The obsessive-compulsive spectrum is a heterogeneous class of conditions. Recently, expert consen... more The obsessive-compulsive spectrum is a heterogeneous class of conditions. Recently, expert consensus has emerged regarding possible candidate disorders [Mataix-Cols, D., Petrusa, A., Leckman, J.F., 2007. Issues for DSM-V: How should obsessive-compulsive and related disorders should be classified. American Journal of Psychiatry, 164, 1313-1314]. Further, expert survey data suggest that obsessive-compulsive disorder is composed of overlapping subtypes. However, methodological approaches for testing whether candidate disorders properly belong in the spectrum have varied widely, and do not necessarily differentiate conditions from subtypes. We describe preliminary methodological and statistical recommendations for a systematic approach to determining what constitutes a subtype, how to determine inclusion in the spectrum, and means for ruling out candidate disorders.
Handbook of Child and Adolescent Anxiety Disorders, 2011
Coined the “omnivore’s dilemma” (Rozin & Fallon, 1987), this ... more Coined the “omnivore’s dilemma” (Rozin & Fallon, 1987), this evolutionarily-based mechanism, which is characterized by seemingly conflicting inclinations to ingest and avoid unfamiliar foods, is thought to influence the food preferences and consumption of humans and other omnivorous species (Addessi, Galloway, Visalberghi, & Birch, 2005; Birch, Gunder, Grimm-Thomas, & Laing, 1998; Dovey, Staples, Gibson, & Halford, 2008; Martins & Pliner,
The efficacy of cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (O... more The efficacy of cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) has been the subject of much study over the past fifteen years. Building on a foundation of case studies and open clinical trials, the literature now contains many methodologically sound studies that have compared full CBT protocols to waitlist controls, pill placebo, psychosocial comparison conditions, active medication, combined treatments, and brief CBT. This review is part of a series commissioned by The Canadian Institute for Obsessive Compulsive Disorders (CIOCD) in an effort to publish in one place what is known about the efficacy of treatments for OCD. A total of fourteen studies were identified; collectively their findings support the efficacy of CBT for youth with OCD. CBT protocols that emphasized either strictly behavioral or cognitive conceptualizations have each been found efficacious relative to waitlist controls. Efforts to enhance CBT׳s efficacy and reach have been u...
Parents are often perceived as a contributing or maintaining source of youth anxiety disorders, m... more Parents are often perceived as a contributing or maintaining source of youth anxiety disorders, making them natural targets for either intervention or involvement in treatment protocols. Efforts to increase the efficacy and durability of standard treatments by incorporating parents have been successful, yet they often do not outperform child-focused treatment. Breinholst et al. (2012) review and discuss several overlooked parental research variables (anxiety, overcontrol, beliefs and assumptions, global family dysfunction) found to promote and maintain child anxiety. However, it remains unclear how these proposed variables interfere with active therapeutic ingredients (e.g., exposure) or how the identified problems might be addressed. We propose that insufficient attention to exposure-based treatment and family behavioral responses explain the comparatively low added value for parental involvement in child anxiety treatment and outline directions for research to address them. With m...
Mental contamination has been described as an internal experience of dirtiness that can arise and... more Mental contamination has been described as an internal experience of dirtiness that can arise and persist in the absence of contact with observable physical contaminants. Recent research has examined mental contamination specifically related to unwanted physical contact and sexual trauma. This study evaluated the degree to which disgust propensity and both self-focused and perpetrator-focused peritraumatic disgust were associated with mental contamination in a sample of women who experienced sexual trauma (n = 72). Results showed that peritraumatic self-focused disgust, but not peritraumatic perpetrator-focused disgust or fear, was significantly associated with mental contamination. Additionally, disgust propensity contributed significantly to the incremental validity of the model. These findings support the nascent literature showing that disgust plays a significant role in mental contamination, particularly following sexual trauma. Future research directions, and clinical/theoretical implications of these results are discussed.
