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BACKGROUND Individual vegetable oils have a characteristic fatty acids (FA) composition and unique phytonutrient profiles, enabling formulation of oil blends that may have health-promoting effects. OBJECTIVE The primary objective of this study was to investigate effects of 2 oil blends made with refined rice bran, flaxseed, and sesame oils, with distinct monounsaturated to saturated FA, polyunsaturated to saturated FA, and omega-3 (n-3) to omega-6 FA ratios and different phytonutrient concentrations on blood lipid profile, compared with refined olive oil as a control. The secondary outcomes were other markers of cardiometabolic health. METHODS A parallel-design, randomized controlled trial compared consumption of 30 g of allocated intervention oil per day for a period of 8 wk. The study recruited 143 borderline hypercholesterolemic (LDL cholesterol: 3.06-4.51 mmol/L) Chinese volunteers between 50 and 70 y old and with a BMI (kg/m2) ≤27.5. All outcomes were measured every 2 wk, and the time × treatment interactions and the main effects of treatment and time were analyzed using an intention-to-treat approach. RESULTS Compared with baseline (week 0), there were significant reductions during the post-intervention time points in serum total cholesterol (-3.47%; P more...

INTRODUCTION: Overdoses of beta-adrenergic antagonists and calcium channel antagonists represent an uncommonly encountered but highly morbid clinical presentation. Potential therapies include fluids, calcium salts, vasopressors, intravenous lipid emulsion, methylene blue, and high-dose insulin. Although high-dose insulin is commonly used, the kinetics of insulin under these conditions are unknown. CASE REPORT: We present a case of a 51-year-old male who sustained a life-threatening overdose after ingesting approximately 40 tablets of a mixture of amlodipine 5 mg and metoprolol tartrate 25 mg. Due to severe bradycardia and hypotension, he was started on high-dose insulin (HDI) therapy; this was augmented with epinephrine. Despite the degree of his initial shock state, he ultimately recovered, and HDI was discontinued. Insulin was infused for a total of approximately 37 hours, most of which was dosed at 10 U/kg/hour; following discontinuation, serial serum insulin levels were drawn and remained at supraphysiologic levels for at least 24 hours and well above reference range for multiple days thereafter. CONCLUSION: The kinetics of insulin following discontinuation of high-dose insulin therapy are largely unknown, but supraphysiologic insulin levels persist for some time following therapy; this may allow for simple discontinuation rather than titration of insulin at the end of therapy. Dextrose replacement is frequently needed; although the duration is often difficult to predict, prolonged infusions may not be necessary. more...

Review of scientific instruments 93(11), 113301 (2022). doi:10.1063/5.0082932, Published by American Institute of Physics, [S.l.]

