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PubMed1979

Enuresis, firesetting, and cruelty to animals: the significance of two thirds of this triad.

The full childhood triad of enuresis, firesetting, and cruelty to animals is seldom reported by patients in acute care psychiatric facilities. Two of the three elements have been reported with greater frequency and constitute useful diagnostic information. Literature on the triad has been reviewed and data from three studies have been presented. The authors concluded that a history of two thirds of the triad is significantly associated with aggressive behaviours directed against people.

Adolescent↗
PubMed1980

Obsessions: source of inefficiency in the workplace.

Obsessions are persistent, intrusive, unwanted ideas that are unproductive and anxiety-arousing. Although the magnitude of their importance in the workplace has not been established by acceptable scientific research criteria, they are in all probability a major source of inefficiency in jobs involving a high percentage of intellectual effort. The current body of knowledge of clinical psychiatry and behavioral psychology can provide rudimentary insights and hypotheses. The need is emphasized for further research to elucidate more precisely the extent of the problem.

Behavior Therapy↗
PubMed1993

Binge eating disorder: its further validation in a multisite study.

Binge eating disorder (BED) is a new eating disorder that describes the eating disturbance of a large number of individuals who suffer from recurrent binge eating but who do not regularly engage in the compensatory behaviors to avoid weight gain seen in bulimia nervosa. This multisite study of BED involved 1,785 subjects drawn from 18 weight control programs, 942 subjects from five nonpatient community samples, and 75 patients with bulimia nervosa. Approximately 29% of subjects in weight control programs met the criteria for BED. In the nonpatient community samples BED was more common than purging bulimia nervosa. The validity of BED was supported by its strong association with (1) impairment in work and social functioning, (2) overconcern with body/shape and weight, (3) general psychopathology, (4) significant amount of time in adult life on diets, (5) a history of depression, alcohol/drug abuse, and treatment for emotional problems.

Adolescent↗
PubMed1980

Behavior completion mechanisms rather than primary drives maintain behavioral patterns.

Anxiety is identified with a state of high arousal. Agoraphobia is differentiated from specific phobias which are inherent responses to situations which threatened primitive man. In agoraphobia, attacks of high arousal are produced by situations which delay ongoing activity. It is hypothesised that such delays produce arousal by activating behavior completion mechanisms. Evidence is reviewed which indicates desensitization has a specific effect in agoraphobia but not in specific phobias. It is suggested that desensitization reduces the arousal produced by behavior completion mechanisms. -- Aversive therapy in homosexuality reduces the subjects' drive to carry out compulsive sexual behaviors but does not alter sexual orientation. It is suggested that the compulsive sexual behaviors are not activated by primary sexual drive but by behavior completion mechanisms. Aversive therapy reduces the arousal produced by the behavior completion mechanisms. -- A similar mode of action is advanced for desensitization and aversive therapy. Both inhibit arousal by establishing a focal experimental neurosis which results from alternation of excitatory and inhibitory impulses.

Agoraphobia↗
PubMed2003

Telephone-administered cognitive behavior therapy for obsessive-compulsive disorder.

Exposure with response prevention and cognitive behavior therapy are widely recognized as effective treatments for obsessive-compulsive disorder. Unfortunately, many people with obsessive-compulsive disorder--particularly those living in rural areas--do not have access to therapists providing these treatments. Accordingly, we investigated the efficacy of telephone-administered cognitive behavior therapy for obsessive-compulsive disorder. Two open trials are reported, for a total of 33 people with obsessive-compulsive disorder (without major depression). The first trial consisted of 12 weeks on a waiting list followed by 12 weeks of treatment (delayed treatment). The second trial consisted of 12 weeks of immediate treatment. Obsessive-compulsive symptoms did not change during the waiting period. Symptoms declined from pre- to post-treatment, with gains maintained at 12-week follow-up. For the pooled sample our pre-to-post-treatment effect size was as large or larger than those obtained in other studies of reduced contact treatment, and similar to those of face-to-face exposure with response prevention. Our proportion of treatment dropouts tended to be lower than those of other reduced contact interventions. The results suggest that telephone-administered cognitive behavior therapy is effective and well-tolerated, at least for people with obsessive-compulsive disorder without major depression. It remains to be seen whether this treatment is safe and effective when comorbid major depression is present.

Journal Article↗
PubMed1998

Behavioral treatment of obsessive-compulsive disorder in African Americans: clinical issues.

African Americans with obessive-compulsive disorder are underrepresented in behavioral treatment outcome studies. This paper consists of a clinical discussion of issues arising during the treatment with exposure plus response prevention of two African-American women with obessive-compulsive disorder. Clinical issues, such as excessive shame, insanity fears, and a sense of uniqueness, complicated the treatment process. However, both clients made significant improvement as assessed by behavioral testing, target ratings and the Yale-Brown Obsessive-Compulsive Scale.

Adult↗
PubMed2003

Symptom presentation and outcome of cognitive-behavioral therapy for obsessive-compulsive disorder.

Previous researchers have classified obsessive-compulsive disorder (OCD) patients by the themes of their obsessions and compulsions (e.g., washing, checking); however, mental compulsions have not been adequately assessed in these studies. The authors conducted 2 studies using a large sample of OCD patients (N=132). In the 1st study, they categorized patients on the basis of symptom presentation, giving adequate consideration to mental compulsions. Five patient clusters were identified: harming, contamination, hoarding, unacceptable thoughts, and symmetry. Mental compulsions were most prevalent among patients with intrusive, upsetting religious, violent, or sexual thoughts. In the 2nd study, they compared response to cognitive-behavioral therapy across symptom categories, finding poorer outcomes among patients with hoarding symptoms compared with those with other symptom themes.

Adolescent↗