master of Science in Criminal Justice." Includes bibliographical references (leaves 27-29). Also available via the World Wide Web.

Compulsive repetitive behaviors and mental acts due to concerns about your appearance, are symptoms of body dysmorphic disorder (BDD). Previous research suggests that the compulsive behaviors found in people with BDD occur in online and offline settings (e.g., extensive editing of selfies intended for publication online and excessive mirror gazing offline). Also, previous research shows that BDD and social media use vary with age. Therefore, the current study aimed to examine age as a moderator in the relationship between compulsive behaviors online and the risk behaviors of BDD offline, through a cross-sectional design. The inclusion criteria for the study were being a minimum of 16 years old, a Swedish citizen and a user of social media. The data were collected through a survey, consisting of questions intended to screen for compulsive behaviors online in relation to appearance concerns, risk behaviors of BDD offline and the prevalence of BDD. The results showed that younger participants engaged in more compulsive behaviors online and risk behaviors of BDD. The group in high risk of BDD also engaged more in both behaviors, than participants in low risk of BDD. In addition, the results showed that age did act as a moderator in the relationship between compulsive behaviors online and risk behaviors of BDD. Age showed to especially affect the relationship between the number of compulsive behaviors online and risk behaviors of BDD in older participants.
Tvångsmässiga repetitiva beteenden och mentala handlingar som beror på oro kring sitt utseende, är symptom av dysmorfobi (BDD). Tidigare forskning visar att tvångsmässiga beteenden sker både online och offline (tex., överdriven redigering av selfies i syfte att publicera dem online och att spegla sig överdrivet mycket offline). Tidigare forskning visar även att BDD och sociala medier-användning varierar med ålder. Genom en tvärsnittsdesign ämnade därför denna studie att undersöka om ålder modererar relationen mellan tvångsmässigt beteende online och riskbeteende för BDD. Datainsamlingen bestod av ett frågeformulär med frågor kring tvångsmässigt beteende online i relation till oro kring utseendet, riskbeteende för BDD samt prevalensen av BDD. Inklusionskriterierna för att delta i studien var att vara minst 16 år gammal, svensk medborgare samt användare av sociala medier. Resultaten visade att de yngre deltagarna i studien utför både fler tvångsmässiga beteenden online samt fler riskbeteenden offline än de äldre deltagarna. Den grupp som ansågs ha hög risk för BDD utförde även båda beteendena mer än de deltagarna med låg risk för BDD. Resultaten visade vidare att ålder var en moderator i relationen mellan tvångsmässiga beteenden online och riskbeteenden för BDD. Mer specifikt hade en äldre ålder störst effekt på relationen mellan beteendena online och offline.

Researchers vary on their definitions of paraphilia. A difference exists between an individual possessing a paraphilia versus an individual possessing a paraphilic disorder. Hanson (2010) proposed a dimensional model of sexual deviance that includes a measure of intensity. However, research on sexual intensity has been lacking. A majority of existing research focuses on the potential risk factors of possessing a paraphilia or paraphilic disorder (e.g., criminality). There is less focus on whom in the population has the potential to develop a paraphilia; or which factors predict paraphilic behavior. The Big Five personality factors (openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism), obsessive-compulsive behavior, and sexual fantasy (exploratory, intimacy, impersonal, and sadomasochism) were used to predict paraphilic intensity using the Edwards Paraphilic Inventory (EPI). Surveys were placed on Amazon Mechanical Turk (n = 100), the Celebrity Feet in the Pose website (via https://celebrityfeetinthepose.com), and its social media (n = 163) to reach a total of 263 participants. Results indicated that obsessive-compulsive behavior, sadomasochism, and agreeableness significantly predicted the level of paraphilic intensity. Such findings support that paraphilic disorders are likely obsessive-compulsive in nature. Furthermore, agreeableness and paraphilic intensity were negatively correlated. This suggests that the lower the individual is in agreeableness, the higher the likelihood he or she falls on the paraphilic spectrum. Lastly, those who practice sadomasochistic roleplay in the bedroom are likely to report higher levels of paraphilic intensity. According to the United States sample, 1 out of every 10 participants reported some type of paraphilic activity. Individuals who participated in the survey from the website self-reported higher levels of paraphilic behavior than those who completed the survey from Amazon Mechanical Turk. In addition, these individuals are represented in more than one paraphilic category. It remains unclear how large of a role pleasure plays in an individual seeking therapeutic or pharmacological help with paraphilic disorders. Pedophilic disorder was not examined due to ethical concerns with the United States and other various countries. Future research should examine education level and sexual orientation as predictors of paraphilic intensity.

