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

Published online by Cambridge University Press:  10 May 2017

Luisa Prochazkova ,
Linden Parkes Open the ORCID record for Linden Parkes [Opens in a new window] ,
Andrew Dawson ,
George Youssef ,
Gabriela M. Ferreira ,
Valentina Lorenzetti ,
Rebecca A. Segrave ,
Leonardo F. Fontenelle  and
Murat Yücel
Luisa Prochazkova
Affiliation:
Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
Linden Parkes
Affiliation:
Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
Andrew Dawson
Affiliation:
Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
George Youssef
Affiliation:
Cognitive Neuroscience Unit, School of Psychology, Deakin University, Geelong, Victoria, Australia Centre for Adolescent Health, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
Gabriela M. Ferreira
Affiliation:
Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia D'Or Institute for Research and Education, Rio de Janeiro, Brazil
Valentina Lorenzetti
Affiliation:
Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
Rebecca A. Segrave
Affiliation:
Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
Leonardo F. Fontenelle
Affiliation:
Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil D'Or Institute for Research and Education, Rio de Janeiro, Brazil
Murat Yücel*
Affiliation:
Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
*
*Address correspondence to Murat Yücel, Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, c/o 770 Blackburn Road, Clayton, Victoria 3800, Australia. (Email: murat.yucel@monash.edu)
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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

CompulsivityimpulsivityOCDmachine learningsubtypes
Type
Original Research
Information
CNS Spectrums , Volume 23 , Issue 1 , February 2018 , pp. 51 - 58
Copyright
© Cambridge University Press 2017 

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Footnotes

†

These authors contributed equally.

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