Obsessive-compulsive disorder: Strategies for using CBT and pharmacotherapy

Department of Pediatrics, University of Florida, Gainesville, FL 32610, USA.
The Journal of family practice (Impact Factor: 0.89). 05/2006; 55(4):329-33.
Source: PubMed
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    • "One CBT explanation for the maintenance of OCD symptoms is that the person tends to have difficulties interpreting his or her feelings (Salkovskis, Shafran, Ranchman, & Freeston, 1999; Wahl, Salkovskis, & Cotter, 2008). Storch and Merlo (2006) suggested that OCD can be understood as thought–action fusion, implying that negative thoughts and negative actions are seen as synonymous. In thought–action fusion, individuals may mix up thoughts and reality, such as fearing that dangerous thoughts automatically lead to actions or that forbidden thoughts are as reprehensible as forbidden behavior (Shafran, Thordarson, & Rachman, 1996). "
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    ABSTRACT: Accession Number: 2013-24148-005. First Author & Affiliation: Kullgard, Niclas; Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden. Release Date: 20130729. Publication Type: Journal, (0100); Peer Reviewed Journal, (0110); . Media Covered: Electronic. Document Type: Journal Article. Language: English. Major Descriptor: Obsessive Compulsive Disorder; Symptoms. Minor Descriptor: Reflectiveness. Classification: Neuroses & Anxiety Disorders (3215) . Population: Human (10); Male (30); Female (40); . Age Group: Adulthood (18 yrs & older) (300) Young Adulthood (18-29 yrs) (320) Thirties (30-39 yrs) (340) Middle Age (40-64 yrs) (360) . Tests & Measures: Reflective Function Scale; Symptom-Specific Reflective Function Scale; Yale-Brown Obsessive Compulsive Scale; Adult Attachment Interview; . Methodology: Empirical Study; Interview; Quantitative Study. References Available: Y.. Page Count: 16.. Issue Publication Date: Jun, 2013. Publication History: Accepted Date:
    Psychoanalytic Psychotherapy 06/2013; 27(2-2):154-169. DOI:10.1080/02668734.2013.795909
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    ABSTRACT: Obsessive-compulsive disorder is a common, chronic, and oftentimes disabling disorder. The only established first-line treatments for obsessive-compulsive disorder are exposure and response prevention therapy and the serotonin reuptake inhibitors. Many patients do not experience complete symptom resolution with either modality and require augmentation approaches. Recent animal and clinical data suggest that D-cycloserine, a partial agonist that acts at the strychnine-insensitive glycine-recognition site of the N-methyl-D-aspartate receptor complex, may enhance extinction learning that occurs in exposure-based psychotherapies. Given this, this study examined if D-cycloserine (250 mg) enhances the overall efficacy and rate of change of exposure and response prevention therapy for adult obsessive-compulsive disorder. Participants were 24 adults meeting Diagnostic and Statistical Manual of Mental Disorders-IV criteria for obsessive-compulsive disorder. The study design was a randomized, double-blinded, placebo-controlled augmentation trial examining exposure and response prevention therapy+D-cycloserine versus exposure and response prevention therapy+placebo. All patients received 12 weekly sessions of exposure and response prevention treatment. The first session involved building a ritual hierarchy and providing psychoeducation about obsessive-compulsive disorder. The second session involved a practice exposure. Sessions 3-12 involved exposure and response prevention exercises. D-cycloserine or placebo (250 mg) was taken 4 h before every session. No significant group differences were found across outcome variables. The rate of improvement did not differ between groups. The present results fail to support the use of D-cycloserine with exposure and response prevention therapy for adult obsessive-compulsive disorder. As this study is the first to explore this question and a number of methodological issues must be considered when interpreting the findings, the conclusions that may be drawn from our results are limited.
    International Clinical Psychopharmacology 08/2007; 22(4):230-7. DOI:10.1097/YIC.0b013e32819f8480 · 2.46 Impact Factor
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    ABSTRACT: Obsessive Compulsive Disorder (OCD) involves exaggerated or excessive worry about threatening and non-threatening stimuli coupled with impairing rituals believed to reduce anxiety. Autism Spectrum Disorders (ASD) are characterized by impairment in social and communicative activities as well as restricted and repetitive behaviors. Approximately 2% of children with ASD are also diagnosed with OCD. Although there is extensive research demonstrating the effectiveness of behavioral interventions for pediatric OCD, little is known about how effective these treatments are for children who have a dual diagnosis of OCD and ASD. This report describes a 12-year-old male with Autism who was treated successfully with cognitive behavioral therapy with exposure and response prevention. This case study provides initial support that cognitive-behavioral therapy is effective in symptom reduction for children with comorbid autism and OCD.
    Journal of Autism and Developmental Disorders 10/2007; 38(5):977-81. DOI:10.1007/s10803-007-0457-2 · 3.34 Impact Factor
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