RESUMO: pela contracção involuntária de grupos musculares de extensão variável, originando movimentos involuntários e posturas anómalas, por vezes dolorosas. O tratamento convencional consiste em injecções localizadas de toxina botulínica, podendo, em casos refractários, estar indicado o tratamento por estimulação cerebral profunda. A neurobiologia da distonia focal primária permanece incompletamente compreendida. Os estudos de neuro-imagem estrutural e funcional revelam alterações subtis da anatomia e funcionamento do estriado e das vias cortico-basais, com destaque para o aumento do volume, da actividade metabólica e da neuroplasticidade do putamen e de áreas corticais motoras, pré-motoras e sensitivas. O conjunto destas alterações aponta para uma disrupção da regulação inibitória de programas motores automáticos sustentados pelo estriado e pelas vias ortico-subcorticais. Nos últimos anos tem crescido o interesse pelas manifestações psiquiátricas e cognitivas da distonia (estas últimas muito pouco estudadas). Tem despertado particular interesse a possível associação entre distonia focal primária e perturbação obsessivo-compulsiva (POC), cuja neurobiologia parece notavelmente sobreponível à da distonia primária. Com efeito, os estudos de neuro-imagem estrutural e funcional na POC revelam consistentemente aumento do volume e actividade do estriado e do córtex órbito-frontal, apontando mais uma vez para uma disfunção do controlo inibitório, no estriado, de programas comportamentais e cognitivos automáticos. Objectivos: 1. Explorar a prevalência e intensidade de psicopatologia em geral, e de psicopatologia obsessivo-compulsiva em particular, numa amostra de indivíduos com distonia focal primária; 2. Explorar a ocorrência, natureza e intensidade de alterações do funcionamento cognitivo numa amostra de indivíduos com distonia focal primária; 3. Investigar a associação entre a gravidade da distonia focal, a intensidade da psicopatologia, e a intensidade das alterações cognitivas. Metodologia: Estudo de tipo transversal, caso-controlo, observacional e descritivo, com objectivos puramente exploratórios. Casos: 45 indivíduos com distonia focal primária (15 casos de blefaroespasmo, 15 de cãibra do escrivão, 15 de distonia cervical espasmódica), recrutados através da Associação Portuguesa de Distonia. Critérios de inclusão: idade = 18; distonia focal primária pura (excluindo casos de distonia psicogénica possível ou provável de acordo com os critérios de Fahn e Williams); Metabolismo do cobre e Ressonância Magnética Nuclear sem alterações. Controlos doentes: 46 casos consecutivos recrutados a partir da consulta externa do Hospital Egas Moniz: 15 doentes com espasmo hemifacial, 14 com espondilartropatia cervical, 17 com síndrome do canal cárpico. Controlos saudáveis: 30 voluntários. Critérios de exclusão para todos os grupos: Mini-Mental State Examination patológico, tratamento actual com anti-colinérgicos, antipsicóticos, inibidores selectivos da recaptação da serotonina, antidepressivos tri- ou tetracíclicos. Avaliação: Avaliação neurológica: história e exame médico e neurológico completos. Cotação da gravidade da distonia com a Unified Dystonia Rating Scale. Avaliação psicopatológica: Symptom Check-List-90-Revised; entrevista psiquiátrica de 60 minutos incluindo a Mini-International Neuropsychiatric Interview (MINI), versão 4.4 (validada em Português), complementada com os módulos da MINI Plus versão 5.0.0 para depressão ao longo da vida e dependência/ abuso do álcool e outras substâncias ao longo da vida; Yale-Brown Obsessive-Compulsive Symptom Checklist e a Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Avaliação neuropsicológica: Wisconsin Card Sorting Test (WCST; flexibilidade cognitiva); Teste de Stroop (inibição de resposta); Block Assembly Test (capacidade visuo-construtiva); Teste de Retenção Visual de Benton (memória de trabalho visuo-espacial). Análise estatística:os dados foram analisados com a aplicação informática SPSS for Windows, versão 13. Para a comparação de proporções utilizaram-se o teste do Chi-quadrado e o teste de Fisher. Para a comparação de variáveis quantitativas entre dois grupos utilizou-se o teste t de Student ou o teste U de Mann-Whitney (teste de Wilcoxon no caso de amostras emparelhadas). Para comparações de médias entre três grupos recorreu-se à Análise de Variância a um factor (variáveis de intervalo e de rácio), ou ao teste de Kruskal-Wallis (variáveis ordinais). Para o estudo da associação entre variáveis foram utilizados os coeficientes de correlação de Pearson ou de Spearman, a análise de correlações canónicas, a análise de trajectórias e a regressão logística. Adoptou-se um Alpha de 0.05. Resultados: Os doentes com distonia focal primária apresentaram uma pontuação média na Y- -BOCS significativamente superior