TY - JOUR
T1 - The correlates of social phobia in OCD: Findings from a large clinical sample
AU - Tibi, Lee
AU - Asher, Sapir
AU - van Oppen, Patricia
AU - van Balkom, Anton J. L. M.
AU - Eikelenboom, Merijn
AU - Visser, Henny A.
AU - Penninx, Brenda W.
AU - Anholt, Gideon E.
N1 - Funding Information: The research infrastructure needed to complete the baseline measurements was financed almost exclusively by the participating organizations: Academic department VU Medical Centre/GGZinGeest, Amsterdam, The Netherlands; Innova Research Centre, Mental Health Care Institute GGZ Centraal, Marinade Wolf Anxiety Research Centre, Ermelo, The Netherlands; Institute of Integrated Mental Health Care ‘Pro Persona’, ‘Overwaal’ Centre of Expertise for AnxietyDisorders OCD and PTSD Nijmegen, the Netherlands; Dimence, GGZ Overijssel; Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands; ‘Vincent van Gogh institute’ Mental Health Care Centre Noorden Midden‐Limburg, Venray, The Netherlands; Academic Anxiety Center, PsyQ Maastricht University, Division Mental Health and Neuroscience, Maastricht, The Netherlands, except for the field work coordinator, which was financed by a research grant from ‘Stichting tot Steun VCVGZ’, awarded to Patricia van Oppen and Anton J. L. M. van Balkom. Publisher Copyright: © 2021 The British Psychological Society Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/9
Y1 - 2021/9
N2 - Objectives: Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder, often complicated with comorbidities. Social phobia (SP) is the most frequent co-occurring anxiety disorder in OCD, associated with increased clinical severity. However, no study had examined the relevance of interpersonal processes in this comorbidity, which are at the core of SP. This study characterized the clinical (i.e., symptom profile, age of onset, chronicity, and comorbidity), vulnerability (i.e., childhood trauma, negative life events), and interpersonal (attachment style, expressed emotion, and social support) correlates of comorbid SP in a large sample of OCD patients. Methods: We analysed the data of 382 OCD patients participating in the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. We examined the correlates of SP in OCD using self-report questionnaires and structured clinical interviews. In addition, data of 312 non-OCD SP patients were drawn from the Netherlands Study of Depression and Anxiety (NESDA), to compare the age of onset of SP between groups. Descriptive univariate analyses were followed by backward stepwise logistic regression analyses. Results: Social phobia was present among approximately 20% of OCD patients. Social phobia in OCD was associated with increased depression severity and decreased ratings of secure attachment style. Among OCD patients, SP had a significantly earlier age onset as compared to SP in non-OCD patients. Conclusion: Social phobia in OCD might render a vulnerable clinical picture, characterized with early onset of SP symptoms, insecure attachment style, and increased depressive symptoms. Future studies should use prospective designs to better understand the nature of comorbid SP in OCD. Practitioner points: Approximately one fifth of OCD patients were diagnosed with comorbid social phobia in a large representative clinical sample. OCD patients with comorbid social phobia presented with a vulnerable clinical picture, characterized with increased depression severity and decreased ratings of secure attachment style. Social phobia in OCD was associated with an earlier AOO as compared to the AOO of social phobia without OCD. The findings are limited by a cross-sectional design; thus, causality could not be assessed. Research is needed to further examine the mechanisms of comorbid social phobia in OCD.
AB - Objectives: Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder, often complicated with comorbidities. Social phobia (SP) is the most frequent co-occurring anxiety disorder in OCD, associated with increased clinical severity. However, no study had examined the relevance of interpersonal processes in this comorbidity, which are at the core of SP. This study characterized the clinical (i.e., symptom profile, age of onset, chronicity, and comorbidity), vulnerability (i.e., childhood trauma, negative life events), and interpersonal (attachment style, expressed emotion, and social support) correlates of comorbid SP in a large sample of OCD patients. Methods: We analysed the data of 382 OCD patients participating in the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. We examined the correlates of SP in OCD using self-report questionnaires and structured clinical interviews. In addition, data of 312 non-OCD SP patients were drawn from the Netherlands Study of Depression and Anxiety (NESDA), to compare the age of onset of SP between groups. Descriptive univariate analyses were followed by backward stepwise logistic regression analyses. Results: Social phobia was present among approximately 20% of OCD patients. Social phobia in OCD was associated with increased depression severity and decreased ratings of secure attachment style. Among OCD patients, SP had a significantly earlier age onset as compared to SP in non-OCD patients. Conclusion: Social phobia in OCD might render a vulnerable clinical picture, characterized with early onset of SP symptoms, insecure attachment style, and increased depressive symptoms. Future studies should use prospective designs to better understand the nature of comorbid SP in OCD. Practitioner points: Approximately one fifth of OCD patients were diagnosed with comorbid social phobia in a large representative clinical sample. OCD patients with comorbid social phobia presented with a vulnerable clinical picture, characterized with increased depression severity and decreased ratings of secure attachment style. Social phobia in OCD was associated with an earlier AOO as compared to the AOO of social phobia without OCD. The findings are limited by a cross-sectional design; thus, causality could not be assessed. Research is needed to further examine the mechanisms of comorbid social phobia in OCD.
KW - attachment style
KW - comorbidity
KW - interpersonal
KW - obsessive-compulsive disorder
KW - social phobia
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85104376311&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/33870535
UR - http://www.scopus.com/inward/record.url?scp=85104376311&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/bjc.12292
DO - https://doi.org/10.1111/bjc.12292
M3 - Article
C2 - 33870535
SN - 0144-6657
VL - 60
SP - 312
EP - 332
JO - British journal of clinical psychology
JF - British journal of clinical psychology
IS - 3
ER -