Characterizing intrusive destructive behaviors and the core population of patients in which they present
OA Version
Citation
Abstract
BACKGROUND: Intrusive destructive behaviors (IDBs) comprise a behavioral symptom construct initially observed in individuals with Tourette syndrome (TS) and commonly co-occurring conditions such as attention-deficit/hyperactivity disorder (ADHD) with executive dysfunction and obsessive-compulsive disorder (OCD). IDBs are behaviors characterized by feeling compelled to and then acting on intrusive unwanted urges despite (and because of) exquisite awareness of the negative implications. OBJECTIVE: This study aims to illuminate the phenomenology of IDBs using a clinical population comprised of youth with tic and OCD spectrum conditions. The study also aims to begin to characterize the prevalence of IDBs in this population, and to explore the correlations between IDBs and commonly co-occurring conditions (such as TS, OCD, ADHD, etc.) often linked to similar disrupted CSTC neurocircuitry.
METHODS: Twenty-five participants from the MGH Pediatric Psychiatry OCD and Tic Disorders program voluntarily completed the survey-based study. Statistical analyses were conducted based on the survey results.
RESULTS: From our study sample, 63.2% of participants reported experiencing IDBs. The most commonly occurring co-morbid disorders for participants that selected “yes” to experiencing IDBs were obsessive-compulsive-related disorders (OCRD), including OCD and body-focused repetitive behavior disorders (94.7%), tic and related disorders (73.7%), and ADHD (57.9%).
CONCLUSIONS: The high rates of reported IDBs in this clinical sample highlight the need for further research into the phenomenology of IDBs so that we can better learn how to identify and treat this impairing behavioral symptom. Future studies should involve sampling a larger tic/OCD population, a neurotypical population, and a population of individuals with non-tic/OCD psychopathology (e.g. bipolar disorder, autism spectrum disorder).
Description
2024