à dos dois grupos de controlo. Em 24.4% dos doentes com distonia a pontuação na Y-BOCS foi superior a 16. Estes doentes eram predominantemente mulheres, tinham uma maior duração média da doença e referiam predominantemente sintomas obsessivo-compulsivos (SOC) de contaminação e lavagem. Os dois grupos com doença crónica apresentaram pontuações médias superiores às dos indivíduos saudáveis nas escalas de ansiedade, somatização e psicopatologia geral. Os doentes com distonia tratados com toxina botulínica apresentaram pontuações inferiores às dos doentes não tratados nas escalas de ansiedade generalizada, fobia, somatização e depressão, mas não na Y-BOCS. Sessenta por cento dos doentes com distonia apresentavam pelo menos um diagnóstico psiquiátrico actual ou pregresso. O risco de apresentar um diagnóstico psiquiátrico actual era menor nos doentes tratados com toxina botulínica, aumentando com a gravidade da doença. A prevalência de POC foi 8,3% e a de depressão major 37,7%. No WCST e na Prova de Benton, os doentes com distonia focal primária demonstraram um desempenho inferior ao de ambos os grupos de controlo, cometendo sobretudo erros perseverativos. Os doentes com distonia e pontuação na Y-BOCS > 16 cometeram mais erros e respostas perseverativas no WCST do que os restantes doentes com distonia. As análises de correlações e de trajectórias revelaram que nos doentes com distonia a gravidade da distonia foi, juntamente com a idade e a escolaridade, o factor que mais interagiu com o desempenho cognitivo. Discussão: o nosso estudo é o primeiro a descrever, nos mesmos doentes com distonia focal primária, SOC significativos e alterações cognitivas. Os nossos resultados confirmam a hipótese de uma associação clínica específica entre distonia focal primária e psicopatologia obsessivo-compulsiva. Confirmam igualmente que a distonia focal primária está associada a um maior risco de desenvolver morbilidade psiquiátrica ansiosa e depressiva. O tratamento com toxina botulínica reduz este risco, mas não influencia os SOC. Entre os doentes com distonia, os que têm SOC significativos poderão diconstituir um grupo particular com maior duração da doença (mas não uma maior gravidade), predomínio do sexo feminino e predomínio de SOC de contaminação e limpeza. Em termos cognitivos, os indivíduos com distonia focal primária apresentam défices significativos de flexibilidade cognitiva (particularmente acentuados nos doentes com SOC significativos) e de memória de trabalho visuo-espacial. Estes últimos devem-se essencialmente a um défice executivo e não a uma incapacidade visuo-construtiva ou visuo-perceptiva. A disfunção cognitiva não é explicável pela psicopatologia depressiva nem pela incapacidade motora, já que os controlos com doença periférica crónica tiveram um desempenho superior ao dos doentes com distonia. No seu conjunto os nossos resultados sugerem que os SOC que ocorrem na distonia focal primária constituem uma das manifestações clínicas da neurobiologia desta doença do movimento. O predomínio de sintomas relacionados com higiene e o perfil disexecutivo de alterações cognitivas–perseveração e dificuldades executivas de memória de trabalho visuo-espacial – apontam para a via cortico-basal dorso-lateral e para as áreas corticais que lhe estão associadas como estando implicadas na tripla associação entre sintomas motores, obsessivo-compulsivos e cognitivos. Conclusões: A distonia focal primária é um síndrome neuropsiquiátrico complexo com importantes manifestações não motoras, nomeadamente compromisso cognitivo do tipo disexecutivo e sintomas obsessivo-compulsivos. Clinicamente estas manifestações representam necessidades de tratamento que vão muito para além da simples incapacidade motora, devendo ser activamente exploradas e tratadas.-------------- ABSTRACT: Introduction: primary focal dystonia is an idiopathic movement disorder that manifests as involuntary, sustained contraction of muscular groups, leading to abnormal and often painful postures of the affected body part. Treatment is symptomatic, usually with local intramuscular injections of botulinum toxin. The neurobiology of primary focal dystonia remains unclear. Structural and functional neuroimaging studies have revealed subtle changes in striatal and cortical-basal pathway anatomy and function. The most consistent findings involve increased volume and metabolic activity of the putamen and of motor, pre-motor and somato-sensitive cortical areas. As a whole, these changes have been interpreted as reflecting a failure of striatal inhibitory control over automatic motor programs sustained by cortical-basal pathways. The last years have witnessed an increasing interest for the possible non-motor – mainly psychiatric and cognitive – manifestations of primary focal dystonia. The possible association of