By Esther Landhuis When Angela Tang’s teenage son came down with a baffling illness, few households could have been better equipped to deal with it. The family lives in a wealthy Los Angeles suburb. Both parents are doctors — Tang in internal medicine, her husband in infectious disease — and their son, a straight-A student well-liked at school, had been cared for by the family’s pediatrician since birth. Still, the parents worried as their son’s symptoms appeared, seemingly out of the blue, in September 2018: He’d meticulously line up pencils in groups of five, recite prayers unrelentingly, make homework illegible as he had to erase or cross out every C, D, and F. Eating, too, became a chore. If he had a contaminating thought while taking a bite, he’d have to spit out the food, wash his mouth, and try again, but the new bite couldn’t have touched the old one. It got to the point where he could only eat mushy or semi-liquid foods carefully placed “in little aliquots on his plate, so that if one bite got contaminated,” it wouldn’t touch the others, Tang said. Before long, she and her husband were working around the clock just to get him through the day. In a panic, Tang consulted their pediatrician, and recalls the doctor asking an intriguing question: “Has he had any unusual infections recently — because you know about PANDAS, right?” At the time, Tang knew nothing about PANDAS. She had completed her own medical residency two years before the illness — short for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections — was first outlined in a 1998 paper. That publication detailed how a child’s behavior could change alarmingly after a strep infection, and may include symptoms of obsessive-compulsive behavior and tics. It has also stirred controversy: Many doctors hesitate to diagnose or treat the condition even today.

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 29241 - Posted: 04.04.2024

Perspective by Dan O'Brien I was 12 years old when I developed obsessive-compulsive disorder. My older brother had recently tried to kill himself by jumping from our attic window. I was the one who saw him first, as he limped around the side of the house, his back and hair matted with snow. Inside I found his suicide note and showed it to our mother. She collapsed in my arms, crying, and whispered, “This is a secret we must take to our graves.” Live well every day with tips and guidance on food, fitness and mental health, delivered to your inbox every Thursday. Before long, I found myself obsessing about any number of vague yet existential threats, and compulsively taking defensive action against them. I cycled through most of the classic OCD manifestations: avoiding cracks in the sidewalk, flipping light switches three, six, nine times (depending on my mood), checking and rechecking — and rechecking again — that our front and back doors were indeed locked. I had no idea what was happening to me. I simply knew with certainty that if I did not execute these actions correctly, my loved ones and I would suffer. And hypochondria, too: A book titled “Symptoms” lived in the tall bookcase behind the potted plant in the living room; one searched for one’s symptoms in an index up front, then proceeded to the indicated page where one would be provided with the most dire diagnosis imaginable. “Symptoms,” with its heft, its red-linen hardcover and tissue-thin paper, became my Bible. I touched things and people with trepidation and regret. I probed my body for swollen glands. My frequent handwashing desiccated my skin like a riverbed in drought, blood breaking through the cracks. I was forever certain that I was coming down with something catastrophic, like tuberculosis, AIDS, cancer. I was morally scrupulous, in the clinical sense, and prayed three times a day. (I wasn’t particularly religious; I was trying to cover all my bases.) Morning and evening prayer was easy, at home, but lunchtime at school could be tricky; I’d have to abscond to the boy’s room, or a shadowy, chain-link corner of the playground. I grew adept at praying without moving my lips in rote run-on sentences in which I begged God’s forgiveness for everything and anything I had done wrong in the past and would do wrong in the future.

