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New Dimensions in the OCD Spectrum: Autism, Pathologic Gambling, and Compulsive Buying

Published online by Cambridge University Press:  07 November 2014

Cheryl M. Wong  and
Eric Hollander
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Abstract

The obsessive-compulsive spectrum can be divided into two subclusters: disorders of impulsivity and neurologic disorders (Figure 1). This article examines autism (from the neurologic cluster) and pathologic gambling and compulsive shopping (from the impulse side of the spectrum). These three disorders are major mental health problems, impacting on society, the affected individuals, and their families. In addition, these three disorders are underrecognized and underdiagnosed. In this article, we outline and review the phenomenology, psychopathology, and treatment options of these three disorders.

Type
Feature Articles
Information
CNS Spectrums , Volume 1 , Issue 2 , November 1996 , pp. 44 - 53
Copyright
Copyright © Cambridge University Press 1996

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References

1.Kanner, L. Autistic disturbances of affective contact. Nervous Child. 1943;2:217–250.Google Scholar
2.Diagnostic and Statistical Manual of Mental Disorders, 4th ed, Washington, DC: American Psychiatric Association; 1994.Google Scholar
3.Cook, EH, Leventhal, B. Neuropsychiatric disorders of child-hood and adolescence. In: Yudofsky, SC, Hales, E, eds. The American Psychiatric Press Textbook of Neuropsychiatry, 2nd ed, Washington, DC: American Psychiatric Press; 1992: chap 28.Google Scholar
4.McDougle, GJ, Kresch, LE, Goodman, WK, et al. , A case-controlled study of repetitive thoughts and behaviors in adults with autistic disorder and obsessive-compulsive disorder. Am J Psychiatry. 1995; 152:772–777.Google ScholarPubMed
5.Deykin, EY, Macmahon, B. The incidence of seizures among children with autistic symptoms. Am J Psychiatry. 1979; 136:1310–1312.Google ScholarPubMed
6.Volkmar, FR, Nelson, DS. Seizure disorders in autism. J Am Acad Child Adolesc Psychiatry. 1990;29:127–129.CrossRefGoogle ScholarPubMed
7.Smalley, SL, McCraken, J, Tanguay, P. Autism, affective disorders, and social phobia. Am J Med Genet. 1995;60:19–26.CrossRefGoogle ScholarPubMed
8.Ando, H, Yoshimura, I. Prevalence of maladaptive behavior in retarded children as a function of IQ and age. J Abnormal Psychol. 1978;6:345–349.Google ScholarPubMed
9.Ritvo, ER, Mason-Brothers, A, Freeman, BJ, et al. , The UCLA-University of Utah epidemiological survey of autism: the etiologic role of rare diseases. Am J Psychiatry. 1990; 147:1614–1621.Google ScholarPubMed
10.Gillberg, C, Steffenberg, S, Schaumann, H. Is autism more common now than ten years ago? Br J Psychiatry. 1991;158:403–409.CrossRefGoogle ScholarPubMed
11.Gillberg, C, Persson, U, Grufman, M, et al. , Psychiatric disorders in mildly and severely mentally retarded children and adolescents: epidemiological aspects. Br J Psychiatry. 1986;149:68–74.CrossRefGoogle ScholarPubMed
12.Bryson, S, Clark, B, Smith, I. First report on a Canadian epidemiological study of autistic syndromes. J Child Psychol Psychiatry. 1988;29:433–445.CrossRefGoogle ScholarPubMed
13.Matsuishi, T, Shiotsuki, Y, Yoshimura, K, et al. , High prevalence of infantile autism in Kurume City, Japan. J Child Neurol. 1987;2:268–271.CrossRefGoogle ScholarPubMed
14.Rutter, M. Infantile autism. In: Shaffer, D, Ehrhardt, AA, Greenhill, LL, eds. The Clinical Guide to Child Psychiatry. New York: Free Press; 1985:48–78.Google Scholar