primary focal dystonia with obsessive-compulsive disorder (OCD) has raised particular interest. The neurobiology of the two disorders has indeed remarkable similarities: structural and functional neuroimaging studies in OCD have revealed increased volume and metabolic activity of the striatum and orbital-frontal cortex, again pointing to a disruption of inhibitory control of automatic cognitive and behavioural programs by the striatum. Objectives: 1. To explore the prevalence and severity of psychopathology – with a special emphasis on obsessive-compulsive symptoms (OCS) – in a sample of patients with primary focal dystonia;2. To explore the nature and severity of possible cognitive dysfunction in a sample of patients with primary focal dystonia; 3. To explore the possible association between dystonia severity, psychiatric symptom severity, and cognitive performance, in a sample of patients with primary focal dystonia. Methods: cross-sectional, case-control, descriptive study. Cases: forty-five consecutive, primary pure focal dystonia patients recruited from the Portuguese Dystonia Association case register (fifteen patients with blepharospasm, 15 with cervical dystonia and 15 with writer’s cramp). Inclusion criteria were: age = 18; primary pure focal, late-onset dystonia (excluding possible or probable psychogenic dystonia according to the Fahn & Williams criteria); normal copper metabolism and Magnetic Resonance Imaging. Diseased controls: forty-six consecutive subjects from our hospital case register (15 patients with hemi-facial spasm; 14 with cervical spondilarthropathy and cervical spinal root compression; 17 with carpal tunnel syndrome). Healthy controls were 30 volunteers.Exclusion criteria for all groups: Mini-Mental State Examination score below the validated cut-off for the Portuguese population (<23 for education between 1 and 11 years; <28 for education >11 years); use of anti-cholinergics, neuroleptics, selective serotonin reuptake inhibitors, triciclic or tetraciclic antidepressants. Assessment: neurological assessment: complete medical and neurological history and physical examination; dystonia severity scoring with the Unified Dystonia Rating Scale. Psychiatric assessment:Symptom Check-List-90-Revised; 60 minute-long psychiatric interview, including Mini-International Neuropsychiatric Interview (MINI), version 4.4 (validated Portuguese version), extended with the sections for life-time major depressive disorder and life-time alcohol and substance abuse disorder from MINI-Plus version 5.0.0; Yale-Brown Obsessive-Compulsive Symptom Checklist and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Cognitive assessment: Wisconsin Card Sorting Test (WCST; cognitive set-shifting ability); Stroop Test (response inhibition); Block Assembly Test(visual-constructive ability); Benton’s Visual Retention Test (visual-spatial working memory). Statistic analysis: Data were analyzed with SPSS for Windows version 13. Proportions were compared using Chi-Square test, or Fisher’s exact test when appropriate. Student’s t-test or Mann-Whitney’s U test (or Wilcoxon’s teste in the case of matched samples) were used for two-group comparisons. P-values were corrected for multiple comparisons. One-way ANOVA with Bonferroni post-hoc analysis (interval data), or the Kruskal-Wallis Test (ordinal data), were used for three-group comparisons. Associations were analysed with Pearson’s or Spearman’s correlation coefficients, canonical correlations, path analysis and logistic regression analysis. Alpha was set at 0.05. Results: Dystonia patients had higher Yale-Brown Obsessive-Compulsive Symptom scores than both control groups. 24.4% of primary dystonia patients had a Y-BOCS score > 16. These patients were predominantly women; they had longer disease duration, and showed a predominance of hygiene-related OCS. The two groups with chronic disease had higher anxiety, somatization and global psychopathology scores than healthy subjects. Primary dystonia patients undergoing treatment with botulinum toxin had lower anxiety, phobia, somatization and depression scores than their untreated counterparts, but similar Y-BOCS scores. Sixty percent of primary dystonia patients had at least one lifetime psychiatric diagnosis. The odds of having a currently active psychiatric diagnosis were lower in botulinum toxin treated patients, and increased with dystonia severity. The prevalence of OCD was 6.7%, and the lifetime prevalence of major depression was 37.7%. Primary dystonia patients had a lower performance than the two control groups in both the WCST and Benton’s Visual Retention Test, mainly due to an excess of perseveration errors. Primary dystonia patients with Y-BOCS score > 16 had much higher perseveration error and perseveration response scores than dystonia patients with