Sex-specific clinical correlates of hoarding in obsessive-compulsive disorder

Little is known about whether the clinical correlates of hoarding behavior are different in men and women with obsessive-compulsive disorder (OCD). In the current study, we evaluated the association of hoarding with categories of obsessions and compulsions, psychiatric disorders, personality dimensions, and other clinical characteristics separately in 151 men and 358 women with OCD who were examined during the OCD Collaborative Genetics Study. We found that, among men but not women, hoarding was associated with aggressive, sexual, and religious obsessions and checking compulsions. In men, hoarding was associated with generalized anxiety disorder and tics whereas, among women, hoarding was associated with social phobia, post-traumatic stress disorder, body dysmorphic disorder, nail biting, and skin picking. In women but not men, hoarding was associated with schizotypal and dependent personality disorder dimensions, and with low conscientiousness. These findings indicate that specific clinical correlates of hoarding in OCD are different in men and women and may reflect sex-specific differences in the course, expression, and/or etiology of hoarding behavior in OCD.     

Gender and ethnic differences in the relationship between body esteem and self-esteem.

Gender and ethnic differences in the relationship between body esteem and self-esteem were examined to assess the degree to which these variables change in relation to each other over time. Difference scores (between Time 1 and Time 2, 1 week apart) were obtained using the Self-Esteem Scale (M. Rosenberg, 1979) and the Body Esteem Scale (S. L. Franzoi & S. A. Shields, 1984) for 163 White women, 140 White men, 55 Black women, and 37 Black men. The results indicated that the correlation of the difference scores was stronger for the group of White women than for the other 3 groups, suggesting that changes in self-esteem parallel changes in body esteem more for White women than for White men, Black men, and Black women. The findings are discussed in relation to the prevalence of bulimia nervosa among White women.     

Need fulfillment in the career development of women

To test Harmon's proposal that Maslow's needs theory can explain differences in women's career decisions, need importance scores of 481 college graduate women of 1968 were contrasted. Since full-time homemakers are dependent upon another person for fulfillment of basic needs (Maslow's security-safety and social needs), it was hypothesized that these needs would remain prepotent and, therefore, would be higher for homemakers than for women employed outside the home. Esteem and self-actualization needs of employed women were expected to be higher for employed women than for homemakers. The results of the analyses generally supported the hypotheses. The major resulting discriminant function contrasted negative weights on basic needs with positive weights on high-level needs. Homemakers scored highest on security-safety and social needs, while professional-managerial and clerical-sales workers scored highest on the esteem need. In an unexpected finding, self-actualization was found to be the highest-ranked need for all groups of women in the study.     

Relation between the syndromes of bulimia nervosa and obsessive compulsive disorder

Bulimia nervosa (BN) has been conceptualized as similar to obsessive compulsive disorder (OCD). The results of studies investigating the relation between BN and OCD, however, are inconclusive. Our goal was to attempt to clarify the relation between the syndromes of BN and OCD. The Padua Inventory (PI), a measure of OCD, and the Bulimia Test—Revised (BULIT-R), a measure of bulimic behaviors, were administered to 981 women and 722 men. A significant relationship, equal in magnitude for women and men, was found between BN and OCD. Bulimic symptoms also had a stronger relation to obsessions than compulsions. Finally, 6 of 23 women (26%) who met the diagnostic criteria for BN also met the criteria for OCD, while 1 of 1 man who met the criteria for BN also met the criteria for OCD. Implications for similarities between the two disorders as well as future issues in the study of comorbidity are discussed.This report is based on the first author's masters thesis, which was supervised by the second author.     

