The Wiley Handbook of Obsessive Compulsive Disorders (eBook)
John Wiley & Sons (Verlag)
978-1-118-89025-7 (ISBN)
- Provides the most complete and up-to-date information on the highly diverse spectrum of OCD-related issues experienced by individuals through the lifespan and cross-culturally
- Covers OCD-related conditions including Tourette's syndrome, excoriation disorder, trichotillomania, hoarding disorder, body dysmorphic disorder and many others
- OCD and related conditions present formidable challenges for both research and practice, with few studies having moved beyond the most typical contexts and presentations
- Includes important material on OCD and related conditions in young people and older adults, and across a range of cultures with diverse social and religious norms
Jonathan S. Abramowitz is Professor and Associate Chair of Psychology, at the University of North Carolina at Chapel Hill. He serves as the Director of Anxiety and Stress Disorders Clinic at UNC-Chapel Hill. Dr. Abramowitz has received multiple grants and awards for his research and contributions to the field of OCD and anxiety disorders, and has authored more than 250 articles, book chapters, and books.
Dean McKay is Professor in the Department of Psychology, Fordham University and former President of the Association for Behavioral and Cognitive Therapies (ABCT). Dr. McKay has published over 170 articles and book chapters, and edited or co-edited 14 books related to the treatment of complex cases in children and adults, OCD, disgust in psychopathology and research methodology.
Eric A. Storch is Professor and All Children's Hospital Guild Endowed Chair in the Departments of Pediatrics, Psychiatry and Behavioral Neurosciences, and Psychology at the University of South Florida. Dr. Storch has published 12 books and over 450 articles and chapters on topics relating to the nature and treatment of childhood and adult OCD, anxiety disorders, and anxiety among youth with autism.
The Wiley Handbook of Obsessive Compulsive Disorders, 2 volume set, provides a comprehensive reference on the phenomenology, epidemiology, assessment, and treatment of OCD and OCD-related conditions throughout the lifespan and across cultures. Provides the most complete and up-to-date information on the highly diverse spectrum of OCD-related issues experienced by individuals through the lifespan and cross-culturally Covers OCD-related conditions including Tourette s syndrome, excoriation disorder, trichotillomania, hoarding disorder, body dysmorphic disorder and many others OCD and related conditions present formidable challenges for both research and practice, with few studies having moved beyond the most typical contexts and presentations Includes important material on OCD and related conditions in young people and older adults, and across a range of cultures with diverse social and religious norms
Jonathan S. Abramowitz is Professor and Associate Chair of Psychology, at the University of North Carolina at Chapel Hill. He serves as the Director of Anxiety and Stress Disorders Clinic at UNC-Chapel Hill. Dr. Abramowitz has received multiple grants and awards for his research and contributions to the field of OCD and anxiety disorders, and has authored more than 250 articles, book chapters, and books. Dean McKay is Professor in the Department of Psychology, Fordham University and former President of the Association for Behavioral and Cognitive Therapies (ABCT). Dr. McKay has published over 170 articles and book chapters, and edited or co-edited 14 books related to the treatment of complex cases in children and adults, OCD, disgust in psychopathology and research methodology. Eric A. Storch is Professor and All Children's Hospital Guild Endowed Chair in the Departments of Pediatrics, Psychiatry and Behavioral Neurosciences, and Psychology at the University of South Florida. Dr. Storch has published 12 books and over 450 articles and chapters on topics relating to the nature and treatment of childhood and adult OCD, anxiety disorders, and anxiety among youth with autism.
