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      Avoid jumping to conclusions under uncertainty in Obsessive Compulsive Disorder

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          Abstract

          High levels of intolerance of uncertainty (IU) could contribute to abnormal decision making in uncertain situations. Patients with Obsessive Compulsive Disorder (OCD) often report high IU, indecisiveness and the need to seek greater certainty before making decisions. The Beads task is a commonly used task assessing the degree of information gathering prior to making a decision and so would be predicted to show impairments in OCD patients. Results to date have found mixed support for this, possibility due to methodological issues. Here, a group of OCD patients (n = 50) with no comorbidities was compared with age, gender, and verbal-IQ matched controls (n = 50) on the most commonly used version of the Beads task. An independent sample of healthy volunteers with high versus low OC symptoms, and high versus low IU were also assessed (n = 125). There was no evidence that patients with OCD differed from control volunteers in the degree of information gathering prior to making a decision. Medication status and age did not appear to mediate performance. Similarly, there were no association in healthy volunteers between task performance and OC or IU characteristics. Additional measures examining the degree of certainty initially showed support for greater uncertainty in patients, but this was due to deviations from task instructions in a subset of patients. We conclude that despite the large sample size and good matching between groups, the Beads task in its most widely used form is not a useful measure of IU or of information gathering in OCD. The results argue against a robust behavioural difference in OCD when compared to controls. Recommendations for future studies employing the task are discussed.

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          Into the unknown: A review and synthesis of contemporary models involving uncertainty.

          The current review and synthesis serves to define and contextualize fear of the unknown relative to related constructs, such as intolerance of uncertainty, and contemporary models of emotion, attachment, and neuroticism. The contemporary models appear to share a common core in underscoring the importance of responses to unknowns. A recent surge in published research has explored the transdiagnostic impact of not knowing on anxiety and related pathologies; as such, there appears to be mounting evidence for fear of the unknown as an important core transdiagnostic construct. The result is a robust foundation for transdiagnostic theoretical and empirical explorations into fearing the unknown and intolerance of uncertainty.
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            The neuropsychology of adult obsessive-compulsive disorder: a meta-analysis.

            A vast and heterogeneous body of literature on the neuropsychology of obsessive-compulsive disorder (OCD) has accumulated in recent decades, yielding inconsistent results. In an attempt to quantitatively summarize the literature, we conducted a meta-analysis of 115 studies (including 3452 patients), comparing adult OCD patients with healthy controls on tests of 10 neuropsychological domains. Across studies, medium mean effect sizes were found for all executive function subdomains, processing speed, and sustained attention. Small effect sizes were found for visuospatial abilities and working memory. A large effect size was found for non-verbal memory whereas a small effect size was found for verbal memory, where only the former was found to be associated with impairments in executive functions. Moderators of effect sizes were also investigated. Results are discussed in terms of their clinical significance as well as their implications for current neurobiological models of OCD and methodological caveats.
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              Revision of the Padua Inventory of obsessive compulsive disorder symptoms: distinctions between worry, obsessions, and compulsions.

              The Padua Inventory (PI), a self-report measure of obsessive and compulsive symptoms, is increasingly used in obsessive compulsive disorder (OCD) research. Freeston, Ladouceur, Rheaume, Letarte, Gagnon and Thibodeau (1994) [Behaviour Research and Therapy, 32, 29-36], however, recently showed that the PI measures worry in addition to obsessions. In an attempt to solve this measurement problem, this study used a content distinction between obsessions and worry to revise the PI. The revision was constructed to measure five content dimensions relevant to OCD i.e. (1) obsessional thoughts about harm to oneself or others; (2) obsessional impulses to harm oneself or others; (3) contamination obsessions and washing compulsions; (4) checking compulsions; and (5) dressing/grooming compulsions. A total of 5010 individuals participated in the study, 2970 individuals completing the PI and the Penn State Worry Questionnaire (PSWQ) and an additional 2040 individuals completing only the PI. The results provided support for the reliability and validity of the revision. In addition, the revision of the PI was more independent of worry, as measured by the PSWQ, than the original PI. Support was thus found for the validity of the content distinction between obsessions and worry. The importance of this content distinction is also discussed for the evaluation of other hypothesized distinctions between obsessions and worry.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SoftwareRole: SupervisionRole: Writing – original draft
                Role: InvestigationRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: Funding acquisitionRole: ResourcesRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                15 January 2020
                2020
                : 15
                : 1
                : e0225970
                Affiliations
                [1 ] School of Psychology and Sports Science, Anglia Ruskin University, Cambridge, United Kingdom
                [2 ] Behavioural and Clinical Neuroscience Institute; Department of Psychology, Cambridge University, Cambridge, United Kingdom
                [3 ] Hertfordshire Partnership University NHS Foundation Trust, NHS; University of Hertfordshire, Hatfield, United Kingdom
                University of Wuerzburg, GERMANY
                Author notes

                Competing Interests: TWR reports consultancy for Cambridge Cognition, Unilever, and Greenfields Bioventrures; grants from Shionogi, Smallpharma; royalties from Cambridge Cognition (CANTAB). NAF reports personal fees from Otsuka, Lundbeck, Abbott, Sun Pharma, Taylor and Francis, Elsevier; personal fees and non-financial support from RANZCP, Wiley; grants from NIHR, Wellcome; grants, all outside the submitted work. All other authors have declared that no competing interests exist. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                Author information
                http://orcid.org/0000-0002-6919-6692
                http://orcid.org/0000-0003-0578-8311
                Article
                PONE-D-19-16196
                10.1371/journal.pone.0225970
                6961894
                31940308
                f4432c17-90a3-41b1-8f12-7000225809bd
                © 2020 Morein-Zamir et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 7 June 2019
                : 15 November 2019
                Page count
                Figures: 2, Tables: 4, Pages: 17
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/100004440, Wellcome Trust;
                Award ID: 104631/Z/14/Z
                Award Recipient :
                This research was supported in part by a grant from the Wellcome Trust ( https://wellcome.ac.uk/) to TW Robbins (104631/Z/14/Z). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Neuropsychiatric Disorders
                Anxiety Disorders
                Obsessive-Compulsive Disorder
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Neuroses
                Anxiety Disorders
                Obsessive-Compulsive Disorder
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                Obsessive-Compulsive Disorder
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                Impulsivity
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                The data underlying this study are available via OSF ( https://osf.io/w7z3g/).

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