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Transforming the understanding
and treatment of mental illnesses.

Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is a common, chronic, and long-lasting disorder characterized by uncontrollable, reoccurring thoughts (obsessions) and/or behaviors (compulsions) that people feel the urge to repeat over and over. Symptoms can fluctuate over time, and people with OCD may try to help themselves by avoiding situations that trigger their obsessions. OCD is a common disorder that affects adults, adolescents, and children, and most people with the disorder are diagnosed by early adulthood. Learn more about obsessive-compulsive disorder (OCD).

Featured Studies

Featured studies include only those currently recruiting participants. Studies with the most recent start date appear first.


CO2 Reactivity as a Biomarker of Non-Response to Exposure-Based Therapy

Study Type: Interventional
Start Date: November 2, 2022
Eligibility: 18 Years to 70 Years, Does Not Accept Healthy Volunteers
Location(s): The University of Texas at Austin, Austin, Texas, United States; Boston University, Boston, Massachusetts, United States

Anxiety-, obsessive-compulsive and trauma- and stressor-related disorders reflect a significant public health problem. This study is designed to evaluate the predictive power of a novel biomarker based on a CO2 challenge, thus addressing the central question "can this easy-to-administer assay aid clinicians in deciding whether or not to initiate exposure-based therapy?"


Computerized Intervention Targeting the Error-Related Negativity and Balance N1 in Anxious Children

Study Type: Interventional
Start Date: October 12, 2022
Eligibility: 9 Years to 12 Years, Accepts Healthy Volunteers
Location(s): RADLAB at Innovation Park, Tallahassee, Florida, United States

Anxiety disorders are the most common form of psychopathology, and frequently begin in childhood, resulting in lifelong impairment. Increased brain activity after making mistakes, as reflected by the error-related negativity (ERN), is observed in people with anxiety disorders, even before disorder onset. The ERN is therefore of great interest as a potentially modifiable risk factor for anxiety. However, methodological issues can make the ERN difficult to measure.

Increased brain activity in response to a balance disturbance, as reflected by the balance N1, resembles the ERN, but does not share its methodological issues. The investigators' preliminary data demonstrate that the balance N1 and the ERN are associated in amplitude in adults, suggesting they may depend on the same brain processes. The balance N1 has never been investigated in individuals with anxiety disorders, but it increases in amplitude within individuals under anxiety-inducing environmental contexts. Further, balance and anxiety are related in terms of brain anatomy, daily behavior, disorder presentation, and response to treatment.

The present investigation will measure the ERN and the balance N1 in children (ages 9-12) with anxiety disorders, and further, how these brain activity measures change in response to a brief, 45-minute, computerized psychosocial intervention that was developed to reduce reactivity to errors, and has been shown to reduce the ERN. The investigators will recruit approximately 80 children with anxiety disorders, half of whom will be randomly assigned to the active intervention condition. The other half will be assigned to an active control condition, consisting of a different 45-minute computerized presentation. Participants assigned to the control condition can access the computerized intervention after participation in the study.

The purpose of this investigation is to test the hypothesis that the balance N1 and the ERN will be reduced to a similar extent after the intervention, to demonstrate that these brain responses arise from shared brain processes. Transfer of the effect of the psycho-social intervention to the balance N1 would provide insight into prior work demonstrating that balance training can alleviate anxiety in young children, and well-documented benefits of psychotherapy to balance disorders. Collectively, these data may guide the development of multidisciplinary interventions for the prevention and treatment of anxiety disorders in children.


Motivational Interviewing to Enhance Behavioral Change in Older Adults With Hoarding Disorder

Study Type: Interventional
Start Date: June 1, 2022
Eligibility: 60 Years and Older, Does Not Accept Healthy Volunteers
Location(s): Mississippi State University, Starkville, Mississippi, United States

This study will compare two behavioral interventions for hoarding disorder in older adults.


