The International OCD Foundation is committed to finding and promoting the most effective treatment methods for OCD and related disorders. Research is vital to our goals of better understanding OCD and related disorders, and improving treatment. To help achieve these goals, each year the IOCDF awards research grants to promising studies thanks to generous donors from within the OCD community. The IOCDF awards grants to investigators whose research focuses on the nature, causes, and treatment of OCD and related disorders. Each year, we encourage junior investigators to apply, as a grant from us will help build OCD research programs and keep these young researchers interested in studying the field of OCD and related disorders. Senior investigators may also ask for grant funding for projects that would provide pilot data for future larger scale federal grant applications. Since 1994, over $3,000,000 in research grants have been awarded. In the past year, we were able to award over $130,000 in research grant funding. Thank you to all who contributed!
How to Apply
The IOCDF Research Grants submission system opens in January. To submit a proposal, and for additional information and submission guidelines go to the IOCDF Research Grants Site. If you have additional questions, please contact Barbara Rosemberg at firstname.lastname@example.org.
IOCDF Research Grant Recipients
In 2014, the IOCDF received over 50 proposals for our Research Grants, which were reviewed by the Grant Review Committee led by Sabine Wilhelm, PhD, Vice Chair of the IOCDF Scientific and Clinical Advisory Board. Recommendations by this committee were submitted to the IOCDF Board of Directors, who made the final selection of projects to be funded. Congratulations to the Research Grant Winners listed below!
Explicating the Influence of Object Attachment in Hoarding Disorder
Melissa Norberg, PhD
Macquarie University, Sydney, Australia
Award Amount: $49,310
After completing cognitive behavioral treatment (CBT), many patients continue to experience clinically significant hoarding symptoms, with the clutter in their homes remaining virtually unchanged. In addition, very little research has examined why individuals who hoard become attached to objects. Current treatment challenges the importance of objects, but does not address why individuals are attached to objects. Our recent research demonstrates that excessive object attachment may be the primary cause of saving, and thus, might be a key target for improving treatment. Some research suggests that individuals with an insecure attachment to people may turn to objects for support because people are unreliable and rejecting. Furthermore, according to one theory, viewing objects in human-like terms allows objects to restore needs of belonging. This project brings together these disparate fields to test our overarching hypothesis that social exclusion leads to object attachment, and that this relationship will be stronger for individuals who experience more attachment anxiety. Additionally, this project will examine if social over-inclusion leads to less object attachment. Our results could substantially advance the cognitive-behavioral model of hoarding disorder and also provide a pathway for improving current treatment.
PANDAS Autoantibodies and the Blood-Brain Barrier
Dritan Agalliu, PhD
Columbia University Medical Center, New York, NY
Award Amount: $43,500
Infections with S. pyogenes (GAS) are associated with brain autoimmune disorders: Sydenham’s chorea (SC) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS). Autoantibodies form when the immune system fails to recognize the body’s own cells and tissues as “self” and attacks healthy tissue. Autoantibodies that recognize neuronal targets are found in acutely ill children with SC or PANDAS; however, how these autoantibodies cross the blood-brain barrier (BBB) remain unclear. We have found that GAS-specific immune cells in mice enter the brain, cause BBB breakdown, and allow circulating autoantibodies to enter the brain. Therefore, one objective of this study is to examine whether autoantibodies enhance permeability of the human BBB. We will also test whether compounds that promote BBB repair, also prevent transport of autoantibodies across the BBB. This proposal has the potential to establish a new mechanism by which PANDAS autoantibodies cross the BBB and develop therapies for the disease.
Sleep and Circadian Disturbances as a Vulnerability for OCD
Kiara Timpano, PhD
University of Miami, Miami, FL
Award Amount: $45,989
Despite growing research, much regarding risk for OCD remains unknown. As a basic human need, sleep and circadian rhythms are a potential factor that may be important to consider as a vulnerability for OCD. Insomnia and related sleep impairments have been shown to have profound negative consequences on daily functioning and psychological difficulties. Preliminary work by our group and others has suggested that insomnia and delayed sleep may be linked with OCD. The proposed project is positioned to answer key questions and will address important limitations of past research. The overarching aim of our study is to conduct a multi-method investigation — including subjective, objective, and biological indicators — of sleep and circadian disturbances in relation to OCD. We plan to establish whether insomnia and delayed sleep are uniquely related to OCD compared to healthy controls and those with Hoarding Disorder. We also plan to examine the specificity of identified relationship, by taking symptoms of depression into account, and will furthermore consider how sleep deficits may exacerbate existing core cognitive features of OCD. Our findings will contribute meaningfully to current OCD vulnerability models and may also shed light on potential treatment implications.
