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Evaluation ViewAttendees 2

Transdiagnostic
Session Type:: Symposia

Symposium 78 - Bound by Control: Identifying and Targeting Shared and Unique Mechanisms Among Disorders of Rigidity

Sunday, November 23, 2025
2:00 PM - 3:30 PM CST
Location: Bolden 5, Level 2
CE: 1.5

Keywords: Transdiagnostic, Comorbidity, Cognitive Processes
Level of Familiarity: All
Recommended Readings: Haynos, A. F., Widge, A. S., Anderson, L. M., & Redish, A. D. (2022). Beyond Description and Deficits: How Computational Psychiatry Can Enhance an Understanding of Decision-Making in Anorexia Nervosa. Current Psychiatry Reports, 24, 77-87.,   Bohane, L., Maguire, N,, & Richardson, T. (2017). Resilients, overcontrollers and undercontrollers: A systematic review of the utility of a personality typology method in understanding adult mental health problems. Clinical Psychology Review, 57, 75-92.,   Levinson, C. A., Kapadia, A., Sandoval-Araujo, L. E., Vanzhula, I. A., & Machry, K. (2025). Movement Toward Dimensional Symptom Models of Comorbid Obsessive-Compulsive Disorder and Eating Disorders. Annual Review of Clinical Psychology. 10. doi: 10.1146/annurev-clinpsy-081423-020831,   ,  

Psychological concerns are often perceived as emerging from insufficient cognitive, emotional, and behavioral control. As a result, many transdiagnostic cognitive and behavioral interventions aim to strengthen self-discipline. However, a subset of concerns (e.g., anorexia nervosa [AN], obsessive-compulsive disorder [OCD], obsessive-compulsive personality disorder [OCPD], certain anxiety or mood disorders) can be characterized as disorders of “overcontrol” associated with heightened rigidity, perfectionism, and self-control. Despite these disorders being linked with severe consequences, elevated premature mortality, and high comorbidity rates, minimal research has examined the mechanisms uniting these disorders. Certain disorders of overcontrol are vastly under-studied (e.g., OCPD) and, even among better-investigated psychopathology, the degree to which mechanisms of rigidity are shared and distinct across disorders remains poorly understood. Further, more research is needed to expand beyond trait models to understand environmental- and societal-level influences (e.g., family dynamics, discrimination) promoting inflexible control. Based on these gaps, transdiagnostic individual and environmental treatment models targeting overactive control remain underdeveloped. In this symposium, the presenters bring together rigorous science spanning the bench-to-bedside translational spectrum across a diverse set of methods (e.g., neurocognitive, psychophysiological, EEG measures), developmental stages, and psychological concerns (i.e., eating, anxiety, depressive, and personality disorders) to examine the biopsychosocial mechanisms that unite or distinguish disorders of overcontrol, and how they can be clinically targeted in precise, yet inclusive care.

First, Dr. Ann Haynos (chair), will provide a brief overview highlighting the need for novel transdiagnostic models of overcontrol to promote the next generation of treatment for these concerns. Next, presenters will showcase cutting-edge data related to: 1) Individual neurocognitive mechanisms of rigidity differentiating AN and OCPD (Dr. Haynos); 2) Parental neurocognitive risk factors for overcontrol children with anxiety and OCD symptoms (Dr. Kirsten Gilbert); 3) Systemic factors (e.g., racism) necessitating overcontrol in minoritized groups (e.g., Black Americans) (Dr. Briana Brownlow); 4) OCD, perfectionism, and disgust as potential predictors of relapse and remission in eating disorders (Avantika Kapadia); and 5) Novel treatment approaches (e.g., neuromodulation) targeting transdiagnostic neurocognitive mechanisms related to flexibility in adults with AN (Dr. Lisa Anderson). Finally, Dr. Douglas Samuel (discussant), will lend his expertise related to overcontrolled traits and disorders to reflect upon the layers of influence promoting heightened cognitive rigidity and self-control across and between disorders and how to guide individual and societal interventions for these severe, yet often neglected psychological targets.

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Describe the characteristics of excess self-control and rigidity that span multiple diagnostic presentations.
  2. Critically evaluate the shared and distinct mechanisms that promote self-control and rigidity across disorders.
  3. Explain how individual-level characteristics (e.g., neurocognition, biology) influence the development of overcontrol across diagnoses.
  4. Explain how environmental-level experiences (e.g., family dynamics, racism) influence the development of overcontrol across diagnoses.
  5. Identify novel treatment directions for targeting overcontrol across systemic, environmental, and individual levels of influence.

Presentations:

  • 2:03 PM - 2:32 PM CST
    (SYM 78) Shared and Distinct Neuroeconomic Pathways to Cognitive Rigidity in Anorexia Nervosa and Obsessive-compulsive Personality Disorder

    Speaker: Ann F. Haynos, Ph.D. (she/her/hers) – Virginia Commonwealth University

    Co-author: Hannah Monette, M.S. (she/her/hers) – Virginia Commonwealth University

    Co-author: Samantha Abram, Ph.D. (she/her/hers) – San Francisco VA Health Care System & University of California, San Francisco,

    Co-author: Scott Crow, MD – University Minnesota Medical School

  • 2:32 PM - 3:01 PM CST
    (SYM 78) The Influence of Parental Neural Error Monitoring on Child Anxiety and Peer Outcomes in Children Characterized by Overcontrol

    Speaker: Kirsten Gilbert, Ph.D. (she/her/hers) – Washington University in St. Louis

    Co-author: Joan Luby, MD (she/her/hers) – Washington University in st Louis

    Co-author: Susan Perlman, PhD (she/her/hers) – Washington University in st Louis

  • 3:01 PM - 3:30 PM CST
    (SYM 78) Do Obsessive-compulsive Disorder (OCD) Symptoms, Perfectionism, and Disgust Predict Eating Disorder Relapse and Remission?

    Speaker: Avantika Kapadia, M.S. (she/her/hers) – University of Louisville

    Co-author: Cheri A. Levinson, Ph.D. – University of Louisville