Research consistently demonstrates that individuals with anxiety symptoms exhibit attentional biases toward threatening stimuli using various computer-based tasks. However, the presence of attentional biases across obsessive-compulsive symptom presentations has been mixed and requires clarification. This study was the first to use the dot probe paradigm to investigate the association between scrupulosity symptoms (obsessions and compulsions having to do with religion and morality) and selective attention to scrupulosity-relevant lexical stimuli. Contrary to hypotheses, individuals with higher levels of scrupulosity did not selectively attend (i.e., have faster reaction times) to scrupulosity-specific threat words (e.g., hell) more so than to general threat or neutral words. Various potential explanations for these null findings, as well as directions for future research, are discussed.Keywords: attention bias; religiosity; obsessive-compulsive disorderScrupulosity is a presentation of obsessive-compulsive disorder (OCD) involving obsessions and compulsions having to do with religion and morality (Abramowitz, 2001, 2008; Abramowitz & Jacoby, 2014; Huppert & Siev, 2010). Specifically, individuals with scrupulosity experience unwanted intrusive thoughts (i.e., obsessions) associated with the possibility that they have committed a moral or religious transgression (e.g., "Did I commit a sin without realizing it?"); intrusive blasphemous thoughts or images (e.g., images of the devil); doubts that one may not be faithful, moral, or pious enough (e.g., "Am I truly a Christian?"); concerns that one didn't perform a religious prayer or ceremony correctly (e.g., "Did I really confess all of my sins at confession?"); and fears of eternal damnation (e.g., "Am I going to hell?"). These intrusions are experienced as highly distressing and are accompanied by the drive to perform compulsive rituals-such as excessive prayer, re-reading Bible verses until they are read "perfectly," and repeatedly seeking reassurance from religious figures or loved ones about religious topics-that function to reduce anxiety. Individuals with scrupulosity also often avoid situations and stimuli that trigger obsessional thoughts and distress.Cognitive behavioral models of scrupulosity propose that one maintaining factor of this problem is attentional biases for threat (Abramowitz & Jacoby, 2014), which refers to the preferential processing of danger-related stimuli over neutral stimuli when both types of stimuli are competing for processing priority (MacLeod, Mathews, & Tata, 1986). For example, consider the case of Rebecca, a Catholic woman with scrupulosity whose obsessional doubts include uncertainty over whether she has fully confessed all of her sins at confession. Hypervigilant for cues related to confession, sin, and hell, Rebecca has become exquisitely sensitive to these words and notices every time they appear or whenever someone uses them (and even words that sound similar; e.g., being greeted by someone saying "Hello"). She also has difficulty disengaging her attention from these intrusive words and starts to ruminate about whether she has committed a sin that she has not confessed and if God is going to punish her by damning her to hell. Her anxiety steadily increases until she feels she can no longer tolerate the discomfort. To make herself feel better, she often makes excuses to leave these situations and return to church, confess any possible perceived sins, and reduce her anxiety.Research on anxiety, more generally consistently demonstrates-using various experimental paradigms-that individuals with anxiety symptoms exhibit attentional biases toward threatening stimuli (for a meta-analytic review, see Bar-Haim, Lamy, Pergamin, Bakermans-Kranenburg, & van IJzendoorn, 2007). The dot probe task (MacLeod et al., 1986) is one such paradigm, in which participants are asked to indicate as quickly as possible which letter (i. … more...

Intolerance of Uncertainty (IU) is a key construct in the development and maintenance of obsessive-compulsive disorder (OCD). Recent research has examined the Beads Task as a behavioral measure of IU in which an incorrect decision is tied to an aversive outcome. The current study aimed to increase ecological validity of the Beads Task as an analog for decisional uncertainty in OCD. Specifically, we investigated whether the aversive outcome's “victim” impacted associations between IU and distress during decision-making. Undergraduates (N = 85) completed the Beads Task either alone or with a confederate partner. They were told that errors on the task would either lead to themselves (solo condition) or their “partner” (partner condition) having to complete the Cold Pressor Task (CPT). As hypothesized, participants in the partner condition experienced the Beads Task as significantly more distressing and important than those in the solo condition. Furthermore, self-report prospective IU was associated with distress about harm befalling oneself and perceived importance of the decision (solo condition), whereas inhibitory IU was associated with distress about harm befalling others (partner condition). Clinical implications for addressing uncertainty using exposure and response prevention, and future research of decision-making in the context of responsibility for harm are discussed. more...

The unwillingness to remain in contact with obsessions and anxiety (i.e., experiential avoidance, EA) may explain how normally occurring unwanted intrusive thoughts develop into clinical obsessions as seen in obsessive-compulsive disorder (OCD). Studies examining the relationship between EA and OC symptoms are mixed, potentially because the existing self-report measure of EA (i.e., the Acceptance and Action Questionnaire, AAQ-II) is a general measure that does not adequately capture EA specific to obsessions and compulsions. Thus, we aimed to develop and evaluate an OC-specific version of the AAQ-II. First, we used exploratory factor analysis to empirically reduce an initial pool of 49 items (adapted from original AAQ-II items to reference “intrusive thoughts”) to 13 items. A two-factor solution (Valued Action and Willingness) provided the best fit to the data, accounting for 60.57% of the variance. Second, the reduced AAQ-OC was administered, along with other self-report measures, to an independent sample of adults. The AAQ-OC subscales evidenced good internal consistency as well as convergent, discriminant, and incremental validity. Future work examining the psychometric properties of the AAQ-OC in a clinical sample, as well as the measure's treatment sensitivity are needed. more...

