Core Dimensions Predict Manifest Symptom Expression in a Community Sample With Obsessive-Compulsive Disorder

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Obsessive-compulsive disorder (OCD) presents significant symptom heterogeneity, complicating research and clinical practice.
• Existing models attempt to organize OCD symptoms dimensionally, including a four-factor manifest symptom model and a two-dimensional core emotional-motivational model (harm avoidance and incompleteness).
• Previous comparative studies faced limitations due to inadequate measures for assessing manifest symptoms or supporting dimensional scoring.

Purpose of the Study:

• To investigate the relationship between two prominent OCD symptom models: the four-factor manifest symptom model and the two core emotional-motivational dimensions (harm avoidance and incompleteness).
• To explore how these core dimensions predict specific manifest symptom dimensions in a community sample with OCD.
• To assess the utility of the core dimensions in organizing and explaining OCD symptom heterogeneity.

Main Methods:

• Utilized a voluntary adult community sample with lifetime OCD diagnoses.
• Employed the Dimensional Obsessive-Compulsive Scale (DOCS) and the Obsessive-Compulsive Core-Dimensions Questionnaire-Trait (OC-CD-Trait) for comparable dimensional assessments.
• Conducted regression analyses to examine the predictive relationships between core dimensions and manifest symptom dimensions.

Main Results:

• Harm avoidance (HA) and incompleteness (INC) were moderate predictors of overall OCD symptom severity.
• HA uniquely predicted symptoms related to harm/injury/bad luck and unacceptable thoughts.
• INC uniquely predicted symptoms related to germs/contamination and symmetry.

Conclusions:

• The core dimensions of harm avoidance and incompleteness effectively explain and organize patterns of OCD symptom heterogeneity.
• Findings support the core dimensions as candidate endophenotypes for OCD.
• This study provides novel insights into the association between manifest symptom and core dimension models in a community-based OCD sample.