Why do we repeat choices that know are bad for us? Decision making is characterized by the parallel engagement of two distinct systems, goal-directed and habitual, thought to arise from computational learning mechanisms, model-based model-free. The habitual system a candidate source pathological fixedness. Using decision task measures contribution either mechanism, show bias towards model-free (habit) acquisition in disorders involving both natural (binge eating) artificial (methamphetamine)...

Background Cognitive behaviour therapy (CBT) is an effective treatment for obsessive–compulsive disorder (OCD) but access to CBT limited. Internet-based (ICBT) with therapist support potentially a more accessible treatment. There are no randomized controlled trials testing ICBT OCD. The aim of this study was investigate the efficacy OCD in trial. Method Participants ( n =101) diagnosed were either 10 weeks or attention control condition, consisting online supportive therapy. primary outcome...

<b>Objectives</b>&nbsp;To evaluate the efficacy of therapist guided internet based cognitive behavioural therapy (CBT) programme for body dysmorphic disorder (BDD-NET) compared with online supportive therapy. <b>Design</b>&nbsp;A 12 week single blind parallel group randomised controlled trial. <b>Setting</b>&nbsp;Academic medical centre. <b>Participants</b>&nbsp;94 self referred adult outpatients a diagnosis and modified Yale-Brown obsessive compulsive scale (BDD-YBOCS) score ≥20. Concurrent...

It is unclear whether d-cycloserine (DCS), a partial N-methyl-d-aspartate agonist that enhances fear extinction, can augment the effects of exposure-based cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD).To examine DCS augments CBT OCD and to explore (post hoc) concomitant antidepressant medication moderates DCS.A 12-week, double-blind randomized clinical trial with 3-month follow-up conducted at an academic medical center between September 4, 2012, 26, 2013....

Our decisions are based on parallel and competing systems of goal-directed habitual learning, which can be impaired in pathological behaviours. Here we focus the influence motivation compare reward loss outcomes subjects with obsessive-compulsive disorder (OCD) model-based model-free behaviours using two-step task. We further investigate relationship acquisition learning a one-step probabilistic Forty-eight OCD 96 healthy volunteers were tested 30 53 version Thirty-six 72 also reversal...

Importance Cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) is a highly specialized treatment that in short supply worldwide. Objectives To investigate whether both therapist-guided and unguided internet-based CBT (ICBT) are noninferior to face-to-face adults with OCD, conduct health economic evaluation, determine effects were moderated by source of participant referral. Design, Setting, Participants This study single-blinded, noninferiority, randomized clinical...

As relapse after completed cognitive behavior therapy (CBT) for obsessive-compulsive disorder (OCD) is common, many treatment protocols include booster programs to improve the long-term effects. However, effects of are not well studied. In this study, we investigated efficacy Internet-based CBT (ICBT) with therapist support OCD or without an program.A total 101 participants were included in follow-up analysis ICBT. Of these, 93 randomized a program no program. Outcome assessments collected...

Therapist-guided internet-delivered cognitive behaviour therapy (ICBT) is an efficacious treatment for obsessive-compulsive disorder (OCD) and body dysmorphic (BDD), but it unclear if the results obtained in controlled trials can be reproduced clinical settings. We evaluated implementation of ICBT OCD (OCD-NET) BDD (BDD-NET) Swedish public health system.Consecutive referrals to outpatient psychiatric clinic providing ICBT, with a primary diagnosis or BDD, were included study. Four hundred...

Body dysmorphic disorder (BDD) usually begins during adolescence but little is known about the prevalence, etiology, and patterns of comorbidity in this age group. We investigated prevalence BDD symptoms adolescents young adults. also report on relative importance genetic environmental influences symptoms, risk for co-existing psychopathology.Prevalence was determined by a validated cut-off Dysmorphic Concerns Questionnaire (DCQ) three population-based twin cohorts at ages 15 (n = 6968), 18...

The monoamine hypothesis of psychopharmacology has been dominating the biological psychiatric research field for decades. Currently increasingly appreciated disorders and suicidal behavior as being highly complex multi-etiological. In this pathway gut microbiome its interrelationship with brain is gaining traction. usage selective serotonin reuptake inhibitors (SSRIs) increasing in general population. This due to their effect on a broad range disorders, favorable side profile. Still, there...

Objectives Cognitive–behavioural therapy (CBT) is an effective treatment for body dysmorphic disorder (BDD). However, most sufferers do not have access to this treatment. One way increase CBT administer remotely via the Internet. This study piloted a novel therapist-supported, Internet-based program BDD (BDD-NET). Design Uncontrolled clinical trial. Participants Patients (N=23) were recruited through self-referral and assessed face at clinic specialising in obsessive–compulsive related...