Sex differences in trauma symptoms,body image and intensity of pain in a Polish sample of patients suffering from chronic pain

The main goal of the current study was to investigate sex differences in the relationship between the level of trauma symptoms appearing in posttraumatic stress disorder (PTSD) and intensity of pain in a sample of 300 Polish patients suffering from chronic pain, specifically rheumatoid arthritis and lower back pain. We also focused on participants’ body image with body esteem as a mediator. To assess the intensity of pain among participants, we used the Numerical Rating Scale. The level of trauma symptoms was assessed with the PTSD Factorial Version Inventory. To measure body image among participants, we used the Body Esteem Scale. The results of our study suggest that trauma symptoms and body image dimensions were significant predictors of pain intensity among men suffering from chronic pain. Moreover, trauma symptoms and age were significant predictors of pain intensity among women suffering from chronic pain. Finally, we demonstrated that sex differentiates the reaction to chronic pain.     

Women and anxiety disorders: implications for diagnosis and treatment. Proceedings of a conference, November 19-21, 2003, Chantilly, Virginia, USA

Community studies indicate that 19% of men and 31% of women will develop some type of anxiety disorder during their lifetime. The impact of gender is profound in that it increases the likelihood of developing an anxiety disorder by 85% in women compared to men. Sex difference in prevalence rates are apparent as early as age 6, when girls are twice as likely as boys to have an anxiety disorder. In the National Comorbidity Survey, the prevalence rates for panic disorder in women and men were 5% and 2%, respectively. Agoraphobia, which often coexists with panic disorder, has a lifetime prevalence rate of 7% in women and 3.5% in men. Prevalence of trauma is increased in young women as well, and is experienced earlier in life; 62% of sexual assaults are inflicted on females < or = 18 years of age, and 29% occur in children < 11 years of age. Comorbidity of anxiety in women complicates other medical conditions as well. For example, panic disorder is highly comorbid with CHD, which remains the leading cause of death in women in developed countries. Fluctuations in reproductive hormone levels during the female life cycle is thought to be responsible for modulating anxiety. This is often implicated in the later age of onset, the more sudden and acute symptom emergence, and the more episodic course of OCD in women, and in the high prevalence(47.4%) of PMDD. Pregnancy appears to be a protective period for some anxiety disorders, including panic, while for others, such as OCD, it may be associated with onset. Hormonal changes during pregnancy, such as increased prolactin, oxytocin, and cortisol, may contribute to the suppression of stress response that occurs during this period. Despite a large and growing body of literature on anxiety disorders in general, the available data relating to women and girls falls short of informing aspects of diagnosis, treatment, and prevention that may entail sex differences. Additional work is required to understand the biological and psychosocial causes of these differences.     

Clinical features of tic-related obsessive-compulsive disorder: results from a large multicenter study

OBJECTIVE: To evaluate the clinical features of obsessive-compulsive disorder (OCD) patients with comorbid tic disorders (TD) in a large, multicenter, clinical sample.MethodA cross-sectional study was conducted that included 813 consecutive OCD outpatients from the Brazilian OCD Research Consortium and used several instruments of assessment, including the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Yale Global Tic Severity Scale (YGTSS), the USP Sensory Phenomena Scale, and the Structured Clinical Interview for DSM-IV Axis I Disorders. RESULTS: The sample mean current age was 34.9 years old (SE 0.54), and the mean age at obsessive-compulsive symptoms (OCS) onset was 12.8 years old (SE 0.27). Sensory phenomena were reported by 585 individuals (72% of the sample). The general lifetime prevalence of TD was 29.0% (n = 236), with 8.9% (n = 72) presenting Tourette syndrome, 17.3% (n = 141) chronic motor tic disorder, and 2.8% (n = 23) chronic vocal tic disorder. The mean tic severity score, according to the YGTSS, was 27.2 (SE 1.4) in the OCD + TD group. Compared to OCD patients without comorbid TD, those with TD (OCD + TD group, n = 236) were more likely to be males (49.2% vs. 38.5%, p < .005) and to present sensory phenomena and comorbidity with anxiety disorders in general: separation anxiety disorder, social phobia, specific phobia, generalized anxiety disorder, post-traumatic stress disorder, attention-deficit hyperactivity disorder, impulse control disorders in general, and skin picking. Also, the "aggressive," "sexual/religious," and "hoarding" symptom dimensions were more severe in the OCD + TD group.ConclusionTic-related OCD may constitute a particular subgroup of the disorder with specific phenotypical characteristics, but its neurobiological underpinnings remain to be fully disentangled.     

