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Article ; Online: Hoarding disorder: evidence and best practice in primary care.

Morein-Zamir, Sharon / Ahluwalia, Sanjiv

The British journal of general practice : the journal of the Royal College of General Practitioners

2023 Volume 73, Issue 729, Page(s) 182–183

MeSH term(s)	Humans ; Hoarding Disorder/diagnosis ; Hoarding Disorder/therapy ; Obsessive-Compulsive Disorder ; Primary Health Care
Language	English
Publishing date	2023-03-30
Publishing country	England
Document type	Journal Article
ZDB-ID	1043148-2
ISSN	1478-5242 ; 0035-8797 ; 0960-1643
ISSN (online)	1478-5242
ISSN	0035-8797 ; 0960-1643
DOI	10.3399/bjgp23X732513
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Article: Stopping a Response When You Really Care about the Action: Considerations from a Clinical Perspective.

Morein-Zamir, Sharon / Anholt, Gideon

Brain sciences

2021 Volume 11, Issue 8

Abstract: Response inhibition, whether reactive or proactive, is mostly investigated in a narrow cognitive framework. We argue that it be viewed within a broader frame than the action being inhibited, i.e., in the context of emotion and motivation of the ... ...

Abstract	Response inhibition, whether reactive or proactive, is mostly investigated in a narrow cognitive framework. We argue that it be viewed within a broader frame than the action being inhibited, i.e., in the context of emotion and motivation of the individual at large. This is particularly important in the clinical domain, where the motivational strength of an action can be driven by threat avoidance or reward seeking. The cognitive response inhibition literature has focused on stopping reactively with responses in anticipation of clearly delineated external signals, or proactively in limited contexts, largely independent of clinical phenomena. Moreover, the focus has often been on stopping efficiency and its correlates rather than on inhibition failures. Currently, the cognitive and clinical perspectives are incommensurable. A broader context may explain the apparent paradox where individuals with disorders characterised by maladaptive action control have difficulty inhibiting their actions only in specific circumstances. Using Obsessive Compulsive Disorder as a case study, clinical theorising has focused largely on compulsions as failures of inhibition in relation to specific internal or external triggers. We propose that the concept of action tendencies may constitute a useful common denominator bridging research into motor, emotional, motivational, and contextual aspects of action control failure. The success of action control may depend on the interaction between the strength of action tendencies, the ability to withhold urges, and contextual factors.
Language	English
Publishing date	2021-07-23
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2651993-8
ISSN	2076-3425
ISSN	2076-3425
DOI	10.3390/brainsci11080979
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Article: Gender bias in autism screening: measurement invariance of different model frameworks of the Autism Spectrum Quotient.

Belcher, Hannah L / Uglik-Marucha, Nora / Vitoratou, Silia / Ford, Ruth M / Morein-Zamir, Sharon

BJPsych open

2023 Volume 9, Issue 5, Page(s) e173

Abstract: Background: The Autism Spectrum Quotient is a popular autism screening tool recommended for identifying potential cases of autism. However, many women with autism demonstrate a different presentation of traits to those currently captured by screening ... ...

Abstract	Background: The Autism Spectrum Quotient is a popular autism screening tool recommended for identifying potential cases of autism. However, many women with autism demonstrate a different presentation of traits to those currently captured by screening measures and assessment methods, such as the Autism Spectrum Quotient. Aims: Different models of the Autism Spectrum Quotient have been proposed in the literature, utilising different items from the original 50-item scale. Within good-fitting models, the current study aimed to explore whether these items assess autistic traits similarly across men and women. Method: Seventeen Autism Spectrum Quotient models were identified from the literature. Using the responses of a large sample of adults from the UK general population (5246 women, 1830 men), confirmatory factor analysis was used to evaluate the fit of each model. Measurement invariance with respect to gender, adjusting for age, was explored in the 11 model frameworks that were found to have satisfactory fit to our data. Results: It emerged that only two items were gender invariant (non-biased), whereas for the remaining items, the probability of endorsement was influenced by gender. In particular, women had a higher probability of endorsing items relating to social skills and communication. Conclusions: If the items of the Autism Spectrum Quotient indeed reflect autism-related traits, those items should be rephrased to ensure they do not present a gender-related bias. This is vital for ensuring more timely diagnoses and support for all people with autism.
Language	English
Publishing date	2023-10-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2829557-2
ISSN	2056-4724
ISSN	2056-4724
DOI	10.1192/bjo.2023.562
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Article ; Online: Cognitive flexibility: neurobehavioral correlates of changing one's mind.