Volume 1 3
Title Page 5
Copyright Page 6
Contents 7
List of Contributors 10
Obsessive-Compulsive and Related Disorders: Where Have We Been? 15
References 17
Chapter 1 Description and Prevalence of OCD in Children and Adolescents 19
Diagnosis 20
Symptomology 23
Comorbidity 26
Prevalence 27
Course 30
Summary 31
References 32
Chapter 2 Diagnostic Description and Prevalence 38
Symptom Presentation 38
Cultural Differences 39
Diagnostic Changes in DSM 5 39
Symptom Presentation Summary 41
Prevalence and Comorbidity 41
Psychological Comorbidities 41
Summary of Prevalence and Comorbidity 44
Risk Factors for the Development of OCD 45
Environmental Risk Factors 45
Genetic Risk Factors 46
Summary of Risk Factors for the Development of OCD 47
Impairment and Quality of Life in OCD 47
Predictors of Impairment 47
Areas of Impairment 48
Summary of Impairment and Quality of Life in OCD 50
Conclusion 50
References 50
Chapter 3 Description and Prevalence of OCD in the Elderly 58
Prevalence of OCD in the Elderly 58
Late-Onset OCD 60
Presentation in Late Life 61
Assessment 62
Psychotropic Interventions 63
Empirically-based Psychotherapeutic Interventions 64
Treatment Considerations 66
Summary 66
References 67
Chapter 4 Cross-Cultural Phenomenology of Obsessive-Compulsive Disorder 70
Introduction 70
OCD in Non-Hispanic Whites/European Americans & Western Cultures
OCD in African Americans 72
OCD in Western Christian Samples 73
OCD in Jewish Communities 74
OCD in Middle Eastern Islamic Cultures 75
OCD in India 76
OCD in Indonesia 77
OCD in East Asia 78
OCD in Africa 80
OCD in Hispanic and South American Samples 81
Discussion 82
Religious Differences 82
Regional Differences 83
Similarities in Symptoms 83
Conclusions 83
References 84
Chapter 5 Diagnostic Assessment and Measures of Symptom Severity for OCD in Adults 89
Overview 89
The Challenges of OCD 90
Heterogeneity 90
Dimensionality 95
Insight/Data Source 98
Formats 99
Omnibus Interviews 99
Stand-alone OCD Interviews 100
Questionnaires 100
Behavioral Measures 101
Measurement of Related/Ancillary Constructs 102
Related Conditions 102
Obsessive-Compulsive Cognitions 103
Issues of Diversity, Sex, and Culture 103
Previous Reviews 104
Conclusions 105
References 105
Chapter 6 Measures for Diagnosing and Measuring Severity of OCD Symptoms in Children 109
Screening for OCD 110
OCD-Specific Screening Measures 118
Other Measures 118
Diagnosing OCD 118
Structured Interviews 119
Unstructured Clinical Interview 121
Assessing OCD Severity and Impairment 121
Clinician-administered 122
Child/Parent Report 123
Assessing Family Accommodation and Family Functioning 125
Assessment Tools 126
Functional Assessment 127
Clinical Considerations for Using OCD Measures with Children and Adolescents Developmental Considerations 128
Differential Diagnoses 130
Conclusions 132
References 133
Chapter 7 Functional Assessment 138
Adam’s Presenting Symptoms 138
Parameters of the Functional Assessment 139
Review of Recent Episodes 139
Identifying External Triggers 140
Identifying Obsessional Thoughts 141
Identifying Feared Consequences and Dysfunctional Beliefs 143
Identifying Responses to Obsessional Anxiety 145
Self-Monitoring 148
Practical Considerations 149
Functional Assessment for Evaluating Treatment 150
Conclusions 150
References 150
Chapter 8 Assessment of Cognitive Distortions and Cognitive Biases 152
Questionnaires Assessing Cognitive Distortions in OCD 153
Obsessive Beliefs Questionnaire (OBQ) 153
Using the OBQ in Clinical Practice 155
Interpretation of Intrusions Inventory (III) (OCCWG, 1997, 2001) 156
Use of the III in Clinical Settings 156
Thought–Action Fusion Scale (TAFS) (Shafran, Thordarson, & Rachman, 1996)
Not Just Right Experiences Questionnaire (NJRE-Q-R) (Coles, Frost, Heimberg, & &
Clinical use of the NJRE-Q-R 158
Metacognitive Questionnaires 159
Insight and Conviction of Beliefs 161
Clinical Use of Measures of Insight 162
Concluding Remarks 163
References 164
Chapter 9 A Critical Review of Neuropsychological Functioning and Heterogeneity in Individuals with Obsessive-Compulsive Disorder 169
Executive Functioning 169
Set-shifting 170
Inhibition 171
Planning 171
Performance Monitoring 172
Anatomical Abnormalities 172
Memory 174
Generalized Memory 174
Nonverbal Memory 174
Executive Function in Memory 175
Meta-Memory 176
Visuospatial Abilities 177
Attention and Processing Speed 178
Heterogeneity in Neuropsychological Findings 179
Conclusions and Future Directions 181
References 182
Chapter 10 An International Perspective on Obsessive-Compulsive Disorder Assessment 190
Introduction 190
Screening Instruments 190
Diagnostic Instruments 191
Measures of Symptoms and Severity 191
Clinician-administered Measures of Severity 195
Self-report Questionnaires 197
Assessment in Children and Adolescents 207
Measures of OCD-related Phenomena 210
Summary 212
References 213
Chapter 11 Using Objective Personality Assessment for Effective Treatment Planning 223
