Higher order dimensions in the DSM/ICD obsessive-compulsive and related disorders

Area of Science:

• Psychiatry
• Psychopathology
• Factor Analysis

Background:

• Hierarchical dimensional models of psychopathology often exclude obsessive-compulsive spectrum disorders due to insufficient data.
• This study investigates the higher-order structure of obsessive-compulsive and related disorders (OCRDs) within the DSM/ICD framework.

Purpose of the Study:

• To determine the optimal structural model for OCRDs.
• To explore the associations between OCRD dimensions and indicators from internalizing, externalizing, and thought disorder spectra.

Main Methods:

• Confirmatory factor analyses were conducted on data from community (N=1110) and clinical (N=690) samples.
• Structural regression models examined associations between OCRD dimensions and other psychopathological spectra.

Main Results:

• A two-factor model, comprising grooming (hair pulling, skin picking, nail biting/picking) and compulsivity (OCD, hoarding, body dysmorphic, olfactory reference, illness anxiety disorders), provided the best fit.
• The compulsivity factor, but not the grooming factor, demonstrated robust associations with internalizing and thought disorder spectra.
• Both factors showed weak and inconsistent associations with alcohol and substance use.

Conclusions:

• The findings support a model of OCRDs characterized by separable compulsivity and grooming dimensions.
• Further research is required to elucidate the scope of these dimensions and their integration into the broader meta-structure of psychopathology.