MRS Glutamate-Stratified Treatment of Pediatric OCD
Erika Nurmi, MD, PhD
University of California, Los Angeles, School of Medicine
Award Amount: $49,989
Although effective treatments exist for obsessive-compulsive disorder (OCD), most patients experience only partial recovery and many fail to respond adequately at all, negatively impacting public health through increased morbidity and patient care expenses. Through our recent work, we have identified a brain-based biomarker of non-response to cognitive-behavior therapy (CBT) in youth with OCD, the recommended initial treatment for this disorder. This proposal aims to test a personalized treatment approach where youth with the biomarker will receive CBT augmented with a medication hypothesized to reduce its impact and lead to enhanced treatment outcomes.
In vivo identification of antibody targets in PANDAS/PANS
Luciana Frick, PhD
Award Amount: $49,277
Obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) often strike in childhood and can disrupt the course of normal development. Acute onset of OCD and tics has been associated with recent infection with β-hemolytic streptococcus or other infectious diseases and has been hypothesized to result from autoantibodies that cross-react with brain proteins; this has been termed ‘pediatric autoimmune neuropsychiatric disorder associated with Streptococcus (PANDAS) or ‘pediatric acute-onset neuropsychiatric syndrome’ (PANS). Therapies aimed at purging autoantibodies, like intravenous immunoglobulin (IVIG), have shown promise, but the nature of the autoantibodies remains obscure. Pathological changes in PANDAS/PANS have been documented in the basal ganglia, a network of nuclei deep within the forebrain, which has long been associated with OCD and TS. Sera from PANDAS patients have been shown to cross-react with human caudate, a component of this system. However, the basal ganglia are cellularly heterogeneous; ex vivo studies have not identified which specific cells are targeted by antibodies in PANDAS/PANS serum. We have developed a novel in vivo approach in mice to achieve this specificity. We will determine the differential binding of PANDAS/PANS serum from an NIMH/Yale clinical trial to different types of neurons after in vivo infusion into the striatum of transgenic mice, and whether IVIG treatment prevents this binding correlating with clinical improvement in patients.
Targeted Real-time NIRS-driven Neurofeedback: A Novel Treatment for OCD
Benjamin Kelmendi, MD
Yale University School of Medicine, Department of Psychiatry
Award Amount: $47,890
A quarter of patients with OCD receive little benefit from established treatments, and remission is rare. The development of new noninvasive treatments is an urgent clinical need. We have developed real-time fMRI neurofeedback targeting the orbitofrontal cortex (OFC), which has consistently been found to be hyperactive in OCD. We measure OFC activity using fMRI and present it to subjects as a visual feedback signal in real time. Subjects learn through trial and error to control their OFC. In published work, we have shown that this is efficacious in moderating both contamination anxiety in subclinically anxious individuals and symptom severity in patients with OCD, and to lead to lasting changes in brain functional organization. A recently funded R01 grant will support a sham-controlled study to test the efficacy of this intervention in patients. We are optimistic that this will prove to be a significant advance in the nonpharmacological treatment. However, even if efficacy is proven, this fMRI-based approach is likely to have limited impact, for practical reasons: it requires many hours of costly fMRI time in a highly specialized setting. Here we propose to adapt the neurofeedback strategy to be more generalizable, using near-infrared spectroscopy (NIRS). If therapeutic neurofeedback can be realized using NIRS, it would have enormous potential to become a generalized office-based treatment and to benefit many patients with refractory OCD.
