Group behavior therapy for obsessive-compulsive disorder.
Explore the source record for details and available documents.
Behavior Therapy↗
SEARCH · PubMed Health
Results for “Compulsive Behavior”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The normalcy of neurosis: evolutionary origins of obsessive-compulsive disorder and related behaviors.
One of the most curious questions plaguing subscribers of evolutionary theory is how natural selection's fine-tuned editing function could allow disease to persist. For evolutionary psychiatrists, the existence of psychopathology is thus perplexing. To illustrate a potential answer to one instance of this broad question, we examine the correlates of obsessive-compulsive disorder (OCD) within our normal repertoire of thought and action. The evidence presents a picture of OCD as a dysregulation of normal behaviors and mental states throughout the course of human development. We speculate that such correspondence may be more than a coincidence and that OCD is a consequence of a dysregulation of the neural circuits that are crucially involved in threat detection and harm avoidance. These neural systems are also likely to underlie aspects of religious experience and ritual as well as the wonders of romantic and early parental love.
Animals↗
Group and multifamily behavioral treatment for obsessive compulsive disorder: a pilot study.
Recent trends toward managed care in mental health settings require investigation of the efficacy and cost-effectiveness of treatments conducted over shorter time frames or with less therapist involvement. Findings are presented in an uncontrolled trial of two types of group behavioral treatments of OCD: group (GBT) and multifamily (MFBT). Seventeen patients (10 women and 7 men) diagnosed with OCD received a partially manualized GBT delivered by co-therapy teams in three groups of ten 2-hr sessions. Mean interview-based YBOCS scores reduced significantly at posttest and at 1-year follow-up, as did measures of overall functioning on the Sheehan Disability Scale at posttest and follow-up. A second cohort of 19 patients (14 women and 5 men) was treated with MFBT that included spouses/partners and parents in three co-therapy groups. Two groups received ten 2-hr sessions and one received twelve 2-hr sessions. YBOCS scores reduced significantly at posttest and at 1-year follow-up, with corresponding gains in disability scores. Both group treatments showed large effects comparable to those reported for a more intensive individual behavioral treatment. Comparisons of treatments indicated that similar proportions of subjects were reliably changed at posttest and follow-up respectively, but more MFBT than GBT participants were clinically significantly improved. These promising cost effective group treatments remain to be tested in a controlled trial.
Adolescent↗
Obsessive-compulsive scale of the child behavior checklist: specificity, sensitivity, and predictive power.
OBJECTIVE: To create an obsessive-compulsive disorder subscale (OCS) of the Child Behavior Checklist (CBCL) and to determine its internal consistency, sensitivity, specificity, and positive and negative predictive power to identify obsessive-compulsive disorder (OCD) in children and adolescents. METHODS: Three samples of equal size (n = 73) of children and adolescents, matched for age, gender, and race, were selected for these analyses: 1) a clinically ascertained OCD group, 2) a psychiatrically treated group whose records revealed no evidence of OCD, and 3) a general population control group. An OCS was created by applying factor analysis to 11 CBCL items. Examinations of internal consistency, sensitivity, specificity, and positive and negative predictive value were undertaken. RESULTS: Of 11 items hypothesized to predict OCD, 8 items were retained after factor analyses (smallest factor loading: 0.49) and used to calculate OCS scores. The retained items displayed excellent internal consistency (Cronbach's alpha coefficient = 0.84). OCD participants had significantly higher OCS scores than either psychiatrically treated or general population control groups. With the use of the 2 cutoff scores closest to the true rate of OCD in the overall sample, sensitivity was 75.3% to 84.9%, specificity was 82.2% to 92.5%, positive predictive value was 70.5% to 83.3%, and negative predictive value was 88.2% to 91.6%. CONCLUSION: The performance of the proposed CBCL OCS compares favorably with that of the only previously studied screening instrument for OCD, the Leyton Obsessional Inventory-Child Version. Unlike the Leyton Obsessional Inventory-Child Version, the CBCL is already in widespread use as a screen for most other forms of psychopathology. As the performance of the CBCL OCS will need to be replicated in other sample populations, data with various cutoff levels are provided to enable investigators and clinicians to tailor its use to specific study populations.
