Temporal Dynamics of Rituals in Obsessive Compulsive Disorder

Obsessive-compulsive disorder (OCD) is characterized by obsessions, defined as intrusive and persistent thoughts, and compulsions, defined as repetitive ritualistic behaviors that attempt to neutralize the anxiety associated with the obsessions. The present study investigated the patterns of symptoms as they occur over time in order to generate new insights about the triggers to symptoms. Fourteen adult participants who met the DSM-5 criteria for OCD completed 7-day logbooks of daily activities including the times when they engaged in compulsive rituals. Orbital Decomposition (ORBDE) was used to extract symptom patterns and revealed a wide range of symptom cycle lengths, some of which were hierarchically organized in time and some were not. Furthermore the results of the ORBDE analysis were logically consistent with those of a previously reported nonlinear regression analysis. Both analytic techniques supported a turbulence model for OCD onset: Combinations of cognition, emotion, and behavioral responses that would occur randomly for nonclinical samples self-organize into deterministic and chaotic patterns for clinical samples. It is speculated that knowledge of the individuals' temporal dynamics could inform effective treatment strategies, allowing a therapist to develop an individualized yet empirically supported treatment plan.