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 28926 - Posted: 09.27.2023

By Baland Jalal Obsessive-compulsive disorder (OCD) has puzzled artists and scientists for centuries. Afflicting one in 50 people, OCD can take several forms, such as compulsively putting things in just the right order or checking if the stove is turned off 10 times in a row. One type of OCD that affects nearly half of those with the condition entails irresistible washing urges. People with this type can spend hours scrubbing their hands in agitation after touching something as trivial as a doorknob even though they know this makes no sense. There is currently a shortage of effective therapies for OCD: 40 percent of patients do not benefit from existing treatments. A major issue is that today’s treatments are often too stressful. First-line “nonpharmacological therapies” involve telling patients to repeatedly touch things such as toilet seats and then refrain from washing their hands. But recent work by my colleagues and me has found something surprising: people diagnosed with OCD appear to have a more malleable “sense of self,” or brain-based “self-representation” or “body image”—the feeling of being anchored here and now in one’s body—than those without the disorder. This finding suggests new ways to treat OCD and perhaps unexpected insights into how our brain creates a distinction between “self” and “other.” In our recent experiments, for example, we showed that people with and without OCD responded differently to a well-known illusion. In our first study, a person without OCD watched as an experimenter used a paintbrush to stroke a rubber hand and the subject’s hidden real hand in precise synchrony. This induces the so-called rubber hand illusion: the feeling that a fake hand is your hand. When the experimenter stroked the rubber hand and the real one out of sync, the effect was not induced (or was greatly diminished). This compelling illusion illustrates how your brain creates your body image based on statistical correlations. It’s extremely unlikely for such stroking to be seen on a rubber hand and simultaneously felt on a hidden real one by chance. So your brain concludes, however illogically, that the rubber hand is part of your body. © 2021 Scientific American

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 8: General Principles of Sensory Processing, Touch, and Pain
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 5: The Sensorimotor System
Link ID: 27980 - Posted: 09.08.2021

By Diana Kwon Obsessive-compulsive disorder (OCD) is marked by repetitive, anxiety-inducing thoughts, urges and compulsions, such as excessive cleaning, counting and checking. These behaviors are also prevalent in the general population: one study in a large sample of U.S. adults found more than a quarter had experienced obsessions or compulsions at some point in their life. Although most of these individuals do not develop full-blown OCD, such symptoms can still interfere with daily life. A new study, published on January 18 in Nature Medicine, hints that these behaviors may be alleviated by stimulating the brain with an electrical current—without the need to insert electrodes under the skull. Robert Reinhart, a neuroscientist at Boston University, and his group drew on two parallel lines of research for this study. First, evidence suggests that obsessive-compulsive behaviors may arise as a result of overlearning habits—leading to their excessive repetition—and abnormalities in brain circuits involved in learning from rewards. Separately, studies point to the importance of high-frequency rhythms in the so-called high-beta/low-gamma range (also referred to as simply beta-gamma) in decision-making and learning from positive feedback. Drawing on these prior observations, Shrey Grover, a doctoral student in Reinhart’s lab, hypothesized with others in the team that manipulating beta-gamma rhythms in the orbitofrontal cortex (OFC)—a key region in the reward network located in the front of the brain—might disrupt the ability to repetitively pursue rewarding choices. In doing so, the researchers thought, the intervention could reduce obsessive-compulsive behaviors associated with maladaptive habits. To test this hypothesis, Grover and his colleagues carried out a two-part study. The first segment was aimed at identifying whether the high-frequency brain activity influenced how well people were able to learn from rewards. The team recruited 60 volunteers and first used electroencephalography to pinpoint the unique frequencies of beta-gamma rhythms in the OFC that were active in a given individual while that person took part in a task that involved associating symbols with monetary wins or losses. Previous work had shown that applying stimulation based on the particular patterns of rhythms in a person’s brain may enhance the effectiveness of the procedure. © 2021 Scientific American

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 3: Neurophysiology: The Generation, Transmission, and Integration of Neural Signals
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 3: The Chemistry of Behavior: Neurotransmitters and Neuropharmacology
Link ID: 27657 - Posted: 01.20.2021

