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PubMedDate not supplied

Personality disorders do not influence the results of cognitive and behavior therapy for obsessive compulsive disorder.

This study examined whether categorical or dimensional personality disorder variables affected treatment outcome in a sample of 52 patients with obsessive compulsive disorder who followed a standardized cognitive behavior therapy program. Treatment consisted of 12 weekly sessions and was completed by 43 patients. The Structured Clinical Interview for DSM-III-R personality disorders (SCID-II) was taken before the start of treatment by an independent rater. The treatment outcome measures included questionnaires and a Behavioral Assessment Test. Measurements were taken before and after treatment, and at 1 and 6 month follow-up tests. After the first follow-up test, further treatment was provided if clinically indicated. Neither categorical, nor dimensional personality disorder variables affected treatment outcome significantly. The inclusion of drop-outs in the analyses, did not change these results. Therefore, patients with obsessive compulsive disorder and concomitant personality disorder pathology should not be excluded from cognitive or behavior therapy for their obsessive compulsive complaints. Attributing therapy failure to concomitant Axis II pathology should be approached with caution.

Adolescent↗
PubMed2001

The neurobiology of pathological gambling.

Despite relatively high prevalence rates and significant morbidity and mortality associated with pathological gambling (PG), our understanding of the neurobiological basis of PG lags in comparison to that for other psychiatric illnesses of comparable magnitude. An improved understanding of the neurobiology of PG would facilitate targeted investigations into more effective treatments. Emerging data suggest shared neurobiological features determine in part pathological gambling and substance use disorders. These findings both challenge current conceptualizations of addictions and provide a substantial basis of knowledge on which to design investigations into the understanding and treatment of pathological gambling. The findings that substance use disorders and the behavioral "addiction" of PG share common causative features raise the question as to what extent other compulsive disorders (eg, compulsive shopping, compulsive sexual behaviors, compulsive computer use) might be biologically related.

Animals↗
PubMed2004

[What is the place of emotion in cognitive-behavioral approaches of obsessive-compulsive disorders?].

The efficacy of behavioral techniques based on exposure and response prevention has been well validated in the treatment of obsessive-compulsive disorder. Nevertheless in a large proportion of patients the disease persists, among others due to refusal of the treatment or due to non-response. About one of two patient entering treatment seems therefore to possibly benefit from behavioral therapy (Ladouceur et al., 1999). Cognitive techniques may extend the behavioral approach, and may represent a more indirect and progressive method, and may improve patients' commitment in the therapy. However, the proportion of treatment resistant patients remains important. New techniques are therefore warranted in order to progress in the understanding and treatment of these patients. Emotion focused therapy could possibly represent an interesting approach based on the improvement of emotional awareness, the exploration and the cognitive restructuring of emotions. The different techniques are described throughout clinical case reports.

Adult↗
PubMed1993

Behavior therapy for obsessive compulsive disorder in the office-based practice.

The article provides guidance for the clinician in applying scientifically proven behavior therapy techniques for obsessive compulsive disorder. Rationale for considering behavior therapy for all patients with OCD is presented, along with guidelines for determining an adequate trial of this approach and for predicting if a particular patient is likely to benefit.

Ambulatory Care↗
PubMed1994

The role of central oxytocin in obsessive compulsive disorder and related normal behavior.

Oxytocin (OT) is a neurosecretory nonapeptide synthesized in hypothalamic cells, which project to widely distributed sites in the CNS as well as the neurohypophysis. Central OT affects a variety of cognitive, grooming, affiliative, sexual, and reproductive behaviors in animals. Obsessive Compulsive Disorder (OCD) includes a range of cognitive and behavioral symptoms that bear some relationship to dimensions of behavior associated with OT. Anecdotal data and a recently completed cerebrospinal fluid (CSF) study provide evidence that some forms of OCD are related to OT dysfunction. Based on these findings, we hypothesize: 1) that some forms of OCD are at the extreme end of a range of normal behaviors that are mediated by OT and related systems; and that 2) some normal cognitive, affiliative, and sexual behaviors contain elements that are similar to features of OCD. Alternative hypotheses are considered, and a series of predictions are presented concerning the relationship between central OT and the onset, course, treatment response, and response to challenge procedures seen in this form of OCD.

Animals↗
PubMed2005

Cognitive behavioral therapy for obsessive-compulsive disorder: an update.

Cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) has been shown to be a highly effective treatment for children and adults. In the current review, we briefly describe the historical developments of the treatment, and recent findings related to five areas of inquiry: 1) Does intensity of CBT impact outcome? 2) Does CBT work better on some subtypes of OCD than others? 3) How do cognitive and behavioral strategies relate to outcome? 4) How well does CBT work for children and adolescents with OCD? and 5) Does the combination of CBT and medication work better than CBT alone? After a discussion of these questions, we mention some areas currently being examined.

Cognitive Behavioral Therapy↗
PubMedDate not supplied

A randomized controlled trial of cognitive therapy versus intensive behavior therapy in obsessive compulsive disorder.

