DOCSLIB.ORG

Couples-OCD-Treatment-Outcome.Pdf

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Couples-OCD-Treatment-Outcome.Pdf This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier’s archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/authorsrights Author's personal copy Available online at www.sciencedirect.com Behavior Therapy 44 (2013) 395–407 www.elsevier.com/locate/bt Treating Obsessive-Compulsive Disorder in Intimate Relationships: A Pilot Study of Couple-Based Cognitive-Behavior Therapy Jonathan S. Abramowitz Donald H. Baucom Sara Boeding Michael G. Wheaton Nicole D. Pukay-Martin Laura E. Fabricant Christine Paprocki Melanie S. Fischer The University of North Carolina at Chapel Hill terms of the importance of addressing interpersonal processes Although cognitive-behavioral therapy (CBT) involving that maintain OCD symptoms. exposure and response prevention (ERP) is an established treatment for obsessive-compulsive disorder (OCD), not all patients respond optimally, and some show relapse upon Keywords: obsessive-compulsive disorder; OCD; couple therapy; discontinuation. Research suggests that for OCD patients in exposure; response prevention; cognitive-behavioral therapy close relationships, targeting relationship dynamics enhances the effects of CBT. In the present study, we developed and pilot OBSESSIVE-COMPULSIVE DISORDER (OCD) involves tested a 16-session couple-based CBT program for patients (a) recurrent intrusive thoughts that evoke fear and with OCD and their romantic partners. This program distress (i.e., obsessions) and (b) excessive avoidance included (a) partner-assisted ERP, (b) techniques targeting and compulsive rituals (or mental acts) to reduce the maladaptive relationship patterns focal to OCD (e.g., symp- obsessional fear (American Psychiatric Association, tom accommodation), and (c) techniques targeting non 2000). For example, someone with obsessional fears OCD-related relationship stressors. OCD, related symptoms, of germs and contamination might spend hours and relationship functioning were assessed at baseline, washing and cleaning and also demand that family immediately following treatment (posttest), and at 6- and members avoid feared contaminants. Research in- 12-month follow-up. At posttest, substantial improvements in dicates that avoidance and rituals usually result in OCD symptoms, relationship functioning, and depression short-term fear reduction, which negatively rein- were observed. Improvements in OCD symptoms were forces these behaviors, leading to their repetition maintained up to 1 year. Results are compared to findings (e.g., Rachman & Hodgson, 1980). In the long run, from studies of individual CBT for OCD and discussed in however, avoidance and rituals prevent the extinc- tion of obsessional fear, thus completing a vicious This study was funded by a research grant from the International cycle that maintains OCD symptoms. Obsessive-Compulsive Disorder Foundation. Address correspondence to Jonathan Abramowitz, Ph.D., The most effective psychological treatment for Department of Psychology, University of North Carolina–Chapel OCD is cognitive-behavioral therapy (CBT) involving Hill, Campus Box 3270 (Davie Hall), Chapel Hill, NC 27599; exposure and response prevention (ERP; e.g., Kozak e-mail: [email protected]. & Foa, 1997). Exposure involves repeated and 0005-7894/44/395-407/$1.00/0 © 2013 Association for Behavioral and Cognitive Therapies. Published by prolonged confrontation with obsessional triggers; Elsevier Ltd. All rights reserved. response prevention entails resisting urges to perform Author's personal copy 396 abramowitz et al. compulsive rituals. These procedures weaken the was more effective than individual ERP without such associations between (a) obsessional triggers and a coach. In a similarly designed study, however, fear provocation, and (b) compulsive rituals and fear Emmelkamp, de Haan, and Hoogduin (1990) found reduction, thus allowing the patient to learn that no between-group differences. Finally, Emmelkamp obsessional fears are unrealistic and that avoidance or and de Lange (1983) reported that partner-assisted rituals are not necessary to reduce fear. Cognitive ERP was more effective at posttest, but not at therapy techniques (e.g., Wilhelm & Steketee, 2006) 1 month follow-up. It is