Adolescent↗
Brain-behavior relationships in obsessive-compulsive disorder.
Advances in neuroimaging have led to a greater understanding of brain-behavior relationships in obsessive-compulsive disorder (OCD). This article provides an updated review and analysis of the structural and functional neuroimaging studies in OCD published to date and discusses how evidence from various types of neuroimaging studies has been synthesized to generate and test hypotheses regarding these relationships. We also review the basic science literature on the functional neuroanatomy of cortico-basal ganglia-thalamo-cortical circuits and integrate this information with neuroimaging data in OCD, to present a theoretical model of brain mediation of OCD symptoms and response to treatment. Taken together, neuroimaging studies indicate that OCD symptoms are mediated by hyperactivity in orbitofrontal-subcortical circuits, which may be attributable to an imbalance of tone between direct and indirect striato-pallidal pathways. Serotonergic drugs may ameliorate OCD symptoms by changing the relative balance of tone through the indirect versus direct orbitofrontal-subcortical pathways, thereby decreasing activity in the overall circuit that exists in the symptomatic state.
Brain↗
Behavior in the Lesch--Nyhan syndrome.
The Lesch--Nyhan syndrome is a heritable disorder of the metabolism of uric acid in which behavioral manifestations are prominent and among the most provocative. The mutated or variant gene that determines this disorder is carried on the X chromosome. The disease is expressed exclusively in males. The molecular expression of the abnormal gene is in the completely defective activity of the enzyme hypoxanthine guanine phosphoribosyl transferase. As a result these patients overproduce uric acid and may develop early in life many of the clinical findings we associate with gout. They have in addition a variety of neurological abnormalities including mental retardation, spastic cerebral palsy, and involuntary, choreoathetoid movements. Involved patients have unusual, compulsive, aggressive behavior. Its most prominent but by no means exclusive feature is self-mutilation. The central feature in the management of this behavior is physical restraint. A number of practical procedures have been learned which facilitate the care and feeding of these patients. Promising new findings suggest that behavioral modification using extinction techniques and pharmacologic methods utilizing agents designed to increase the effective cerebral content of serotonin may each have a place in the management of behavior in this syndrome.
5-Hydroxytryptophan↗
Behavioral and neural mechanisms of compulsive drug seeking.
Not the mere procurement and use of drugs, but the fact that patterns of seeking and taking become compulsive after prolonged drug use is a defining characteristic of drug addiction. Development of a therapy that targets the compulsive aspects of drug use and thus addresses addiction at its core would therefore be very desirable. In the present review, we will discuss animal studies that attempt to model loss of control over drug use. Furthermore, we will try to put these studies in a theoretical perspective, and discuss the hypothesized underlying neural and behavioral mechanisms.
Animals↗
Dissociable contribution of 5-HT1A and 5-HT2A receptors in the medial prefrontal cortex to different aspects of executive control such as impulsivity and compulsive perseveration in rats.
