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CNS Spectr. 2018 Feb;23(1):51-58. doi: 10.1017/S1092852917000244. Epub 2017 May 10.

Unpacking the role of self-reported compulsivity and impulsivity in obsessive-compulsive disorder.

Author information

1
1Monash Institute of Cognitive and Clinical Neurosciences,School of Psychological Sciences,Monash University,Clayton,Victoria,Australia.
2
2Cognitive Neuroscience Unit,School of Psychology,Deakin University,Geelong,Victoria,Australia.

Abstract

OBJECTIVE:

We aimed to determine whether individuals with obsessive-compulsive disorder (OCD) and demographically matched healthy individuals can be clustered into distinct clinical subtypes based on dimensional measures of their self-reported compulsivity (OBQ-44 and IUS-12) and impulsivity (UPPS-P).

METHODS:

Participants (n=217) were 103 patients with a clinical diagnosis of OCD; 79 individuals from the community who were "OCD-likely" according to self-report (Obsessive-Compulsive Inventory-Revised scores equal or greater than 21); and 35 healthy controls. All data were collected between 2013 and 2015 using self-report measures that assessed different aspects of compulsivity and impulsivity. Principal component analysis revealed two components broadly representing an individual's level of compulsivity and impulsivity. Unsupervised clustering grouped participants into four subgroups, each representing one part of an orthogonal compulsive-impulsive phenotype.

RESULTS:

Clustering converged to yield four subgroups: one group low on both compulsivity and impulsivity, comprised mostly of healthy controls and demonstrating the lowest OCD symptom severity; two groups showing roughly equal clinical severity, but with opposing drivers (i.e., high compulsivity and low impulsivity, and vice versa); and a final group high on both compulsivity and impulsivity and recording the highest clinical severity. Notably, the largest cluster of individuals with OCD was characterized by high impulsivity and low compulsivity. Our results suggest that both impulsivity and compulsivity mediate obsessive-compulsive symptomatology.

CONCLUSIONS:

Individuals with OCD can be clustered into distinct subtypes based on measures of compulsivity and impulsivity, with the latter being found to be one of the more defining characteristics of the disorder. These dimensions may serve as viable and novel treatment targets.

KEYWORDS:

Compulsivity; OCD; impulsivity; machine learning; subtypes

PMID:
28487007
DOI:
10.1017/S1092852917000244
[Indexed for MEDLINE]

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