There is conflicting research on the association between parents’ and children's obsessive-compulsive (OC) features (obsessive beliefs, interpretation biases, and OC symptoms) and how other parent-level risk factors (e.g., depression) influence the emergence of OC features in youth. To bridge this gap, we adopted a multi-method and multi-informant approach, including both child- and parent-report measures, as well as in vivo behavioral tasks, to evaluate how parent-level factors contribute to children's OC features. Twenty-seven parents and 48 children, who reported OC features across a spectrum of severity, completed diagnostic interviews, self-report questionnaires, and attended an experimental session in our laboratory. We first conducted univariate linear regressions to identify the significant parent-level predictors and applied the False Discovery Rate to control for Type 1 error. Next, significant predictors were entered into a multivariate mixed-effects linear regression model that included a random intercept for family unit. Results suggested that the transmission of beliefs, interpretations, and symptoms is not domain-specific; rather, certain parent factors - religiosity, depression, anxiety, stress, and psychological control - seem to operate as general vulnerability factors for children's OC features. Although the cross-sectional design precludes conclusions regarding causation, findings can inform individualized prevention programs that alter the trajectory of at-risk youth. more...

Mental contamination (MC) is an experience in which individuals feel dirty or impure even though they have not come into direct contact with a contaminated object (e.g., merely thinking about something immoral or disgusting). Although limited research has examined MC in relation to contact contamination-relevant cognitions and symptoms, no studies to date have investigated the extent to which this construct is associated with the “unacceptable thoughts” obsessive-compulsive (OC) subtype. In our sample of unselected participants ( n = 304) who completed a self-report battery we found: (a) as in previous studies, MC was related to contact contamination OC symptoms and relevant cognitive distortions (i.e., threat overestimation and contamination thought action fusion), and (b) as hypothesized, MC was also associated with unacceptable thoughts symptoms and relevant cognitive distortions (intolerance of uncertainty and experiential avoidance). However, contrary to hypotheses, MC was also related to the responsibility for harm and symmetry/incompleteness OC symptom dimensions. Accordingly, rather than being uniquely tied to specific dimensions, it appears that MC may be associated with more general latent vulnerability factors associated with OCD. Additional implications for the way MC is conceptualized and treated and directions for further study are also discussed. more...

Family accommodation (FA) is key in the maintenance of OCD. However, most studies are cross-sectional, and have not identified long-term trajectories and correlates of FA changes over treatment. This study investigated changes in clinician-rated FA over 10 sessions of cognitive behavioral therapy (CBT) for 142 children with OCD, as well as several key predictors/correlates: (a) clinician-rated OCD symptom severity, (b) child- and parent-rated functional impairment, (c) parent-rated treatment expectancies, and (d) child- and parent-rated therapeutic alliance. Multi-level models indicated that FA changed significantly during treatment, with gains maintained over 6-months. Baseline clinician-rated OCD severity did not predict changes in FA. Significant interactions indicated that children with higher child- and parent-rated impairment exhibited greater FA improvements over treatment (versus children with lower impairment). Child- and parent-rated therapeutic alliance and parent-rated expectancies did not predict FA changes. Finally, FA mediated the relationship between OCD severity and parent- (but not child-) rated impairment. Reverse mediation models were also significant. Findings indicate that CBT can successfully reduce FA (a) even if children experience high OCD severity and interference in school, relationships, and family life, and (b) regardless of non-specific factors like treatment expectancies and alliance. FA reductions are an important mechanism mediating treatment response. more...

