Changes in contamination-related obsessions and compulsions during the COVID-19 pandemic: A Norwegian longitudinal study

Too much of a good thing? Hand hygiene and the long-term course of contamination-related obsessive-compulsive symptoms

“…Similar to a study from Norway (Grøtte et al, 2022), C-OCS decreased, with a small effect size. This tendency toward a decrease in C-OCS is mirrored by the percentage of scores in the current study above the clinical cut-off score, which fell from 36% (t1) at the start of pandemic to 27% a year later (t3).…”

“…This tendency toward a decrease in C-OCS is mirrored by the percentage of scores in the current study above the clinical cut-off score, which fell from 36% (t1) at the start of pandemic to 27% a year later (t3). Though not fully comparable (as they used the Dimensional Obsessive-Compulsive Scale Short-Form, DOCS-SF), the results of Grøtte et al (2022) -27.8% (in April 2020 and 24.0% (in December 2020)-are similar to ours. Although only assessed in a subsample (n = 430) in 2014, only 11% of the participants in the pre-pandemic period scored above the clinical cut-off.…”

“…Although only assessed in a subsample (n = 430) in 2014, only 11% of the participants in the pre-pandemic period scored above the clinical cut-off. Grøtte et al (2022) did not have access to pre-pandemic data but used retrospective assessments as an estimate, reporting a much smaller percentage of 2.33% above the cut-off score. Differences between the two studies may be explained by the measure (DOCS vs. OCI-R) and the point in time (2014 vs. retrospectively in 2020) when C-OCS was measured.…”

“…However, although evidence of an increase in obsessive compulsive symptoms in general at the start and over the early course of the pandemic is accumulating for the general population and clinical samples with OCD (Grant et al, 2021;Guzick et al, 2021;Zaccari et al, 2021;Linde et al, 2022), findings on the course of C-OCS are mixed (Alonso et al, 2021;Fontenelle et al, 2021;Khosravani et al, 2021;Jelinek et al, 2021a,b;Hezel et al, 2022;Moreira-de-Oliveira et al, 2022;Otte et al, 2023). Investigating an interval of 8 months, Grøtte et al (2022) reported that while C-OCS was still elevated in a large population-based sample (N = 3,405), the C-OCS trend declined from April to December 2020. As in previous studies (Fontenelle et al, 2021;Jelinek et al, 2021a;Alonso et al, 2021), the predictor with the largest effect sizes for the long-term course of C-OCS was the baseline level of C-OCS (β = 0.44).…”

“…First, we aimed to investigate the longitudinal course of C-OCS (OCI-R washing subscale) 12 months after the start of the pandemic. Second, we sought to examine the effect of changes in hand hygiene (i.e., duration and frequency of handwashing) and distress regulation (i.e., reinforcement after handwashing) over the first months of the COVID-19 pandemic on the longitudinal course of C-OCS beyond established predictors such as age, educational level, and baseline scores of contaminationrelated OCS (Abba-Aji et al, 2020;Fontenelle et al, 2021;Jelinek et al, 2021a;Alonso et al, 2021;Grøtte et al, 2022). Building on previous cross-sectional results in individuals with contamination fears (Dean and Purdon, 2021), on behavioral models of OCD (Dollard and Miller, 1950;Salkovskis, 1999), as well as experimental studies with student samples (Deacon and Maack, 2008), we expected that an increase in the duration rather than the frequency of handwashing and increased negative reinforcement after handwashing (distress reduction) would be associated with a long-term increase in C-OCS in the general population.…”