15.Mundy, P, Sigman, M. The theoretical implications of joint attention deficits in autism. Development Psychopathology. 1989;1:173–183.CrossRefGoogle Scholar
16.Rumsey, JM, Rappaport, JL, Sceery, WR. Autistic children as adults—psychiatric, social, and behavioral outcomes. J Am Acad Child Adolesc Psychiatry. 1985;24:465–473.CrossRefGoogle ScholarPubMed
17.Folstein, SE, Rutter, ML. Infantile autism: a genetic study of 21 twin pairs. J Child Psychol Psychiatry. 1977;18:297–321.CrossRefGoogle ScholarPubMed
18.Steffenburg, S, Gillberg, C, Hellgren, L, et al. , A twin study of autism in Denmark, Finland, Iceland, Norway and Sweden. J Child Psychol Psychiatry. 1989;30:405–416.CrossRefGoogle ScholarPubMed
19.Rutter, M, Bartak, L. Causes of infantile autism: some considerations from recent research. J Autism Child Schizophrenia. 1971;1:20–32.CrossRefGoogle ScholarPubMed
20.Smalley, SL, Asarnow, RF. Spence, MA. Autism and genetics. Arch Gen Psychiatry. 1988;45:953–961.CrossRefGoogle ScholarPubMed
21.Folstein, SE, Piven, J. Etiology of autism: genetic influences. Pediatrics. 1991;87:767–773.CrossRefGoogle ScholarPubMed
22.Spiker, DK, Lotspeich, L, Kraemer, HC, et al. , The genetics of autism: characteristos of affected and unaffected children from 37 multiplex families. Am J Med Genet. 1994;54:27–35.CrossRefGoogle ScholarPubMed
23.Hallmayer, J, Mountain, J, Ritvo, E, et al. , A linkage study of familial infantile autism. Psychiatric Genet. 1991;2:50A.Google Scholar
24.Herault, J, Perrot, A, Barthelemy, G, et al. , Possible association of c-Harvey-Ras-l (HRAS-1) marker with autism. Psychiatry Res. 1993;46:261–267.CrossRefGoogle ScholarPubMed
25.Petit, E, Herault, J, Martineau, J. Association study with two markers of a human homeogene in infantile autism. J Med Genet. 1995;32:269–274.CrossRefGoogle ScholarPubMed
26.Gillberg, C, Coleman, M. The Biology of the Autistic Syndrome, 2nd ed. New York: Cambridge University Press; 1992:310.Google Scholar
27.Schain, RJ, Freedman, DX. Studies on 5-hydroxyindole metabolsm in autistic and other mentally retarded children. J Pediatr. 1961;58:315–318.CrossRefGoogle Scholar
28.Piven, J, Tsai, G, Nehme, E, et al. , Platelet serotonin: a possible marker for familial autism. J Autism Dev Disord. 1991;21:51–59.CrossRefGoogle ScholarPubMed
29.Todd, RD, Ciaranello, RD. Demonstration of inter- and intraspecies differences in serotonin binding sites by antibodies from an autistic child. Proc Natl Acad Sci USA. 1985;82:612–616.CrossRefGoogle ScholarPubMed
30.Popper, CW. Disorders usually first evident in infancy, child-hood, or adolescence. In Talbott, JA, Hales, RE, Yudofsky, SC, eds. The APP Textbook of Psychiatry. Washington, DC: American Psychiatric Press; 1988: chap 1.Google Scholar
31.Warren, RP, Burger, RA, Odell, D, et al. , Decreased plasma concentration of C4B complement protein in autism. Arch Pediatr Adolesc Med. 1994;148:180–183.CrossRefGoogle ScholarPubMed
32.Bauman, M, Kemper, TL. Histoanatomic observation of the brain in early infantile autism. Neurology. 1985;35:866–874.CrossRefGoogle ScholarPubMed
33.Courchesne, E, Yeung-Chourchesne, R, Press, RA, et al. , Hypoplasia of cerebellar hemisphere size and its relationship to vermal hypolasia in autism. Arch Neurol. 1989;46:689–694.Google Scholar
34.Murakami, JW, Chourchesne, E, Press, GA, et al. , Reduced cerebellar hemisphere size and its relationship to vermal hypoplasia in autism. Arch Neurol. 1989;46:689–694.CrossRefGoogle ScholarPubMed