Obesity is related to an increasing risk of chronic diseases. Medium- and long-chain triacylglycerols (MLCT) have been recognized as a promising choice to reduce body weight. In this study, three MLCT with different contents of medium-chain fatty acids (MCFA) (10-30%, w/w) were prepared, and their effects on lipid metabolism and fecal gut microbiota composition of C57BL/6J mice were systematically investigated. MLCT with 30% (w/w) MCFA showed the best performance in decreasing body weight gain as well as optimizing serum lipid parameters and liver triacylglycerol content. The expression levels of genes encoding enzymes for fatty acid degradation increased markedly and expression levels of genes encoding enzymes for de novo fatty acid biosynthesis decreased significantly in the liver of mice treated with MLCT containing 30% (w/w) MCFA. Interestingly, the dietary intake of a high fat diet containing MLCT did significantly decrease the ratio of Firmicutes to Bacteroidetes and down-regulate the relative abundance of Proteobacteria that may attribute to weight loss. Furthermore, we found a notable increase in the total short-chain fatty acid (SCFA) content in feces of mice on a MLCT containing diet. All these results may be concomitantly responsible for the antiobesity effect of MLCT with relatively high contents of MCFA. more...

Serious illnesses such as Ebola are often highly publicized in the mass media and can be associated with varying levels of anxiety and compensatory safety behavior (e.g., avoidance of air travel). The present study investigated psychological processes associated with Ebola-related anxiety and safety behaviors during the outbreak in late 2014. Between October 30 and December 3, 2014, which encompassed the peak of concerns and of the media’s attention to this particular outbreak, 107 university students completed a battery of measures assessing fear of Ebola, performance of safety behaviors, factual knowledge of the virus, and psychological variables hypothesized to predict Ebola-related fear. We found that while our sample was generally not very fearful of contracting Ebola, the fear of this disease was correlated with general distress, contamination cognitions, disgust sensitivity, body vigilance, and anxiety sensitivity-related physical concerns. Regression analyses further indicated that anxiety sensitivity related to physical concerns and the tendency to overestimate the severity of contamination were unique predictors of both Ebola fear and associated safety behaviors. Implications for how concerns over serious illness outbreaks can be conceptualized and clinically managed are discussed. more...

Both graduate and undergraduate students in design and product development acquire very specific domain related competences throughout their study program. These educational targets, compiled in 12 domain-specific core competences a student in product dev more...

Obsessive-compulsive and related disorders (OCRDs) consist of a cluster of impairing psychological conditions including obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder, hair-pulling disorder (i.e., trichotillomania), skin-picking disorder (i.e., excoriation), and other specified and unspecified OCRDs (American Psychological Association, 2013). Across OCRDs and anxiety disorders, there is considerable overlap in symptomatology, theorized mechanisms, and evidence-based treatment approaches. However, there is significant heterogeneity in the presentation and functional relationships between symptoms across OCRDs, as well as important nuances to consider in the assessment, diagnosis, conceptualization, and treatment of OCRDs and anxiety disorders. As such, the present chapter provides an overview of (1) the diagnostic criteria and cognitive-behavioral conceptualization of OCRDs, (2) considerations for functional assessment and differential diagnosis among OCRDs and anxiety disorders, and (3) a discussion of empirically supported interventions and relevant treatment considerations for these conditions. more...

Cognitive-behavioral models of obsessions, which posit that such symptoms arise from the misinterpretation of intrusive thoughts, have empirical support. Yet, these models do not entirely explain obsessive-compulsive (OC) symptoms. Cognitive fusion, derived from relational frame theory (RFT), refers to the tendency for behavior to be overly regulated and influenced by cognition, and may incrementally improve our understanding of OC symptoms. The current study examined the extent to which constructs within these theoretical approaches predict various OC symptom dimensions. Participants completed measures of cognitive fusion, psychological flexibility, and obsessive beliefs, as well as OC symptoms. Regression analyses revealed that constructs from cognitive-behavioral and RFT models were associated with certain OC symptom dimensions. Moreover, RFT-related constructs uniquely predicted the unacceptable thoughts OC dimension over and above variance explained by cognitive-behavioral constructs. Results suggest... more...