2014 Grant Award Recipients
Extinction as a Facilitator of Cognitive Bias Modification in Pediatric OCD
Michelle Rozenman, PhD
Post-Doctoral Research Fellow
UCLA Semel Institute for Neuroscience & Human Behavior
Award Amount: $49,197
A significant number of youths with OCD do not respond to evidence-based treatments. As a result, experts have called for new interventions that may directly target mechanisms underlying OCD. Cognitive Bias Modification for Interpretation biases (CBM-I) may be one such approach. CBM-I is a computerized intervention that helps individuals change their thinking patterns by training them to interpret ambiguous (unclear) information in a neutral, rather than threatening, manner; this change in thinking patterns may lead to reduction of OCD symptoms. CBM-I has not yet been tested as a potential intervention for pediatric OCD. The current study will test whether CBM-I reduces OCD symptoms in youth and how the intervention might work to change thinking patterns. Youths ages 10 to 17 (N=40) with high levels of OCD symptoms will be randomly assigned to 4 weeks (12 sessions) of either a personalized CBM-I program or a computerized control condition. At pre-, mid-, and post-treatment assessments, OCD symptoms and interpretation biases (i.e., how youths interpret ambiguous or unclear information) will be assessed. In addition, physiological arousal (heart rate, skin conductance, respiration) will be assessed during both a fear paradigm and behavioral approach tasks to examine whether extinction learning (a decline in fear-related behavior after learning new thinking patterns) is a mechanism underlying CBM-I. Should findings indicate that CBM-I works by extinction learning of fearful thinking, then the intervention might be particularly helpful before beginning exposure-based therapy. This study is innovative and has important clinical applications in its approach to testing CBM-I as a potential intervention for pediatric OCD.
Defining the Prevalence, Impacts, and Risk Factors of Hoarding Disorder
Ashley Nordsletten, PhD
Fellow Karolinska Institutet
Award Amount: $49,918
Hoarding Disorder (HD), a newly recognized psychiatric diagnosis, is characterized by a profound inability to get rid of one’s possessions, resulting in dangerous amounts of clutter throughout the sufferer’s home. Individuals with HD are often highly impaired, with symptoms affecting even basic day-to-day activities (e.g., cooking, bathing). Issues with poor sanitation, meanwhile, can pose broader health risks for the community. In addition, when legal interventions are used (e.g., forced cleanouts, evictions), these tend to generate large costs for society. Despite these widespread impacts, research focused on this newly acknowledged disorder is still in the beginning stages. In the absence of large-scale research, basic questions remain about the true prevalence, associated risk factors, and social/health consequences of HD. In response, we propose a research program with four goals: 1) To determine the prevalence of HD in a national sample; 2) to clarify the relationship between object hoarding, excessive acquisition, animal hoarding, and squalor at the population level; 3) to identify the social and medical consequences of HD using population databases only available in Sweden; and 4) to estimate the contribution of genetic as well as non-shared environmental risk factors in the possible causes of hoarding difficulties and excessive acquisition in two large groups of twins.
Effect of Intranasal Oxytocin on Social Cognition in Body Dysmorphic Disorder
Angela Fang, MA Clinical Fellow in Psychology/Psychiatry, Massachusetts General Hospital/Harvard Medical School Award Amount: $31,476 Despite the development of effective medication- and psychological-based treatments for body dysmorphic disorder (BDD), treatment outcome data suggest that there is still a lot of room for improvement. A closer examination of the biology associated with BDD may help uncover areas to target during interventions, and thus provide another approach to treatment. Oxytocin (a hormone) has been shown to be involved in the regulation of emotion recognition and social attentional processing. It is possible that oxytocin levels play a role in the development of these difficulties among individuals with BDD. The current study therefore aims to examine the effect of oxytocin administration on social cognitive impairments in BDD and OCD. Twenty treatment-seeking males in outpatient treatment with BDD, 20 individuals with OCD, and 20 participants with no BDD or OCD diagnosis will be assigned to receive an oxytocin and placebo nasal spray one week apart. During each visit, subjects will complete the Reading the Mind in the Eyes Test (which assesses emotion recognition) and the Trust Game (which assesses trust behavior) to measure oxytocin’s effect on each behavior. Importantly, our findings may show that a single administration of oxytocin may alter social cognitive processes thought to maintain BDD, and ultimately inform treatments for BDD.