Y-BOCS = 16. Correlation and path analysis showed that, in the primary dystonia group, dystonia severity, along with age and education, was the main factor influencing cognitive performance. Discussion: our study is the first description ever of concomitant significant OCS and cognitive impairment in primary dystonia patients. Our results confirm that primary dystonia is specifically associated with obsessive-compulsive psychopathology. They also confirm that primary focal dystonia patients are at a higher risk of developing anxious and depressive psychiatric morbidity. Treatment with botulinum toxin decreases this risk, but does not influence OCS. Primary focal dystonia patients with significant OCS may constitute a particular subgroup. They are predominantly women, with higher disease duration (but not severity) and a predominance of hygiene related OCS.In terms of cognitive performance, primary focal dystonia patients have significant deficits involving set-shifting ability and visual-spatial working memory. The latter result from an essentially executive deficit, rather than from a primary visual-constructive apraxia or perceptual deficit. Furthermore, cognitive flexibility difficulties were more prominent in the subset of primary dystonia patients with significant OCS. The cognitive dysfunction found in dystonia patients is not attributable to depressive psychopathology or motor disability, as their performance was significantly lower than that of similarly impaired diseased controls. Our results suggest that OCS in primary focal dystonia are a direct, primary manifestation of the motor disorder’s neurobiology. The predominance of hygiene-related symptoms and the disexecutive pattern of cognitive impairment – set-shifting and visual-spatial working memory deficits – suggest that the dorsal-lateral cortical-basal pathway may play a decisive role in the triple association of motor dysfunction, OCS and cognitive impairment. Conclusions: primary focal dystonia is a complex neuropsychiatric syndrome with significant non- -motor manifestations, namely cognitive executive deficits and obsessive-compulsive symptoms.Clinically, our results show that PFD patients may have needs for care that extend far beyond a merely motor disability and must be actively searched for and treated.

Esta tesis busca contribuir al estudio de los correlatos neurobiológicos de los síntomas obsesivos-compulsivos subclínicos (SOCS) con la esperanza de que sus hallazgos puedan ser eventualmente vinculados al desarrollo del trastorno obsesivo-compulsivo (TOC) y servir para identificar individuos vulnerables a desarrollarlo. Para ello, presentamos tres estudios realizados en una muestra de niños sanos, en los que utilizamos un enfoque multidimensional de los síntomas e implementamos distintas modalidades de neuroimagen, así como la combinación de datos de neuroimagen y genética, para aportar una visión integral de los factores que subyacen los SOCS. En el primer estudio, analizamos cambios volumétricos en la sustancia gris y blanca asociados a los SOCS y, en el segundo, evaluamos alteraciones de conectividad funcional asociadas a estos síntomas. En ambos, estudiamos el efecto de la edad y el sexo en dichas asociaciones. Finalmente, en el tercer estudio, identificamos nodos cerebrales en los que la conectividad funcional dinámica tiende a reverberar (atractores) y estudiamos su relación con los SOCS y su base genética. Nuestros resultados vinculan los SOCS totales con alteraciones en el circuito cortico-estriato- talamo-cortical (CSTC), hecho que concuerda con el modelo neurobiológico del TOC, pero también en regiones límbicas fuera de este circuito. También observamos que diferentes síntomas se asocian a alteraciones neurobiológicas distintas, lo que coincide con el modelo multidimensional del trastorno. Además, encontramos que los cambios estructurales relacionados con los síntomas de orden eran específicos de niños menores de 10 años, mientras que los cambios estructurales y funcionales asociados con los síntomas de acumulación eran específicos de sujetos de más de 10 años, especialmente en niñas, lo que sugiere que estos grupos demográficos pueden ser especialmente vulnerables a desarrollar dichos síntomas. Finalmente, identificamos polimorfismos en los genes GRM7 y GNAQ, implicados en la modulación de la neurotransmisión glutamatérgica, y PARVA, asociado a la regulación del citoesqueleto de actina, que predisponen al aumento de la capacidad atractora del hipocampo, vinculada a los SOCS totales. Del mismo modo, hallamos polimorfismos en los genes ATP1B1 y TESC, implicados en el mantenimiento de gradientes electroquímicos, que predisponen y protegen, respectivamente, al aumento de las propiedades atractoras del córtex parietal superior, relacionadas con los síntomas de orden.