The number of clinical trials in body dysmorphic disorder (BDD) has steadily increased recent years. As the studies grows, it is important to define most empirically useful definitions for response and remission order enhance field-wide consistency comparisons treatment outcomes across studies. In this study, we aim operationally BDD. We pooled data from three randomized controlled cognitive-behavior therapy (CBT) BDD (combined n = 153) conducted at four academic sites Sweden, USA, England....

Abstract Background Previous attempts to identify predictors of treatment outcomes in body dysmorphic disorder (BDD) have yielded inconsistent findings. One way increase precision and clinical utility could be use machine learning methods, which can incorporate multiple non-linear associations prediction models. Methods This study used a random forests approach test if it is possible reliably predict remission from BDD sample 88 individuals that had received internet-delivered cognitive...

Hoarding disorder (HD) is difficult to treat. In an effort increase efficacy and engagement in cognitive-behavioral therapy (CBT), we developed evaluated a novel intervention comprising group CBT combined with between-session Internet-based clinician support for people HD.Twenty participants HD received Internet-support system enabling therapist-participant communication between sessions.The treatment was associated significant reduction on the Saving Inventory-Revised (SI-R) large effect...

Most patients with body dysmorphic disorder (BDD) do not receive evidence-based treatment. A randomised controlled trial (RCT) has found that a therapist-guided internet-based cognitive-behavioural therapy (CBT) programme for BDD (BDD-NET) can be delivered safely via the internet significant improvements in symptom severity short term. The purpose of this study was to evaluate if therapeutic gains BDD-NET are maintained 2 years after treatment.Academic medical centre.A naturalistic 2-year...

Previous research indicates that body dysmorphic disorder (BDD) is associated with risk of suicidality. However, studies have relied on small and/or specialist samples and largely focussed adults, despite these difficulties commonly emerging in youth. Furthermore, the aetiology relationship remains unknown.Two independent twin were identified through Child Adolescent Twin Study Sweden, at ages 18 (N = 6027) 24 3454). Participants completed a self-report measure BDD symptom severity. Young...

To evaluate the cost-effectiveness of internet-delivered cognitive behaviour therapy for body dysmorphic disorder (BDD-NET).

Cognitive-behavioural therapy (CBT) has been shown to be an effective treatment for body dysmorphic disorder (BDD), but access around the world is limited. One way increase administer CBT remotely via internet. This study represents first effort deliver a therapist-supported, internet-based with no restrictions on enrolment based geographical location, and it aims assess whether this can delivered safely across international borders, outcomes comparable previous BDD-NET trials.Uncontrolled...

Dissatisfaction with the appearance and size of one's genitalia is a common issue, use cosmetic genital surgery increasing among people normal genitalia.This cross-sectional study aimed to investigate distribution self-image in large sample males females, whether selected factors could predict self-image.Three thousand five hundred three anonymous participants completed online questionnaires. Multiple linear regressions were used identify association between (length penis or protrusion labia...

The Dimensional Obsessive-Compulsive Scale (DOCS) was designed to address the current limitations of existing obsessive-compulsive (OC) symptom measures and is a self-report questionnaire that assesses severity four most empirically supported OC dimensions. aim this study examine psychometric properties Swedish version DOCS when administered via Internet. Internal consistency, factor structure, convergent discriminant validity were examined in sample consisting 101 patients diagnosed with...

Obsessive-compulsive disorder and autism spectrum commonly co-occur. Adapted cognitive behavior therapy for obsessive-compulsive in adults with has not previously been evaluated outside the United Kingdom. In this study, 19 were treated using an adapted protocol that consisted of 20 sessions focused on exposure response prevention. The primary outcome was clinician-rated Yale-Brown Obsessive-Compulsive Scale. Participants assessed up to 3 months after treatment. There significant reductions...

Although cognitive interventions for obsessive-compulsive disorder (OCD) have been tested in randomized trials, there are few trials that the specific mechanisms of interventions, i.e. how they achieve their effects. In this study, we aimed to investigate mediating effects a short intervention treatment OCD and used data from recently conducted controlled trial where 101 participants were allocated either Internet-based CBT (ICBT) or control condition. Obsessive beliefs measured at...

Expert guidelines recommend cognitive-behavioural therapy (CBT) as a first-line treatment for obsessive-compulsive disorder (OCD), but the majority of patients with OCD do not have access to CBT. Internet-delivered CBT (ICBT) has potential make this evidence-based more accessible while requiring less therapist time than traditional face-to-face (f2f) Data from six clinical trials suggest that ICBT is both efficacious and cost-effective, whether non-inferior f2f yet unknown. A single-blind,...