Downward Comparison in Infertile Couples

The tendency of infertile individuals to compare themselves favorably to others with regard to coping efficacy was examined among 61 women and 52 men, including 52 husband-wife pairs. Comparison targets were same-sex infertile others and the spouse. Eighty-three percent of men, but only 45% of women, believed that they were coping better than same-sex others (i.e.,downward comparison). Both men (51%) and women (47%) tended to see no difference between their own and their spouses' coping efficacy. However, comparing themselves to their spouses, men in general compared downward, whereas women compared upward. For both same-sex and spouse comparisons, husbands were significantly more likely to engage in downward comparison than their partners. Analyses testing the correlates of downward comparison revealed that (a) infertile participants who were more likely to engage in downward comparison felt less threatened by infertility, (b) no association emerged between comparison indices and self-esteem, and (c) downward same-sex comparison was more likely for men who had been attempting conception for a longer period.     

Past speech therapy experiences of individuals exploring a new stuttering treatment

Perceptions of benefits of speech therapy, success of therapy across clinical settings, reasons for returning to therapy, client-clinician relationships, and clinicians' competency were assessed in 57 participants (47 men, 10 women; M age = 34 yr.) trying a new therapy. A majority of respondents had cumulatively five or more years in therapy and at least two stuttering therapies. Respondents rated university or hospital settings as more successful than services in public schools. 70% of the respondents noted difficulty communicating basic needs; they blamed themselves for inability to maintain posttherapeutic gains while perceiving their clinicians to be competent and attentive--although 47% of the respondents had minimal to no contact with their therapist after therapy.     

Changes in women’s interpersonal styles across the menstrual cycle

Past research suggests that women alter their behaviors during periods of high fertility to attract mates. Consistent with this notion, the current research examined the interpersonal style, as defined by the interpersonal circumplex, men tend to find most attractive in potential mates and the change in women’s interpersonal styles across the menstrual cycle. In Study 1, a sample of 101 single men reported the interpersonal style they found most attractive in a potential mate. In Study 2, a sample of 86 women reported their interpersonal styles during each day of their menstrual cycle. Results indicated that men tended to prefer mates who were interpersonally warm and that women tended to become more interpersonally warm during periods of high fertility.     

Taiwanese junior college students' needs for and perceptions of a career planning course

A 30-item survey was developed to assess the career planning needs of junior college students in Taiwan. 159 men and 493 women were surveyed about career planning needs and perceptions of a proposed course model to answer whether women differ from men in such needs and upper and lower division students differ. A series of two-way analyses of variance identified 7 items on which the women expressed needs more strongly than the men and another 8 items on which the responses of lower division students were significantly different from those of upper division students. Students' perceptions of a course model provided recommendations for a course in career education.     

Sleep predicts the response to rTMS and CBT in patients with OCD: an open label effectiveness study

BackgroundAlthough many OCD patients benefit from repetitive transcranial magnetic stimulation (rTMS) as treatment, there is still a large group failing to achieve satisfactory response. Sleep problems have been considered transdiagnostic risk factors for psychiatric disorders, and prior work has shown comorbid sleep problems in OCD to be associated with non-response to rTMS in OCD. We therefore set out to investigate the utility of sleep problems in predicting response to rTMS in treatment resistant OCD.MethodA sample of 61 patients (treated with 1-Hz SMA or sequential 1-Hz SMA+DLPFC rTMS, combined with cognitive behavioral therapy) were included. Sleep disturbances were measured using the PSQI, HSDQ and actigraphy. Treatment response was defined as a decrease of at least 35% in symptom severity as measured with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS).Results32 of 61 patients (52.5%) responded to rTMS, and trajectories of response were similar for both rTMS protocols. Three PSQI items (Subjective Sleep Quality; Sleep Latency and Daytime Dysfunction) and the HSDQ-insomnia scale were found to predict TMS response. A discriminant model yielded a significant model, with an area under the curve of 0.813.ConclusionFuture replication of these predictors could aid in a more personalized treatment for OCD.     