Consistent research using a variety of computer-based tasks demonstrates that individuals with anxiety symptoms exhibit attentional biases towards threatening stimuli. Whether or not attentional biases contribute to the development and maintenance of illness anxiety (IA), however, remains unclear given inconsistent findings in previous studies. The present study used the dot-probe paradigm to investigate the association between IA and selective attention to illness-relevant threat words. Contrary to hypotheses, higher levels of IA were not associated with preferential attention (i.e., faster reaction times for trials with short stimulus duration and longer reaction times for trials with long stimulus duration) to illness-specific threat words (e.g., “cancer”) more so than to general-threat or neutral words. Given the variety of methodologies and mixed findings regarding attentional biases in individuals with IA, such reporting of null findings is important to elucidate where true relationships exist. more...

Background and objectives Studies show that attentional bias towards threat is a key maintenance factor for panic disorder (PD). Attentional bias may be an important mechanism of symptom reduction, and thus, a useful target for optimizing outcomes. The current study examined whether an attention bias modification (ABM) task enhanced CBT outcomes. Multiple methods for assessing PD were used, including physiological measurement and clinician-rated assessment. Methods Adults with panic disorder (N = 24) received seven sessions of CBT with either ABM or sham attention tasks. Psychophysiological reaction to a loud tones startle paradigm was assessed before and after treatment. Results Across both groups, panic symptom severity decreased with CBT. The ABM group showed greater reductions in PD symptoms compared to the placebo group. Notably, however, changes in attentional bias were not associated with symptom reductions across groups. No significant group differences on psychophysiological assessment were observed. Limitations This study is limited by the small sample size, which rendered our power to investigate mediators and moderators insufficient. More research is needed to validate the effect of attention bias modification on attentional bias to threat. Conclusions This pilot study suggests that future research should investigate attentional bias in conjunction with CBT. A larger sample would provide opportunity to further investigate the mechanisms through which ABM works, along with potential moderating factors and the use of psychophysiological measurements in panic disorder. more...

A plasma window (PW) is a device for separating two areas of different pressures while letting particle beams pass with little to no loss. It has been introduced by A. Hershcovitch. In the course of this publication, the properties of a PW with apertures of 3.3 mm and 5.0 mm are presented. Especially the link between the pressure properties relevant for applications in accelerator systems and the underlying plasma properties depending on external parameters are presented. At the low pressure side around some mbar, high-pressure values reached up to 750 mbar while operating with volume flows between 1 slm and 4 slm (standard liter per minute) and discharge currents ranging from 45 A to 60 A. Unique features of the presented PW include simultaneous plasma parameter determination and the absence of ceramic insulators between the cooling plates. Optical analysis reveals no significant damage or wear to the components after an operation time well over 10 h, whereas the cathode needle needs replacement after 5 h., Comment: 7 pages, 7 figures more...

Rice bran oil (RBO) is not a popular oil worldwide, but its demand is increasing due to its popularity as a “healthy oil” in Asian countries, particularly in Japan, Korea, India, China, and Indonesia. RBO is an excellent cooking oil and salad oil due to its high smoke point and delicate flavor. It is unique among edible oils due to its rich source of commercially and nutritionally important phytoceuticals such as oryzanol, lecithin, squalene, phytosterols, polyphenols, tocopherols, tocotrienols, and many more. Many studies on humans and animals have shown that RBO is as effective as some other vegetable oils that are rich in polyunsaturated fatty acids in lowering plasma cholesterol levels and lipoprotein profiles. In some cases, RBO was found to lower plasma cholesterol more effectively, and this effect can be attributed to the occurrence of these other specific components in RBO. This chapter provides a comprehensive review of the phytonutrients from RBO that have shown promising disease-preventing and health-related benefits in experimental research studies. more...