This study extends support for a 5-day intensive exposure and response prevention (ERP) treatment... more This study extends support for a 5-day intensive exposure and response prevention (ERP) treatment protocol for pediatric obsessive compulsive disorder (OCD). Twenty-two children with OCD received ERP treatment twice daily for 5 days. The treatment also emphasized teaching children and parents how to conduct ERP independently after they returned home. Symptoms were assessed at four time-points: Baseline, 4 weeks later at pre-treatment, one week after the intensive treatment 5-day treatment, and at 3 month follow-up. Changes on the primary outcome measure, clinician severity ratings on the Anxiety Disorders Interview Schedule for Children, and secondary measures, indicated that OCD symptoms remained stable from the evaluation to baseline and improved significantly from baseline to follow-up. Moreover, parental accommodation of OCD decreased significantly from baseline to post-treatment and from post-treatment to follow-up. These data suggest that the 5-day intervention demonstrates ef...
Journal of Obsessive-Compulsive and Related Disorders, 2013
Executive dysfunction has been implicated in the neurobiology of obsessive-compulsive disorder. F... more Executive dysfunction has been implicated in the neurobiology of obsessive-compulsive disorder. Few studies have examined differences between individuals with OCD with or without tics. In this study executive functioning was compared between patients with obsessive-compulsive disorder with and without a history of tics. Participants diagnosed with OCD, with and without tics (n ¼ 10 per group) were administered the Wisconsin card sorting test (WCST) along with a measures of symptom severity for OCD, tics and depression. The groups did not differ in demographic variables or depression. Results indicated differences in performance on the WCST. Specifically, patients with past or current tics made more non-perseverative and total errors on the WCST and also demonstrated significantly more difficulty with conceptual level responding as compared to a normative sample, whereas the group without a tic history did not. Our findings, along with supporting evidence from imaging research and clinical trials, suggests that the presence of tics may be a valid means for subtyping individuals with obsessivecompulsive disorder.
The obsessive-compulsive spectrum is a heterogeneous class of conditions. Recently, expert consen... more The obsessive-compulsive spectrum is a heterogeneous class of conditions. Recently, expert consensus has emerged regarding possible candidate disorders [Mataix-Cols, D., Petrusa, A., Leckman, J.F., 2007. Issues for DSM-V: How should obsessive-compulsive and related disorders should be classified. American Journal of Psychiatry, 164, 1313-1314]. Further, expert survey data suggest that obsessive-compulsive disorder is composed of overlapping subtypes. However, methodological approaches for testing whether candidate disorders properly belong in the spectrum have varied widely, and do not necessarily differentiate conditions from subtypes. We describe preliminary methodological and statistical recommendations for a systematic approach to determining what constitutes a subtype, how to determine inclusion in the spectrum, and means for ruling out candidate disorders.
Handbook of Child and Adolescent Anxiety Disorders, 2011
Coined the “omnivore’s dilemma” (Rozin & Fallon, 1987), this ... more Coined the “omnivore’s dilemma” (Rozin & Fallon, 1987), this evolutionarily-based mechanism, which is characterized by seemingly conflicting inclinations to ingest and avoid unfamiliar foods, is thought to influence the food preferences and consumption of humans and other omnivorous species (Addessi, Galloway, Visalberghi, & Birch, 2005; Birch, Gunder, Grimm-Thomas, & Laing, 1998; Dovey, Staples, Gibson, & Halford, 2008; Martins & Pliner,
The efficacy of cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (O... more The efficacy of cognitive-behavioral therapy (CBT) for pediatric obsessive-compulsive disorder (OCD) has been the subject of much study over the past fifteen years. Building on a foundation of case studies and open clinical trials, the literature now contains many methodologically sound studies that have compared full CBT protocols to waitlist controls, pill placebo, psychosocial comparison conditions, active medication, combined treatments, and brief CBT. This review is part of a series commissioned by The Canadian Institute for Obsessive Compulsive Disorders (CIOCD) in an effort to publish in one place what is known about the efficacy of treatments for OCD. A total of fourteen studies were identified; collectively their findings support the efficacy of CBT for youth with OCD. CBT protocols that emphasized either strictly behavioral or cognitive conceptualizations have each been found efficacious relative to waitlist controls. Efforts to enhance CBT׳s efficacy and reach have been u...