Multimodal Assessment of Cannabinoid Target Engagement in Adults With Obsessive-Compulsive Disorder

Study Type: Interventional
Start Date: March 1, 2022
Eligibility: 21 Years to 55 Years, Does Not Accept Healthy Volunteers
Location(s): New York State Psychiatric Institute, New York, New York, United States

The purpose of this research study is to test how a medication called nabilone (Cesamet) affects neurocognitive processes involved in obsessive-compulsive disorder (OCD), including threat response, processing of fear signals, and habitual behavior. OCD is a disabling illness that affects around 2% of the population and involves recurrent intrusive thoughts (obsessions) and repetitive behaviors (compulsions) that lead to distress and/or impaired functioning. Nabilone is a synthetic form of delta-9-tetrahydrocannabinol (THC, the primary psychoactive component of the cannabis plant). It acts on the brain's endocannabinoid system, which has been hypothesized to play a role in OCD symptoms. Nabilone is approved by the FDA for the treatment of chemotherapy-induced nausea and vomiting. It is not FDA-approved for treating OCD.

In this study, 60 adults with OCD will receive a single dose of either nabilone or placebo. Participants will then complete a series of assessments including neuroimaging, psychophysiology (e.g., skin conductance recording), computerized behavioral tasks, and self-report measures. The information gained from this study could contribute to the development of new treatments for people with OCD and related disorders.


Connectomic Deep Brain Stimulation for Obsessive Compulsive Disorder

Study Type: Interventional
Start Date: August 13, 2021
Eligibility: 18 Years and Older, Does Not Accept Healthy Volunteers
Location(s): Mount Sinai West, New York, New York, United States

Deep brain stimulation (DBS) is an effective treatment for people suffering from severe obsessive-compulsive disorder (OCD) whose symptoms have failed to improve after years and multiple methods of intervention. An effective DBS target for OCD is the anterior limb of the internal capsule (ALIC) brain region. On average 60% of all OCD patients have a clinically significant response to ALIC DBS. However, ALIC DBS may become even more effective with the ability to predict which specific ALIC connections in the brain need to be stimulated for each individual OCD patient. This study therefore investigates personalized stimulation to the ALIC that allows for precise modulation of brain circuits associated with individual OCD symptoms. The study aims to specify the ideal anatomical target for ALIC DBS for maximum therapeutic benefit in each patient.


Increasing Treatment Efficacy Using SMART Methods for Personalizing Care

Study Type: Interventional
Start Date: June 22, 2021
Eligibility: 18 Years and Older, Accepts Healthy Volunteers
Location(s): University of Kentucky, Lexington, Kentucky, United States

The proposed study will determine the feasibility, tolerability, and acceptability of a study that tests: 1) personalized treatment delivery (i.e., module sequencing and treatment discontinuation timing) aimed at increasing the efficiency of care, and 2) the research protocol designed to evaluate the effects of this personalized care. A sample of 60 participants with heterogeneous anxiety disorders (and comorbid conditions, including depression) will be enrolled in a pilot sequential multiple assignment randomized trial (SMART). Patients will be randomly assigned to one of three sequencing conditions: transdiagnostic treatment administered in its standard module order, module sequences that prioritize capitalizing on relative strengths, and module sequences that prioritize compensating for relative weaknesses. Next, after 6 sessions, participants will be randomly assigned to either continue or discontinue treatment to evaluate post-treatment change at varying levels of target engagement. This proposal will enable us to 1) test the feasibility, acceptability, and tolerability of the research protocol, treatment sequencing conditions, and early treatment discontinuation, 2) determine whether a preliminary signal that capitalization or compensation module sequencing improves treatment efficiency exists, and 3) explore preliminary associations between core process engagement at treatment discontinuation and later symptom improvement. The proposed study, and the subsequent research it will support, will inform evidence-based decision rules to make existing treatments more efficient, ultimately reducing patient costs and increasing the mental health service system's capacity to address the needs of more individuals.


Improving Attentional and Cognitive Control in the Psychological Treatment of Intrusive Thoughts

Study Type: Interventional
Start Date: April 30, 2021
Eligibility: 18 Years to 60 Years, Does Not Accept Healthy Volunteers
Location(s): Massachusetts General Hospital, Boston, Massachusetts, United States

The investigators are conducting this study to learn more about the cognitive and attentional processes among individuals with three types of repetitive negative thinking (RNT): mental rituals (as seen in obsessive compulsive disorder, OCD), worries (as seen in generalized anxiety disorder, GAD), and ruminations (as seen in major depressive disorder, MDD). Specifically, the investigators are studying whether psychological treatment can help people with RNT who have trouble stopping unwanted thoughts and shifting their attention.


