Nonfunctional Redundant Acts Characterize OCD, Even in OCD-Unrelated Tasks: A Demonstration in Questionnaire Completion

Abstract

Background: Ethological methods used to analyze human obsessive-compulsive disorder (OCD) rituals demonstrated excess of unnecessary repetitions as well as irrelevant, idiosyncratic acts (additions) compared to normal activity. A question that still remains is whether these well-known repetitions and additions are manifested in behaviors unrelated to the OCD rituals. Our objectives were to: (1) assess whether OCD-related repetitions and additions as found in previous studies also affect the patients' activity of filling out questionnaires and (2) evaluate the specificity of these behaviors to OCD as opposed to other anxiety disorders and healthy controls. Sampling and Methods: Several standardized disorder-specific self-report questionnaires were used in order to assess the patient's psychopathologies. The style of filling-out these questionnaires by OCD and non-OCD anxiety outpatients and normal controls was analyzed. Four categories were used: omissions, repetitions, corrections, and additions. Results: The OCD group scored significantly higher on the number of additions as compared with both the anxiety group and the nonclinical group, and significantly higher on the number of corrections and repetitions as compared with the nonclinical group. Conclusions: The hallmarks of OCD, repetitions and additions, are manifested not only in the patient's rituals and thoughts, but in apparently “neutral” tasks that do not a priori involve the intrusive thoughts, urges, and images typical of obsessive-compulsive behavior. Additions seem to be more specific to OCD than repetitions. These two executive faults impede routine functionality of OCD patients in tasks related and unrelated to their rituals. Our study delineates simple, observable behavioral characteristics that distinguish between OCD and non-OCD anxiety patients as well as healthy individuals. These symptomatic behaviors may offer a clue to personality traits or deficits in executive functions that possibly play a part in the pathophysiology of OCD. Our results are an additional indication that nonfunctionality in obsessive-compulsive behavior deserves full attention for a better understanding of the psychopathological mechanisms of OCD.

The motor profile of obsessive-compulsive rituals: psychopathological and evolutionary implications

“…Following Zor and colleagues, for each participant (OCD patients and matched controls), we divided the acts into "functional" (FA), compulsory for task performance, and "nonfunctional" (NFA), unnecessary or even irrelevant for that task. 12,28 According to such a definition, we chose to label as FA also some kinds of acts that are functional in themselves (eg, regarding the action of washing hands: "rubbing between the fingers" or "rubbing thumb") but so specific that they were generally not performed by healthy controls.…”

“…Elementary action units were then categorized into functional/common acts (i.e., necessary for task completion) and nonfunctional ones (unnecessary or even irrelevant for the task). 11,12,27,28 Using this approach, it was possible to lump together and assess statistically different kinds of ritual behaviors in humans 11,12 and to investigate their formal features compared with the corresponding physiological behaviors. 27 In this regard, compared with normal performance of the same motor tasks, OCD rituals were longer in duration, comprised a greater repertoire of unnecessary acts and significantly more repetitions of both superfluous and common acts.…”

“…Adopting a strictly ethological approach, these authors deconstructed the complex behavioral sequence of rituals of both animals and humans (OCD patients, habitual daily tasks, and cultural rituals) into elementary acts, in order to highlight its internal structure. Elementary action units were then categorized into functional/common acts (i.e., necessary for task completion) and nonfunctional ones (unnecessary or even irrelevant for the task) 11 , 12 , 27 , 28 . Using this approach, it was possible to lump together and assess statistically different kinds of ritual behaviors in humans 11 , 12 and to investigate their formal features compared with the corresponding physiological behaviors 27 .…”

The association between childhood trauma and motor structure in obsessive-compulsive rituals: An ethological and evolutionary approach.

“…Following Zor and colleagues, acts considered essential to the performance of the task were classified as “functional” (FA); acts considered as being not compulsory for the task were classified as “nonfunctional” (NFA) (Amitai et al, 2017; Zor, Keren, et al, 2009). According to such a definition, we chose to label as FA also some kinds of acts that are functional in themselves (e.g., regarding the action of washing hands: “rubbing between the fingers” or “rubbing thumb”) but so specific that they were generally not performed by healthy controls.…”

A Robot Model of OC-Spectrum Disorders: Design Framework, Implementation, and First Experiments

“…Our model does not yet include other characteristics of OCD, such as additional nonfunctional ritual behaviors (Amitai et al, 2017;Eilam, Zor, Fineberg, & Hermesh, 2012) or indecision aspects (Sachdev & Malhi, 2005) that can occur in OCD and TTM. At its present level of development, our model lacks some key mechanisms hypothesized to be behind such nonfunctional ritual behaviors.…”