Obsessive--Compulsive DisorderM. Mavissakalian, Samuel M. Turner, Larry Michelson Recent advances in behavioral and biological treatments have raised the hopes and expectations of patients and clinicians alike in regard to obsessive-compulsive disorder-one of the most disabling, crippling, and resistant conditions in psy chiatry. In addition to their therapeutic efficacy, these new treatments have also opened new conceptual perspectives, thus complementing the traditional psychological theories of obsessive-compulsive disorder. Therefore, it is timely for these various conceptual frameworks and the treatment modalities they engender to be integrated and synthesized in the pres ent volume. To this end, eminent scholars in their respective areas were invited to contribute to this book, which we hope will symbolize and-in some measure-actualize the spirit of collaboration required if we are to fully comprehend the com plex nature of this disorder as well as to address existing ther apeutic challenges. In Chapter 1, Rachman sets the stage by providing an overview of the conceptual and therapeutic issues of obsessive-compulsive disorder. This is followed by an in depth review of the behavioral interventions from which Foa vii viii PREFACE and colleagues successfully distill the specific therapeutic processes of exposure and response prevention. In the third chapter, Sifneos deals with the psychodynamic factors under lying obsessive-compulsive phenomena and details his in novative technique of brief, anxiety-provoking psychotherapy aimed specifically at the obsessional state. |
Contents
An Overview of Clinical and Research Issues in Obsessional Compulsive Disorders | 1 |
COURSE OF DISORDER | 5 |
RELATION TO OTHER DISORDERS | 7 |
GENESIS | 10 |
TYPES | 13 |
PERSISTENCE | 15 |
COMPULSIVE URGES | 19 |
NATURE OF OBSESSIONS | 24 |
Avoidance of Pregenital Characterological Issues | 148 |
Repeated Challenge to the Ambivalence | 149 |
Outcome | 151 |
REFERENCES | 154 |
Comments on the Psychological Treatment of ObsessiveCompulsive Patients | 155 |
Pharmacotherapy of ObsessiveCompulsive Disorder | 167 |
DIAGNOSIS | 168 |
ASSESSMENT | 170 |
TREATMENT | 29 |
SUMMARY | 42 |
REFERENCES | 43 |
Behavior Therapy with ObsessiveCompulsives FROM THEORY TO TREATMENT | 49 |
BEHAVIORAL MODELS | 51 |
CognitiveBehavior Theory | 54 |
CLASSIFICATION | 56 |
BEHAVIORAL TREATMENT | 60 |
Exposure Procedures | 61 |
Blocking Procedures | 66 |
Comparisons between Exposure and Blocking Procedures | 70 |
Summary | 71 |
TREATMENT BY EXPOSURE AND RESPONSE PREVENTION | 73 |
Variants of Exposure and Response Prevention | 83 |
Differential Effects of Exposure and Response Prevention | 92 |
Classification and Treatment | 100 |
Processes during Exposure | 101 |
Success and Failure with Exposure and Response Prevention | 111 |
FURTHER CONSIDERATIONS | 115 |
REFERENCES | 119 |
ShortTerm Dynamic Psychotherapy for Patients Suffering from an ObsessiveCompulsive Disorder | 131 |
PSYCHODYNAMIC EXPLANATIONS | 133 |
Reaction Formation | 134 |
Undoing | 135 |
PSYCHOTHERAPY | 136 |
Developmental History Taking | 143 |
THERAPEUTIC TECHNIQUES OF SHORTTERM DYNAMIC PSYCHOTHERAPY | 145 |
Early Utilization of Positive Transference | 146 |
ParentTransference Links | 147 |
BIOCHEMISTRY | 175 |
PHARMACOLOGICAL TREATMENT | 178 |
Anxiolytics | 180 |
Tricyclic Antidcpressants | 181 |
Clomipramine | 183 |
Combination Treatments | 188 |
Antidepressant Drugs and Behavior Therapy | 189 |
Monoamine Oxidase Inhibitors MAO1 | 192 |
Lithium | 194 |
PSYCHOSURGERY | 195 |
Orbital Undercutting | 198 |
Stereotactic Tractotomy | 199 |
Limbic Leucotomy | 201 |
CONCLUSION | 202 |
REFERENCES | 203 |
Future Directions in the Assessment and Treatment of ObsessiveCompulsive Disorder | 213 |
PHENOMENOLOGICAL VARIANCE | 214 |
FUNCTIONAL DIVERSITY | 216 |
UNIFYING CLINICAL CONCEPTS | 218 |
RECENT FUNCTIONAL FORMULATIONS | 222 |
RELATION TO ANXIETY DISORDERS | 226 |
RELATION TO DEPRESSION | 232 |
TREATMENT | 235 |
COMBINED TREATMENTS | 239 |
PREDICTOR VARIABLES | 240 |
ASSESSMENT | 243 |
REFERENCES | 244 |
249 | |
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Obsessive-Compulsive Disorder M. Mavissakalian,Larry Michelson,Samuel M. Turner No preview available - 2014 |
Common terms and phrases
agoraphobia amitriptyline Ananth antidepressants anxiety disorders anxiety/discomfort assessment associated Beech Behavior Therapy behavioral treatment Behaviour Research Boulougouris British Journal clinical clomipramine Cobb cognitive compulsive behavior compulsive disorder compulsive neurosis compulsive urges depressed patients depression desensitization discomfort doxepin drug effects Emmelkamp evidence exposure and response fear follow-up habituation haloperidol havior imipramine improved intrusive Journal of Psychiatry leucotomy Marks Mavissakalian Medical ment neurotic obses obsessional disorder obsessional neurosis obsessional patients obsessional-compulsive disorders obsessions and compulsions obsessive compulsive obsessive symptoms obsessive-compulsive disorder obsessive-compulsive neurosis obsessive-compulsive patients OCD patients onset outcome overt phobic placebo posttreatment psychological psychosurgery psychotherapy Rabavilas Rachman reduction relationship reported Research and Therapy response prevention ritualistic behavior ruminations sessions short-term dynamic sions sive Solyom spontaneous Steketee Stern stimuli subjective anxiety systematic desensitization technique ther therapeutic therapist thought stopping tients tion Tourette syndrome treated treatment of obsessive treatment of obsessive-compulsive Turner vivo exposure