By Elizabeth Landau At dinnertime, 10-year-old Clive Rodgers used to wrap his arms around his plate because he was afraid of germs at the table. “I was really scared, and if somebody tried to move my arm, I would, like, get really angry and stuff,” says Clive, who lives in San Diego with his parents and two younger siblings. Clive is just one of many young people who have struggled with obsessive-compulsive disorder. OCD affects about 1 in every 200 children and teenagers, which is similar to the prevalence of diabetes in this age group. The hallmarks of OCD are intrusive, unwanted thoughts and repetitive behaviors in response to those thoughts, a cycle that may cause significant anxiety and hamper daily activities. As the coronavirus pandemic rages on, it’s a tough time for any kid who has to stay home all day, studying remotely instead of going to school, unable to enjoy normal social activity with friends. Such stressors are making OCD symptoms worse in some children, even those who didn’t specifically fear germs before, doctors say. Andy Rodgers and his son, Clive, of in San Diego. Clive is just one of many youths who has struggled with obsessive-compulsive disorder. OCD affects about 1 in every 200 children and teenagers, which is similar to the prevalence of diabetes in this age group. “Their rituals and obsessions are just worse because their general mental health is worse,” said Suzan Song, director of the Division of Child/Adolescent & Family Psychiatry at George Washington University. Fears of contamination and illness are generally common among people with OCD, but usually their concerns are not in line with likely threats, said Joseph McGuire, assistant professor of psychiatry and behavioral sciences at Johns Hopkins Medicine. With the coronavirus, which causes the disease covid-19, there is actual danger present. He is seeing a “rekindling” of symptoms in many patients who received treatment in the past, and need a refresher.

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 27471 - Posted: 09.14.2020

By Jenny Marder In May, a 15-year-old boy set up a socially distanced visit with a friend. They met on opposite sides of a sidewalk — a full six feet apart — and talked. But when the teenager returned home, he brought with him a new set of Covid-19 fears, according to John Duffy, the boy’s therapist and a child psychologist in Chicago. How could he be sure six feet was a safe distance?, the teenager wanted to know. He began washing his hands more frequently. He stopped touching countertops. And he hasn’t wanted to see friends since. The pandemic has understandably intensified our need for good hygiene and safety precautions. But for some children and teens, these precautions have crossed the line from careful to compulsive. And for parents, it can sometimes be hard to distinguish between a reasonable reaction to a very real threat and something more concerning. There’s little data available yet on the toll the pandemic has taken on the mental health of children. But Eric Storch, an expert on obsessive-compulsive disorder and a professor at the Baylor College of Medicine, said calls to the university’s O.C.D. program have jumped significantly, by about 25 percent, since March. He attributed it in part to telemedicine improving access, and in part to worsening mental health concerns. Dr. Duffy said the number of his patients experiencing O.C.D.-like symptoms has tripled during this time. About 500,000 children and teens in the United States have obsessive-compulsive disorder, according to the International OCD Foundation. Obsessive-compulsive disorder has two main components. Obsessions take the form of uncontrollable thoughts, urges, feelings or uncomfortable sensations. Compulsions are behaviors repeated over and over. These can include excessive handwashing, showering or sanitizing, but also checking things, putting things in order, tapping, touching, seeking reassurance or asking the same question repeatedly. © 2020 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 27445 - Posted: 09.02.2020

By Katherine Rosman The coronavirus outbreak has turned many of us into nervous germophobes, seeking to protect ourselves from infection by washing our hands methodically and frequently, avoiding unnecessary contact with so called high-touch surfaces and methodically sanitizing packages, our homes and our bodies. For people diagnosed with obsessive-compulsive disorder, or O.C.D., the worry created by the threat of coronavirus has the potential for more intense and longer-lasting implications. According to the International OCD Foundation, there are about three million Americans who have been diagnosed with O.C.D. It’s a condition characterized by unwanted thoughts or urges that generate high levels of anxiety and repetitive acts meant to neutralize the obsessional thought. The cleaning and sanitizing practices that help prevent coronavirus infection are bringing people with O.C.D. into closer orbit to behaviors that are a gateway to detrimental patterns that could interfere with their ability to engage meaningfully with the world outside their homes for years to come. Courtenay Patlin, a 28-year-old in Los Angeles, is trying to find balance between appropriate caution and overreaction. Several weeks ago, before the California shelter-in-place order, Ms. Patlin decided to mostly stay indoors. She had read enough about how quickly coronavirus had spread in China, Italy and then Seattle, and how very sick it was making so many. She felt she could rely on only herself and her Clorox to stay healthy. “I keep a very clean apartment, and I feel safe at home,” she said. Ms. Patlin, a graduate student studying clinical psychology, was diagnosed with O.C.D. about five years ago, she said, after years of being afraid of public toilets, refusing to eat off dishes that she hadn’t scrubbed herself or witnessed being sufficiently cleaned by others and being fearful of being hugged by basically anyone. ImageMs. Patlin’s hands. She used to clean her hands and apartment with pure bleach and cleaning solutions until the skin on her fingers started to peel off, which she would take as a sign that she was cleaning the proper amount. © 2020 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 27167 - Posted: 04.03.2020

