{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T04:37:27Z","timestamp":1792211847788,"version":"4.4.0"},"reference-count":41,"publisher":"Cambridge University Press (CUP)","issue":"14","license":[{"start":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:00:00Z","timestamp":1612828800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0033291720005437_sec_a1\"><jats:title>Background<\/jats:title><jats:p>The symptoms of obsessive\u2212compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291720005437_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD (<jats:italic>N<\/jats:italic> = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive\u2212Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the resulting dimensions were established using network analysis. Associations between dimensions and sociodemographic and clinical variables were explored using structural equation modeling (SEM).<\/jats:p><\/jats:sec><jats:sec id=\"S0033291720005437_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Thirteen first-order symptom dimensions emerged that could be parsimoniously reduced to eight broad dimensions, which were valid across the lifespan: Disturbing Thoughts, Incompleteness, Contamination, Hoarding, Transformation, Body Focus, Superstition, and Loss\/Separation. A general OCD factor could be included in the final factor model without a significant decline in model fit according to most fit indices. Network analysis showed that Incompleteness and Disturbing Thoughts were most central (i.e. had most unique interconnections with other dimensions). SEM showed that the eight broad dimensions were differentially related to sociodemographic and clinical variables.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291720005437_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Future research will need to establish if this expanded hierarchical and multidimensional model can help improve our understanding of the etiology, neurobiology and treatment of OCD.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291720005437","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T07:02:09Z","timestamp":1612854129000},"page":"3267-3279","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":78,"title":["Towards a definitive symptom structure of obsessive\u2212compulsive disorder: a factor and network analysis of 87 distinct symptoms in 1366 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