Individually Targeted Neuromodulation for Contamination-based OCD

Eligibility Criteria

• 1. male or female age 18-55 years old
• 2. DSM-5 diagnosis of OCD as primary presenting disorder
• 3. CONTAM as the predominant symptom dimension (i.e., Dimension 4 (CONTAM symptoms) is the highest score on the Dimensional Yale-Brown Obsessive Compulsive Scale (D-YBOCS); participants with more than one Dimension as highest score will still be eligible as long as Dimension 4 is one of these)
• 4. score of ≥ 8 on Dimension 4 of the D-YBOCS
• 5. taking no psychiatric medications or on a stable dose of an SSRI, clomipramine, SNRI, or second generation antipsychotic for at least 4 weeks prior to enrollment. Use of PRN benzodiazepines will be permitted as long as the dose/usage has not changed significantly leading up to enrollment. No medication changes will be permitted during the study
• 6. have not initiated a new course of exposure and response prevention (ERP) therapy within 4 weeks of enrollment (ongoing ERP will be permitted if initiated more than 8 weeks before enrollment).
• 1. positive urine drug screen (other than prescribed benzodiazepines)
• 2. use of psychiatric medications other than permitted above
• 3. substance use disorder in the last 3 months (with the exception of nicotine)
• 4. history of schizophrenia, bipolar disorder, autism, Tourette's syndrome (current and past history of depressive, anxiety, and eating disorders permitted as long as OCD is considered the primary disorder)
• 5. active suicidal ideation over the week prior to screening (as indicated by answering yes to questions 1 or 2 on the C-SSRS)
• 6. history of traumatic brain injury, seizure disorder, neurodegenerative disease, or other organic brain disease
• 7. pregnancy or lactating
• 8. contraindication to MRI scanning or TMS