Zühlsdorff, Katharina / Dalley, Jeffrey W / Robbins, Trevor W / Morein-Zamir, Sharon

Cerebral cortex (New York, N.Y. : 1991)

2022 Volume 33, Issue 9, Page(s) 5436–5446

Abstract: Behavioral and cognitive flexibility allow adaptation to a changing environment. Most tasks used to investigate flexibility require switching reactively in response to deterministic task-response rules. In daily life, flexibility often involves a ... ...

Abstract	Behavioral and cognitive flexibility allow adaptation to a changing environment. Most tasks used to investigate flexibility require switching reactively in response to deterministic task-response rules. In daily life, flexibility often involves a volitional decision to change behavior. This can be instigated by environmental signals, but these are frequently unreliable. We report results from a novel "change your mind" task, which assesses volitional switching under uncertainty without the need for rule-based learning. Participants completed a two-alternative choice task, and following spurious feedback, were presented with the same stimulus again. Subjects had the opportunity to repeat or change their response. Forty healthy participants completed the task while undergoing a functional magnetic resonance imaging scan. Participants predominantly repeated their choice but changed more when their first response was incorrect or when the feedback was negative. Greater activations for changing were found in the inferior frontal junction, anterior insula (AI), anterior cingulate, and dorsolateral prefrontal cortex. Changing responses were also accompanied by reduced connectivity from the AI and orbitofrontal cortices to the occipital cortex. Using multivariate pattern analysis of brain activity, we predicted with 77% reliability whether participants would change their mind. These findings extend our understanding of cognitive flexibility in daily life by assessing volitional decision-making.
MeSH term(s)	Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Algorithms ; Brain/cytology ; Brain/physiology ; Brain Mapping ; Choice Behavior/physiology ; Cognition/physiology ; Healthy Volunteers ; Magnetic Resonance Imaging ; Neural Pathways
Language	English
Publishing date	2022-11-16
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1077450-6
ISSN	1460-2199 ; 1047-3211
ISSN (online)	1460-2199
ISSN	1047-3211
DOI	10.1093/cercor/bhac431
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Article ; Online: Camouflaging Intent, First Impressions, and Age of ASC Diagnosis in Autistic Men and Women.

Belcher, Hannah L / Morein-Zamir, Sharon / Mandy, Will / Ford, Ruth M

Journal of autism and developmental disorders

2021 Volume 52, Issue 8, Page(s) 3413–3426

Abstract: Camouflaging of autistic traits may make autism harder to diagnose. The current study evaluated the relations between camouflaging intent, first impressions, and age of autism diagnosis. Participants comprised autistic and non-autistic adults (n = 80, 50% ...

Abstract	Camouflaging of autistic traits may make autism harder to diagnose. The current study evaluated the relations between camouflaging intent, first impressions, and age of autism diagnosis. Participants comprised autistic and non-autistic adults (n = 80, 50% female) who completed the Camouflaging of Autistic Traits Questionnaire. They were later video-recorded having a conversation with a person unaware of their diagnostic status. Ten-second clips from half these videos were later shown to 127 non-autistic peers, who rated their first impressions of each participant. Results showed that autistic participants were rated more poorly on first impressions, males were rated less favourably than females, and male raters were particularly harsh in their evaluations of autistic males. Camouflaging intent did not predict first impressions but better first impressions were linked with a later age of diagnosis.
MeSH term(s)	Adult ; Autism Spectrum Disorder ; Autistic Disorder/diagnosis ; Female ; Humans ; Intention ; Male ; Peer Group ; Surveys and Questionnaires
Language	English
Publishing date	2021-08-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	391999-7
ISSN	1573-3432 ; 0162-3257
ISSN (online)	1573-3432
ISSN	0162-3257
DOI	10.1007/s10803-021-05221-3
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Article ; Online: Elevated levels of hoarding in ADHD: A special link with inattention.

Morein-Zamir, Sharon / Kasese, Michael / Chamberlain, Samuel R / Trachtenberg, Estherina

Journal of psychiatric research

2021 Volume 145, Page(s) 167–174

Abstract: Hoarding Disorder (HD) is under recognised and under-treated. Though HD develops by early adulthood, patients present only later in life, resulting in research based largely on samples of predominantly older females. Whilst formerly associated with ... ...