35.Piven, J, Berthier, ML, Starkstein, SE, et al. , Magnetic resonance imaging evidence for a defect of cerebral cortical development in autism. Am J Psychiatry. 1990;147:734–739.Google ScholarPubMed
36.Hashimoto, T, Tayama, M, Mori, K, et al. , Magnetic resonance imaging in autism: preliminary report. Neuro-pediatrics. 1988;20:142–146.Google Scholar
37.Egaas, B, Chourchesne, E, Saitoh, O. Decreased size of corpus callosum in autism. Arch Neurol. 1995;52:794–801.CrossRefGoogle Scholar
38.Mounts, JM, Tolbert, LC, Lill, DW, et al. , Functional deficits in autistic disorder, characterization by technitium-99-m HMPAO and SPECT. J Nucl Med. 1995;6:1156–1162.Google Scholar
39.Chiron, C, Lebayer, M, Leon, F, et al. , SPECT of brain in child-hood autism. Evidence for lack of normal hemispheric asymmetry. Dev Med Child Neurol. 1995;37:849–860.CrossRefGoogle Scholar
40.Schifter, Hoffman JM, Halten, HP. Neuroimaging in infantile autism. J Child Neurol. 1994;9:155–161.CrossRefGoogle ScholarPubMed
41.Rogers, S, Lewis, H. An effective day treatment module for young children with pervasive developmental disorder. J Am Acad. Child Adolesc Psychiatry. 1989;28:207–214.CrossRefGoogle Scholar
42.Lovaas, OI. Behavioral treatment and normal educational and intellectual functioning in young autistic children. J Consult Clin Psychol. 1987;55:3–9.CrossRefGoogle ScholarPubMed
43.LeBlanc, R. Educational management of self-injurious behavior. Aca Paedopsychiatrica. Interntional J Child Adolesc Psychiatry. 1993;56:91098.Google ScholarPubMed
44.Wolfberg, PJ, Schuler, AL. Integrated play groups: a model for promoting the social and cognitive dimensions of play in children with autism. J Autism Dev Disord. 1979;9:11–29.Google Scholar
45.Gordon, C, Rappaport, J, Hamburger, S, et al. , Differential response of autistic disorder to clomipramine. J Am Acad Child Adolesc Psychiatry. 1991;30:164.CrossRefGoogle Scholar
46.Cook, EH, Rowlett, R, Jaselskis, C, et al. , Fluoxetine treatment of children and adults with autistic disorders and mental retardation. J am Acad. Child Asoies Psych. 1992;31:739–745.CrossRefGoogle ScholarPubMed
47.Todd, RD. Fluoxetine in autism (letter). Am J Psychiatry 1991;148:1089.Google Scholar
48.McDougle, CJ, Kresch, LE, Goodman, WK, et al. , A case-controlled study of repetitive thoughts and behaviors in adults with autistic disorders and obsessive-compulsive disorder. Am J Psychiatry. 1995;152:772–777.Google ScholarPubMed
49.Hellings, JA, Kelley, LA, Gabrielli, WF, Kilgore, E, et al. , Sertraline response in adults with mental retardation and autistic disorder. J Clin Psychiatry. 1996;57:333–336.Google ScholarPubMed
50.Campbell, M. Schizophrenic disorders and pervasive developmental disorders/infantile autism. In: Wiener, JM, ed. Diagnosis and Psychopharmacol-ogy of Childhood and Adolescent Disorders. New York: John Wiley and Sons; 1985.Google Scholar
51.Purden, SE, Lit, W, Labelle, A, , et al. , Risperidone in the treatment of pervasive developmental disorders. Can J Psychiatry. 1994;39:400–405.CrossRefGoogle Scholar
52.Kolman, BK, Feldman, HM, Harden, BL, et al. . Naltrexone in young autistic children. A double-blind placebo-controlled crossover study. J Am Acad Child Adolesc Psychiatry. 1995;34:223–231.CrossRefGoogle Scholar
53.Quintana, H, Birmaher, B, Stedge, D, et al. , Use of methylphenidate in the treatment of children with autistic disorder. J Autism Dev Disord. 1995;251:283–294.CrossRefGoogle Scholar
54.Holm, VA, Varley, CK. Pharmacological treatment of autistic children. In: Dawson, G, ed. Autism: nature, diagnosis, and treatment. New York: Guilford Press, 1985. pp.386–404.Google Scholar