difficult to draw strong are also employed to weaken cognitive distortions conclusions from these early studies as they suffered associated with OCD symptoms (e.g., an inflated from various methodological limitations such as sense of responsibility). Although there is consider- small sample sizes and suboptimal implementation able evidence for the effectiveness of CBT (e.g., Eddy of ERP (e.g., no therapist-supervised exposure), often et al., 2004; Olatunji, Davis, Powers, & Smits, 2013), resulting in substandard outcomes study-wide. not everyone with OCD responds well to this Another issue is that while partner-assisted ERP treatment, and many patients discontinue treatment might facilitate cooperation between partners when it prematurely or show relapse upon finishing an comes to completing specific exposure tasks, it does adequate trial (Olatunji et al., 2013; Simpson et al., not directly address other couple interaction patterns 2004). Thus, improving the acceptability and the (e.g., accommodation, hostile communication) that short- and long-term effectiveness of this intervention maintain OCD, attenuate treatment response, and remains a priority. increase the risk of relapse following treatment. For Research on predictors of outcome with CBT example, it might be beneficial to incorporate suggests that tending to patients’ interpersonal re- techniques to teach couples healthier and more lationships is one way to improve the prognosis for adaptive ways of showing mutual care and concern OCD (e.g., Chambless & Steketee, 1999; Steketee, that are not focused on OCD symptoms. Given the 1993). Indeed, OCD symptoms often negatively lack of interventions for OCD that target such impact interpersonal functioning, which in turn main- relationship dynamics in combination with ERP, we tains OCD symptoms. One way this occurs is when developed a 16-session couple-based CBT program avoidance and rituals create relationship conflict, that involves (a) psychoeducation, (b) partner-assisted which increases stress and anxiety. Second, nonaf- ERP, (c) couple-based interventions focused on fected partners frequently (albeit inadvertently) main- reducing OCD-specific accommodation behavior tain patients’ OCD symptoms by “helping” with and increasing alternative strategies for couple en- avoidance and rituals (e.g., providing reassurance for gagement, and (d) general couple therapy focused on the patient; Calvocoressi et al., 1999; Shafran, Ralph, stressful aspects of the relationship not directly related & Tallis, 1995). Such symptom accommodation can to OCD (Abramowitz et al., 2013). occur in happy as well as in relationally distressed In the present study, we conducted an open trial of couples, and might be performed to prevent the OCD this treatment program for 21 adult couples in which sufferer from becoming anxious and hostile or simply one partner had OCD. The aim of this pilot study was to express care and concern within the relationship. to examine the feasibility and the immediate and Regardless, symptom accommodation is predictive of long-term effectiveness of the intervention in a greater OCD severity and poorer treatment outcome treatment-naïve sample. We assessed OCD and (Boeding et al., in press; Calvocoressi et al.). Finally, related symptoms (patients only) as well as relation- couples might struggle with chronic relationship ship functioning (both partners) at baseline, post- discord unrelated to OCD (e.g., financial concerns) treatment, 6-month, and 12-month (1 year) follow- that elevates stress, exacerbates OCD symptoms, and up. We hypothesized statistically and clinically can also attenuate treatment response (Steketee & significant improvement in OCD, related symptoms Chambless, 1999). (e.g., insight, depression), and relationship function- The bidirectional association between OCD symp- ing at post-treatment; and that improvements would toms and relationship functioning suggests that for be maintained through 12-month follow-up. We also patients in close relationships, the effects of CBT predicted that the long-term effects of our couple- might be enhanced by involving the partner in based ERP program would appear superior when treatment and addressing the ways in which relation- benchmarked with long-term follow-up results from ship factors (as described above) maintain OCD. comparable previous studies of individual CBT. Only a few studies, however, have systematically examined “partner assisted” CBT for OCD, and the Method results of these investigations are mixed. Mehta participants (1990), for example, found that including a partner Participants were 21 adult couples (age ≥ 18) who (or other family member) as a coach during ERP had been married or living together for at least Author's personal copy ocd in couples