Obsessive-compulsive disorder with and without tic disorder: a comparative study from India

Introduction: Evidence from phenomenological, family, genetic, and treatment studies from Western centers have suggested that tic-related obsessive-compulsive disorder (OCD) could be different from non-tic-related OCD. This study from India investigated the differences in OCD with and without tics, with respect to sociodemographics, symptom profile, and comorbidity, including obsessive-compulsive spectrum disorders, to examine whether the clinical profile of tic-related OCD is similar to that reported previously. Methods: Fifty subjects with OCD and tics (chronic motor tics and Tourette syndrome) were compared with 141 OCD subjects without tics. Results: Subjects having OCD with tics tended to be males, and had an earlier onset of illness. They had more of symmetry/aggressive and religious obsessions, and cleaning, ordering/arranging, hoarding, and repeating compulsions and were associated with trichotillomania and hypochondraisis. Stepwise backward (Wald) regression analysis showed that an early age of onset, male gender, aggressive obsessions, cleaning compulsions, and trichotillomania were significantly associated with tic-related OCD. Conclusion: The findings of this study from India are broadly similar to those reported previously from the West indicating the universality of differences in tic- and non-tic-related OCD. Our findings also support the existing evidence that tics contribute to the heterogeneity of OCD.     

Prevalence of dieting among working men and women: the healthy worker project

Examined dieting to lose weight in a population of 2,107 men and 2,540 women employed in 32 worksites in the upper Midwest. Lifetime prevalence of this behavior was estimated to be 47% in men and 75% in women, and point prevalence was reported as 13% and 25% in men and women, respectively. Lifetime prevalence of participation in organized weight-loss programs was 6% in men and 31% in women; current prevalence was 1% in men and 6% in women. The strongest correlate of dieting behavior was relative body weight. In logistic regression analyses, dieting tended to be associated positively with education and occupational status and, in men only, was more prevalent among those with a history of hypertension. Dieters reported lower food intakes than nondieters, but the two groups did not differ consistently in reported physical activity. Overall, dieting appears to be a pervasive behavioral U.S. phenomenon that may contribute in part to population differences in the prevalence of obesity.     

Fear survey schedule-III: Oblique and orthogonal factorial structures in an American college population

The 78-item Fear Survey Schedule-III (Wolpe and Lang, 1964) was administered to 474 men and 545 women, ages 17–27, from the University of Wyoming and the scores were evaluated in orthogonal and oblique factor analyses using stringent criteria. Four main factors, similar in both genders, were identified, relating to fear of interpersonal events, animals and insects, medical and surgical procedures and bodily insults, and environmental concerns (agoraphobia-like). A majority of both men (59%) and women (78%) reported one or more extremely intense fears (rated “very much”), ranging in number from 1 to 40. This has not been reported in previous literature, yet is shown to have relevance for psychological research. The mean score on the majority of fear items was higher for women than men. Needs for additional items that are more male-oriented in the FSS-III and a greater theoretical grounding in FSS-III research are discussed.     

Social Identity, Modern Sexism, and Perceptions of Personal and Group Discrimination by Women and Men

Perceptions of gender-related discrimination against the self and group were examined in women and men, with a focus on the predictive utility of modern sexism and 3 dimensions of social identification (ingroup ties, centrality, and ingroup affect). Questionnaires were completed by 321 undergraduates (206 women and 115 men), of whom 78% self-identified as White and 10% as Asian. Higher levels of personal and group discrimination tended to be perceived by high-neosexism men and low-neosexism women. The centrality of gender identification was positively related to men's personal-level perceptions of discrimination, whereas effects of the emotional facets of social identity—ingroup ties and ingroup affect—occurred jointly with both gender and modern sexism. The results are discussed with reference to social identity theory and the personal/group discrimination discrepancy.     

