Self-Ambivalence in the Cognitive-Behavioural Treatment of Obsessive-Compulsive Disorder

Therapeutic management of obsessional ideas without compulsions is considered to be a rather difficult clinical problem. This report discusses the case of a 24-year old lady with a nine year history of recurrent Obsessive-Compulsive Disorder which most recently presented with a year-long obsessional rumination concerning her superstitious personal responsibility for the accidental death of her cousin. Repeated audio-taped listening to the cognitively restructured content of her obsession resulted both in a rapid elimination of her ruminations and the alleviation of her depressive and general psychopathology.

Download Full-text

The Impact of Obsessive Compulsive Personality Disorder on Cognitive Behaviour Therapy for Obsessive Compulsive Disorder

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465815000582 ◽

2015 ◽

Vol 44 (4) ◽

pp. 444-459 ◽

Cited By ~ 9

Author(s):

Olivia M. Gordon ◽

Paul M. Salkovskis ◽

Victoria Bream

Keyword(s):

Initial Assessment ◽

Obsessive Compulsive ◽

Behavioural Treatment ◽

Compulsive Disorder ◽

Cognitive Behavioural Treatment ◽

Cognitive Behavioural ◽

Axis I Disorders ◽

Axis I ◽

Obsessive Compulsive Personality Disorder ◽

The Impact

Background: It is often suggested that, in general, co-morbid personality disorders are likely to interfere with CBT based treatment of Axis I disorders, given that personality disorders are regarded as dispositional and are therefore considered less amenable to change than axis I psychiatric disorders. Aims: The present study aimed to investigate the impact of co-occurring obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) on cognitive-behavioural treatment for OCD. Method: 92 individuals with a diagnosis of OCD participated in this study. Data were drawn from measures taken at initial assessment and following cognitive-behavioural treatment at a specialist treatment centre for anxiety disorders. Results: At assessment, participants with OCD and OCPD had greater overall OCD symptom severity, as well as doubting, ordering and hoarding symptoms relative to those without OCPD; however, participants with co-morbid OCD and OCPD demonstrated greater treatment gains in terms of OCD severity, checking and ordering than those without OCPD. Individuals with OCD and OCPD had higher levels of checking, ordering and overall OCD severity at initial assessment; however, at post-treatment they had similar scores to those without OCPD. Conclusion: The implications of these findings are discussed in the light of research on axis I and II co-morbidity and the impact of axis II disorders on treatment for axis I disorders.

Download Full-text

COGNITIVE-BEHAVIOURAL TREATMENT OF A 14-YEAR-OLD TEENAGER WITH OBSESSIVE-COMPULSIVE DISORDER

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465801001084 ◽

2001 ◽

Vol 29 (1) ◽

pp. 71-84 ◽

Cited By ~ 4

Author(s):

Mark H. Freestone

Keyword(s):

Obsessive Compulsive Disorder ◽

Single Case ◽

Behavioural Intervention ◽

Single Case Design ◽

Unified Framework ◽

Obsessive Compulsive ◽

Behavioural Treatment ◽

Compulsive Disorder ◽

Cognitive Behavioural ◽

Almost All

This study describes the treatment of severe obsessive-compulsive disorder in a 14-year-old male with an experimental single case design. Onset of OCD was at age 12. He had been hospitalized for 6 months the year before consulting. Almost all life spheres were affected by OCD. An initial behavioural intervention, which targeted tooth brushing, was used as a springboard to understand OCD and the process of change was framed within a cognitive account of OCD. The approach was then applied to a number of different targets within a unified framework. There was a 46% reduction in Y-BOCS score at post-treatment and 67% reduction through to 11-month follow-up. Points discussed include the involvement of other professionals, the changing role of the family as treatment progressed and as the patient started to seek more autonomy, and the choice of the initial target.

Download Full-text