By Rachel Zamzow One night in December 2013, Hans Korbmacher awoke in a fury. The book-loving, introverted 10-year-old was feverish, agitated and gnawing on his tongue. He headed downstairs, leaped onto an ottoman and threw his hands over his head, startling his parents. He was “clearly not present,” says his mother, Heather Korbmacher. When the same thing happened two weeks later, she thought fevers may have induced Hans’ bizarre behavior. A nurse said it could be the flu. Meanwhile, Hans’ condition worsened. He was anxious and volatile. His handwriting, once a model of penmanship, morphed into angry scribbles. And he became a peculiarly picky eater. Korbmacher, a behavioral specialist for schools in Bellingham, Wash., tried to manage Hans’ symptoms on her own. “It was working OK during those first five months, until it was absolutely not,” she says. Extreme rages came weekly and then daily, keeping Hans out of school. He punched holes in walls and ripped down curtains. The worst part: Hans was acutely aware that something was very wrong. He pleaded with his parents to make it stop. “He would beg us to kill him,” Korbmacher says. Several doctors’ appointments later, a psychiatrist suggested that Hans’ symptoms stemmed from obsessive-compulsive disorder, or OCD. The diagnosis seemed off base to Korbmacher until she read online about a rare form of OCD with a mouthful of a name: pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections, or PANDAS for short. Hans had all but one of the listed symptoms. Korbmacher immediately had Hans tested for a strep infection. A throat swab came back negative, but blood tests revealed that he had four times the typical levels of immune molecules that the body produces in response to a strep infection. © Society for Science & the Public 2000–2019.

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 26542 - Posted: 08.26.2019

By Aimee Berg Virginia Fuchs announced herself to the boxing world at the 2016 United States Olympic Trials, where she twice upset Marlen Esparza, a world champion. In 2017, Fuchs went 18-0. In 2018, she claimed a bronze medal at the world championships by attacking her flyweight opponents, on average, every four seconds during nine minutes of boxing. “That’s an engine!” said Billy Walsh, the head coach for the American team. “She’s a supreme athlete. We joke and call her Seabiscuit because she’s like a racehorse.” Fuchs, known as Ginny, is now the most established fighter from the United States at the Pan American Games this week. The same will most likely be true at the 2020 Tokyo Olympics. “Pretty much everybody’s looking at me to win gold,” said Fuchs, a 31-year-old Texan. Boxing, though, is the least of her battles. About 20 years ago, she learned she had severe obsessive-compulsive disorder. In January, Fuchs had a breakdown that sent her to inpatient treatment for the second time in her life. She spent a month at an O.C.D. clinic in Houston. “I was like: I can’t function like this anymore,” she said. She grew so stuck in her cleaning rituals that she was training daily on three hours of sleep. One night, she said, she couldn’t stop at all and thought: “I’m out of control. I’m scared. I need serious help.” Elite athletes usually know how to solve their opponents. If they are taller and stronger, be quicker. If they are faster, be smarter. If they are tactically superior, be relentless. But what do you do when the most powerful opponent lies permanently within? By definition, O.C.D. involves unwanted, recurring and distressing thoughts. In response, people often perform repetitive behaviors, or rituals, to alleviate the anxiety caused by the obsessions. “But the ritual only works very temporarily,” said Dr. Joyce Davidson, a psychiatrist and medical director at the Menninger Clinic in Houston. “The obsessions keep coming back so people get stuck in this vicious circle of obsessions and rituals. In many cases, it really snowballs.” © 2019 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 26469 - Posted: 07.31.2019