Load more

Recommended publications
  • Cognitive Psychother Apy
    With the Compliments of Springer Publishing Company, LLC JOURNAL OF COGNITIVE PSYCHOTHER APY www.springerpub.com/jcp Journal of Cognitive Psychotherapy: An International Quarterly Journal of Cognitive Psychotherapy: An International Quarterly Volume 27, Number 3 • 2013 27 3 2013 A Comparison of Two Brief Interventions for Obsessional Thoughts: Exposure and Acceptance Laura E. Fabricant, MA Jonathan S. Abramowitz, PhD University of North Carolina at Chapel Hill John P. Dehlin, MS Michael P. Twohig, PhD Utah State University Exposure and response prevention (ERP) is the most effective psychological treatment for unwanted, intrusive thoughts associated with obsessive-compulsive disorder (OCD). However, the procedures involved in ERP (i.e., exposure) are challenging, provoke high levels of anxiety, and may contribute to treatment refusal and dropout (Franklin & Foa, 1998). To address this problem, researchers have begun to evaluate alternative treatments for OCD, such as Acceptance and Commitment Therapy (ACT). Despite the value of both techniques, little is known about the differential impact of these strategies. This study examined the relative effects of a single session of ACT or exposure for obsessional thoughts. There were 56 under- graduate participants with obsessional thoughts randomly assigned to receive a brief interven- tion with the core components of exposure, ACT, or an expressive writing control condition. Obsessional symptoms and related process variables were assessed at baseline and at 1-week follow-up. There were no statistical differences in believability or acceptability of the 3 condi- tions. Significant reductions in obsessional severity, behavioral tests of distress and willingness to experience intrusive thoughts, and negative appraisals of intrusive thoughts occurred in all conditions, but no differences were found between these conditions.
    [Show full text]
  • The Utility of Obsessive Compulsive Analogue Research: a Comparison of Ocd Patient, Analogue, and Nonclinical Samples
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Carolina Digital Repository THE UTILITY OF OBSESSIVE COMPULSIVE ANALOGUE RESEARCH: A COMPARISON OF OCD PATIENT, ANALOGUE, AND NONCLINICAL SAMPLES Laura E. Fabricant A dissertation submitted to the faculty of the University of North Carolina at Chapel Hill in partial fulfillment of the requirements for a degree of Doctor of Philosophy in the Department of Psychology (Clinical Psychology). Chapel Hill 2014 Approved by: Jonathan S. Abramowitz Anna Bardone-Cone Donald H. Baucom David Penn Lilly Shanahan © 2015 Laura E. Fabricant ALL RIGHTS RESERVED ii ABSTRACT Laura E Fabricant: The Utility of Obsessive Compulsive Analogue Research: A Comparison of OCD Patient, Analogue, and Nonclinical Samples (Under the direction of Jonathan Abramowitz) Many researchers interested in studying obsessive compulsive disorder (OCD) often include individuals who do not meet full diagnostic criteria for OCD, but who experience some obsessive compulsive (OC) symptoms, as study participants. While research using these analogue samples is common, it is unclear as to how closely they resemble samples of individuals with a diagnosis of OCD. The current study thus examined the relationship between analogue and clinical samples in order to better understand the generalizability of data from these analogue samples. Specifically, this study compared an OC analogue sample to an OCD clinical sample, as well as to a healthy control group, on the following domains: OC symptom content, the frequency and severity of both obsessions and compulsions, distress and interference related to these symptoms, endorsement of obsessional beliefs that contribute to the development and maintenance of OC symptoms, and rates of psychiatric comorbidity.