Obsessive-compulsive disorder (OCD) is characterized by the presence of intrusive thoughts that cause anxiety (obsessions) and lead to repetitive behaviors or mental acts aimed at reducing this anxiety (compulsions). Although OCD has been associated with alterations in the cortico-striato- thalamo-cortical (CSTC) circuits, the clinical heterogeneity of the disorder makes its neurobiology difficult to investigate. Given that the evidence suggests that different OCD symptoms could arise from distinct neurobiological alterations, the use of the multidimensional model, which allows characterizing different symptom dimensions, could help define more homogeneous subgroups of patients and identify more robust endophenotypes. However, the studies that have used this approach have given heterogeneous findings, possibly due to differences between patients in terms of medication, chronicity, or comorbidities. Notably, epidemiological studies show that obsessive-compulsive symptoms (OCSs) in childhood predispose to developing OCD in adulthood. Furthermore, the symptom profile observed in adulthood is consistent with the same symptom precursors in childhood. Therefore, OCSs could be studied in samples of healthy children from a dimensional perspective, thus avoiding the confounding factors typically observed in clinical samples. This thesis seeks to contribute to the study of the neurobiological correlates of OCSs in hopes that its findings may eventually be linked to the development of OCD and serve to characterize at-risk individuals. With that aim, we present three studies assessing a sample of healthy children, in which we use a multidimensional approach and implement different neuroimaging modalities and techniques, as well as the combination of neuroimaging and genetic data, to provide a comprehensive view of the factors underlying OCSs. In the first study, we analyzed volumetric changes in gray and white matter associated with total and dimensional OCSs whereas, in the second one, we evaluated functional connectivity alterations associated with total and dimensional OCSs. In both studies, we also assessed the effect of age and sex on these associations. In the third one, we identified brain nodes in which dynamic functional connectivity tends to reverberate (attractors) and we studied their relationship with total and dimensional OCSs. Furthermore, by combining neuroimaging and gene expression data, we identified genetic variants that moderated the relationship between OCSs and attractors. Our results link total OCSs with alterations in the CSTC circuit, which concurs with the prevailing neurobiological model of OCD, but also in limbic regions outside of this circuit. We also observed that different symptoms were associated with distinct neurobiological alterations: obsessing symptoms were related to alterations in limbic regions; doubt/checking symptoms were associated with changes in the ventral cognitive CSTC loop, the insula and regions mediating frontal processing; ordering symptoms were associated with alterations in the ventral cognitive and sensorimotor CSTC loops and the superior parietal cortex; hoarding symptoms were related to alterations in different CSTC loops, suggesting a larger CSTC alteration. Structural changes related to ordering symptoms were specific to boys under 10 years of age, whereas structural and functional changes associated with hoarding symptoms were specific to children over 10 years of age, especially to girls, which suggests that these demographic groups may be more susceptible to developing such symptoms. Finally, we identified polymorphisms in the GRM7 and GNAQ genes, involved in the modulation of glutamate neurotransmission, and in the PARVA gene, associated with the regulation of the actin cytoskeleton, that predisposed to an increase in the attractor properties of the hippocampus, linked to total OCSs. We also found polymorphisms in the ATP1B1 and TESC genes, involved in the maintenance of electrochemical gradients, that predisposed and protected, respectively, to an increase in the attractor properties of the superior parietal cortex, related to ordering symptoms.

The present scoping review of the literature was conducted to analyze all studies of assessment and treatment approaches for individuals diagnosed with obsessive compulsive disorder (OCD) and intellectual disabilities (ID). Search terms were used to identify articles published in behavioral journals. The criteria for the articles reviewed included articles that were peer-reviewed and empirical articles. Online search engines used contained information from the Journal of Applied Behavior Analysis, Journal of Experimental Analysis, The Psychological Record, Behavior Analysis in Practice, The Analysis of Verbal Behavior, and The Behavior Analysis. Key words used in the procedural method of searching for information included obsessive compulsive disorder, OCD, obsessions, compulsions, obsessive hand washing, ordering, checking, praying, counting, repetition, delusional beliefs, grandiose thoughts, controlled thoughts, hoarding, anxiety, panic, fears, germs, look feel sound just right, contamination, and excessive worries. The findings included total of 13,785 articles. After screening for duplication and relevant citations, 13 scoping reviews were identified as meeting eligibility criteria. The present paper reviewed what articles were available with respect to assessments and treatments among individuals with obsessive compulsive disorders and individuals with intellectual disabilities. The result of this study was that one article was found meeting the criteria of assessments and treatments among individuals with obsessive compulsive disorder and intellectual disabilities. The indication, as a result of this study, is that the current literature for assessments and treatments of the symptoms of obsessive compulsive disorders and intellectual disabilities is lacking, and future research is indicated.

