Hostname: page-component-669899f699-qzcqf Total loading time: 0 Render date: 2025-04-25T14:58:37.808Z Has data issue: false hasContentIssue false
  • English
  • Français

The motor profile of obsessive-compulsive rituals: psychopathological and evolutionary implications

Published online by Cambridge University Press:  21 February 2022

Matteo Tonna Open the ORCID record for Matteo Tonna [Opens in a new window] ,
Rebecca Ottoni Open the ORCID record for Rebecca Ottoni [Opens in a new window] ,
Clara Pellegrini ,
Lorenzo Mora ,
Luca Gambolo ,
Anna Di Donna ,
Stefano Parmigiani  and
Carlo Marchesi
Matteo Tonna*
Affiliation:
Department of Mental Health, Local Health Service, Parma, Italy Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
Rebecca Ottoni
Affiliation:
Department of Mental Health, Local Health Service, Parma, Italy
Clara Pellegrini
Affiliation:
Department of Mental Health, Local Health Service, Parma, Italy
Lorenzo Mora
Affiliation:
Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
Luca Gambolo
Affiliation:
Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
Anna Di Donna
Affiliation:
Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
Stefano Parmigiani
Affiliation:
Department of Chemistry, Life Sciences and Environmental Sustainability, Unit of Behavioral Biology, University of Parma, Parma, Italy
Carlo Marchesi
Affiliation:
Department of Mental Health, Local Health Service, Parma, Italy Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy
*
*Author for correspondence: Matteo Tonna, MD, PhD Email: matteo.tonna@unipr.it
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Studies investigating obsessive-compulsive disorder from an ethological approach have highlighted a specific motor pattern of compulsive rituals with respect to corresponding ordinary behaviors. Particularly, compulsive motor profile is built through the repetition of acts, with prevalence of nonfunctional ones and redirection of attention to its basic structural units. These formal features would characterize ritual behavior throughout evolution, from nonhuman animals to human cultures. However, no study to date has investigated a possible relationship between such motor profile and underlying psychopathology. Therefore, the first objective of the study was to confirm previous findings on a larger sample size of obsessive patients; the second objective was to elucidate whether motor profile might be associated with obsessive-compulsive psychopathology and/or prepsychotic symptoms of schizophrenia.

Methods

Twenty-one obsessive-compulsive outpatients provided a videotape of their rituals. An equal number of healthy controls, matched for sex and age, were registered for corresponding ordinary acts. Obsessive patients were administered the Yale-Brown Obsessive-Compulsive Scale, the Brown Assessment of Beliefs Scale, the Hamilton Rating Scale for Depression, and the Frankfurt Complaint Questionnaire.

Results

The results of the present study confirm that ritual compulsions present a specific motor structure characterized by repetition of both functional and nonfunctional acts and their longer duration. Such a motor pattern is independent from obsessive-compulsive psychopathology, whereas it results specifically associated with prepsychotic symptoms of schizophrenia.

Conclusions

We argue that this association may reflect the adaptive significance of ritual behavior across evolution, that is, its homeostatic function in conditions of unpredictability.