    [Show full text]
  • Strategies for Improving Long-Term Outcomes in Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder: Insights from Learning Theory
    CBPRA-00475; No of Pages 12: 4C Cognitive and Behavioral Practice xx (2013) xxx-xxx www.elsevier.com/locate/cabp Strategies for Improving Long-Term Outcomes in Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder: Insights From Learning Theory Jonathan S. Abramowitz, University of North Carolina at Chapel Hill Joanna J. Arch, University of Colorado Boulder Cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) is often highly effective, yet some patients experience relapses following a seemingly successful course of treatment. In this article we describe the components of CBT for OCD and then present a patient who relapses after making significant gains during a course of CBT. Likely explanations for the patient’s relapse, and methods for optimizing long-term treatment outcomes, are explored from the standpoint of research on learning and memory. These strategies mainly apply to the implementation of situational (in vivo) and imaginal exposure therapy, but also include suggestions for optimizing the psychoeducational and cognitive therapy components. HE beneficial effects of exposure-based cognitive-- posing a threat for which the individual is responsible T behavioral therapy (CBT) for obsessive-compulsive (Salkovskis, 1985; “I can and must prevent this”). That is, disorder (OCD) are among the most consistent findings in the intrusive thoughts are not considered the problem; research and clinical settings. Still, as anyone who has rather, it is how the person interprets, responds to, and tries implemented this treatment knows, not all individuals to control the intrusions that is thought to lead to obsessional respond equally well; and even those who show impressive fear and distress.
    [Show full text]
  • 2015 Annual Report
    International OCD Foundation 2015 Annual Report International OCD Foundation 2015 Annual Report 1 The mission of the International OCD Foundation is to help everyone affected by obsessive compulsive disorder (OCD) and related disorders to live full and productive lives. Our aim is to increase access to effective treatment, end the stigma associated with mental health issues, and foster a community for those affected by OCD and the professionals who treat them. retired National Hockey League goalie who is best known While the Annual OCD Conference, our OCDvocate program, Dear friends and for a life-threatening accident that happened on the ice in and the 1 Million Steps 4 OCD Walk are all ways to become 1989. What many people did not realize is that he had also involved in the IOCDF community, others have chosen been fighting OCD since childhood. At the Conference, Clint philanthropy. We were excited to be the recipient of a supporters of the and Joanie talked frankly about their journey together with matching grant for our Research Fund. Since 1994, the IOCDF Clint’s OCD, substance abuse, and mental health issues. has sought to fund important research into finding the cause They described their struggles, confronting shame, isolation, and effective treatments for OCD and related disorders International OCD and the many obstacles to getting the help and support through our IOCDF Research Grant Program. Generous they both needed. Mental illness takes a toll on one’s life individuals within the IOCDF community have donated Foundation, and relationships. While there are many challenges in any funds, enabling the IOCDF to provide more than 3 million marriage, when OCD and substance abuse enter the picture, dollars to support important research projects.
    [Show full text]
  • Assessing the Contributions of Cognitive-Behavioral and ACT
    Assessing the contributions of cognitive-behavioral and ACT constructs in the prediction of health anxiety Tate A. Overbey Senior Honor Thesis Department of Psychology and Neuroscience University of North Carolina at Chapel Hill April 2nd 2018 Approved: ______________________________ COGNITIVE-BEHAVIORAL & ACT CONSTRUCTS IN HEALTH ANXIETY 2 Acknowledgments I would like to recognize and thank Lillian Reuman who has taken a great deal of time out of her final year as a graduate student to act as my primary advisor. She has provided me with tremendous support throughout this project from start to finish and has always been there for me without exception to act as a mentor and source of encouragement whenever I needed someone to point me in the right direction. Secondly, I would like to thank the other individuals serving on my committee, both of whom have played pivotal roles in inspiring me to become interested in psychological research. I would like to thank Dr. Jonathan Abramowitz for providing me with an environment where I could pursue my interest in studying anxiety-related disorders and teaching me about the field of clinical psychology as a researcher and as an instructor. And I would like to thank Dr. Mitch Prinstein for being the first to introduce me to the world of psychological research and for his willingness to provide career guidance to myself as well as all those who are interested in the field of psychology. Furthermore, I would like to thank Shannon Blakey and Jennifer Buchholtz for their contributions to my development as a researcher and allowing me to aid them in carrying out their research projects.