55.Raitan, D. Nutrition and developmental disabilities: a clinical assessment. In: Schopler, E, Mesibov, G, eds. Diagnosis and assessment of autism. New York: Plenum. 1988. pp211–223.CrossRefGoogle Scholar
56.Rimland, B. Controversies in the treatment of autistic children: vitamin and drug therapy. J Child Neurol. 1988; 3(supp):66–72.CrossRefGoogle ScholarPubMed
57.Kozlowski, BW. Megavitamin treatment of mental retardation in children: a review of effects on behavior and cognition. J Child adolesc Psychopharmacol. 1992;2:307–320.CrossRefGoogle ScholarPubMed
58.Hollander, E, Wong, CM. Body dysmorphic disorder, pathological gambling, and sexual compulsions. J Clin Psychiatry. 1995; 56(suppl 4): 7–12.Google ScholarPubMed
59.DeCaria, CM. Hollander, E. Pathological gambling. In: Hollander, E, ed. Obsessive Compulsive Related Disorders. Washington, DC; American Psychiatric Press: 1993, chap 8.Google Scholar
60.Anderson, G, Brown, R. Real and laboratory gambling, sensation-seeking and arousal. Br J Psychol. 1984;75:401–411.CrossRefGoogle ScholarPubMed
61.Moran, E. Pathological gambling. Br J Hosp Med. 1970;4:59–70.Google Scholar
62.Peck, CP. A public mental health issue: risk-taking behavior and compulsive gambling. Am Psychol. 1986;41:461–465.CrossRefGoogle ScholarPubMed
63.McElroy, SL, Hudson, JI, Pope, HG, et al. , The DSM-III-R impulse control disorders not elsewhere classified: clinical characteristics and relationship to other psychiatric disorders. Am J Psychiatry. 1992;149:318–327.Google Scholar
64.Livingston, J. Compulsive Gamblers. Observations on Actions and Abstinence. New York: Harper Torchbooks; 1974.Google Scholar
65.Custer, RL, Custer, LF. Characteristics of the recovering compulsive gambler: a survey of 150 members of Gamblers Anonymous. Paper presented at the 4th Annual Conference on Gambling; December 1978; Reno, Nevada.Google Scholar
66.Ciarrocchi, J, Richardson, R. Profile of compulsive gamblers in treatment. Update and comparison. Journal of Gambling Behavior. 1989;5:53–65.CrossRefGoogle Scholar
67.Carlton, PL, Goldstein, L. Physiologic determinants of patholgical gambling. In: Glaski, T, ed. A Handbook of Pathological Gambling. Springfield, Ill: Charles C. Thomas; 1987:657–663.Google Scholar
68.Review of the National Policy Toward Gambling in America. Washington, DC: US Government Printing Office; 1976.Google Scholar
69.Lesiuer, HR, Rosenthal, RJ. Pathological gambling: a review of the literature. Journal of Gambling Behavior. 1991;7:5–39.Google Scholar
70.Lesiuer, HR. The female pathological gambler. In: Eadington, WR, ed; Gambling Studies: Proceedings of the 7th International Conference on Gambling and Risk-Taking. Reno, Nevada: University of Nevada; 1988.Google Scholar
71.Rosenthal, RJ. Pathological gambling. Psychiatric Annals. 1992;22:72–78.CrossRefGoogle Scholar
72.Blume, SB. Compulsive gambling and the medical model. Journal of Gambling Behavior. 1987;3:237–247.CrossRefGoogle Scholar
73.Moreno, I, Saiz-Ruiz, JY, Lopez-Ibor, JJ. Serotonin and gambling dependence. Human Psychopharmacology. 1991; 6:9–12.CrossRefGoogle Scholar
74.DeCaria, C, Hollander, E, Frenkel, M, et al. , Psychobiology of pathological gambling. Paper presented at the Forty-Seventh Annual Convention and Scientific Program, Society of Biological Psychiatry; 1992; Washington, DC.Google Scholar
75.DeCaria, CM, Stein, DJ, Cohen, L, et al. , Psychobiology of pathological gambling. Paper presented at the First International Obsessive-Compulsive Disorder Congress; March 1993; Capri, Italy.Google Scholar
