Sensory Overresponsivity and Symptoms Across the Obsessive-Compulsive Spectrum: Web-Based Longitudinal Observational Study

Abstract

Background Sensory overresponsivity (SOR) has emerged as a potential endophenotype in obsessive-compulsive disorder (OCD), but few studies have examined SOR in relation to the major symptom dimensions of OCD and to symptoms across the full obsessive-compulsive (OC) symptom spectrum. Objective This study had 2 main objectives. First, we examined the psychometric properties of the SOR Scales in a community-based sample of Spanish adolescents and adults. Second, we identified how SOR difficulties are related to symptoms across the full OC spectrum (eg, OC, body dysmorphic, hoarding, skin-picking, and hair-pulling symptoms), including the heterogeneity of OC symptoms. Methods We translated the SOR Scales into Spanish—a measure that assesses SOR across the 5 sensory modalities—and created a web-based version of the measure. A sample of 1454 adolescents and adults (mean age 23.84, SD 8.46 years) participated in the study, and 388 (26.69%) participants completed the survey twice (approximately 8 months apart). The survey also contained a web-based measure that assesses symptoms across the full OC spectrum: harm and checking, taboo obsessions, contamination or cleaning, symmetry and ordering, body dysmorphic, hoarding, hair-pulling, and skin-picking symptoms. Results The psychometric properties of the SOR Scales were excellent, and the test-retest reliability was adequate. All types of SOR were related to all major symptom dimensions of OCD and to all OC spectrum symptoms. Conclusions SOR across the sensory modalities can be validly assessed using a web-based measure. SOR emerged as a pure transdiagnostic phenomenon in relation to symptoms across the OC spectrum, with no specific sensory modality being more strongly related to OC symptoms. SOR can shed much needed light on basic mechanisms that are important for the onset and maintenance of OC spectrum symptoms, and this study shows that large-scale web-based studies can aid in this endeavor. Future studies should examine whether SOR precedes or emerges alongside OC symptoms.

Obsessive–Compulsive Symptoms in Children Are Related to Sensory Sensitivity and to Seeking Proxies for Internal States

“…Also, in accordance with our hypotheses, there was a significant positive correlation between obsessive-compulsive symptoms and sensory sensitivity, corroborating previous findings of associations between abnormalities in sensory sensitivity and pediatric as well as adult obsessive-compulsive symptoms [5,[12][13][14][15][16][17][18][19][20][21]. One interpretation of these findings is that children who experience overwhelming sensory input combined with difficulties in accessing the internal states may be at risk of developing obsessive-compulsive behaviors.…”

“…The present study also aims to explore whether atypical sensory processing is involved in the relation between the access to the internal states and obsessive-compulsive symptoms. Preliminary findings from research with both children and adults with OCD suggest multiple connections between obsessive-compulsive symptoms and atypical sensory processing, sensory over-responsivity, and sensory hypersensitivity [5,[12][13][14][15][16][17][18][19][20][21]. Sensory processing refers to the way in which the nervous system receives, organizes, and deciphers sensory stimuli from internal and external sources [22].…”

SAPAP3, SPRED2, and obsessive-compulsive disorder: the search for fundamental phenotypes

“…As of now, there is no direct evidence linking this putative genetic continuum to abnormalities of sensory processing. However, a recent study of over 1,400 adolescents and adults, examining the entire spectrum of obsessive-compulsive phenomena, reported that sensory over-responsiveness was associated with this spectrum in a transdiagnostic manner (Moreno-Amador et al, 2023 ). Though requiring replication, this result suggests that the possibility of a genetically influenced neurodevelopmental vulnerability to symptoms across the OC spectrum may be linked to sensory over-sensitivity.…”

Psychometric Properties of the Gastrointestinal Symptom Severity Scale in a Sample of Adolescents and Young Adults

“…Overall scores for each subscale are calculated separately and range from 0 to 16, with higher scores indicating greater severity. Cronbach alpha outcomes evaluating the internal consistency of the SORS overall and of its subscales indicated strong internal consistency when used in a sample from the United States (SOR-total = 0.93; SOR-hearing = 0.89; SOR-touch = 0.88; SOR-smell = 0.90; SOR-sight = 0.94; SORtaste = 0.88) and in a sample from Spain (hearing = 0.89; touch = 0.86; smell = 0.91; sight = 0.90; taste = 0.86) [30]. -Obsessive-Compulsive Inventory-Revised (OCI-R): The OCI-R is an 18-item self-report questionnaire that assesses obsessive-compulsive symptom severity using a five-point Likert scale ranging from 0 (not at all) to 4 (very much).…”