    [Show full text]
  • New Directions in the Cognitive-Behavioral Treatment of OCD: Theory, Research, and Practice
    Available online at www.sciencedirect.com ScienceDirect Behavior Therapy 49 (2018) 311–322 www.elsevier.com/locate/bt New Directions in the Cognitive-Behavioral Treatment of OCD: Theory, Research, and Practice Jonathan S. Abramowitz Shannon M. Blakey Lillian Reuman Jennifer L. Buchholz University of North Carolina at Chapel Hill CHARACTERIZED BY (a) obsessions—persistent intru- The beneficial effects of cognitive-behavioral interventions sive unwanted thoughts, images, or doubts that (particularly exposure and response prevention) for OCD provoke anxiety and distress—and (b) compul- are among the most consistent research findings in the sions—repetitive or ritualistic behaviors or thoughts mental health literature. Nevertheless, even after an performed deliberately to neutralize the distress adequate trial, many individuals experience residual symp- associated with obsessions, untreated obsessive- toms, and others never receive adequate treatment due to compulsive disorder (OCD) generally follows a limited access. These and other issues have prompted deteriorating course (Pinto, Mancebo, Eisen, Pagano, clinicians and researchers to search for ways to improve &Rasmussen,2006). Moreover, people with OCD the conceptual and practical aspects of existing treatment often have diminished quality of life (Jacoby, Leonard, approaches, as well as look for augmentation strategies. In Riemann, & Abramowitz, 2014; Subramaniam, Soh, the present article, we review a number of recent develop- Vaingankar, Picco, & Chong, 2013), as do their ments and new
    [Show full text]
  • Spring 2015: Volume 18, Issue 2
    APA CLINICAL SCIENCE Society for the Science of Clinical Psychology III Section III of the Division of Clinical Psychology of Division12 Ψ the American Psychological Association Developing clinical psychology as an experimental-behavioral science N E W sle TT E R SPRING 2015: VOLUME 18, ISSUE 2 SSCP Executive Board Table of Contents President: Presidential Column Mitch Prinstein, Ph.D. M. Prinstein................................................................................................2 University of North Carolina at Chapel Hill Treasurer’s Report S. Shankman..............................................................................................4 Past-President: Lawrence H. Cohen Outstanding Mentor Award........................................4 Bethany Teachman, Ph.D. “How Did I Get Here” video series..................................................................5 University of Virgina President-Elect: SSCP Varda Shoham Clinical Scientist Training Grant Awardees...............6 Steve Hollon, Ph.D. Vanderbilt University Diversity Corner Y. Yoon....................................................................................................10 Secretary/Treasurer: Stewart Shankman, Ph.D. University of Illinois-Chicago Clinical Science Early Career Paths Series C. Alcántara....................................................................................................14 Division 12 Representative: David Smith, Ph.D. University of Notre Dame Student Perspectives Series I S. Gorka....................................................................................................16
    [Show full text]
  • About the Editors
    Cognitive–Behavioral Therapy for Refractory Cases Turning Failure Into Success Edited by Dean McKay, Jonathan S. Abramowitz, and Steven Taylor Cognitive–behavioral therapy (CBT) is effective in treating a wide range of psychological problems. Yet many clients whose symptom presentations significantly differ from textbook examples feel that their treatment has failed. Cognitive–Behavioral Therapy for Refractory Cases: Turning Failure Into Success expertly demonstrates how these standard intervention protocols can be appropriately modified to meet client needs. With each chapter, leaders in the field of CBT address the management and prevention of treatment nonresponsiveness with a range of populations that include social anxiety disorder, obsessive–compulsive disorder, posttraumatic stress disorder, eating disorders, depression, insomnia, impulse control disorder, anger issues, and borderline personality disorder among others. Using illustrative case examples and intervention protocols, this volume offers practical guidance for clinicians facing resistance and limited response to CBT from their clients. The editors also closely examine future directions in research to further advance the success of CBT in treating these refractory cases. 2010. 480 pages. Hardcover. List: $79.95 APA Member/Affiliate: $59.95 ISBN 978-1-4338-0472-4 Item # 4317198 About the Editors Dean McKay, PhD, ABPP, is associate professor, Department of Psychology, Fordham University. He currently serves on the editorial boards of Behaviour Research and Therapy, Journal of Clinical Psychology and Journal of Anxiety Disorders, and is associate editor of Journal of Cognitive Psychotherapy. He has published over 120 journal articles and book chapters, and he is editor or coeditor of 8 published or forthcoming books, and has over 150 conference presentations.
