B4231 - Psychological and neural correlates of excessive rationalisation in obsessive-compulsive disorder - 16/01/2023

B number: 
Principal applicant name: 
Elizabeth Kirkham | University of Edinburgh (Scotland, UK)
Dr Heather Whalley
Title of project: 
Psychological and neural correlates of excessive rationalisation in obsessive-compulsive disorder
Proposal summary: 

Obsessive-compulsive disorder (OCD) is common and often debilitating, yet it remains under-researched and poorly
understood. OCD usually develops during childhood or adolescence, often amidst stressful environments. This raises the
possibility that OCD emerges as a psychological strategy aimed at reducing the anxiety caused by unavoidable stressful
situations (such as domestic violence). I term this strategy “excessive rationalisation”. Neurologically, excessive
rationalisation might be related to prefrontal “control” brain regions trying too hard to calm down “anxious” limbic regions.
Previous research suggests that people who show these patterns of brain activity may get less benefit from OCD
treatment. Therefore improved understanding of these patterns of brain activity and related psychological mechanisms
could help the 30-40% of people whose OCD doesn’t respond to treatment. This project will therefore investigate the novel
concept of excessive rationalisation and how it relates to brain activity in people with OCD.

Growing up with OCD has given me a passion to advance our scientific understanding of this debilitating condition. The
initial idea for this research came from my perspective as a person with OCD. I then drew on my expertise in mental health
and neuroscience to translate the idea into a research proposal, and showed it to three external advisors who also have
OCD. They wrote that focusing on early life stress and treatment-resistance is a “really important” endeavour which could
plug a significant gap in our understanding and treatment of OCD. After reading the proposal one person wrote, “this
research gives people like me some hope.”

Impact of research: 
My research will likely lead to new ways of understanding OCD, a mental health condition which is common and highly disabling, yet chronically under-researched. Given the lack of existing research which takes either a longitudinal or neuroscientific approach to OCD, any findings from this project are likely to "punch above their weight" in terms of impact in the mental health research sphere. In addition, I am hoping that successful research using ALSPAC will help me make a stronger case for inclusion of OCD measures in other imaging cohorts, such as UK Biobank.
Date proposal received: 
Thursday, 22 December, 2022
Date proposal approved: 
Wednesday, 4 January, 2023
Mental health - Psychology, Psychiatry, Cognition, Mental health, Medical imaging, Qualitative study, Statistical methods, Cohort studies - attrition, bias, participant engagement, ethics, Childhood - childcare, childhood adversity, Cognition - cognitive function, Development, Equipment - MRI, Environment - enviromental exposure, pollution, Neurology, Psychology - personality, Social science