The temporal relationship between premonitory urges and covert compulsions in patients with obsessive-compulsive disorder
Abstract
Recent studies in patients with obsessive-compulsive disorder (OCD) have shown that many compulsions are associated with urges rather than obsessions. Premonitory urges are uncomfortable sensory feelings or a rising inner tension, often likened to the urge to scratch, yawn or blink. We studied premonitory urges preceding mental compulsions in 19 patients with OCD and preceding eye blinks in 16 healthy controls. Urge intensity was assessed continuously over 20 min using a real-time urge intensity monitor; compulsions and blinks were measured as discrete events in a free compulsion/blinking and a compulsion/blink suppression condition. Urge intensity showed an inverted U-shaped relationship (increase then decrease) around compulsions within a time-window of approximately 60 s in patients with OCD and within 13 s around blinks in healthy controls. Urge intensity was higher during compulsion / blink suppression and varied more independently of compulsion execution in patients with OCD. There is a close temporal relationship between premonitory sensations and compulsion execution that changes when compulsions are suppressed, indicating that urge intensity might drive the execution of and is then alleviated by compulsions. Suppression weakens the association between urge intensity and compulsion execution.
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In some individuals with obsessive-compulsive disorder, compulsions are driven by sensory phenomena.
“in some individuals with OCD, compulsions are driven by sensory phenomena (SP) (Brandt et al., 2018; Ferrao et al., 2012; Lee et al., 2009; Miguel et al., 2000; Shavitt et al., 2014).”
From Differences in response inhibition between medication-free patients with obsessive-compulsive disorder with and without sensory phenomena (2026) · cites this paper as Brandt et al., 2018
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The buildup of an urge in obsessive–compulsive disorder: Behavioral and neuroimaging correlates
Stern, E. R., Brown, C., Ludlow, M., Shahab, R., Collins, K., Lieval, A., Tobe, R. H., Iosifescu, D. V., Burdick, K. E., & Fleysher, L. (2020) · Human Brain Mapping · doi:10.1002/hbm.24898 · Cited by 29 · see citing works
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- Authors
- Brandt, V. C., Hermanns, J., Beck, C., Bäumer, T., Zurowski, B., & Münchau, A.
- Affiliations
- University of Southampton (GB)
- University of Lübeck (DE)
- Corresponding author
- Brandt, Valerie C.
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2018-04
- Volume
- 262
- Pages
- 6-12
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2787559258
- Cited by
- 23
- References
- 9
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 5 · 2019: 2 · 2018: 1
- FWCI
- 2.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- obsessive-compulsive disorder, premonitory urges, blinking
- MeSH terms
- Adult, Blinking, Compulsive Behavior, Female, Humans, Male, Middle Aged, Obsessive Behavior, Obsessive-Compulsive Disorder, Reaction Time, Sensation, Time Factors, Case-Control Studies, Prodromal Symptoms
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