The objective of this study was to test whether treatment acceptability, exposure engagement, and completion rates could be increased by integrating acceptance and commitment therapy (ACT) with traditional exposure and response prevention (ERP). 58 adults (68% female) diagnosed with obsessive-compulsive disorder (OCD; M age = 27, 80% white) engaged in a multisite randomized controlled trial of 16 individual twice-weekly sessions of either ERP or ACT + ERP. Assessors unaware of treatment condition administered assessments of OCD, depression, psychological flexibility, and obsessional beliefs at pretreatment, posttreatment, and six-month follow-up. Treatment acceptability, credibility/expectancy, and exposure engagement were also assessed. Exposure engagement was high in both conditions and there were no significant differences in exposure engagement, treatment acceptability, or dropout rates between ACT + ERP and ERP. OCD symptoms, depression, psychological inflexibility, and obsessional beliefs decreased significantly at posttreatment and were maintained at follow-up in both conditions. No between-group differences in outcome were observed using intent to treat and predicted data from multilevel modeling. ACT + ERP and ERP were both highly effective treatments for OCD, and no differences were found in outcomes, processes of change, acceptability, or exposure engagement. more...

Cognitive-behavioral models of obsessive–compulsive disorder (OCD) propose that erroneous beliefs about the importance and need to control thoughts lead individuals with OCD to overuse maladaptive thought control strategies such as worry and self-punishment. These strategies are thought to backfire, leading to obsessional symptoms. Whereas previous studies have examined predictors of the use of thought control strategies, none have investigated these strategies as mediators in the prediction of OCD symptom severity. An additional gap in the literature is the lack of attention to OCD symptom dimensions. The present study, therefore, extended existing work by examining thought control strategies as mediators of the relationship between obsessive beliefs and OCD symptom dimensions in a treatment-seeking sample of 102 adults with OCD. In line with our hypotheses, the use of punishment (but not worry) as a thought control tactic mediated the relationship between dysfunctional beliefs about the importance/control of thoughts and unacceptable obsessions. These findings are discussed in terms of the conceptualization and treatment of OCD. Future research should investigate the extent to which these various thought control strategies may be helpful versus harmful using idiographic measures of thought control and employing experimental designs. more...

Background: Obsessive beliefs account for substantial (but not all) obsessive-compulsive (OC) symptoms. Intolerance of internal experiences (IIE), which encompasses the constructs of experiential avoidance (EA) and distress tolerance (DT), refers to difficulty managing unwanted thoughts, emotions, and other internal states, and might add to current explanatory models. Although IIE appears to be conceptually relevant to obsessive-compulsive (OC) symptoms, scant research has examined this relationship empirically. Aim: The present study examined the relative contributions of EA and DT as predictors of OC symptom dimensions. Method: A nonclinical sample (n = 496) completed self-report questionnaires measuring general distress, EA, DT and OC symptom dimensions. Results: All variables of interest were significantly (all ps ≤ .001) correlated with one another, such that higher general distress, higher EA, and lower DT were associated with greater OC symptom severity for all symptom dimensions; however, only EA independently predicted obsessional symptoms, but not other OC symptom dimensions. Conclusions: One's willingness to endure (i.e. EA), rather than their ability to tolerate (i.e. DT) unpleasant internal experiences best predicts obsessional symptoms (i.e. obsessing) above and beyond general distress. Potential implications for understanding, assessing, and treating OC symptoms are discussed. more...

Relationships between young people with anxiety and their non-affected siblings are important for both individuals in the dyad, and for family dynamics throughout the lifespan; however, these relationships are not well understood. This study examined the experience of growing up with an anxious sibling from the sibling without anxiety’s point of view. We measured psychosocial factors associated with sibling relationship quality in 64 young adults with an anxious sibling. Overall, participants with anxious siblings were resilient, reporting comparable sibling relationship quality, anxiety symptoms, and psychological functioning relative to peers without anxious siblings. The contributions of caregiver burden and attributions about the causes of the sibling’s anxiety-related behavior accounted for significant variance in both sibling relationship warmth/closeness and conflict, with responsibility attributions emerging as an individual predictor of conflict. Clinical and research implications for understanding sibling relationships in the context of anxiety, and for the role of attributions in family relationships are considered. more...

This article addresses the use of exposure therapy for OCD as informed by an acceptance and commitment therapy (ACT) framework. The model on which ACT is based is covered, including its philosophy, basic research, targeted process of change, individual treatment components, and general manual. Specific suggestions for how to prepare, select, set up, and conclude exposure exercises from an ACT perspective are included and illustrated using the case of Monica as an example. Empirical support for this approach is briefly covered. more...