BACKGROUND: The study was designed to compare cognitive therapy (CT) with intensive behavior therapy (BT) in obsessive-compulsive disorder (OCD) and to study their change process. METHODS: Sixty-five outpatients with DSM-4 OCD were randomized into 2 groups for 16 weeks of individual treatment in 3 centers. Group 1 received 20 sessions of CT. Group 2 received a BT program of 20 h in two phases: 4 weeks of intensive treatment (16 h), and 12 weeks of maintenance sessions (4 h). No medication was prescribed. RESULTS: Sixty-two patients were evaluated at week 4, 60 at week 16 (post-test), 53 at week 26 and 48 at week 52 (follow-up). The response rate was similar in the 2 groups. The Beck Depression Inventory (BDI) was significantly more improved by CT (p = 0.001) at week 16. The baseline BDI and Obsessive Thoughts Checklist scores predicted a therapeutic response in CT, while the baseline BDI score predicted a response in BT. At week 16, only the changes in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and a scale measuring the interpretation of intrusive thoughts correlated in CT, while the changes in Y-BOCS, BDI, and interpretation of intrusive thoughts correlated in BT. Improvement was retained at follow-up without a between-group difference. The intent-to-treat analysis (last observation carried forward) found no between-group differences on obsessions, rituals and depression. CONCLUSIONS: CT and BT were equally effective on OCD, but at post-test CT had specific effects on depression which were stronger than those of BT. Pathways to improvement may be different in CT and BT. The outcomes are discussed in the light of an effect size analysis.

Adult↗
PubMed1979

Morbid jealousy featuring as obsessive-compulsive neurosis: treatment by behavioral psychotherapy.

Morbid jealousy can occasionally be indistinguishable from obsessive-compulsive neurosis and then be partially amenable to broad-spectrum behavioural treatment. This can involve the partner and includes (a) methods to reduce jealousy and (b) other methods where appropriate, such as social skills training, and sex and marital therapy. This pilot study describes such treatment of four jealous out-patients. Rituals improved in three patients but ruminations in only one. Of three patients who were depressed at the start of treatment, two improved in rituals and in mood. The patient who failed was poorly motivated and did not comply with treatment.

Adult↗
PubMed1994

Behavioral group therapy with obsessive-compulsives: an overview.

During the last two decades, effective psychotherapeutic interventions have been developed and proven successful in treating patients with Obsessive-Compulsive Disorder (OCD). Behavior therapy, using exposure to anxiety-evoking stimuli and response prevention directed toward rituals, provides lasting benefit for most patients who engage in and comply with treatment. A recent study indicated that, for certain OCD patients, these interventions could be applied successfully in a group therapy context. This article describes the general procedures used in this study to treat obsessive-compulsives with exposure and response prevention in a group context.

Behavior Therapy↗
PubMed1967

Enzyme defect associated with a sex-linked human neurological disorder and excessive purine synthesis.

A sex-linked familial neurological disease consisting of cerebral palsy, mental retardation, choreoathetosis, and compulsive aggressive behavior is associated with a loss of an enzyme that participates in purine metabolism, namely, hypoxanthine-guanine phosphoribosyltransferase. The production of excessive uric acid in this disorder implies that the enzyme is involved in the normal regulation of purine biosynthesis. This is the first example of a relation between a specific enzyme defect and abnormal compulsive behavior. It is also the first enzyme defect in purine metabolism demonstrated in a neurological disease.

Adenine↗
PubMed2005

Sexual sensation seeking, compulsivity, and HIV risk behaviors in college students.

The purpose of this descriptive and correlational study was to understand the role of sexual compulsivity, sensation seeking, and alcohol use as mediators of HIV risk behaviors among college students. College students (n = 256) completed an online survey in 2003. Instruments included the Sexual Compulsivity Scale (SCS), Sexual Sensation Seeking Scale (SSS), and the College Alcohol Problem Scale (CAPS). Men scored higher on the SSS and SCS than women. Women who belong to Greek organizations reported significantly more personal problems, including depression and low self-esteem, after consuming alcohol than women who were not members of Greek organizations. Four predictor variables associated with HIV risk behaviors were age, high score on SSS and CAPS, but a low score on SCS. The personality dispositions of sexual sensation seeking and compulsivity among college students may need to be explored in other college settings, to determine if these traits are related to HIV risk taking behaviors. Interventions to help women better cope with the effects of alcohol and self-esteem issues may be beneficial.

Adolescent↗
PubMed1983

Family treatment of an obsessive-compulsive child: a case report.

This paper presents a family therapy approach to the treatment of an obsessive-compulsive child. Psychodynamic, behavioral and family therapy approaches to the etiology and treatment of this dysfunction are described briefly, and a detailed case report of a 15-session treatment utilizing behavioral interventions designed to change the family context is presented. Various procedures for dealing with the obsessive-compulsive behavior have been reported in the literature, including eliminating it directly by interruption or ordeal and modifying it. In this case, the author proceeded by ignoring the compulsive behaviors and concentrating on more functional ones using a paradoxical charting intervention. At one-year follow-up, the child was symptom free. Relationship factors, technical interventions, and stylistic aspects of the therapy are discussed, and the importance of rapid symptom alleviation in these children is underscored.

Adult↗