Parents are often perceived as a contributing or maintaining source of youth anxiety disorders, m... more Parents are often perceived as a contributing or maintaining source of youth anxiety disorders, making them natural targets for either intervention or involvement in treatment protocols. Efforts to increase the efficacy and durability of standard treatments by incorporating parents have been successful, yet they often do not outperform child-focused treatment. Breinholst et al. (2012) review and discuss several overlooked parental research variables (anxiety, overcontrol, beliefs and assumptions, global family dysfunction) found to promote and maintain child anxiety. However, it remains unclear how these proposed variables interfere with active therapeutic ingredients (e.g., exposure) or how the identified problems might be addressed. We propose that insufficient attention to exposure-based treatment and family behavioral responses explain the comparatively low added value for parental involvement in child anxiety treatment and outline directions for research to address them. With m...
Mental contamination has been described as an internal experience of dirtiness that can arise and... more Mental contamination has been described as an internal experience of dirtiness that can arise and persist in the absence of contact with observable physical contaminants. Recent research has examined mental contamination specifically related to unwanted physical contact and sexual trauma. This study evaluated the degree to which disgust propensity and both self-focused and perpetrator-focused peritraumatic disgust were associated with mental contamination in a sample of women who experienced sexual trauma (n = 72). Results showed that peritraumatic self-focused disgust, but not peritraumatic perpetrator-focused disgust or fear, was significantly associated with mental contamination. Additionally, disgust propensity contributed significantly to the incremental validity of the model. These findings support the nascent literature showing that disgust plays a significant role in mental contamination, particularly following sexual trauma. Future research directions, and clinical/theoretical implications of these results are discussed.
This study extends support for a 5-day intensive exposure and response prevention (ERP) treatment... more This study extends support for a 5-day intensive exposure and response prevention (ERP) treatment protocol for pediatric obsessive compulsive disorder (OCD). Twenty-two children with OCD received ERP treatment twice daily for 5 days. The treatment also emphasized teaching children and parents how to conduct ERP independently after they returned home. Symptoms were assessed at four time-points: Baseline, 4 weeks later at pre-treatment, one week after the intensive treatment 5-day treatment, and at 3 month follow-up. Changes on the primary outcome measure, clinician severity ratings on the Anxiety Disorders Interview Schedule for Children, and secondary measures, indicated that OCD symptoms remained stable from the evaluation to baseline and improved significantly from baseline to follow-up. Moreover, parental accommodation of OCD decreased significantly from baseline to post-treatment and from post-treatment to follow-up. These data suggest that the 5-day intervention demonstrates ef...
Journal of Obsessive-Compulsive and Related Disorders, 2013
Executive dysfunction has been implicated in the neurobiology of obsessive-compulsive disorder. F... more Executive dysfunction has been implicated in the neurobiology of obsessive-compulsive disorder. Few studies have examined differences between individuals with OCD with or without tics. In this study executive functioning was compared between patients with obsessive-compulsive disorder with and without a history of tics. Participants diagnosed with OCD, with and without tics (n ¼ 10 per group) were administered the Wisconsin card sorting test (WCST) along with a measures of symptom severity for OCD, tics and depression. The groups did not differ in demographic variables or depression. Results indicated differences in performance on the WCST. Specifically, patients with past or current tics made more non-perseverative and total errors on the WCST and also demonstrated significantly more difficulty with conceptual level responding as compared to a normative sample, whereas the group without a tic history did not. Our findings, along with supporting evidence from imaging research and clinical trials, suggests that the presence of tics may be a valid means for subtyping individuals with obsessivecompulsive disorder.
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Papers by Dean McKay