Safety behaviors—actions performed to prevent, escape from, or reduce the severity of perceived threat—are typically eliminated during exposure therapy for clinical anxiety. Yet some experts have called for the strategic and “judicious use” of safety behaviors during exposure to improve treatment acceptability/tolerability without diminishing its efficacy. Empirical findings regarding this debate are mixed and existing work is subject to several methodological limitations. The current randomized controlled trial incorporated longitudinal design and multimethod assessment to compare the efficacy of traditional exposure with the elimination of safety behaviors (E/ESB) and exposure with judiciously used safety behaviors (E/JU). Adults with clinically significant spider fear (N = 60) were randomized to four twice-weekly sessions of E/ESB or E/JU. Self-report and behavioral measures were administered at pretreatment, posttreatment, and 1-month follow-up. Participants exhibited large effects on all measures from pretreatment to posttreatment, with no change from posttreatment to follow-up. There were no significant group differences in treatment outcome or treatment acceptability/tolerability. Exploratory analyses were used to compare behavioral and inhibitory learning processes between conditions. Clinical implications, study limitations, and future directions are discussed in terms of inhibitory learning theory. more...

Intolerance of uncertainty (IU) is a key cognitive construct in the maintenance of obsessive-compulsive disorder (OCD) symptoms. Whereas most individuals feel “certain-enough” that situations are relatively safe, those with OCD who have elevated IU have difficulty managing the feeling of not knowing “for sure” whether a feared outcome may occur. As a result, they engage in compulsive rituals (e.g., checking, reassurance seeking) with the aim of restoring a sense of certainty. Given the pervasiveness of uncertainty in daily life, these doubts and rituals can lead to heightened daily distress for individuals with OCD. Accordingly, the present chapter reviews the following: (a) a comprehensive definition of IU, (b) the conceptualization of IU as important in the development and maintenance of OCD across various symptom presentations, (c) the measurement of IU using both self-report and behavioral methods, and (d) recommendations for the consideration of IU in OCD treatment. more...

Sn-2 palmitic acid triacylglycerols (sn2PA fat) and polyunsaturated fatty acids are thought to influence the metabolic status and intestinal bacterial population of the host. In this study, the impact of sn2PA fat in combination with DHA or ARA in the diet on lipid metabolism in the liver and faecal microbiota composition were investigated in rats fed diets containing sn2PA fat, 90% sn2PA fat + 10% DHA oil (wt%), or 90% sn2PA fat + 10% ARA oil (wt%). Tissue fatty acid composition was measured using gas chromatography (GC), whereas the faecal microbial composition was assessed using 16S rRNA high-throughput sequencing technology. In addition, faecal short-chain fatty acids (SCFA) were analyzed using ion chromatography. The results showed that sn2PA fat in combination with DHA or ARA significantly reduced liver triacylglyceride (TG) content compared with the sn2PA fat only group. Moreover, the supplementation with sn2PA fat in combination with DHA or ARA significantly promoted the growth of Lactobacillus in the feces at the genus level. On the other hand, the growth of the opportunistic pathogen Desulfovibrio was significantly inhibited by sn2PA fat in combination with ARA compared with the sn2PA fat group. In addition, sn2PA fat in combination with DHA or ARA significantly increased total SCFA concentration in the faeces, suggesting a beneficial effect on host intestinal health. more...