Serotonin (5-HT) receptors are increasingly recognized as major targets for cognitive enhancement in schizophrenia. Several lines of evidence suggest a pathophysiological role for glutamate NMDA receptors in the prefrontal cortex in schizophrenia and associated disorders in attention and executive functioning. We investigated how the interactions between 5-HT1A and 5-HT2A and glutamate NMDA receptor mechanisms in the medial prefrontal cortex (mPFC) contribute to the control of different aspects of attentional performance. Rats were trained on a five-choice serial reaction time (5-CSRT) task, which provides indices of attentional functioning (percentage of correct responses), executive control (measured by anticipatory and perseverative responses), and speed. The competitive NMDA receptor antagonist CPP (50 ng/side) was infused directly into the mPFC 5 min after infusion of either 8-OH-DPAT (30 and 100 ng/side) or M100907 (100 and 300 ng/side) into the same brain area. Impairments in attentional functioning induced by CPP were completely abolished by both doses of 8-OH-DPAT or M100907. In addition, M100907 abolished the CPP-induced anticipatory responding but had no effects on perseverative over-responding, while 8-OH-DPAT reduced the perseverative over-responding but had no effects on anticipatory responding induced by CPP. The selective 5-HT(1A) receptor antagonist WAY100635 (30 ng/side) antagonized the effects of 8-OH-DPAT (100 ng/side). 8-OH-DPAT at 30 ng/side reduced the latency of correct responses in controls and CPP-injected rats and lowered the percentage of omissions in CPP-injected rats. The data show that 5-HT1A and 5-HT2A receptors in the mPFC exert opposing actions on attentional functioning and demonstrate a dissociable contribution of 5-HT1A and 5-HT2A receptors in the mPFC to different aspects of executive control such as impulsivity and compulsive perseveration.
8-Hydroxy-2-(di-n-propylamino)tetralin↗
Discontinuing obsessive-compulsive disorder medication with behavior therapy.
Explore the source record for details and available documents.
Adult↗
Behavior therapy for obsessive-compulsive disorder guided by a computer or by a clinician compared with relaxation as a control.
BACKGROUND: The demand for effective behavior therapy for obsessive-compulsive disorder (OCD) by exposure and ritual prevention exceeds its supply by trained therapists. A computer-guided behavior therapy self-help system (BT STEPS) was created that patients access by telephone from home via interactive voice response technology. This study compared the value of computer-guided behavior therapy value with that of clinician-guided behavior therapy and systematic relaxation as a control treatment. METHOD: After screening by a clinician, 218 patients with DSM-IV OCD at 8 North American sites were randomly assigned to 10 weeks of behavior therapy treatment guided by (1) a computer accessed by telephone and a user workbook (N = 74) or (2) a behavior therapist (N = 69) or (3) systematic relaxation guided by an audiotape and manual (N = 75). RESULTS: By week 10, in an intent-to-treat analysis, mean change in score on the Yale-Brown Obsessive Compulsive Scale was significantly greater in clinician-guided behavior therapy (8.0) than in computer-guided (5.6), and changes in scores with both clinician-guided and computer-guided behavior therapy were significantly greater than with relaxation (1.7), which was ineffective. Similarly, the percentage of responders on the Clinical Global Impressions scale was significantly (p < .05) greater with clinician-guided (60%) than computer-guided behavior therapy (38%), and both were significantly greater than with relaxation (14%). Clinician-guided was superior to computer-guided behavior therapy overall, but not when patients completed at least 1 self-exposure session (N = 36 [65%]). At endpoint, patients were more satisfied with either behavior therapy group than with relaxation. Patients assigned to computer-guided behavior therapy improved more the longer they spent telephoning the computer (mostly outside usual office hours) and doing self-exposure. They improved slightly further by week 26 follow-up, unlike the other 2 groups. CONCLUSION: For OCD, computer-guided behavior therapy was effective, although clinician-guided behavior therapy was even more effective. Systematic relaxation was ineffective. Computer-guided behavior therapy can be a helpful first step in treating patients with OCD when clinician-guided behavior therapy is unavailable.
Adolescent↗
Adolescent compulsion: a case study involving cognitive-behavioral treatment.
Explore the source record for details and available documents.
Adolescent↗
Use of behavioral techniques in a case of compulsive stealing.
Explore the source record for details and available documents.
Behavior Therapy↗
Behavioral treatment of obsessive-compulsive disorders: current status.
Explore the source record for details and available documents.
Behavior Therapy↗
[The correlates of healthcare seeking behavior in obsessive-compulsive disorder: a multidimensional approach].