Theta Burst Stimulation Plus Habit Override Training for Compulsive Behaviors

Study Type: Interventional
Start Date: December 28, 2020
Eligibility: 18 Years to 60 Years, Does Not Accept Healthy Volunteers
Location(s): Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania, United States

This project seeks to identify causal neural mechanisms underlying unwanted, repetitive behaviors (compulsions). Using non-invasive brain stimulation coupled with practice in a computer task, we will modulate activity in a target brain region and measure effects on compulsive behaviors and related measures. This work could ultimately lead to the ability to treat compulsions more effectively by targeting the regions of the brain that can help or hinder attempts to overcome compulsions.


Brain Network Changes Accompanying and Predicting Responses to Pharmacotherapy in OCD

Study Type: Interventional
Start Date: October 14, 2019
Eligibility: 18 Years to 65 Years, Accepts Healthy Volunteers
Location(s): Yale OCD Research Clinic - CMHC/CNRU, 34 Park ST, New Haven, Connecticut, United States

The proposed randomized, double-blind research study will use functional magnetic resonance neuroimaging using state-of-the-art HCP acquisition protocols and analytic pipelines, to identify predictors and correlates of response to an accepted first-line pharmacological treatment for obsessive-compulsive disorder.


Task Control Circuit Targets for Obsessive Compulsive Behaviors in Children

Study Type: Interventional
Start Date: March 24, 2019
Eligibility: 7 Years to 14 Years, Accepts Healthy Volunteers
Location(s): New York State Psychiatric Institute, New York, New York, United States

This study will use magnetic resonance imaging (MRI) to assess the function and structure of overlapping task control circuits in children with a range of Obsessive-Compulsive symptoms (OCS). The functioning of task control circuits will be assessed using the well-validated Multisource interference task (MSIT). This study will also assess functional and anatomical connectivity within task control circuits in the same children, and determine whether disturbances in these overlapping circuits are associated with Obsessive-Compulsive Disorder (OCD) symptom severity. Behavioral measures will be administered to further assess regulatory, learning and memory functions. Children with OCD will then be offered a standard course of up to 12 cognitive behavioral therapy (CBT), either via remote video conference sessions or in person visits when clinically indicated, before scanning (along with age-and gender-matched control participants) in order to assess how these circuits may change with treatment. Children with subclinical OC symptoms will be offered referral for treatment on an as-needed basis. In addition, de-identified data may be used in the future to conduct secondary data analyses. As more about OC symptoms and neurobiological mechanisms of interest in the current study are understood, data may be used to answer questions beyond those described in this protocol. All study procedures will be conducted on-site at Columbia University/the New York State Psychiatric Institute (New York, NY) and the University of Michigan's outpatient Child and Adolescent Psychiatry (Ann Arbor, Michigan).


Overlapping Neural Circuits in Pediatric OCD

Study Type: Interventional
Start Date: October 31, 2014
Eligibility: 5 Years to 17 Years, Accepts Healthy Volunteers
Location(s): NY State Psychiatric Institute, New York, New York, United States

The purpose of this study is to examine the brain functioning of children and adolescent with OCD before and after treatment with Exposure and Response Prevention (EXRP) therapy.


Physiological Brain Atlas Development

Study Type: Observational
Start Date: August 31, 2006
Eligibility: 6 Years to 90 Years, Does Not Accept Healthy Volunteers
Location(s): Vanderbilt Univeristy, Nashville, Tennessee, United States

The NIH grant has funded the development of a physiological brain atlas registry that will allow us to significantly improve the data collectioin and use of physiological data into a normalized brain volume. This initially was used to improve DBS implants for Parkinson's Disease, Dystonia, Essential Tremor, and OCD, but now includes data acquired during all stereotactic brain procedures.