Abstract	Hoarding Disorder (HD) is under recognised and under-treated. Though HD develops by early adulthood, patients present only later in life, resulting in research based largely on samples of predominantly older females. Whilst formerly associated with Obsessive-Compulsive Disorder (OCD), it is now recognised that individuals with HD often have inattention symptoms reminiscent of Attention Deficit/Hyperactivity Disorder (ADHD). Here, we investigated HD in adults with ADHD. Patients in an ADHD clinic (n = 88) reported on ADHD, HD and OCD-related symptoms, and compared with age, gender and education matched controls (n = 90). Findings were assessed independently in an online UK sample to verify replication using a dimensional approach (n = 220). Clinically significant hoarding symptoms were found in ∼20% versus 2% of ADHD and control groups, respectively, with those with hoarding being on average in their thirties and with approximately half being male. Greater hoarding severity was noted even in the remaining patients compared with controls (d = 0.89). Inattention was the only significant statistical predictor of hoarding severity in patients. Similarly, inattention, alongside depression and anxiety were the greatest predictors of hoarding in the independent sample where 3.2% identified as having clinically significant hoarding. Patients with ADHD had a high frequency of hoarding symptoms, which were specifically linked to inattention. HD should be routinely assessed in individuals with ADHD, as they do not typically disclose associated difficulties, despite these potentially leading to impaired everyday functioning. Research in HD should also investigate adults with ADHD, who are younger and with a greater prevalence of males than typical HD samples.
Language	English
Publishing date	2021-12-13
Publishing country	England
Document type	Journal Article
ZDB-ID	3148-3
ISSN	1879-1379 ; 0022-3956
ISSN (online)	1879-1379
ISSN	0022-3956
DOI	10.1016/j.jpsychires.2021.12.024
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Article ; Online: Shining a Light on a Hidden Population: Social Functioning and Mental Health in Women Reporting Autistic Traits But Lacking Diagnosis.

Belcher, Hannah L / Morein-Zamir, Sharon / Stagg, Steven D / Ford, Ruth M

Journal of autism and developmental disorders

2022 Volume 53, Issue 8, Page(s) 3118–3132

Abstract: Female Phenotype Theory (FPT) suggests that autistic women often present with less obvious social impairments than autistic men. We examined the possibility of an exaggerated female phenotype among undiagnosed but probably autistic women. In two ... ...

Abstract	Female Phenotype Theory (FPT) suggests that autistic women often present with less obvious social impairments than autistic men. We examined the possibility of an exaggerated female phenotype among undiagnosed but probably autistic women. In two nationwide online surveys, we compared self-reported social functioning and mental health between diagnosed autistic women and women without diagnosis who scored ≥ 32 on the Autism Quotient. Compared to diagnosed autistic women, probably autistic women had higher empathy and general social functioning, and were more likely to have received a diagnosis of Borderline Personality Disorder. Autistic women had typically received more mental health diagnoses prior to their ASC diagnosis than autistic men. These findings shed light on the history of misdiagnosis experienced by many autistic women.
MeSH term(s)	Humans ; Female ; Autistic Disorder/diagnosis ; Autistic Disorder/psychology ; Autism Spectrum Disorder/diagnosis ; Autism Spectrum Disorder/psychology ; Social Interaction ; Mental Health ; Empathy
Language	English
Publishing date	2022-05-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	391999-7
ISSN	1573-3432 ; 0162-3257
ISSN (online)	1573-3432
ISSN	0162-3257
DOI	10.1007/s10803-022-05583-2
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Article: From checking the door to checking the app: assessment and treatment implications for obsessive-compulsive disorder in the digital era.

Carmi, Lior / Zohar, Joseph / Arush, Oded Ben / Morein-Zamir, Sharon

CNS spectrums

2020 Volume 26, Issue 5, Page(s) 457–458

Abstract: In the last 20 years, technology is increasingly integrated into daily life. Daily interactions with smart devices have become routine with much of our lives taking place in a digital environment. It is therefore not surprising that the manifestations of ...

Abstract	In the last 20 years, technology is increasingly integrated into daily life. Daily interactions with smart devices have become routine with much of our lives taking place in a digital environment. It is therefore not surprising that the manifestations of psychiatric disorders including Obsessive-Compulsive Disorder have changed in recent years reflecting this reality. Clinicians should be aware of the potential impact of such changes when considering symptom presentation and diagnosis.
Language	English
Publishing date	2020-06-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2008418-3
ISSN	2165-6509 ; 1092-8529
ISSN (online)	2165-6509
ISSN	1092-8529
DOI	10.1017/S1092852920001509
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Article ; Online: Avoid jumping to conclusions under uncertainty in Obsessive Compulsive Disorder.