Hannah Devlin Science correspondent Patients with severe obsessive-compulsive disorder have shown remarkable improvements after undergoing an experimental procedure in which electrodes are placed inside the brain. The first UK trial of deep brain stimulation for OCD involved six people who were extremely severely affected by the condition. The patients each had four electrodes surgically inserted through the skull into the brain. These are used to electrically stimulate brain circuits with the aim of bringing the illness under control. One of the patients, a woman who is now in her 40s, described how her life was entirely dominated by her illness for a decade before taking part in the trial. Her OCD rituals meant it took up to 14 hours to go to the toilet, several hours to get out of bed and she lived in a psychiatric unit. She was terrified of poisons and contamination and would sob in frustration for hours each day because her situation felt so unbearable. “It was paralysing,” said the woman, who wants to remain anonymous. She said her life had been transformed beyond recognition by the procedure. Six years after having the electrodes permanently placed inside her brain, she lives independently in a flat, is in a relationship and does regular voluntary work. “For me it’s just been a miracle,” she said. “Every day when I wake up, I can’t believe my luck, I can’t get used to it.” © 2019 Guardian News & Media Limited

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders
Link ID: 26022 - Posted: 03.09.2019

By Diana Kwon For almost a decade, cleaning rituals ruled Kathrine’s life. The middle-aged resident of Bergen, a coastal town in the southern tip of Norway, was consumed by a fear of germs and contamination that led to endless cycles of tidying, vacuuming and washing. “I realized that I was facing a catastrophe,” Kathrine Mydland-aas, now 41, recalls. “I couldn’t help the kids with homework, couldn’t make dinner for them, couldn’t give them hugs. I didn’t do anything but cleaning. I tried to quit, but the rituals always won.” Last year, around nine years after Mydland-aas’s cleaning rituals began, a psychologist diagnosed her with obsessive-compulsive disorder (OCD) and referred her to a clinic at the Haukeland University Hospital in Bergen. There, a team was administering a behavioral therapy for the condition that, to Mydland-aas’s surprise, was only four days long. “I thought, what can they do in four days?” she says. “[But] it changed my life.” Mydland-aas is one of more than 1,200 people who have received the Bergen four-day treatment for OCD, a concentrated form of exposure therapy designed by two Norwegian psychologists, Gerd Kvale and Bjarne Hansen. The four-day protocol has recently gained international attention for its effectiveness and efficiency—last month Time magazine named the pair, who are both currently affiliated with the Haukeland University Hospital and the University of Bergen, as two of this year’s 50 most influential people in healthcare. © 2018 Scientific American

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 17: Learning and Memory
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 13: Memory and Learning
Link ID: 25736 - Posted: 11.30.2018

By Wajahat Ali Ever since I was young, my mind has gotten stuck. I’ll be flooded with intrusive thoughts. An image or an idea will transform into a burning question — “What if I left the stove on?” “What if the door is unlocked?” “What if I lose control and do something violent?” This plays on an endless loop. To cope, I constantly seek reassurance by reviewing my actions, trying to replace my thoughts or using logic to undo what is utterly illogical. But all those efforts fail, instead energizing the thought, resurrecting it like a zombie on steroids, making it more vicious, resistant and cruel. That’s a snapshot of living life with obsessive-compulsive disorder, an anxiety disorder that afflicts nearly 2 percent of the population. With O.C.D., the brain misfires, causing it to malfunction and react to disturbing thoughts, images and ruminations. The sufferer tries to manage his anxiety with compulsive rituals, which include excessive double-checking, counting, repeating a prayer or mantra, and engaging in mental reassurances that give a short-term relief but ultimately become addictive crutches, fueling an endless cycle of torment. O.C.D. has often been misunderstood, undiagnosed and exploited as a set of amusing quirks for Hollywood characters. I wish my O.C.D. was as fun and lovable as depicted in “Monk.” It’s not. At one point in my life, I endured an endless stream of tormenting thoughts about sex, overwhelmed by visions of every vile variation, partnership and arrangement imaginable. They would make Caligula blush. When this happened, feelings of guilt, disgust and shame would inevitably begin to overwhelm me. Self-doubt bubbled up and asked: “What sick person could imagine such things? Surely, there must be something wrong with you?” Here I am, a somewhat intelligent, moral, responsible individual fully aware that the thoughts are irrational, but nonetheless I must perform ridiculous rituals to try to feel safe and achieve relief. I think of it as God’s sick joke. © 2018 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 25573 - Posted: 10.15.2018

