Functions of compulsions in obsessive-compulsive disorder

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

Functions of compulsions in obsessive-compulsive 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 (6), pp. 449 - 457
Issue Date:: 2011-06-01

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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	2011-06-01	en_US
dc.identifier.citation	Australian and New Zealand Journal of Psychiatry, 2011, 45 (6), pp. 449 - 457	en_US
dc.identifier.issn	0004-8674	en_US
dc.identifier.uri	http://hdl.handle.net/10453/116565
dc.description.abstract	Objectives: The key function of compulsions in obsessive-compulsive disorder (OCD) is to alleviate anxiety or distress caused by the obsessions, but compulsions may also have other functions. The main aim of this study was to systematically ascertain what motivates individuals with OCD to perform compulsions. Method: A total of 108 adults with OCD were assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Functions of Compulsions Interview. The latter instrument elicits the functions of identified compulsions. Results: The functions of 218 compulsions were identified. The mean number of functions per compulsion in the whole sample was 2.94 and the vast majority of compulsions (85.3%) were performed for more than one reason. The total number of functions of compulsions endorsed for the three main compulsions correlated with Y-BOCS total scores (r = 0.37, p < 0.001). Compulsions were most frequently performed automatically and to decrease distress or anxiety, but there was substantial variation, depending on the type of compulsion. Hoarding was often performed for reasons not related to any other compulsion (involving a perceived need for collected objects), whereas ordering/symmetry/repeating compulsions were frequently performed to achieve a 'just right' feeling. Checking was frequently performed because of the belief that something bad or unpleasant would happen if one failed to check; washing/cleaning compulsions were most frequently performed to decrease distress or anxiety and automatically, and mental compulsions were performed automatically far more often than for other reasons. Conclusions: The majority of compulsions have more than one function and they are often performed automatically. The finding of different functions of compulsions in different types of compulsions provides some support to the subtyping of OCD on the basis of obsessions and compulsions. Identifying functions of compulsions allows better understanding of the functional relationship between obsessions and compulsions, which may have implications for cognitive-behavioural therapy of OCD. © 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	10.3109/00048674.2011.567243	en_US
dc.subject.classification	Psychiatry	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Compulsive Behavior	en_US
dc.subject.mesh	Anxiety	en_US
dc.subject.mesh	Obsessive-Compulsive Disorder	en_US
dc.subject.mesh	Psychiatric Status Rating Scales	en_US
dc.subject.mesh	Interview, Psychological	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.title	Functions of compulsions in obsessive-compulsive disorder	en_US
dc.type	Journal Article
utslib.citation.volume	6	en_US
utslib.citation.volume	45	en_US
utslib.for	110319 Psychiatry (incl. Psychotherapy)	en_US
utslib.for	170106 Health, Clinical and Counselling Psychology	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	6	en_US
pubs.publication-status	Published	en_US
pubs.volume	45	en_US

Abstract:

Objectives: The key function of compulsions in obsessive-compulsive disorder (OCD) is to alleviate anxiety or distress caused by the obsessions, but compulsions may also have other functions. The main aim of this study was to systematically ascertain what motivates individuals with OCD to perform compulsions. Method: A total of 108 adults with OCD were assessed with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Functions of Compulsions Interview. The latter instrument elicits the functions of identified compulsions. Results: The functions of 218 compulsions were identified. The mean number of functions per compulsion in the whole sample was 2.94 and the vast majority of compulsions (85.3%) were performed for more than one reason. The total number of functions of compulsions endorsed for the three main compulsions correlated with Y-BOCS total scores (r = 0.37, p < 0.001). Compulsions were most frequently performed automatically and to decrease distress or anxiety, but there was substantial variation, depending on the type of compulsion. Hoarding was often performed for reasons not related to any other compulsion (involving a perceived need for collected objects), whereas ordering/symmetry/repeating compulsions were frequently performed to achieve a 'just right' feeling. Checking was frequently performed because of the belief that something bad or unpleasant would happen if one failed to check; washing/cleaning compulsions were most frequently performed to decrease distress or anxiety and automatically, and mental compulsions were performed automatically far more often than for other reasons. Conclusions: The majority of compulsions have more than one function and they are often performed automatically. The finding of different functions of compulsions in different types of compulsions provides some support to the subtyping of OCD on the basis of obsessions and compulsions. Identifying functions of compulsions allows better understanding of the functional relationship between obsessions and compulsions, which may have implications for cognitive-behavioural therapy of OCD. © 2011 The Royal Australian and New Zealand College of Psychiatrists.

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http://hdl.handle.net/10453/116565