2013 Grant Award Recipients
Stepped Care CBT for Pediatric OCD
Adam Lewin, PhD
Assistant Professor, University of Southern Florida
Award Amount: $43,838
We are proposing a pilot study to develop and assess the feasibility and preliminary efficacy of Stepped Care cognitive-behavioral therapy for the treatment of pediatric obsessive compulsive disorder. This study represents an innovative approach to tailoring treatment to each child and family’s needs by developing a less costly, lower intensity intervention as a first step of treatment and “stepping-up” care for those patients requiring more intensive, personalized care. Without accessible and effective treatment, youth with OCD are at risk for a developmental trajectory of impairment and chronic distress that places undue burden on the child and family, and imposes significant societal costs. In line with the NIMH strategic plan that recognizes that “we are increasingly challenged by the costs and complexities of health care” and with the NIMH mission “to support research that optimizes services,” this project has the potential to empirically support the use of an innovative treatment that could be delivered with less therapist time, thereby reducing the cost of treatment for both patients and providers; improving treatment access; and reducing the societal impact and morbidity of childhood OCD.
Cognitive Biases in OCD: Mechanisms of Generational Transmission
Noah C. Berman, MA
Doctoral Student, Massachusetts General Hospital
Award Amount: $29,661
Cognitive biases (i.e., ways in which threatening information is processed) are recognized as distinct psychological diatheses for OCD. Thus, identifying the factors that contribute to OC-related cognitive biases will help tailor prevention and intervention programs to meet the individual needs of those who carry specific and measurable risk factors. No research, however, has empirically investigated the risk factors that predict attention and interpretation cognitive biases in youth at risk of developing OCD. The current study, therefore, will administer validated and age-appropriate self-report and idiographic behavioral measures to a well-characterized (i.e., diagnostically assessed) sample that is vulnerable to the development of OC-related cognitive biases — the offspring of a parent with OCD. We aim to better understand the complex interactional processes associated with offspring’s cognitive biases in order to improve the early detection and prevention of OC symptoms.
Replication of Genome-wide Association Findings of OCD
James A. Knowles, MD, PhD
Professor of Psychiatry, University of Southern California
Award Amount: $43,629
The International OCD Foundation Genetics Collaborative, a multi-national group established to discover genetic variation predisposing to OCD, has conducted the most extensive genetic study of OCD to date (half a million chromosomal locations in 1,465 affected individuals, 5,557 ancestry-matched controls, and 400 trios). Genome-wide significant evidence of association was found in the trios on chromosome 20 (rs6131295) near the gene encoding transcription factor BTBD3, but this finding was not significant when combined with the case-control data. Interestingly, the best results from this combined analysis were in genes (FAIM2 and ADCY8) with human brain expression patterns that are highly correlated with genes regulated by rs6131295 (BTBD3, DHRS11 and ISM1). This suggests an interrelated set of genes that may predispose individuals to OCD. We want to extend these initial GWAS findings by adding at least 1,348 OCD-affected individuals and 1,349 ancestry-matched controls to unequivocally identify a genetic locus (gene) for OCD and to provide a set of molecular targets for rational development of small molecule therapeutics for OCD.
The Role of Deep Brain Stimulation on Excessive Avoidance in Rats: A Mechanistic Window to Therapeutic Action in OCD
Tomek (Tomasz) Banasikowski, PhD
Post-Doctoral Fellow, University of Pittsburg
Award Amount: $40,000
Research using animal models of avoidance learning and extinction is changing the way we think about the etiology and treatment of anxiety disorders such as obsessive compulsive disorder (OCD). OCD is characterized by inflexible, repetitive behavior that is elicited by environmental stimuli to which the action has become strongly tied. According to the DSM-IV-TR, repetitive behaviors in OCD are perceived as “reducing distress or preventing some dreaded event” and are disruptive to a person’s social relationships and general everyday functioning. Recently, deep brain stimulation (DBS), a neurosurgical technique where high-frequency electrical impulses are applied to a specific brain region called the ventral striatum, has been shown to have potential therapeutic effect in treating refractory OCD symptoms in humans. However, little is known about DBS and how it affects the brain and its impact on behavior, emphasizing the need for translational animal studies. The proposed studies will examine the role of DBS, using a novel animal model of acquired avoidance. We will test an overarching hypothesis that DBS gradually disrupts excessive avoidance behavior by reducing the value and salience of anxiety-triggering stimuli i.e., environmental stimuli previously associated with aversive footshock. Concurrently, by recording electrical activity from brain regions implicated in compulsive behavior we will be able to examine DBS effects on a brain circuit-level in freely-behaving animals. The results from our studies will have a significant impact on understanding i) the neuronal mechanisms involved in compulsivity and its extinction, especially related to anxiety and avoidance reported in OCD, ii) system-level changes in response to DBS and iii) how such activation leads to adaptive behavior.