By RICH MONAHAN “You must really love that song,” my mother says, and for a moment my heart stops. Both of us are plainly aware she need not be more specific than that. I attempt to read her body language out of the corner of my eye. Does she know? There’s no way, right? “Yeah, it’s a favorite.” I nod, smiling, before turning back toward the television with what I hope is all the nonchalance of a typical 14-year-old boy. What I definitely do not do is glance back and say, “Funny story about that song, while you’ve clearly noticed I’ve listened to it every single weeknight this entire school year, would you believe I only ever press play at exactly 8:38 p.m.? “And check this out, once that cable box hits 9:52 p.m., I will casually retire to my bedroom to initiate the final sequence of what has recently ballooned into a nearly 90-minute nightly routine of humiliating compulsions: I’ll touch the same four CDs laid out on my dresser in ‘order’; turn the stereo on and off; move to the entertainment center; touch the ‘Twisted Metal’ video game case; turn on the TV; boot up the PlayStation; shut it off once the load screen finishes; press ‘channel up’ on the cable box until I hit channel 20, then 22, then 40; turn off the cable box, then touch nothing else until it’s lights out at 9:58 p.m. “And that’s not even the craziest part; the craziest part is that I do these things because I believe they will somehow increase my social standing among other ninth graders. Anywho, Mom, the song’s called ‘Daysleeper,’ and I’m pretty sure I’ve lost my mind.” It started in seventh grade, when two childhood friends aged out of hanging out with me. Already depressed and on the verge of friendlessness, I was desperate to preserve life as it had been. © 2018 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 24756 - Posted: 03.15.2018

By Alice Klein Four genes have been identified that are linked to obsessive compulsive disorder (OCD). The genes all play a role in the same brain circuit, and may help explain why people are more likely to have OCD if they have a relative with the condition. People with OCD have intrusive thoughts and feel driven to repeat rituals, such as handwashing, to relieve their anxiety. To investigate if OCD has a genetic basis, Hyun Ji Noh at the Broad Institute of MIT and Harvard and her colleagues compared more than 600 genes across 592 people with OCD, and 560 people who don’t have it. They chose these candidate genes from several lines of evidence. Of these genes, 222 had been linked to compulsive grooming in mice, and 196 had been linked to autism in people – a condition that can involve repetitive behaviours. The team also looked at 56 genes that they had identified in a study of dogs with canine compulsive disorder, a condition in which dogs repeatedly chase their tails, pace back and forth, groom themselves or sucks things, sometimes for hours at a time. Brain safety circuit The analysis identified four genes that are different in people who have OCD. All four of these are active in a brain circuit that links the striatum, thalamus and cortex regions. © Copyright New Scientist Ltd.

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 4: Development of the Brain
Link ID: 24210 - Posted: 10.18.2017