Keywords

Compulsionsevolutionobsessive-compulsive disorderprepsychotic symptomsritual behaviorschizophreniaunpredictability
Type
Original Research
Information
CNS Spectrums , Volume 28 , Issue 4 , August 2023 , pp. 441 - 449
Copyright
© The Author(s), 2022. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Washington, DC: American Psychiatric Association; 2013.Google Scholar
Zhu, TH, Nakamura, M, Farahnik, B, et al. Obsessive-compulsive skin disorders: a novel classification based on degree of insight. J Dermatolog Treat. 2017;28(4):342–346.CrossRefGoogle Scholar
Matsunaga, H, Kiriike, N, Matsui, T, et al. Obsessive-compulsive disorder with poor insight. Compr Psychiatry. 2002;43(2):150–157.CrossRefGoogle ScholarPubMed
Catapano, F, Perris, F, Fabrazzo, M, et al. Obsessive-compulsive disorder with poor insight: a three-year prospective study. Neuropsychopharmacol Biol Psychiatry. 2010;34(2):323–330.CrossRefGoogle Scholar
Jacob, ML, Larson, MJ, Storch, EA. Insight in adults with obsessive-compulsive disorder. Compr Psychiatry. 2014;55(4):896–903.CrossRefGoogle Scholar
Barahona-Corrêa, JB, Camacho, M, Castro-Rodrigues, P, Costa, R, Oliveira-Maia, AJ. From thought to action: how the interplay between neuroscience and phenomenology changed our understanding of obsessive-compulsive disorder. Front Psychol. 2015;6:1–12.CrossRefGoogle Scholar
Fineberg, NA, Apergis-Schoute, AM, Vaghi, MM, et al. Mapping compulsivity in the DSM-5 obsessive compulsive and related disorders: cognitive domains, neural circuitry and treatment. Int J Neuropsychopharmacol. 2018;21(1):42–58.CrossRefGoogle Scholar
Liénard, P, Boyer, P. Whence collective rituals? A cultural selection model of ritualized behavior. Am Anthropol. 2006;108(4):814–827.CrossRefGoogle Scholar
Eilam, D, Zor, R, Szechtman, H, Hermesh, H. Rituals, stereotypy and compulsive behavior in animals and humans. Neurosci Biobehav Rev. 2006;30(4):456–471.CrossRefGoogle ScholarPubMed
Eilam, D. From an animal model to human patients: an example of a translational study on obsessive compulsive disorder (OCD). Neurosci Biobehav Rev. 2017;76:67–76.CrossRefGoogle Scholar
Zor, R, Hermesh, H, Szechtman, H, Eilam, D. Turning order into chaos through repetition and addition of elementary acts in obsessive-compulsive disorder (OCD). World J Biol Psychiatry. 2009;10(4):480–487.10.1080/15622970701416539CrossRefGoogle Scholar
Zor, R, Keren, H, Hermesh, H, Szechtman, H, Mort, J, Eilam, D. Obsessive-compulsive disorder: a disorder of pessimal (non-functional) motor behavior. Acta Psychiatr Scand. 2009;120(4):288–298.CrossRefGoogle Scholar
Boyer, P, Liénard, P. Why ritualized behavior? Precaution Systems and action parsing in developmental, pathological and cultural rituals. Behav Brain Sci. 2007;29(6):595–613.CrossRefGoogle Scholar
Krátký, J, Lang, M, Shaver, JH, Jerotijević, D, Xygalatas, D. Anxiety and ritualization: can attention discriminate compulsion from routine? Commun Integr Biol. 2016;9(3):56–59.CrossRefGoogle Scholar
Lang, M, Krátký, J, Shaver, JH, Jerotijević, D, Xygalatas, D. Effects of anxiety on spontaneous ritualized behavior. Curr Biol. 2015;25(14):1892–1897.CrossRefGoogle Scholar
Tonna, M, Marchesi, C, Parmigiani, S. The biological origins of rituals: an interdisciplinary perspective. Neurosci Biobehav Rev. 2019;98:95–106.CrossRefGoogle Scholar
Tonna, M, Ponzi, D, Palanza, P, Marchesi, C, Parmigiani, S. Proximate and ultimate causes of ritual behavior. Behav Brain Res. 2020;393:112772.CrossRefGoogle Scholar
Graybiel, AM. Habits, rituals, and the evaluative brain. Annu Rev Neurosci. 2008;31:359–387.CrossRefGoogle Scholar
Wilkes, BJ, Lewis, MH. The neural circuitry of restricted repetitive behavior: magnetic resonance imaging in neurodevelopmental disorders and animal models. Neurosci Biobehav Rev. 2018;92:152–171.CrossRefGoogle Scholar
Szechtman, H, Woody, E. Obsessive-compulsive disorder as a disturbance of security motivation. Psychol Rev. 2004;111(1):111–127.CrossRefGoogle Scholar
Woody, EZ, Szechtman, H. A biological security motivation system for potential threats: are there implications for policy-making? Front Hum Neurosci. 2013;7:556.CrossRefGoogle Scholar
Eilam, D, Izhar, R, Mort, J. Threat detection: behavioral practices in animals and humans. Neurosci Biobehav Rev. 2011;35(4):999–1006.CrossRefGoogle Scholar
Blanchard, DC, Blanchard, RJ, Rodgers, RJ. Risk assessment and animal models of anxiety. In: Olivier, B, Mos, J, Slangen, JL, eds. Animal Models in Psychopharmacology. Basel: Birkhäuser; 1991:117–134.CrossRefGoogle Scholar
Schleyer, M, Diegelmann, S, Michels, B, Saumweber, T, Gerber, B. ‘Decision making’ in larval Drosophila. In: Handbooks of Behavioral Neuroscience, Invertebrate Learning and Memory, 22. London: Academic Press; 2013:41–55.Google Scholar
Stürzl, W, Zeil, J, Boeddeker, N, Hemmi, JM. How wasps acquire and use views for homing. Curr Biol. 2016;26(4):470–482.CrossRefGoogle Scholar