76.Carrasco, JL, Saiz-Ruiz, J, Hollander, E, et al. , Low platelet monoamine oxidase activity in pathological gambling. Acta Psychiatr Scand. 1994;90:427–431.CrossRefGoogle ScholarPubMed
77.Stewart, R, Brown, RIF. An outcome study of Gamblers Anonymous. Br J Psychiatry. 1988;152:284–288.CrossRefGoogle ScholarPubMed
78.Brown, RIF. The effectiveness of Gamblers Anonymous. In: Eadington, WR, ed: The Gambling Studies: Proceedings of the Sixth National Conference on Gambling and Risk Taking. Reno, Nevada: Bureau of Business and Economic Research, University of Nevada; 1985.Google Scholar
79.Glen, AM. The treatment of compulsive gamblers at the Cleveland VA Hospital, Brecksville Division. Paper presented at the 84th Annual Convention of American Psychological Association; September 1976; Washington, DC.Google Scholar
80.Barker, J, Miller, M. Aversion therapy for compulsive gamblers. J Nerv Ment Dis. 1968;146:285–302.CrossRefGoogle Scholar
81.Ladouceur, R. Cognitive activities among gamblers. Paper presented at AABT Convention; November 1990; San Francisco.Google Scholar
82.Allcock, CC. Pathological gambling. Australian N Z J Psychiatry. 1986;20:259–265.CrossRefGoogle ScholarPubMed
83.Bergler, E. The Psychology of Gambling. New York: International Universities Press, Hill and Wang; 1957.Google Scholar
84.Moscowitz, JA. Lithium and Lady Luck: use of lithium carbonate in compulsive gambling. NY State J Med. 1980;80:785–788.Google Scholar
85.Miller, WR, Rollnick, S. Motivational Interviewing: Preparing People to Change Addictive Behavior. New York: Guilford Press; 1991.Google Scholar
86.Hollander, E, Wong, CM. Developments in the treatment of obsessive-compulsive disorder. Primary Psychiatry. 1995; 2:28–33.Google Scholar
87.Hollander, E, Frenkel, M, DeCaria, CM, et al. , Treatment of pathological gambling with clomipramine. Am J Psychiatry. 1992;149:710–711 (letter).Google ScholarPubMed
88.Kraeplin, E. Psychiatrie, 8th ed. Leipzig: Verlag Von Johann Ambrosius Barth; 1915:408–409.Google Scholar
89.Bleular, E. Textbook of Psychiatry. The Classics of Psychiatry & Behavioral Science Library. Birmingham, AL: Gryphon Editions; 1988.Google Scholar
90.McElroy, SL, Keck, PE, Pope, HG, et al. , Compulsive buying: a report of 20 cases. J Clin Psychiatry. 1994;55:242–248.Google Scholar
91.Christenson, GA, Faber, RJ, de Zwaan, M, et al. , Compulsive buying: descriptive characteristics and psychiatric comorbidity. J Clin Psychiatry. 1994;55:5–11.Google ScholarPubMed
92.Schlosser, E, Black, DW, Repertinger, S, et al. , Compulsive buying: demography, phenomenology, and comorbidity in 46 subjects. Gen Hosp Psychiatry. 1994;16:205–212.CrossRefGoogle ScholarPubMed
93.McElroy, SL, Pope, HG, Keck, PE, Hudson, JI. Disorders of impulse control. In: Hollander, E, Stein, DJ, eds. Impulsivity and Aggression. New York: John Wiley and Sons; 1995, chap 8.Google Scholar
94.Aber, RJ, O-Guinn, TC. Beyond phenomenology: emerging theoretical notions on compuslive buying. Paper presented at the American Psychological Association Conference; 1993:San Francisco, CA.Google Scholar
95.Krueger, DW. On compulsive shopping and spending: a psychodynamic inquiry. Am J Psychother. 1988;42:574–584.CrossRefGoogle ScholarPubMed
96.Stein, DJ, Hollander, E, Leibowitz, MR. Neurobiology of impulsivity and the impulse control disorders. J Neuro-psychiatry Clin Neurosci. 1993;5:9–11.Google ScholarPubMed
97.Black, BW, Schlosser, E, et al. , Fluvoxamine treatment of Compulsive buyers. J Clin Psychiatry. In press.Google Scholar