The neurobiological mechanisms underlying the pathophysiology of body dysmorphic disorder (BDD) are not well-understood. Oxytocin is a central nervous system peptide which regulates socioemotional functioning and may mediate physiologic processes in a range of psychiatric disorders, particularly those characterized by interpersonal dysfunction. Examining the role of oxytocin in the development and maintenance of BDD may elucidate new targets for intervention. The present study examined endogenous serum oxytocin levels in BDD. Given the prominent deficits in social functioning in BDD, we expected that BDD would be characterized by low basal serum oxytocin concentrations, relative to healthy controls, and that low oxytocin levels would be associated with BDD symptom severity as well as poor performance on measures of social cognition. Twenty individuals with BDD and 28 healthy controls completed a fasting blood draw consisting of frequent sampling every five minutes for one hour to measure pooled levels of oxytocin. Contrary to our hypotheses, people with BDD displayed higher concentrations of oxytocin, compared to their healthy control counterparts, and their oxytocin levels were positively correlated with BDD symptom severity. There were no associations between oxytocin levels and measures of social cognition. These findings suggest increased production of endogenous oxytocin in BDD. Prospective research is needed to determine whether this contributes to or is a consequence of BDD symptomatology. more...

Dimensional definitions of transdiagnostic mental health problems have been suggested as an alternative to categorical diagnoses, having the advantage of capturing heterogeneity within diagnostic categories and similarity across them and bridging more naturally psychological and neural substrates.To examine whether a self-reported compulsivity dimension has a stronger association with goal-directed and related higher-order cognitive deficits compared with a diagnosis of obsessive-compulsive disorder (OCD).In this cross-sectional study, patients with OCD and/or generalized anxiety disorder (GAD) from across the United States completed a telephone-based diagnostic interview by a trained rater, internet-based cognitive testing, and self-reported clinical assessments from October 8, 2015, to October 1, 2017. Follow-up data were collected to test for replicability.Performance was measured on a test of goal-directed planning and cognitive flexibility (Wisconsin Card Sorting Test [WCST]) and a test of abstract reasoning. Clinical variables included DSM-5 diagnosis of OCD and GAD and 3 psychiatric symptom dimensions (general distress, compulsivity, and obsessionality) derived from a factor analysis.Of 285 individuals in the analysis (mean [SD] age, 32 [12] years; age range, 18-77 years; 219 [76.8%] female), 111 had OCD; 82, GAD; and 92, OCD and GAD. A diagnosis of OCD was not associated with goal-directed performance compared with GAD at baseline (β [SE], -0.02 [0.02]; P = .18). In contrast, a compulsivity dimension was negatively associated with goal-directed performance (β [SE], -0.05 [0.02]; P = .003). Results for abstract reasoning task and WCST mirrored this pattern; the compulsivity dimension was associated with abstract reasoning (β [SE], 2.99 [0.63]; P .001) and several indicators of WCST performance (eg, categories completed: β [SE], -0.57 [0.09]; P .001), whereas OCD diagnosis was not (abstract reasoning: β [SE], 0.39 [0.66]; P = .56; categories completed: β [SE], -0.09 [0.10]; P = .38). Other symptom dimensions relevant to OCD, obsessionality, and general distress had no reliable association with goal-directed performance, WCST, or abstract reasoning. Obsessionality had a positive association with requiring more trials to reach the first category on the WCST at baseline (β [SE], 2.92 [1.39]; P = .04), and general distress was associated with impaired goal-directed performance at baseline (β [SE],-0.04 [0.02]; P = .01). However, unlike the key results of this study, neither survived correction for multiple comparisons or was replicated at follow-up testing.Deficits in goal-directed planning in OCD may be more strongly associated with a compulsivity dimension than with OCD diagnosis. This result may have implications for research assessing the association between brain mechanisms and clinical manifestations and for understanding the structure of mental illness. more...

Whereas the specific diagnostic criteria for obsessive-compulsive disorder (OCD) have changed in only minor ways in the transition from DSM-IV to DSM-5, a more substantial change is that OCD is no longer classified as an anxiety disorder. Rather, it is now the flagship diagnosis of a new diagnostic category: the obsessive-compulsive and related disorders (OCRDs). In this article, we describe the nature of obsessional problems as determined through empirical research before turning to a consideration of how OCD is defined in previous editions of the DSM and in DSM-5. We then critically consider the DSM criteria, as well as the basis for removing OCD from the anxiety disorders and creating the new OCRD category. Finally, we consider the implications of these changes for clinical practice and research on OCD. more...