Morein-Zamir, Sharon / Shapher, Sonia / Gasull-Camos, Julia / Fineberg, Naomi A / Robbins, Trevor W

PloS one

2020 Volume 15, Issue 1, Page(s) e0225970

Abstract: High levels of intolerance of uncertainty (IU) could contribute to abnormal decision making in uncertain situations. Patients with Obsessive Compulsive Disorder (OCD) often report high IU, indecisiveness and the need to seek greater certainty before ... ...

Abstract	High levels of intolerance of uncertainty (IU) could contribute to abnormal decision making in uncertain situations. Patients with Obsessive Compulsive Disorder (OCD) often report high IU, indecisiveness and the need to seek greater certainty before making decisions. The Beads task is a commonly used task assessing the degree of information gathering prior to making a decision and so would be predicted to show impairments in OCD patients. Results to date have found mixed support for this, possibility due to methodological issues. Here, a group of OCD patients (n = 50) with no comorbidities was compared with age, gender, and verbal-IQ matched controls (n = 50) on the most commonly used version of the Beads task. An independent sample of healthy volunteers with high versus low OC symptoms, and high versus low IU were also assessed (n = 125). There was no evidence that patients with OCD differed from control volunteers in the degree of information gathering prior to making a decision. Medication status and age did not appear to mediate performance. Similarly, there were no association in healthy volunteers between task performance and OC or IU characteristics. Additional measures examining the degree of certainty initially showed support for greater uncertainty in patients, but this was due to deviations from task instructions in a subset of patients. We conclude that despite the large sample size and good matching between groups, the Beads task in its most widely used form is not a useful measure of IU or of information gathering in OCD. The results argue against a robust behavioural difference in OCD when compared to controls. Recommendations for future studies employing the task are discussed.
MeSH term(s)	Adult ; Case-Control Studies ; Decision Making ; Female ; Humans ; Male ; Neuropsychological Tests ; Obsessive-Compulsive Disorder/psychology ; Uncertainty
Language	English
Publishing date	2020-01-15
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0225970
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Article ; Online: Network failures: When incentives trigger impulsive responses.

Zhukovsky, Peter / Morein-Zamir, Sharon / Meng, Chun / Dalley, Jeffrey W / Ersche, Karen D

Human brain mapping

2020 Volume 41, Issue 8, Page(s) 2216–2228

Abstract: Adequate control of impulsive urges to act is demanded in everyday life but is impaired in neuropsychiatric conditions such as stimulant use disorder. Despite intensive research it remains unclear whether failures in impulse control are caused by ... ...

Abstract	Adequate control of impulsive urges to act is demanded in everyday life but is impaired in neuropsychiatric conditions such as stimulant use disorder. Despite intensive research it remains unclear whether failures in impulse control are caused by impaired suppression of behavior or by the over invigoration of behavior by stimuli associated with salient incentives such as drugs, food, and money. We investigated failures in impulse control using functional magnetic resonance imaging (fMRI) to map the neural correlates of premature (impulsive) responses during the anticipation phase of the Monetary Incentive Delay (MID) task in healthy controls (HC), stimulant-dependent individuals (SDIs), and their unaffected first-degree siblings (SIB). We combined task-based fMRI analyses with dynamic causal modeling to show that failures of impulse control were associated with interactions between cingulo-opercular and dorsal striatal networks regardless of group status and incentive type. We further report that group-specific incentive salience plays a critical role in modulating impulsivity in SDIs since drug-related incentives specifically increased premature responding and shifted task modulation away from the dorsal striatal network to the cingulo-opercular network. Our findings thus indicate that impulsive actions are elicited by salient personally-relevant incentive stimuli and those such slips of action recruit a distinct fronto-striatal network.
MeSH term(s)	Adult ; Anticipation, Psychological/physiology ; Brain Mapping ; Central Nervous System Stimulants ; Female ; Gyrus Cinguli/diagnostic imaging ; Gyrus Cinguli/physiology ; Humans ; Impulsive Behavior/physiology ; Magnetic Resonance Imaging ; Male ; Motivation/physiology ; Neostriatum/diagnostic imaging ; Neostriatum/physiology ; Nerve Net/diagnostic imaging ; Nerve Net/physiology ; Personality/physiology ; Prefrontal Cortex/diagnostic imaging ; Prefrontal Cortex/physiology ; Siblings ; Substance-Related Disorders/diagnostic imaging ; Substance-Related Disorders/physiopathology ; Young Adult
Chemical Substances	Central Nervous System Stimulants
Language	English
Publishing date	2020-03-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1197207-5
ISSN	1097-0193 ; 1065-9471
ISSN (online)	1097-0193
ISSN	1065-9471
DOI	10.1002/hbm.24941
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