WELCOME TO ANXIETY, OBSESSIONS AND COMPULSIONS RESEARCH PROGRAM
HELPING PEOPLE WITH REPETITIVE BEHAVIORS
WHO WE ARE
We are a group of psychiatrists, neurologists, psychologists, and basic scientists based at the Federal University of Rio de Janeiro and D'Or Institute for Research and Education. We perform research that aims to improve the lives of people with anxiety, compulsive and impulsive disorders.
CONSTRUCTS OF INTEREST
We investigate the reasons why people consciously engage in behaviors that prove to be counterproductive in the long term, including several experiences and traits that are often described in the literature, but are still poorly understood, such as compulsivity, impulsivity and habit. We understand that compulsive, impulsive and habitual behavior can vary over a spectrum of severity and that a line that separates normal from pathological features is often blurred. It is therefore extremely important to identify the factors that determine the transition from a healthy to a pathological state and vice versa. For this reason, the natural history of subliminal forms of compulsive, impulsive and anxious disorders is one of the main interests of our group.
TARGET POPULATIONS
Our group is interested in the patterns of evolution of compulsive, impulsive and anxious traits in the general (non-clinical) population and in individuals with a variety of clinical conditions, particularly obsessive-compulsive and related disorders; disorders due to addictive behaviors; anxiety-related disorders and a range of recent and poorly understood compulsive, impulsive and anxious phenotypes.
ENVIRONMENTAL FACTORS
We investigate situations that can lead to the conversion of subliminal forms of compulsivity and impulsivity into clinical conditions, including stressful life events (for example, COVID-19 pandemic), unhealthy lifestyles (poor sleep hygiene, physical inactivity, unhealthy diet, etc.), and people's beliefs about self-efficacy or free will. A greater understanding of risk factors can help populations at risk to develop greater resilience, a better lifestyle and a greater sense of control over their behaviors.
THERAPEUTIC APPROACHES
We believe that the boundaries between different psychiatric disorders are blurred, that these conditions often share biological mechanisms and that their treatments are often unspecific. For this reason, we are interested in studying predictors of response to treatments that affect different disorders, in clinical and subclinical forms. These treatments include pharmacotherapy (for example, serotonin reuptake inhibitors) and the so-called third-wave therapies (for example, acceptance and commitment therapy, mindfulness, etc.), among others.
If you want to learn more about our research, please don’t hesitate to get in touch.
CURRENT PROJECTS
CLINICAL STAGING OF OCD AND RELATED DISORDERS
In this longitudinal project, we are interested in identifying risk factors that allow predicting the conversion of subclinical obsessive-compulsive symptoms to obsessive-compulsive disorder (OCD) according to DSM-5, including traumatic and stressful life events or personality traits. The subliminal OCD can represent the first stage of the DSM-5 OCD, in which a specific intervention can be useful to avoid complete conversion. We also hope that this project will help to characterize a "at risk" phenotype for OCD. This project includes more than 700 subjects from the general population selected via Amazon Mechanical Turk, 100 individuals with problematic accumulation behaviors and collaborations with the study “Clinical High At-Risk Mental State” (CHARMS study), Prof. Barnaby Nelson of Orygen Youth Health, in Melbourne.
a. Representative papers:
i. Fontenelle LF, Yücel M. A Clinical Staging Model for Obsessive-Compulsive Disorder: Is It Ready for Prime Time? EClinicalMedicine. 2019 Feb 12; 7: 65-72. doi: 10.1016 / j.eclinm.2019.01.014. PMID: 31193644; PMCID: PMC6537549.
We are very interested in early interventions for OCD. One of our PhD students, Ms. Emma Thompson, is leading an online intervention study that addresses this important topic. This study is called the ‘OCEAN study’ (Obsessive-Compulsive Early Intervention study) and it will compare two evidence-based online programs in their impact on well-being, particularly in their ability to improve intrusive thoughts and repetitive behaviours in those with subclinical to mild OCD symptoms. If you are interested in participating, please click here to find out more and see if the study is a good fit for you.
http://www.brainpark.com/projects/participate-ocdselfhelp
THE ROLE OF HABIT, REWARD AND FEAR IN COMPULSIVE AND IMPULSIVE DISORDERS
This study aims to investigate the clinical utility of an instrument (The Habit, Reward and Fear Scale) that aims to quantify different types of motivations for performing repetitive behaviors, both in people with OCD-related disorders and in people with substance use disorders.
a. Representative papers:
i. Ferreira GM, Lee RSC, Piquet-Pessôa M, de Menezes GB, Moreira-de-Oliveira ME, Albertella L, Yücel M, Dos Santos Cruz M, Dos Santos-Ribeiro S, Fontenelle LF. Habitual versus affective motivations in obsessive-compulsive disorder and alcohol use disorder. CNS Spectr. 2020 Feb 11:1-8. doi: 10.1017/S1092852919001706. Epub ahead of print. PMID: 32041677.
ii. Ferreira GM, Albertella L, Moreira-de-Oliveira ME, Piquet-Pessôa M, Yücel M, Lee RSC, Batista KB, de Menezes GB, Fontenelle LF. Fear driven compulsive behaviour is associated with worse long-term outcome in obsessive-compulsive disorder. Hum Psychopharmacol. 2020 Jan;35(1):e2720. doi: 10.1002/hup.2720. PMID: 31961460.
iii. Piquet-Pessôa M, Chamberlain SR, Lee RSC, Ferreira GM, Cruz MS, Ribeiro AP, de Menezes GB, Albertella L, Yücel M, Fontenelle LF. A study on the correlates of habit-, reward-, and fear-related motivations in alcohol use disorder. CNS Spectr. 2019 Dec;24(6):597-604. doi: 10.1017/S1092852918001554. PMID: 30915941; PMCID: PMC6885012.
