Developmental pathways and treatment of OCD and anorexia: the role heightened performance monitoring and overcontrol

Project Summary/Abstract Anorexia nervosa (AN) is one of the deadliest psychiatric illnesses, and prognosis is worsened when comorbid with obsessive-compulsive disorder (OCD). Further, childhood OCD typically onsets before AN, indicating a possible developmental trajectory with childhood OCD preceding and predicting AN onset. Therefore, identifying and characterizing the mechanisms that underly the AN/OCD developmental progression and AN/OCD comorbidity is imperative for developing effective, targeted interventions for these difficult-to-treat psychiatric presentations. The overarching aim of this proposal is to use both a large, longitudinal, community dataset and a real-world clinical sample to (a) examine the developmental trajectory of AN/OCD comorbidity, including specific mechanisms that could be targeted in treatment and (b) examine a mechanism-based psychosocial treatment for this comorbidity. Results will help identify at-risk individuals and inform the development of targeted and effective transdiagnostic interventions. This project will also achieve the following training goals: (1) develop expertise in childhood development of AN and OCD psychopathology, (2) gain expertise in clinical translational work, (3) learn advanced analytic techniques and data science skills, (4) gain skills to be an independent investigator, including training in scientific rigor and reproducibility, professional development, and scientific communication. The assembled training team has extensive expertise in AN, OCD, treatment research, and advanced statistics, and will support the applicant in developing the skills and knowledge needed to achieve her career goals of developing an independent program of research examining AN/OCD psychopathology and treatment.