2012 Grant Award Recipients
Investigation of Visual Perceptual Deficits in BDD using EEG
Doctoral student, University of California – Los Angeles
Award Amount: $40,079
Body dysmorphic disorder (BDD) is an obsessive-compulsive related disorder. Those with BDD are consumed with what they see as defects in the way they look, defects that are not noticeable or slight to others. Previous studies in BDD using functional magnetic resonance imaging (fMRI) suggest that how individuals with BDD process visual information might be different and that this difference in processing may cause these distortions (“I look unattractive because of these imperfections I see in my skin”). Our study will use electroencephalography (EEG) on the brains of those with BDD to look at the early visual response to faces, houses, and inverted faces. We will then compare the results to the results of those without BDD (controls) to see whether these distortions are a result of how the visual centers in the brain are working or due to differences in attention. This will help us better understand our earlier fMRI results as well as serve as the first EEG investigation on visual processing in BDD.
Comparison of Brain Activation Patterns in Hoarding Disorder and Non-Hoarding OCD
Carol A. Matthews, MD
Associate Professor, University of California – San Francisco
Award Amount: $49,928
This proposal will use functional MRI (fMRI) neuroimaging methods to examine brain activation patterns in Hoarding Disorder (HD) compared to Non-Hoarding Obsessive Compulsive Disorder (OCD) and healthy matched controls. Compulsive hoarding is currently classified as a subtype of OCD. However, severe compulsive hoarding will soon be categorized as an independent classification under the name Hoarding Disorder (HD), in part because of evidence that although there is overlap with OCD, hoarding disorder has separate genetic causes and different outcomes. Our group has evidence to suggest that people with HD have specific abnormalities in how they process information that differ from those seen in OCD. This study will extend our early work to compare the brain activation patterns of individuals with HD to those with OCD and to identify areas of overlap and areas of separation, eventually allowing for more targeted treatments and other interventions.
Stress Reactivity as a Mechanism of Treatment Response in Pediatric OCD
Tara Peris, PhD Assistant Professor, UCLA Semel Institute Award Amount: $49,580 Families of youth with OCD are characterized by an array of stressful family dynamics that predict poor response to cognitive behavior therapy (CBT), the current treatment of choice for pediatric OCD. However, understanding of the specific mechanisms which family functioning interferes with treatment is limited. Youth in unstable home environments have been found to exhibit prolonged activation of stress response systems, and separate research links this heightened reactivity to disrupted learning and the maintenance of fear/avoidance behaviors. Thus, one possibility is that poor family functioning complicates CBT via heightened stress reactivity. Employing a multi-method battery, this study examines parent and child stress reactivity over the course of CBT with the goal of understanding how the pathophysiology of pediatric OCD changes with treatment; how parent and child stress reactivity relate to ability to complete key CBT tasks; and their role in CBT outcome.
2011 Grant Award Recipients
Combining Acceptance and Commitment Therapy with Exposure and Response Prevention to Enhance Treatment Engagement
Michael Twohig, PhD
Assistant Professor, Utah State University
Award Amount $50,344
The goal of this proposal is to increase the acceptability and client engagement in Exposure with Response Prevention (ERP). Recent research has shown that Acceptance and Commitment Therapy (ACT), without in-session exposure, is an effective treatment for OCD, and it has high acceptability and low refusal and drop-out rates. Research has also shown that procedures taken from ACT can increase engagement in exposures for anxiety disorders. Still, the most logical way for ACT to be implemented for OCD is within an exposure framework. Based on past research, it appears that conducing ACT within an ERP framework should result in high levels of treatment engagement and high acceptability. This study will treat 60 adults with ACT using either traditional ERP or ACT+ERP. Investigators will look at levels of treatment engagement (i.e., number of exposures, how well were exposures attempted, how much response prevention occurred?), and acceptability. If treatment engagement and acceptability can be increased, it is likely that greater improvement could be seen in OCD reduction in a larger study. This is a collaborative cross-site study with leading ACT (Dr. Twohig) and ERP (Dr. Abramowitz) researchers.
