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Towards a definitive symptom structure of obsessive-compulsive disorder: A factor and network analysis of 87 distinct symptoms in 1366 individuals

Cervin, Matti LU ; Miguel, Euripedes ; Güler, Ayşegül ; Ferrão, Ygor ; Burcu Erdoğdu, Ayşe ; Lazaro, Luisa ; Gökçe, Sebla ; Geller, Daniel ; Yulaf, Yasemin and Senem Başgül, Şaziye , et al. (2022) In Psychological Medicine 52(14). p.3267-3279
Abstract
Background. The symptoms of obsessive-compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques.

Methods. A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD (N = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive-Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the... (More)
Background. The symptoms of obsessive-compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques.

Methods. A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD (N = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive-Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the resulting dimensions were established using network analysis. Associations between dimensions and sociodemographic and clinical variables were explored using structural equation modeling (SEM).

Results. Thirteen first-order symptom dimensions emerged that could be parsimoniously reduced to eight broad dimensions, which were valid across the lifespan: Disturbing Thoughts, Incompleteness, Contamination, Hoarding, Transformation, Body Focus, Superstition, and Loss/Separation. A general OCD factor could be included in the final factor model without a significant decline in model fit according to most fit indices. Network analysis showed that Incompleteness and Disturbing Thoughts were most central (i.e., had most unique interconnections with other dimensions). SEM showed that the eight broad dimensions were differentially related to sociodemographic and clinical variables.

Conclusions. Future research will need to establish if this expanded hierarchical and multidimensional model can help improve our understanding of the etiology, neurobiology (Less)
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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Psychological Medicine
volume
52
issue
14
pages
13 pages
publisher
Cambridge University Press
external identifiers
  • scopus:85100757474
  • pmid:33557980
ISSN
1469-8978
DOI
10.1017/S0033291720005437
language
English
LU publication?
yes
id
8bc39b83-7538-46a8-b342-3d4eabd181ef
date added to LUP
2021-02-09 17:33:31
date last changed
2024-02-17 14:42:43
@article{8bc39b83-7538-46a8-b342-3d4eabd181ef,
  abstract     = {{Background. The symptoms of obsessive-compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques.<br/><br/>Methods. A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD (N = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive-Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the resulting dimensions were established using network analysis. Associations between dimensions and sociodemographic and clinical variables were explored using structural equation modeling (SEM).<br/><br/>Results. Thirteen first-order symptom dimensions emerged that could be parsimoniously reduced to eight broad dimensions, which were valid across the lifespan: Disturbing Thoughts, Incompleteness, Contamination, Hoarding, Transformation, Body Focus, Superstition, and Loss/Separation. A general OCD factor could be included in the final factor model without a significant decline in model fit according to most fit indices. Network analysis showed that Incompleteness and Disturbing Thoughts were most central (i.e., had most unique interconnections with other dimensions). SEM showed that the eight broad dimensions were differentially related to sociodemographic and clinical variables.<br/><br/>Conclusions. Future research will need to establish if this expanded hierarchical and multidimensional model can help improve our understanding of the etiology, neurobiology}},
  author       = {{Cervin, Matti and Miguel, Euripedes and Güler, Ayşegül and Ferrão, Ygor and Burcu Erdoğdu, Ayşe and Lazaro, Luisa and Gökçe, Sebla and Geller, Daniel and Yulaf, Yasemin and Senem Başgül, Şaziye and Özcan, Özlem and Karabekiroğlu, Koray and Fontenelle, Leonardo and Yazgan, Yankı and Storch, Eric and Leckman, James and Conceição do Rosário, Maria and Mataix-Cols, David}},
  issn         = {{1469-8978}},
  language     = {{eng}},
  number       = {{14}},
  pages        = {{3267--3279}},
  publisher    = {{Cambridge University Press}},
  series       = {{Psychological Medicine}},
  title        = {{Towards a definitive symptom structure of obsessive-compulsive disorder: A factor and network analysis of 87 distinct symptoms in 1366 individuals}},
  url          = {{https://lup.lub.lu.se/search/files/91027578/towards_a_definitive_symptom_structure_of_obsessivecompulsive_disorder_a_factor_and_network_analysis_of_87_distinct_symptoms_in_1366_individuals.pdf}},
  doi          = {{10.1017/S0033291720005437}},
  volume       = {{52}},
  year         = {{2022}},
}