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A compra compulsiva – doravante chamada de oniomania – é parte de uma categoria mais ampla de comportamentos de consumo compulsivos, e seria baseada por uma compra repetitiva, crônica, que se torna a primeira resposta a eventos ou sentimentos negativos (O'Guinn & Faber, 1989). Dada a prevalência estimada na população em geral, potencialmente projetada em até 16% da população adulta, e as severas consequências negativas oriundas de tal patologia, esta tese se propôs a investigar de forma mais precisa as relações entre tais compradores compulsivos e seus objetos de consumo, notadamente as preferências declaradas por tais indivíduos quanto à preferência pela posse, de natureza temporária, ou propriedade definitiva de produtos, traduzidas por meio de situações hipotéticas e experimentais de aluguel e compra, respectivamente, lacuna ainda inexplorada na literatura inerente à oniomania. Considerando esta mesma literatura sobre o comprar compulsivo, em que premissas teóricas constroem uma narrativa baseada na aquisição / compra de produtos (Faber, O’Guinn & Krych, 1987; Glatt & Cook, 1987; Valence, d'Astous & Fortier, 1988; Krueger, 1988; O’Guinn & Faber, 1989; d'Astous, Maltais & Roberge, 1990; Christenson, Faber, de Zwaan, Raymond, Specker & Eckern, 1994; McElroy, Keck Jr, Pope Jr, Smith & Strakowski, 1994; Faber & Christenson, 1996; Black, 2001; 2007; Dittmar, 2005; Koran, Faber, Aboujaoude, Large & Serpe, 2006; Saraneva & Saaksjarvi, 2008; Tavares, Lobo, Fuentes, & Black, 2008; Kukar-Kinney, Ridgway & Monroe, 2009; Trautmann-Attmann & Johnson, 2009; Workman & Paper, 2010; Bonfanti, 2010; Leite, 2011; Kukar-Kinney, Ridgway e Monroe, 2012; Leite, Rangé, Junior & Fernandez, 2012), a investigação experimental proposta baseou-se na ideia de que indivíduos acometidos por tal patologia seriam menos propensos ao aluguel de produtos, hipótese confirmada em todos os testes, sem considerar dadas manipulações. O estudo mostrou também que o efeito da manipulação proposta, fundamentada na saliência da devolução de produtos, acabou por estimular compradores ditos compulsivos a alugarem produtos, contrariando expectativas iniciais, estas baseadas no suposto desconforto que tais indivíduos teriam ao abrir mão de seus objetos de compulsão. Pelo aparente ineditismo, tais resultados foram considerados importantes achados para a literatura e, portanto, foram explicados não somente à luz dos experimentos propostos, como também a partir da etapa qualitativa, de cunho exploratório e interpretativo.
Compulsive buying – henceforth named Oniomania – is part of a broader category of compulsive consumption behavior, which would be based on a repetitive and chronic purchasing, which becomes the first response to events or negative feelings (O'Guinn & Faber, 1989). Given the high prevalence in the general population - potential estimated up to 16% of the adult population - and severe negative consequences, due to such disorder, this thesis investigated the relationship between such shopaholics and their consumption goods, namely the declared preferences by such individuals about the possession, temporary, or definitive ownership of goods, tested through hypothetic and experimental situations of rental and purchase, respectively, considered an unexploited gap in the literature inherent in oniomania. Considering the same literature on compulsive buying, in which theoretical assumptions construct a narrative based on the acquisition, notably, purchase of products (Faber, O’Guinn & Krych, 1987; Glatt & Cook, 1987; Valence, d'Astous & Fortier, 1988; Krueger, 1988; O’Guinn & Faber, 1989; d'Astous, Maltais & Roberge, 1990; Christenson, Faber, de Zwaan, Raymond, Specker & Eckern, 1994; McElroy, Keck Jr, Pope Jr, Smith & Strakowski, 1994; Faber & Christenson, 1996; Black, 2001; 2007; Dittmar, 2005; Koran, Faber, Aboujaoude, Large & Serpe, 2006; Saraneva & Saaksjarvi, 2008; Tavares, Lobo, Fuentes & Black, 2008; Kukar-Kinney, Ridgway & Monroe, 2009; Trautmann-Attmann & Johnson, 2009; Workman & Paper, 2010; Bonfanti, 2010; Leite, 2011; Kukar-Kinney, Ridgway & Monroe, 2012; Leite, Rangé, Junior & Fernandez, 2012), the proposed experiment was based on the idea that individuals affected by this disorder would be less likely to rent products. This hypothesis was confirmed in all tests, without considering manipulations. The study also showed that the effect of manipulation proposal, based on product return information, eventually stimulate named shopaholics to renting more products, contrary to initial expectations, based on supposed discomfort that such individuals would feel at the time they would give up their compulsion objects. Due to the apparent novelty, these results were considered important findings for literature and thus were explained in the light of the proposed experiments and through complementary research of an explanatory and interpretative nature.

