NEWSFLASH: A New OCD Assessment Scale Pertaining To Its Dimensions


 

In 2010, a new measuring scale became available that is directed more towards an analysis of the relationship between specific obsessive beliefs in a patient and the resulting symptom dimensions, than to an assessment of a single type of compulsion per se. Wheaton et al (2010) put it this way:

“To this end, the Dimensional Obsessive-Compulsive Scale (DOCS; Abramowitz et al., 2010), is a new measure that assesses the severity of the four most empirically supported OCD symptom dimensions: contamination, responsibility for harm and mistakes, symmetry/ordering, and unacceptable thoughts (e.g., Mataix-Cols et al., 2005 D. Mataix-Cols, M.C. Rosario-Campos and J.F. Leckman, A multidimensional model of obsessive-compulsive disorder, American Journal of Psychiatry 162 (2005), pp. 228–238. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (225)[Mataix-Cols et al., 2005] and [McKay et al., 2004]). The DOCS is unique in that it affords an assessment of OCD symptoms based on function rather than form. For example, ordering rituals in response to a sense of “incompleteness” or “not just right” feelings are assessed on a separate dimension (i.e., symmetry dimension) from ordering rituals which function to reduce fears of causing (or failing to prevent) harm (i.e., responsibility for harm and mistakes dimension). Similarly, checking rituals that pertain to inspecting for contaminants are assessed on the contamination dimension, while checking locks and appliances are assessed on the responsibility for harm dimension. The DOCS also assesses multiple empirically-based parameters of severity (frequency, avoidance, distress, and functional interference; Deacon & Abramowitz, 2005) for each of the four OCD symptom dimensions. Accordingly, the DOCS may be better suited than other symptom measures for investigating the relationships between OCD symptoms and dysfunctional beliefs.”

See it as a better emphasis on function of a compulsive act over the form of it. Checking for germs belongs in the ‘contamination area’; and checking for locks in the ‘responsibility for harm’ one.

This group (Wheaton et al, 2010) used the DOCS to investigate a large group of adults seeking treatment for their OCD in a clinic. They sought to know whether there is consistency between a certain type of obsessive belief, and a corresponding symptom dimension. In other words: can a dysfunctional form of belief predict a symptom dimension ‘belonging to’ that belief (is it associated, or correlated with that belief)? If that is consistently and repeatedly the case, then it might underpin future hypothesis about a certain obsession/dimension being located in a specific brain area, for instance. A belief might be: a few hairs of a pet animal can bring me a lethal disease; and the corresponding action could be: endless cleaning and washing, and checking in the context of contamination. Brain areas then could be very specific parts of the amygdala, a brain region intensely involved in the appraisal of fear; and the basal ganglia, regions involved in carrying out particular actions.

What were the actual results of this study by Wheaton et al?

  • Responsibility/threat estimation beliefs predicted contamination fear symptoms.
  • Perfectionism/certainty beliefs predicted symmetry obsessions.
  • Importance and control of thought beliefs predicted having unacceptable thoughts.
  • Responsibility/threat estimation beliefs predicted symptoms related to being responsible for harm.

These findings are consistent with concepts about cognition and behaviour.

I will readily admit that the results may sound a bit vague; but please bear in mind that the scale is very new. As any researcher working with ‘biological material’ will tell you: it can be a tough, resistant type of job, because you deal with subjects (in this case) that are basically unique; no two specimens are completely alike. With repeated replication of this investigation, and with a growing number of patients having been tested, a no doubt more precise picture will emerge.

 

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4 responses to “NEWSFLASH: A New OCD Assessment Scale Pertaining To Its Dimensions

  1. OCD has definitely played an interesting role in my life from the time I entered this world. Looking back, I can say it has made my life colorful to say the least.
    My particular and exotic form of OCD consists of obsessions and compulsions surrounding colors and what particular colors represent to me. At a young age I associated colors with gender, such as pink and blue. In our society, when parents are expecting a child (often, their first born), they run out and buy blue for a boy and pink by a girl. I lived my childhood by this ridiculous practice. I have been told, within the past few years, that this unique brand of obsessive compulsive disorder most commonly fits into the category of symmetry, which is almost laughable because to me “symmetry” represents organization and balance; these compulsions have made my life anything but balanced.
    This sort of rigid and absurd thinking has morphed into more specific and excessive rituals and compulsions. I had to have a male doll to go with every female doll I owned. My clothes came in mainly two colors, pink and blue. If I took place in a female-oriented sport or activity I had to pick a male-dominated sport to participate in as well; I went through a tom-boy stage simply because I previously went through a girly-girl stage. In my mind, this is how I “balanced” my life. There is really no way for an elementary aged child to articulate this specific and strange way of making decisions without it becoming a problem.
    These symptoms were not easy to pick up on as anxiety disorder by those close to me. To my parents and teachers, my behavior just appeared be preferences of a young child and not an obsessive-compulsive condition. Not until I was 14 years old, the year of my parents’ divorce, did things get so severe that I was finally diagnosed with OCD. I don’t remember if I knew what OCD was before that day in the doctor’s office, but I do remember knowing that there was now a term that explained why I always felt different. That day solidified an image I always had in the back of my head about myself. This new concept of being “different” created a character that I soon began to grow into forever shaping my personality.

    – Niki

  2. Hello Niki –

    that is a great call! It has poetic qualities, because it is focused on aesthetics. Recently, I heard of a case of a women who developed OCD after giving birth, and her disorder was focused on symmetry and extreme tidiness. Unfortunately, in her case it had a negative impact on her marriage, and also on the early upbringing of her children.

    Now, mind: I don’t belittle the burden your specific form of the illness has placed on your life. But in some way, it really sounds like it produced ‘interesting’ moves that you made. Moves that ‘normal’ people probably wouldn’t have made, and therefore would have missed new experiences for as a result.

    If I may ask: how did these ‘urges to compensate’ present themselves in your mind? Did they at all? Or did you experience afterwards: Oops, I Did It Again, to quote Britney Spears?

    At any rate, I know a song for you: Joni Mitchell sang: I’ve Looked At Life/ From Both Sides Now…

    Cheers, Frank.

  3. It has really taken my life in an interesting direction, a lot of hurt along the way, but never dull and very eventful. I don’t always look at my OCD as a burden.

    In terms of the ‘urge to compensate’ it was/is almost like an automatic ‘switch’ that goes off whenever an object, event, etc. presented itself to me. I thought…”I must create and equal, but different form of this….”

    I believe this particular form of OCD manifested with me due to my level of creativity. Everyone in my family possesses an artistic gift, including myself. Unfortunately, mine also came with a few extra ‘perks’ known as compulsions.

    -Niki

  4. I do enjoy the Britney Spears reference, although no, it was almost immediate for me.

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