By Simon Makin About 10 years ago David Adam scratched his finger on a barbed wire fence. The cut was shallow, but drew blood. As a science journalist and author of The Man Who Couldn't Stop: OCD and the True Story of a Life Lost in Thought, a book about his own struggles with obsessive-compulsive disorder, Adam had a good idea of what was in store. His OCD involved an obsessive fear of contracting HIV and produced a set of compulsive behaviors revolving around blood. In this instance he hurried home to get some tissue and returned to check there was not already any blood on the barbed-wire. “I looked and saw there was no blood on the tissue, looked underneath the fence, saw there was no blood, turned to walk away, and had to do it all again, and again and again,” he says. “You get stuck in this horrific cycle, where all the evidence you use to form judgments in everyday life tells you there’s no blood. And if anyone asked, you’d say ‘no.’ Yet, when you ask yourself, you say ‘maybe.’” Such compulsive behaviors, and the obsessions to which they are typically linked are what define OCD. Far from merely excessive tidiness, the mental disorder can have a devastating impact on a person’s life. Adam's story illustrates a curious feature of the condition. Sufferers are usually well aware their behavior is irrational but cannot stop themselves from doing whatever it is they feel compelled to do. Advertisement A new study published September 28 in Neuron uses mathematical modeling of decision-making during a simple game to provide insight into what might be going on. The game looked at a critical aspect of the way we perceive the world. Normally, a person's confidence about their knowledge of the surrounding environment guides their actions. “If I think it’s going to rain, I'm going to take an umbrella,” says lead author Matilde Vaghi. The study shows this link between belief and action is broken to some extent in people with OCD. As a consequence, what they do conflicts with what they know. This insight suggests compulsive behaviors are a core feature rather than merely a consequence of obsessions or a result of inaccurate beliefs. © 2017 Scientific America

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 24150 - Posted: 10.05.2017

By Helen Thomson People with obsessive-compulsive disorder (OCD) may get relief simply from watching someone else perform their compulsive actions. If the finding holds up, we may be able to develop apps that help people with OCD stop needing to repeatedly wash their hands or pull their hair. When we watch someone else perform an action, the same parts of our brains become active as when we do the action ourselves. This is called the mirror neuron system, and it is thought to help us understand the actions and feelings of others. Baland Jalal at the University of Cambridge wondered whether this system could be used to help people with OCD. Working with his colleague Vilayanur Ramachandran, at the University of California, San Diego, he studied 10 people with OCD symptoms, who experience disgust when touching things they consider even mildly contaminated. The anxiety this causes forces them to wash their hands compulsively. First, Jalal and Ramachandran showed each participant something to make them feel disgusted – either an open bag of vomit, a bowl containing blood-soaked bandages or a bedpan of faeces and toilet paper. The participants were unaware that each stimulus was in fact fake. In a variety of conditions, either the participant or a researcher touched the bag, bowl or bedpan for 15 seconds while wearing latex gloves. The participants were then asked to rate how disgusted they felt, before being allowed to wash their hands, or watch the researcher do the same. They then rated how relieved they now felt. © Copyright New Scientist Ltd.

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 23927 - Posted: 08.08.2017

By Helen Thomson Life is full of decisions, and sometimes it’s difficult to know if you’re making the right one. But a drug that blocks the rush of noradrenaline through your body can boost your confidence, and may also lead to new treatments for schizophrenia and obsessive compulsive disorder. How much we trust our decisions is governed by the process we use to assess our own behaviour and abilities, known as metacognition. Our judgements shape how we’ll behave in future. For example, if you play Frisbee and you think you played badly, you might be less likely to do it again, says Tobias Hauser at University College London. Having low confidence in our actions can play a part in mental health conditions. “We see many symptoms associated with poor metacognitive judgement in schizophrenia and OCD,” says Hauser. “In OCD, for instance, people may constantly go and check whether they’ve closed a door. They are poor at judging whether they have done something correctly or not.” Little is known about the neural underpinnings of metacognition, but it is likely to involve the prefrontal cortex and the hippocampus, two brain areas modulated by the chemicals dopamine and noradrenaline. To investigate, Hauser and his colleagues asked 40 people to take a drug that blocks dopamine or noradrenaline either before or after a placebo. Another 20 people received two doses of the placebo drug. Eighty minutes after receiving the second drug, the subjects performed a task in which they had to decide whether the overall motion of a burst of randomly moving dots was directed to the left or right. © Copyright New Scientist Ltd.