Hirsh, JB, Mar, RA, Peterson, JB. Psychological entropy: a framework for understanding uncertainty-related anxiety. Psychol Rev. 2012;119(2):304–320.CrossRefGoogle Scholar
Eilam, D. The cognitive roles of behavioral variability: idiosyncratic acts as the foundation of identity and as transitional, preparatory, and confirmatory phases. Neurosci Biobehav Rev. 2015;49:55–70.CrossRefGoogle Scholar
Amitai, M, Arnon, N, Shaham, N, et al. Nonfunctional redundant acts characterize OCD, even in OCD-unrelated tasks: a demonstration in questionnaire completion. Psychopathology. 2017;50(6):389–400.CrossRefGoogle Scholar
Lorenz, K. On Aggression. London: Methuen; 1966.Google Scholar
Insel, TR. Obsessive-compulsive disorder: a neuroethological perspective. Psychopharmacol Bull. 1988;24(3):365–369.Google ScholarPubMed
Tonna, M, Amerio, A, Ottoni, R, et al. The clinical meaning of obsessive-compulsive symptoms in bipolar disorder and schizophrenia. Aust N Z J Psychiatry. 2015;49(6):578–579.CrossRefGoogle Scholar
Rasmussen, AR, Nordgaard, J, Parnas, J. Schizophrenia-spectrum psychopathology in obsessive-compulsive disorder: an empirical study. Eur Arch Psychiatry Clin Neurosci. 2020;270(8):993–1002.CrossRefGoogle Scholar
Cederlöf, M, Lichtenstein, P, Larsson, H, et al. Obsessive-compulsive disorder, psychosis, and bipolarity: a longitudinal cohort and multigenerational family study. Schizophr Bull. 2015;41(5):1076–1083.CrossRefGoogle Scholar
Schultze-Lutter, F, Theodoridou, A. The concept of basic symptoms: its scientific and clinical relevance. World Psychiatry. 2017;16(1):104–105.CrossRefGoogle Scholar
First, MB, Williams, JBW, Karg, RS, Spitzer, RL. Structured Clinical Interview for DSM-5 Disorders, Clinician Version (SCID-5-CV). American Psychiatric Press, Washington, DC; 2016.Google Scholar
Goodman, WK, Price, LH, Rasmussen, SA, et al. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46(11):1006–1011.CrossRefGoogle Scholar
Eisen, JL, Phillips, KA, Baer, L, Beer, DA, Atala, KD, Rasmussen, SA. The Brown Assessment of Beliefs Scale: reliability and validity. Am J Psychiatry. 1998;155(1):102–108.CrossRefGoogle Scholar
Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23(1):56–62.CrossRefGoogle Scholar
Süllwold, L. Frankfurter Beschwerde-Frageboden (FBF). Heidelberg: Springer; 1986.CrossRefGoogle Scholar
Rapoport, JI, Swedo, S, Leonard, H. Obsessive-compulsive disorder. In: Rutter, M, Taylor, E, Hersov, L, eds. Child and Adolescent Psychiatry: Modern Approaches. 3rd ed. Oxford: Blackwell Science; 1994.Google Scholar
Monteiro, P, Feng, G. Learning from animal models of obsessive-compulsive disorder. Biol Psychiatry. 2016;79(1):7–16.CrossRefGoogle Scholar
Wolmarans, W, Scheepers, IM, Stein, DJ, Harvey, BH. Peromyscus maniculatus bairdii as a naturalistic mammalian model of obsessive-compulsive disorder: current status and future challenges. Metab Brain Dis. 2018;33(2):443–455.CrossRefGoogle Scholar
Sobin, C, Sackeim, HA. Psychomotor symptoms of depression. Am J Psychiatry. 1997;154(1):4–17.Google Scholar
Moors, A, De Houwer, J. Automaticity: a theoretical and conceptual analysis. Psychol Bull. 2006;132(2):297–326.CrossRefGoogle Scholar
Brembs, B. Spontaneous decisions and operant conditioning in fruit flies. Behav Processes. 2011;87(1):157–164.CrossRefGoogle Scholar
Keren, H, Boyer, P, Mort, J, Eilam, D. Pragmatic and idiosyncratic acts in human everyday routines: the counterpart of compulsive rituals. Behav Brain Res. 2010;212(1):90–95.CrossRefGoogle Scholar
Falk, JL. The origin and functions of adjunctive behavior. Animal Learning & Behavior. 1977;5(4):325–335.CrossRefGoogle Scholar
Eilam, D. Comparative morphology of locomotion in vertebrates. J Motor behav. 1995;27:100–111.CrossRefGoogle Scholar
Anderson, E, Shivakumar, G. Effects of exercise and physical activity on anxiety. Front Psychiatry. 2013;4:27.CrossRefGoogle Scholar
Karl, JA, Rituals, FR. Repetitiveness and cognitive load: a competitive test of ritual benefits for stress. Hum Nat. 2018;29(4):418–441.CrossRefGoogle Scholar
Legare, CH, Souza, AL. Evaluating ritual efficacy: evidence from the supernatural. Cognition. 2012;124(1):1–15. doi:10.1016/j.cognition.2012.03.004.CrossRefGoogle Scholar
Tonna, M, Ottoni, R, Paglia, F, Ossola, P, De Panfilis, C, Marchesi, C. Obsessive-compulsive symptom severity in schizophrenia: a Janus Bifrons effect on functioning. Eur Arch Psychiatry Clin Neurosci. 2016;266(1):63–69.CrossRefGoogle Scholar
Tonna, M, Ottoni, R, Paglia, F, Ossola, P, De Panfilis, C, Marchesi, C. Obsessive-compulsive symptoms interact with disorganization in influencing social functioning in schizophrenia. Schizophr Res. 2016;171(1–3):35–41.CrossRefGoogle Scholar
Mataix-Cols, D, Wooderson, S, Lawrence, N, Brammer, MJ, Speckens, A, Philips, ML. Distinct neural correlates of washing, checking, and hoarding symptom dimensions in obsessive-compulsive disorder. Arch Gen Psychiatry. 2004;61:564–576.CrossRefGoogle Scholar