Internet-delivered EX/RP for early-onset OCD — A pilot feasibility trial
Jonathan S Comer, PhD
Co-Director of Research Child Program, Boston University Center for Anxiety and Related Disorders
Award Amount $38,600
Early-onset OCD (i.e., onset < 9 years) has been observed, with earlier onset associated with a more complex and intractable course in adulthood. Earlier onset symptoms exhibit considerable stability, are associated with profound disability, and confer sizable risk for later life psychopathology and reduced quality of life. Effective early intervention is critical, although, despite progress in supported programs, gaps persist between treatment in experimental settings and services available in the community. Inadequate numbers of professionals trained in evidence-based programs impinge on availability of care. Cost and transportation issues further constrain access. Youth from low-income or remote communities are particularly unlikely to receive effective treatments. Technological innovations can overcome traditional barriers to care. In the treatment of early OCD, such innovative methods may overcome geographical barriers to care by extending the availability of expert services and addressing regional workforce shortages in care. Families dwelling in underserved regions can participate in real-time treatment conducted by experts, regardless of geographic proximity to an expert OCD clinic. Treating families in their natural settings can overcome issues of space, transportation, and convenience that traditionally hinder treatment accessibility. Moreover, delivering treatment directly to families in their homes may extend treatment relevance, as treatments are delivered in the very context in which many symptoms occur. Given support for CBT for early OCD, establishing the feasibility and preliminary efficacy of an Internet format is a critical step in the evaluation of new technologies and their potential for offsetting the debilitating course of early OCD. The present objective is to develop a real-time, Internet-delivered treatment protocol for early onset OCD in youth ages 4-8, and to evaluate via randomized design the feasibility, acceptability, and preliminary efficacy of enrolling, retaining, and treating children with the modified format relative to those treated with in-office family-based treatment for early childhood OCD.
The Frequency of Oscillations in Obsessive-Compulsive Disorder
Elana Harris, MD, PhD
Assistant Professor, Cincinnati Children’s Hospital Medical Center
Award Amount: $50,000
Obsessive Compulsive Disorder (OCD) is a debilitating neuropsychiatric disorder with a lifetime prevalence of up to 3% in the general population. Aberrant circuitry within cortical-striatal-thalamic-cortical loops has been widely hypothesized to underlie the symptoms of OCD, but our understanding of the pathophysiology of OCD and communication among these structures has been hampered by temporal limitations of imaging modalities. We intend to use magnetoencephalography (MEG) and advanced signal analysis to complement prior functional Magnetic Resonance Imaging (fMRI) studies of OCD. Recordings will be made while healthy subjects and subjects with OCD view blocks of neutral and symptom-provocative images. We will track the time of activation and detect differences in the relative power of frequency bandwidths when we compare patients with healthy subjects. This will allow us to follow the spread of neuronal activity in patients with OCD. Our findings may guide the design of future treatments by indicating the location and frequency at which to stimulate brain regions with transcranial magnetic stimulation.
Thank you to our Grant Review Committee:
- Sabine Wilhelm, PhD, Chairperson of Grant Review Committee, Vice Chair of IOCDF Scientific & Clinical Advisory Board
- Jonathan Abramowitz
- Susanne Ahmari
- Paul Arnold
- Thilo Deckersbach
- Darin Dougherty
- Jamie Feusner
- Martin Franklin
- Jennifer Freeman
- Randy Frost
- Dan Geller
- Wayne Goodman
- Marco Grados
- John Greist
- Jessica Grisham
- Marcelo Hoexter
- Norbert Kathmann
- James Knowles
- Lorrin Koran
- MaryKay Lobo
- Dara Manoach
- Carol Mathews
- Dean McKay
- Jamie Micco
- Moh Milad
- Tanya Murphy
- Gerry Nestadt
- John Piacentini
- Christopher Pittenger
- Katharine Phillips
- Steven Rasmussen
- Peggy Richter
- Bradley Riemann
- Jeremiah Scharf
- Edward Pace-Schott
- Jasper Smits
- Gail Steketee
- S. Evelyn Stewart
- Eric Storch