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Resumen En el presente estudio ha sido utilizado un diseño de línea base (A-B) con conductas múltiples para evaluar la efectividad de un procedimiento de exposi-ción in-vivo con prevención de respuesta (EPR) en un caso de obsesiones intesti-nales (OI) en un varón con 19 años. Los objetivos que se buscan con el presente caso clínico son tanto descriptivos, a través de la realización de un análisis fun-cional exhaustivo, como de comprobación de eficacia terapéutica. Para la eva-luación de resultados fueron utilizados registros simultáneos de diversas con-ductas objetivo (p.e tiempo de espera ante la exposición, duración de la expo-sición, metros de distancia respecto al centro hospitalario). El tratamiento (EPR), realizado bajo internamiento, consistió en 21 sesiones en las que se aplicó un procedimiento de exposición con prevención de respuesta. Nuestros resultados indicaron que un procedimiento de EPR mostraba ser eficaz en este paciente con IO y redujo notablemente sus conductas de evitación y ansiedad ante las distintas situaciones. PALABRAS CLAVE: Obsesiones intestinales, trastorno obsesivo-compulsivo, terapia cognitivo-conductual, diseño de caso único. Abstract In this study, a baseline design (A-B) with multiple behaviors was applied to assess the effectiveness of exposure plus response prevention (ERP) techniques for approaching a case of bowel obsession (BO) in a 19 year-old male. The aim of describing this single case was twofold: to report on a functional analysis of this mental disorder and to assess the degree of effectiveness after using such an approach. For the assessment, simultaneous monitoring included several target behaviors (e.g. waiting time before exposure, duration of exposure, distance from Correspondencia: Susana Jiménez Murcia, Coordinadora de Psicología, Servicio de Psiquiatría, Hospital Universitario de Bellritge, C/ Feixa Llarga s/n, 08907, Barcelona (España).

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[review] a number of suggested dimensions of anxiety from various levels of analysis / [present] data on the core clinical dimensions that seem to run across the anxiety disorders, specifically the broad-based phenomena of panic, general anxiety, and the avoidance, cognitive, and somatic dimensions that characterize, in greater or lesser degree, the various anxiety disorders the reliability of DSM-III [Diagnostic and Statistical Manual of Mental Disorders-III] / anxiety disorders categories / co-morbidity studies (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Behavioral interventions encompassing imaginal flooding, response prevention, graduated exposure and relaxation were used to treat two patients with persistent, disabling bowel obsessions. The cases illustrate the successful treatment of this condition and provides data bearing on the phenomenology of the syndrome including its relationship to panic and obsessional disorders.
This report describes a self-control treatment of an adolescent with a highly unusual and severely debilitating phobia of having bowel movements in public. The treatment focused predominantly on helping the adolescent to modify his maladaptive thinking and also included role plays, graduated exposure, and homework assignments. Multimethod and multisource assessment data were collected as well as measures of social validity. Treatment gains were maintained at 3 and 6 months follow-up.
The authors report on four patients with disabling bowel obsessions who responded to tricyclic antidepressant medication despite the absence of depressive symptoms. The relationship of this symptom constellation to DSM-III obsessive-compulsive disorder and social phobia is discussed.
Bowel obsessions have long been recognized in clinical settings, usually presenting as an overwhelming fear of losing bowel control in public. Conceptual issues with regard to this disorder have hampered treatment efforts. For example, disagreement exists as to its proper classification within the spectrum of anxiety disorders: it has been conceptualized both as a variant of obsessive-compulsive disorder and as a symptom of social phobia, panic disorder, and agoraphobia. In addition, the comorbidity of bowel obsessions and functional bowel disorders such as irritable bowel syndrome is not understood. While reports of pharmacological intervention exist, little has been written about psychological treatment techniques. This paper uses two cases studies of successful behavioral treatment of bowel obsessions as illustrations to address the above issues.
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