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Symposia

Transdiagnostic

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

3 - (SYM 78) Do Obsessive-compulsive Disorder (OCD) Symptoms, Perfectionism, and Disgust Predict Eating Disorder Relapse and Remission?

Sunday, November 23, 2025
3:01 PM - 3:30 PM CST
Location: Bolden 5, Level 2
Keywords: Transdiagnostic, Comorbidity, Cognitive Processes
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,   ,  
Abstract Body
Eating disorders (EDs) are fatal mental health disorders characterized by low rates of remission and high rates of relapse. Yet, predictors of ED relapse and remission remain understudied. We examined OCD symptoms, perfectionism, and disgust as predictors of relapse and remission across ED diagnoses and hypothesized that: (1) Overall OCD and perfectionism dimensions (concern over mistakes, high standards) would predict a higher likelihood of relapse and a lower likelihood of remission (2) OCD dimensions (washing, obsessing, hoarding) and perfectionism dimensions (concern over mistakes, high standards) would predict relapse and remission, with disgust also explored as a potential predictor (3) Overall OCD, disgust, and perfectionism would predict ED severity (4) Perfectionism would mediate the relationship between OCD severity and ED related relapse/remission. We explored if disgust served a similar role. The current study used longitudinal data from a clinical nation-wide ED sample (N= 130) recruited within 4 months post-discharge from intensive ED specialty treatment. Logistic regressions were conducted to examine associations between baseline OCD symptoms, perfectionism, and disgust as predictors of relapse and remission 3 months later. Linear regressions were carried out to examine if baseline OCD symptoms, perfectionism, and disgust predicted ED severity 3 months later. Logistic regressions indicated that OCD washing symptoms (OR = 2.63, 95% confidence interval [CI]: 1.19-6.68, p < .05) predicted relapse and overall OCD symptoms (OR = 0.76, CI: 0.57-0.97, p < .05) and disgust (OR = 0.99, CI: 0.98-1.00, p < .05) predicted remission months later. Other OCD subscales, both perfectionism subscales, and disgust did not predict relapse (p < .11) and no OCD or perfectionism subscales predicted remission (p < .08). Linear regressions indicated that overall OCD symptoms (R2 =.11, F(1,86)=11.5 , p < .001) and perfectionism concern over mistakes (β = 0.47, R2 =.15, F(5,82)=4.11 , p < .05) predicted ED symptom severity 3 months after baseline. No OCD subscales, perfectionism personal standards, nor disgust predicted ED symptom severity (p < 0.03) at follow-up. During the symposium, we will also report on mediation analysis to test if perfectionism and disgust mediate the relationship between OCD symptoms, ED severity, and relapse and remission. Findings suggest that OCD symptoms and disgust are important predictors of ED relapse and remission and both OCD symptoms and perfectionism predict higher ED severity after discharge from treatment.