Obsessive-compulsive disorder (OCD) is a chronic, distressing, and disabling illness that influences the family, academic, occupational, and social functioning of patients. One of the 10 leading causes of disability worldwide is OCD; however, despite the considerable distress and disability associated with the disorder and the availability of treatment options, many OCD sufferers usually are not inclined to seek healthcare. The factors that may be central to healthcare seek behavior in OCD has scarcely been described in the literature. It has been thought that the best predictor of healthcare seeking is severity of illness; however, individuals with OCD may have various barriers to seeking healthcare. Although non-disease and disease-related factors that may influence health care seeking are related in complex ways through reciprocal influences and feedback, each factor might be an independent predictor of use of healthcare services. This review aims to discuss the impact of the disease and general factors that impact healthcare seeking behavior in OCD. In this way, new information might be provided for the identification of targets to enhance the use of mental health services among OCD sufferers in the community.
Humans↗
A cognitive behavioral workshop for subclinical obsessions and compulsions.
The present study investigates the effectiveness of a 3-h cognitive behavioral workshop for individuals, ages 18-22, with subclinical obsessions and compulsions. It was hypothesized that, compared to individuals in an assessment-only waitlist group (n = 42), individuals assigned to the workshop group (n = 43) would experience a significant decrease in obsessive-compulsive (OC) symptomatology, comorbidity, and thought action fusion endorsement at 1-month and 5-month follow-up assessments. An additional outcome of interest was the number of incident cases of obsessive-compulsive disorder (OCD) over the course of the study. The results indicated that the workshop group reported a significantly fewer number of OC symptoms at 5-month follow-up and endorsed significantly less thought action fusion at both follow-up points. However, there were no differences between groups in severity of OC symptoms and number of comorbid diagnoses endorsed. Only one incident case of OCD was observed during the study, from a participant in the waitlist group. These results are discussed in reference to treatment of subclinical anxiety symptoms.
Adolescent↗
Cognitive-behavioral treatment of obsessive-compulsive disorder in a child with Asperger syndrome: a case report.
This case report outlines the cognitive-behavioral treatment of obsessive-compulsive disorder in a 7-year-old female with Asperger syndrome. Interventions were based upon the work of March and Mulle and were adapted in light of the patient's cognitive, social, and linguistic characteristics. Obsessive-compulsive symptoms improved markedly after approximately 6 months of treatment. Issues regarding symptom presentation, assessment, and treatment of a dually diagnosed patient are discussed.
Anxiety↗
Syncopal attacks compulsively self-induced by Valsalva's maneuver associated with typical absence seizures. A case report.
A girl of borderline intelligence developed repeated syncopal attacks that were compulsively self-induced, apparently by forced expiration against a closed glottis (Valsalva's maneuver). In addition, she had typical absence seizures triggered by her apneic attacks, which could also be induced by hyperventilation. The absence seizures were suppressed by treatment with valproate sodium, which had no effect on the self-induced apneas. These were considerably improved with fenfluramine hydrochloride treatment, which was also associated with marked improvement of her previously abnormal behavior.
Apnea↗
The assessment of bulimic symptoms and personality correlates in female college students.
A screening questionnaire for bulimic symptoms was completed by 244 college women. Approximately 79% reported binge eating (uncontrolled, excessive eating) occurrences. Twenty women (8.2% of the sample) reported self-induced vomiting after binge eating or "normal" meals. A subsample of 31 students were interviewed and administered the Restraint Scale, Compulsive Eating Scale, Beck Depression Inventory, Sixteen Personality Factor Questionnaire, and The Tennessee Self Concept Scale. Results showed a number of significant differences among students who binged only (" bingers "), self-induced vomiting (" purgers "), or did not binge or purge ("controls"). Bingers and purgers showed greater restrained eating tendencies and compulsive eating behaviors. On the 16PF, purgers scored lower on Factor Q3, which suggests lowered will control and less regard for social demands. Purgers also showed lower self-esteem, particularly in the areas of identity and family self-concept.
Adolescent↗