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 23705 - Posted: 06.03.2017

/ By Katie Rose Quandt One afternoon in 2013, after swimming and playing outside, 9-year-old Taylor Johnson, from outside Atlanta, began sneezing incessantly. The fit lasted days before stopping abruptly, only to return months later. For a year, her violent sneezing fits came and went, to the bewilderment of a series of doctors. For families, the diagnosis can seem like an answer to their prayers. But there’s a catch: Most doctors won’t treat the diseases — and many don’t believe they even exist. “She was making this noise with her mouth at times 140 to 150 times a minute,” said her mother, Lori Johnson. “She was frantic, she couldn’t eat, she couldn’t sleep.” And “when she wasn’t sneezing, she was very depressed… She lost all interest in anything. Her whole personality just dissolved into nothing.” Then an otolaryngologist (an ear, nose, and throat doctor) realized Taylor wasn’t sneezing at all — the behavior was a repetitive, sneeze-like tic. That prompted a round of visits to neurologists, psychologists, and other specialists, until an allergist finally suggested a set of diagnoses unfamiliar to the Johnsons: PANS and PANDAS. These disorders, a specialist told them, can arise in certain predisposed children when the immune system responds to an infection like strep throat by attacking the brain. The resulting inflammation can lead to violent body tics and OCD-like symptoms. Copyright 2017 Undark

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 15: Emotions, Aggression, and Stress
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 11: Emotions, Aggression, and Stress
Link ID: 23397 - Posted: 03.23.2017

By Clare Wilson The repeated thoughts and urges of obsessive compulsive disorder (OCD) may be caused by an inability to learn to distinguish between safe and risky situations. A brain-scanning study has found that the part of the brain that sends out safety signals seems to be less active in people with the condition. People with OCD feel they have to carry out certain actions, such as washing their hands again and again, checking the oven has been turned off, or repeatedly going over religious thoughts. Those worst affected may spend hours every day on these compulsive “rituals”. To find out more about why this happens, Naomi Fineberg of Hertfordshire Partnership University NHS Foundation Trust in the UK and her team trained 78 people to fear a picture of an angry face. The team did it by sometimes giving the volunteers an electric shock to the wrist when they saw the picture while they were lying in an fMRI brain scanner. About half the group had OCD. The team then tried to “detrain” the volunteers, by showing them the same picture many times, but without any shocks. Judging by how much the volunteers sweated in response to seeing the picture, the team found that people without OCD soon learned to stop associating the face with the shock, but people with the condition remained scared. © Copyright Reed Business Information Ltd.

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 17: Learning and Memory
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 13: Memory and Learning
Link ID: 23323 - Posted: 03.07.2017

By NICHOLAS BAKALAR Extremely high or low resting heart rates in young men may predict psychiatric illness later in life, a large new study has found. Researchers used heart rate and blood pressure data gathered at Swedish military inductions from 1969 to 2010, and linked them with information from the country’s detailed health records through the end of 2013. The study, in JAMA Psychiatry, included 1,794,361 men whose average age was 18 at induction. The highest heart rates — above 82 beats a minute — were associated with increased risks of obsessive-compulsive disorder, anxiety disorder and schizophrenia. The lowest, below 62 beats, were associated with an increased risk of substance abuse and violent criminality. Extremes in blood pressure followed similar patterns, but the associations were not as strong. The lead author, Antti Latvala, a researcher at the University of Helsinki, said that the reasons for the association remain unknown. But, he added, “These measures are indicators of slightly different reactivity to stimuli. These people might have elevated heart rates because of an elevated stress level that is then predictive of these disorders.” Still, Dr. Latvala said, a high or low heart rate does not mean future psychiatric disease. “These are very complex illnesses,” he said. “People with high or low heart rate have nothing to worry about because of these findings. This is just a tiny piece of the puzzle.” © 2016 The New York Times Company

Related chapters from BN: Chapter 16: Psychopathology: Biological Basis of Behavior Disorders; Chapter 7: Life-Span Development of the Brain and Behavior
Related chapters from MM:Chapter 12: Psychopathology: The Biology of Behavioral Disorders; Chapter 4: Development of the Brain
Link ID: 22792 - Posted: 10.27.2016