The nature and correlates of avoidance in obsessivecompulsive disorder

Starcevic, V; Berle, D; Brakoulias, V; Sammut, P; Moses, K; Milicevic, D; Hannan, A

The nature and correlates of avoidance in obsessivecompulsive disorder

Starcevic, V Berle, D

Brakoulias, V Sammut, P Moses, K Milicevic, D Hannan, A

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Publication Type:: Journal Article
Citation:: Australian and New Zealand Journal of Psychiatry, 2011, 45 (10), pp. 871 - 879
Issue Date:: 2011-10-01

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Field	Value	Language
dc.contributor.author	Starcevic, V	en_US
dc.contributor.author	Berle, D https://orcid.org/0000-0002-4861-2220	en_US
dc.contributor.author	Brakoulias, V	en_US
dc.contributor.author	Sammut, P	en_US
dc.contributor.author	Moses, K	en_US
dc.contributor.author	Milicevic, D	en_US
dc.contributor.author	Hannan, A	en_US
dc.date.issued	2011-10-01	en_US
dc.identifier.citation	Australian and New Zealand Journal of Psychiatry, 2011, 45 (10), pp. 871 - 879	en_US
dc.identifier.issn	0004-8674	en_US
dc.identifier.uri	http://hdl.handle.net/10453/116558
dc.description.abstract	Objectives: Avoidance in obsessivecompulsive disorder (OCD) has been neglected by research. This study aimed (i) to collect information on the nature and frequency of avoidance in people with OCD and ascertain the types of obsessions related to avoidance; (ii) compare OCD individuals with and without avoidance, and (iii) determine predictors of avoidance in people with OCD. Method: A total of 124 OCD adults underwent a comprehensive assessment. Participants were asked whether they engaged in any avoidance behaviour because of their OCD, and the nature and number of instances of such avoidance were recorded. The instances of avoidance were grouped according to the type of obsession and compulsion that they were related to. Results: A total of 74 (59.7%) participants reported OCD-related avoidance. Avoidance was most commonly related to contamination obsessions. Almost 80% of all contamination obsessions and more than 50% of all aggressive obsessions were associated with avoidance, and contamination obsessions were significantly more common among the participants with avoidance. In contrast, very few obsessions about a need to collect and keep objects and obsessions about a need for ordering, arranging and doing things right or in an exact way were associated with avoidance; these types of obsessions were also significantly more common among the participants without avoidance. The strongest predictor of avoidance was the presence of contamination obsessions. Participants with avoidance had a significantly more severe OCD than those without avoidance. Conclusions: Avoidance is common in OCD, and it is particularly frequently associated with contamination obsessions. There is a weak link between avoidance and hoarding and between avoidance and ordering/arranging/symmetry obsessions and compulsions. These results, along with the finding that OCD with avoidance is a more severe illness, have implications for the future diagnostic criteria, description, subtyping and treatment of OCD and for its relationship with other anxiety disorders. © 2011 The Royal Australian and New Zealand College of Psychiatrists.	en_US
dc.relation.ispartof	Australian and New Zealand Journal of Psychiatry	en_US
dc.relation.isbasedon	10.3109/00048674.2011.607632	en_US
dc.subject.classification	Psychiatry	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Obsessive Behavior	en_US
dc.subject.mesh	Compulsive Behavior	en_US
dc.subject.mesh	Fear	en_US
dc.subject.mesh	Avoidance Learning	en_US
dc.subject.mesh	Obsessive-Compulsive Disorder	en_US
dc.subject.mesh	Psychiatric Status Rating Scales	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Middle Aged	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Hoarding Disorder	en_US
dc.title	The nature and correlates of avoidance in obsessivecompulsive disorder	en_US
dc.type	Journal Article
utslib.citation.volume	10	en_US
utslib.citation.volume	45	en_US
utslib.for	1799 Other Psychology and Cognitive Sciences	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	10	en_US
pubs.publication-status	Published	en_US
pubs.volume	45	en_US

Abstract:

Objectives: Avoidance in obsessivecompulsive disorder (OCD) has been neglected by research. This study aimed (i) to collect information on the nature and frequency of avoidance in people with OCD and ascertain the types of obsessions related to avoidance; (ii) compare OCD individuals with and without avoidance, and (iii) determine predictors of avoidance in people with OCD. Method: A total of 124 OCD adults underwent a comprehensive assessment. Participants were asked whether they engaged in any avoidance behaviour because of their OCD, and the nature and number of instances of such avoidance were recorded. The instances of avoidance were grouped according to the type of obsession and compulsion that they were related to. Results: A total of 74 (59.7%) participants reported OCD-related avoidance. Avoidance was most commonly related to contamination obsessions. Almost 80% of all contamination obsessions and more than 50% of all aggressive obsessions were associated with avoidance, and contamination obsessions were significantly more common among the participants with avoidance. In contrast, very few obsessions about a need to collect and keep objects and obsessions about a need for ordering, arranging and doing things right or in an exact way were associated with avoidance; these types of obsessions were also significantly more common among the participants without avoidance. The strongest predictor of avoidance was the presence of contamination obsessions. Participants with avoidance had a significantly more severe OCD than those without avoidance. Conclusions: Avoidance is common in OCD, and it is particularly frequently associated with contamination obsessions. There is a weak link between avoidance and hoarding and between avoidance and ordering/arranging/symmetry obsessions and compulsions. These results, along with the finding that OCD with avoidance is a more severe illness, have implications for the future diagnostic criteria, description, subtyping and treatment of OCD and for its relationship with other anxiety disorders. © 2011 The Royal Australian and New Zealand College of Psychiatrists.

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http://hdl.handle.net/10453/116558