    [Show full text]
  • The Behavior Therapist
    ISSN 0278-8403 ASSOCIATION FOR BEHAVIORAL AND COGNITIVE THERAPIES VOLUME 38, NO. 7•OCTOBER 2015 the Behavior Therapist special The Biomedical Model issue of Psychological Problems PRESIDENT’SMESSAGE Co-Editors: Brett Deacon, University of Wollongong Dean McKay, Fordham University The Biomedical Model: Caveat Emptor PRESIDENT'SMESSAGE | Jonathan S. Abramowitz The Biomedical Model: Caveat Emptor 169 Brett Deacon and Dean McKay Jonathan S. Abramowitz, University Introduction to the Special Issue 172 of North Carolina–Chapel Hill Scott O. Lilienfeld, Seth J. Schwartz, Alan Meca, Katheryn C. Sauvigné, Sally Satel THIS SPECIAL ISSUE of tBT on Neurocentrism: Implications for Psychotherapy Practice and Research 173 the biomedical model and treatment of mental illness Kichuk, Matthew S. Lebowitz, T. Grover Adams Jr. covers thought-provoking Can Biomedical Models of Psychopathology Interfere topics for clinicians, With Cognitive-Behavioral Treatment Processes? 181 researchers, and students Amitai Abramovitch and Avraham Schweiger alike. The biomedical model Misuse of Cognitive Neuropsychology in Psychiatry proposes that mental disor- Research: The Intoxicating Appeal of Neo-Reductionism 187 ders are medical diseases caused by abnormalities in brain structure or Robert Whitaker function, or in genetics; and that treatment Anatomy of an Epidemic: must therefore address such biological mecha- The History and Science of a Failed Paradigm of Care 192 nisms. A heady atmosphere of excitement and Glen Spielmans anticipation presently surrounds the biomed- When Marketing Met Science: Evidence Regarding ical model, bolstered by the widespread belief Modern Antidepressants and Antipsychotic Medications 199 that we are on the verge of discoveries in neuro- science that will transform our understanding Jeffrey R. Lacasse and Jonathan Leo and treatment of mental illness.
    [Show full text]
  • Predicting Obsessive-Compulsive Symptom Dimensions from Obsessive Beliefs and Anxiety
    Running head: PREDICTING OC SYMPTOMS! !!1 ! Predicting Obsessive-Compulsive Symptom Dimensions from Obsessive Beliefs and Anxiety Sensitivity Samantha Asofsky University of North Carolina–Chapel Hill Spring 2016 A thesis presented to the faculty of The University of North Carolina at Chapel Hill in partial fulfillment of the requirements for the Bachelor of Arts degree with Honors in Psychology Committee Chair: Jonathan Abramowitz, Ph. D. Committee Member: Donald Baucom, Ph.D. Committee Member: Shannon Blakey, M.S. PREDICTING OC SYMPTOMS! 2 Acknowledgments I would like to thank my advisor, Dr. Jon Abramowitz, for your unforgettable personal, academic, and scientific guidance and encouragement throughout my entire undergraduate career. I would further like to thank the UNC Anxiety lab and its brilliant graduate students who have thought me an immeasurable amount of information about anxiety research and clinical psychology and whose efforts allowed this research to come to fruition through its web surveys. I would like to recognize Dr. Kathleen Gates for teaching me the art of statistics and providing me consultations regarding my research. I want to thank Dr. Beth Kurtz-Costes for her advice during the honors thesis writing process. I hope to extend acknowledgements to Dr. Donald Baucom and Ms. Shannon Blakey for providing warm support and serving on my Honors Committee. Finally I am grateful to my parents, Karen and Seth Asofsky, for their love, support, and edits over the years. PREDICTING OC SYMPTOMS! 3 Abstract Cognitive models propose that obsessive-compulsive (OC) symptoms are maintained by maladaptive (obsessive) beliefs that give rise to anxiety and compulsive urges. Previous research, however, has found inconsistent relationships between obsessive beliefs and OC symptoms, and authors have called for further research to elucidate these associations.