Due to societal and economic costs caused by compulsive consumption behavior, specifically problem drinking and overeating, a search has been launched for a cognitive explanation for the deviant behaviors and the motivations that cause these behaviors to continue. This dissertation attempted to develop a better understanding of continued compulsive consumption behavior by investigating consumers use of the techniques of neutralization theory. Based on methodological concerns in neutralization research, the development of reliable and valid measures of the five techniques of neutralization theory were described and used to examine their moderation of compulsive consumption behavior and its relationship with social norm commitment and guilt. The dissertation resulted in developing four reliable and valid neutralization technique scales. The results of the structural model suggested a negative relationship between social norms and compulsive consumption behavior and a multiple regression indicated a partial moderation of certain neutralization techniques of this relationship. This dissertation has provided a better understanding of the cognitive process surrounding a consumers compulsive consumption behavior, the techniques used to allow the behavior to continue, and marketing applications to entice consumers to stop the behavior.

A central question in the field of Obsessive-Compulsive Disorder (OCD) is the role of symptom-related dysfunctional beliefs thought to underlie symptoms. This study examines change in symptoms and related dysfunctional beliefs during Cognitive Behavior Therapy (CBT) with 32 previously treatment resistant OCD patients. Three questions were examined: (a) What is the relationship between dysfunctional beliefs and symptoms at pre-treatment; (b) How much change occurs in symptoms, and related beliefs, during specialized CBT; and (c) What is the relationship between change in cognitive and symptom variables. On average, symptoms and related beliefs of symptomatic-responders resolved to within normal limits following treatment. Beliefs of patients whose symptoms did not improve remained unchanged. Pre-treatment strength of overestimation of threat and response to unpredictability were significant predictors of symptomatic improvement. Change in overcontrol of intrusive thoughts and overestimation of threat significantly predicted change in symptoms. Theoretical and treatment implications of the findings are discussed.

The purpose of this study was to compare the impact of twelve weeks of instruction in two university-level educational approaches to self management (hatha yoga (EXSCI 119) and the current fitness/wellness core course (PEFWL 101) ) on the problematic behaviors of excessive smoking, dysfunctional eating and excessive alcohol consumption. Some theories of addiction, notably those of Peele and Clemmens, suggest that increased awareness, such as that promoted by hatha yoga, may be valuable to the alteration of the addictive process. The quantitative analysis utilized the stages and processes of change questionnaires developed by many researchers associated with the University of Rhode Island team led by James 0. Prochaska. Analysis of the data did not show any statistical difference between the two approaches. A secondary qualitative analysis suggests that hatha yoga students thought differently about themselves and their experience following their yoga class.
Fisher Institute for Wellness

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2007.
Title from first page of PDF file (viewed September 4, 2007). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 85-90).

Fifty-two individuals 60 years of age or older participated in this research study. This study is of significance because as opportunities to gamble are becoming more available and accessible, older adults are participating in gambling activities for leisure and recreational benefits. This phenomenon is of concern because older adults may be at risk for problems related to gambling that they may not be able to recover from. Furthermore, senior center directors and social workers need to know how to assess, evaluate and intervene with older adults who may have gambling problems or problems related to their gambling behavior.

Thesis (Ed.D.)--Teachers College, Columbia University, 1995.
Includes tables. Typescript; issued also on microfilm. Sponsor: Isabel Contento. Dissertation Committee: Sharon R. Akabas. Includes bibliographical references (leaves 206-215).

This study is a critical, feminist psychological investigation of nurses’ experiences, understandings and perceptions of nursing eating disorder patients. Specifically 19 in-depth semi-structured interviews were conducted at a large metropolitan Australian hospital complex with nurses who care for eating disordered patients. A qualitative discourse analytic methodology was used to analyse the data. The analysis investigates the different ways that the eating disorder patients and the nurses are constituted in a web of explicit and implicit discursive constructions and discursive practices. The analysis also considers how relations of power between the nurses, the patients and the doctors and other health care workers are constituted in discourse and practice, as well as exploring how the eating disorder patient group and the role of the nurse is feminised
Master of Arts (Hons)

The purpose of this study was to assess body-image attitudes and the extent of obligatory exercise among physically active women, and to examine interrelationships among these variables, and age differences. The sample included one hundred and eighty-three female exercise participants, aged 18 to 71 years. The Multidimensional Body-Self Relations Questionnaire was used to assess subjective body-image attitudes. The Obligatory Exercise Questionnaire was used to assess extent of obligatory exercise behavior. It was found that the majority of physically active women are generally satisfied with most aspects of their body images. However, 82% were concerned with their appearance, 30.6% were preoccupied with their weight, and 41% perceived themselves as being overweight. Appearance evaluation was positively related to satisfaction with weight, which was the strongest predictor of global appearance evaluation. Older women (56 to 71 years) were significantly more concerned with their health than were younger women (18 to 25 years). The extent of obligatory exercise behavior among physically active women was very small, and was not related to age. Obligatory exercise scores were predicted by fitness and health orientation, and overweight preoccupation, and inversely predicted by age and health evaluation.