title: Mediators and moderators of functional impairment in adults with obsessive-compulsive disorder.
abstract: The current study examined correlates, moderators, and mediators of functional impairment in 98 treatment-seeking adults with obsessive-compulsive disorder (OCD). Participants completed or were administered measures assessing obsessive-compulsive symptom severity, functional impairment, resistance against symptoms, interference due to obsessive-compulsive symptoms, depressive symptoms, insight, and anxiety sensitivity. Results indicated that all factors, except insight into symptoms, were significantly correlated with functional impairment. The relationship between obsessive-compulsive symptom severity and functional impairment was not moderated by patient insight, resistance against obsessive-compulsive symptoms, or anxiety sensitivity. Mediational analyses indicated that obsessive-compulsive symptom severity mediated the relationship between anxiety sensitivity and obsessive-compulsive related impairment. Indeed, anxiety sensitivity may play an important contributory role in exacerbating impairment through increases in obsessive-compulsive symptom severity. Depressive symptoms mediated the relationship between obsessive-compulsive symptom severity and obsessive-compulsive related impairment. Implications for assessment and treatment are discussed.
authors.affiliation: Department of Pediatrics, University of South Florida, St. Petersburg, FL 33701, USA; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, St. Petersburg, FL 33701, USA. Electronic address: estorch@health.usf.edu.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Storch
authors.affiliation: Department of Pediatrics, University of South Florida, St. Petersburg, FL 33701, USA; Department of Psychology, University of South Florida, St. Petersburg, FL 33701, USA.
authors.forename: Monica S
authors.initials: MS
authors.lastname: Wu
authors.affiliation: School of Aging Studies, University of South Florida, St. Petersburg, FL 33701, USA.
authors.forename: Brent J
authors.initials: BJ
authors.lastname: Small
authors.affiliation: Department of Pediatrics, University of South Florida, St. Petersburg, FL 33701, USA.
authors.forename: Erika A
authors.initials: EA
authors.lastname: Crawford
authors.affiliation: Department of Pediatrics, University of South Florida, St. Petersburg, FL 33701, USA; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, St. Petersburg, FL 33701, USA.
authors.forename: Adam B
authors.initials: AB
authors.lastname: Lewin
authors.affiliation: Department of Pediatrics, University of South Florida, St. Petersburg, FL 33701, USA.
authors.forename: Betty
authors.initials: B
authors.lastname: Horng
authors.affiliation: Department of Pediatrics, University of South Florida, St. Petersburg, FL 33701, USA; Department of Psychiatry and Behavioral Neurosciences, University of South Florida, St. Petersburg, FL 33701, USA.
authors.forename: Tanya K
authors.initials: TK
authors.lastname: Murphy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D055815:Young Adult