    [Show full text]
  • Newsletter Visit Us on the Web At
    WINTER 2008 VOL. 10 NO. 4 Newsletter Visit us on the web at www.njocf.org Monnica Terwilliger Jonathan Abramowitz, Be Sure to Attend: Williams, Ph.D. Presented Ph. D. presented “You Are the Therapist” “Homosexuality Anxiety: “A Couples-Based Part 2 A Misunderstood Approach to the on Monday, Dec. 8th Symptom of OCD” Treatment of OCD” by Rachel Strohl, Psy.D. by Rachel Strohl, Psy. D. On Monday September 8, 2008, Monnica Our next quarterly NJOCF meeting will On Sunday, September 14, 2008 be held on Monday, December 8th, at 7:30 Terwilliger Williams, Ph.D. presented at Jonathan Abramowitz, Ph. D. was the p.m., at Robert Wood Johnson Hospital in the quarterly meeting of the NJ Obsessive keynote speaker at the NJOCF ninth New Brunswick. Dr. Allen H. Weg, Vice Compulsive Foundation. Dr. Williams annual conference. Dr. Abramowitz is President of NJ OCF, will be moderating received her masters and doctorate from Associate Professor in the Department this meeting. the University of Virginia, and practices at of Psychology at the University of the University of Pennsylvania School of North Carolina at Chapel Hill. He is Back in March of 2007, we experimented also Associate Chair of the Department Medicine as an Assistant Professor of with our quarterly meeting by not inviting of Psychology and Director of the a speaker to make a formal presentation, Clinical Psychology in Psychiatry at the Anxiety and Stress Disorders Clinic at Center for the Treatment and Study of but instead ran a program entitled, “YOU Carolina. His research has led to over are the Therapist.” We felt the program Anxiety.
    [Show full text]
  • Where Does Obsessive-Compulsive Disorder Belong in DSM-V?
    DEPRESSION AND ANXIETY 25:336–347 (2008) Research Article WHERE DOES OBSESSIVE–COMPULSIVE DISORDER BELONG IN DSM-V? Ã Eric A. Storch, Ph.D.,1,2 Jonathan Abramowitz, Ph.D.,3 and Wayne K. Goodman, M.D.1 A reclassification of obsessive–compulsive disorder (OCD) into a new diagnostic category spectrum of ‘‘obsessive–compulsive spectrum disorders’’ (OCSDs) has recently been proposed, with considerable debate, for the forthcoming Diagnostic and Statistical Manual—Fifth Edition (DSM-V). This paper provides a critical analysis of the available empirical data regarding this conceptual and nosological shift. Specifically, we review research on shared commonalities and differences between OCD and the putative OCSDs in relation to their clinical presentation, phenotype, neurobiology, and treatment response. We conclude that a reclassification of OCD into a separate OCSD spectrum is premature and not supported by the currently available data. Depression and Anxiety 25:336–347, 2008. & 2008 Wiley-Liss, Inc. Key words: obsessive–compulsive disorder; obsessive–compulsive spectrum; impulse control disorders; Diagnostic and Statistical Manual for Mental Disorders; Tourette’s syndrome INTRODUCTION OCD and related disorders based on endophenotypes and purported commonalities in etiologically relevant A reclassification of obsessive–compulsive disorder factors such as heritability, brain circuitry, neurotrans- (OCD) into a larger spectrum of disorders (termed as mitter abnormalities, and phenotypic similarities with obsessive–compulsive spectrum disorders [OCSD]) has other disorders [Hollander et al., 2007]. recently been proposed, with considerable debate [e.g., The proposed OCSD model and diagnostic shift is Mataix-Cols et al., 2007], for the forthcoming Diag- widely contested by clinicians and researchers alike on nostic and Statistical Manual—Fifth Edition [DSM-V; both conceptual and empirical grounds.
    [Show full text]