How Gendered Attitudes Relate to Women’s and Men’s Sexual Behaviors and Beliefs

This study examines associations between endorsement of a sexual double standard, gender role attitudes, and sexual behaviors and beliefs. First year university students in the northeastern United States (N = 434; 52 % female; 33 % Black, 29 % Latino, 39 % White; ages 17–19) participated during their first year of college. Endorsement of a sexual double standard was associated with more conventionally gender-stereotyped sexual behaviors and beliefs, specifically, more sexual partners and fewer perceived barriers to condom use for young men, and more perceived barriers to condom use for young women. Women who were more conventional about men’s roles in society tended to use condoms less, whereas women who were more conventional about women’s roles tended to use condoms more. Men who were more conventional about men’s roles tended to have fewer sexual partners. Findings suggest the importance of examining gender’s role in sexual behaviors and beliefs by assessing multiple gendered attitudes, rather than simply considering biological sex.     

Connections among symptoms of obsessive-compulsive disorder and posttraumatic stress disorder: a case series

Theoretical, clinical, and empirical implications of the functional connections between symptoms of obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are abundant. As such, four cases are presented here of men and women who met criteria for comorbid OCD and PTSD. All had been diagnosed with treatment-resistant OCD and were seeking treatment from an OCD specialty clinic or institute, all reported a history of traumatic experiences prior to the onset of OCD, and all appeared to demonstrate negative treatment outcomes. Upon examination, it appeared that symptoms of OCD and PTSD were connected such that decreases in OCD-specific symptoms related to increases in PTSD-specific symptoms, and increases in OCD-specific symptoms related to decreases in PTSD-specific symptoms. Speculations about the function of OCD symptoms in relation to post-traumatic psychopathology are put forth; and theoretical, research, and treatment implications are discussed.     

Cerebral Palsy and Personality Traits,as Measured by the NEO PI-R—A Preliminary Study

The aim of this study was to investigate whether or not individuals with cerebral palsy (CP), without psychiatric problems, have a divergent personality. Eighteen individuals with CP (11 women, 7 men) were included. Seventeen had spastic and one dyskinetic CP. The participants completed the personality inventory NEO-PI-R. The group had a low average value in the Openness domain scale. In facet scales, the study group was more fearful, had difficulties coping with stress, tended to keep in the background, found change difficult, had limited curiosity, and was relaxed in tempo, more altruistic, more humble, and more unable to get organized. There was a stereotypical gender result, with low results on Openness to aesthetics and feelings for males and higher vulnerability for women. The results may indicate that individuals with CP have a divergent personality compared to individuals in general.     

The status of hoarding as a symptom of obsessive-compulsive disorder

Hoarding is considered by many to be a symptom of obsessive-compulsive disorder (OCD). Yet although it is observed in people with OCD, hoarding symptoms also appear in a number of other psychological and psychiatric conditions. The present studies were conducted using samples of OCD patients, patients with other anxiety disorders, and a non-clinical sample to further elucidate the relationship between hoarding and OCD. Across two investigations, we found that (a) whereas OCD patients had higher scores than the other groups on non-hoarding symptoms, this was not the case for hoarding symptoms; (b) hoarding tended to correlate more weakly with other OCD symptoms (e.g., washing, checking) than these other symptoms intercorrelated; (c) items measuring hoarding had the weakest factor loadings when a measure of OCD symptoms was submitted to factor analysis; (d) hoarding symptoms were not correlated with global OCD or anxiety severity, whereas other OCD symptoms were; and (e) hoarding did not show consistent relationships with OCD-related cognitive variables. These results do not support a specific relationship between hoarding and OCD; and they call into question hoarding's status as a specific symptom of OCD. Results are also discussed in terms of the importance of functional assessment of hoarding and OCD symptoms.