TRANSDIAGNOSTIC APPROACHES TO DISORDERS RELATED TO ANXIETY AND OCD
This research project aims to investigate constructs that do not fit in the conventional diagnostic limits, although they are associated with important clinical outcomes. For example, we are interested in investigating how symptoms of depression, anxiety, obsessions and compulsions are organized in groups different from those determined by the limits of DSM5 / ICD-11 as well as the impact of different constructs on the response to naturalistic treatment - “treatment as usual”) in OCD, in social anxiety disorder and in uni and bipolar depressions (The Transdiagnostic Predictors of Treatment Response: The Transport Study).
a. Representative papers:
i. Vigne P, Simões BFT, de Menezes GB, Fortes PP, Dias RV, Laurito LD, Loureiro CP, Moreira-de-Oliveira ME, Albertella L, Lee RSC, Stangier U, Fontenelle LF. The relationship between obsessive-compulsive disorder and anxiety disorders: A question of diagnostic boundaries or simply severity of symptoms? Compr Psychiatry. 2019 Oct; 94: 152116. doi: 10.1016 / j.comppsych.2019.152116. Epub 2019 Aug 8. PMID: 31421287.
NEUROIMAGING STUDIES OF DISORDERS RELATED TO ANXIETY AND OCD
In our most recent neuroimaging studies, we used advanced techniques to assess structural connectivity (white matter) between the thalamus and different subdivisions of the prefrontal cortex of people with OCD and other brain regions not thought to be involved in the pathophysiology of the disorder.
a. Representative Papers
i. Fontenelle LF, Frydman I, Hoefle S, Oliveira-Souza R, Vigne P, Bortolini TS, Suo C, Yücel M, Mattos P, Moll J. Decoding moral emotions in obsessive-compulsive disorder. Neuroimage Clin. 2018 Apr 4; 19: 82-89. doi: 10.1016 / j.nicl.2018.04.002. PMID: 30035005; PMCID: PMC6051311.
ii. de Salles Andrade JB, Ferreira FM, Suo C, Yücel M, Frydman I, Monteiro M, Vigne P, Fontenelle LF, Tovar-Moll F. An MRI Study of the Metabolic and Structural Abnormalities in Obsessive-Compulsive Disorder. Front Hum Neurosci. 2019 Jun 26; 13: 186. doi: 10.3389 / fnhum.2019.00186. PMID: 31333428; PMCID: PMC6620433.
FREE WILL IN DISORDERS RELATED TO OCD AND ADDICTIVE BEHAVIORS
This project aims to investigate how beliefs in free will differ and impact the clinic and the evolution of patients with OCD-related disorders and substance use disorders.
a. Representative Papers
i. Moreira-de-Oliveira ME, de Menezes GB; dos Santos-Ribeiro S; Laurito LD; Ribeiro AP; Carter A; Fontenelle LF. Are mental disorders related to disbelief in free will? A systematic review. Systematic Reviews (in press).
NEW BEHAVIORAL ADDICTIONS
Could the concept of addiction be extended to include the so-called “21st century psychopathologies”? To answer this question, this cross-sectional project aims to characterize the phenotype, associated characteristics and clinical utility of a series of disorders due to addictive behaviors, including well-established syndromes (such as gambling disorder), as well as new and more controversial ones, such as “internet addiction”, video game use disorder, food addiction, and problematic use of pornography, among others. In this project, our final goal is to contribute to the identification of clinically useful phenotypes that translate into better treatments.
a. Representative Papers:
i. Ince C, Yücel M, Albertella L, Fontenelle LF. Exploring the clinical profile of problematic pornography use. CNS Spectr. 2020 Jul 21:1-10. doi: 10.1017/S1092852920001686. Epub ahead of print. PMID: 32690117.
COGNITIVE AND THIRD WAVE THERAPIES IN DISORDERS RELATED TO ANXIETY AND OCD
This project includes two ongoing clinical trials. A randomized, controlled clinical trial investigates the efficacy of cognitive therapy in patients with social anxiety disorder resistant to pharmacological treatment. Another, still under development, aims to evaluate the effectiveness of acceptance and commitment therapy in patients with OCD.
a. Representative papers:
Thompson EM, Destree L, Albertella L, Fontenelle LF. Internet-Based Acceptance and Commitment Therapy: A Transdiagnostic Systematic Review and Meta-Analysis for Mental Health Outcomes. Behavior Therapy (in press).
OUR TEAM
We are a group of committed researchers and clinicians who are interested in understanding what makes people fall ill and different ways to help them
LEONARDO F FONTENELLE
Director
Dr. Fontenelle is Professor at the Institute of Psychiatry of Federal University of Rio de Janeiro (IPUB/UFRJ), where he directs the Anxiety, Obsessive, and Compulsive Research Program. Since 2011, Dr. Fontenelle also has an appointment as a Senior Researcher at D’Or Institute for Research and Education (IDOR), a private research institution that collaborates closely with his group at UFRJ. In 2019, Dr. Fontenelle became a full time Professor at the Turner Institute for Brain and Mental Health, in Monash University, Melbourne, Australia, while keeping an Adjunct position within the Department of Psychiatry of the School of Clinical Sciences in the same institution
CONTACT US
Thank you for your interest in our research. Get in touch with us for any questions or comments regarding our work and publications.
(21) 3938-0500