Symptom Checklist-90: Revised and Brief Symptom Inventory 224
Brief Symptom Inventory 225
The Minnesota Multiphasic Personality Inventory 226
The Millon Inventories 228
Five-Factor Model Assessment 230
A Brief Note on Projective Measures 232
Conclusions 233
References 233
Chapter 12 Psychological Models and Treatments of OCD for Adults 237
Behavioral Theory and Therapy for OCD 237
Behavioral Model 237
Behavioral Therapy Overview 238
Empirical Evidence 240
Case Study: Ellen 241
Cognitive Theory and Therapy for OCD 244
Cognitive Model 244
Belief Systems 244
Cognitive Therapy Overview 246
Empirical Support 247
Case Example 248
Acceptance and Commitment Therapy (ACT) for OCD 249
ACT Model 249
Acceptance 249
Defusion 249
Values 250
Self as Context 250
Contact with the Present Moment 250
Committed Action 250
ACT Therapy Overview 251
Empirical Support 252
Case Example 252
Conclusion 253
References 254
Chapter 13 Psychological Models and Treatments for OCD in Children 258
Emotional Processing 258
Cognitive Biases 259
Trauma and Stressful Events 260
Cognitive Theories 261
Perfectionism 261
Thought Suppression 262
Excessive Responsibility 263
Thought–Action Fusion 264
Intolerance of Uncertainty 265
Family Model of OCD 265
Treatment 266
Individual and Group Cognitive?Behavioral Treatment 266
Family-based Behavior Therapy 267
Meta-Analyses 267
Conclusions 267
References 267
Chapter 14 Biological Models and Treatments for OCD in Adults 275
Biological Models 275
Neuroanatomy and Neurocircuitry 276
Neurotransmitters/Neurochemicals 278
Genetic 278
Autoimmune and Other Medical Causes 279
Biological Treatments 279
Monotherapy 280
Treatment Trials and Duration 284
SRI Augmentation 285
Somatic and Other Treatments 286
Other Practical Aspects 286
Maintenance/Discontinuation 287
Conclusion 287
References 287
Chapter 15 Neurobiological and Neurodevelopmental Perspectives on OCD and their Clinical Implications 297
OCD Phenomenology and Neurobiology 297
Goal-directed Behaviors 298
OCD: A Disorder of the Goal-directed Behavioral System 299
Developmental Disorders 299
Current Findings in the Neurobiology of Pediatric OCD 300
Comorbidity 302
Course of Pediatric OCD 302
Conclusion 302
Implications for Treatment 303
Treatment 303
Autism Spectrum Disorders 310
Aggressive Behavior 313
How to Organize Clinics 314
Conclusion 315
References 315
Chapter 16 Pharmacological Augmentations of SRIs for Obsessive Compulsive Disorder 325
Antipsychotic Augmentations 326
Atypical Antipsychotics 327
Typical Antipsychotics 329
Serotonergic Agents 330
Glutamatergic Agents 332
Other Agents 335
Final Notes 338
References 348
Chapter 17 Contamination Fear and Avoidance in Adults 355
Nature of Contamination Fear 355
Concerns with Harm to Self 356
Underlying Cognitive-Behavioral Features 357
Cognitive Avoidance 357
Emotional Concomitants 359
Treatment Approaches 360
Conclusions and Future Directions 361
Managing Disgust versus Fear 362
Social Challenges 362
References 363
Chapter 18 Contamination Concerns in Children and Adolescents 366
Contamination Symptoms 366
Triggers 366
Fears 367
Avoidance 367
Compulsions 368
Assessment Considerations for Contamination 369
Mental Compulsions 369
Disgust 369
Sensory Symptoms 370
Family Accommodation 370
Treatment Considerations 370
Modifying Contamination Levels 371
Modifying Compulsions 371
Modifying Parental Behaviors 372
Targeting Thoughts 372
Disgust 372
Conclusion 373
References 373
Chapter 19 Responsibility, Checking, and Reassurance-seeking in OCD 375
Role of Inflated Responsibility Beliefs and Appraisals in OCD Onset and Maintenance 375
Psychological Theories of Compulsive Checking in OCD 377
Psychological Theories of Reassurance-Seeking 380
Existing Treatment Frameworks for OCD 381
Targeted Interventions for Responsibility, Checking, and Reassurrance Seeking 383
Conclusion 385
References 386
Chapter 20 Harm Avoidance and Checking Rituals in Pediatric Obsessive Compulsive Disorder 391
Harm Avoidance and Checking Rituals as a Clinical Subtype 391
Clinical Characteristics Relevant to the Harm Avoidance and Checking Subtype 393
Assessment of Harm Avoidance and Checking Rituals 394
Treatment 395
Developmental Considerations in Assessment and Treatment of Harm Avoidance and Checking Rituals 397
Assessing for Associated Symptoms 397
Age and Cognitive Development 398
Treatment Considerations 399
Safety 399
The Role of the Family 400
The Role of the Clinician 400
Illustrative Case Examples 400
Maria 401
Justin 402
Treatment for Maria and Justin 403
Concluding Remarks 405
References 405
Chapter 21 Symmetry, Ordering, and Arranging Symptoms in Adults 409
Descriptive Psychopathology 409
Clinical Features 409
Age of Onset 410
Co-occurrence with Other Forms of Psychopathology 410
Differential Diagnosis 411
Biopsychosocial Etiology 411
Genetic and Environmental Factors 411
Motivational Factors 412
Neurocircuitry 412
Treatment 413
Treatment Efficacy Studies 413
Cognitive-Behavioral Interventions 413
Conclusion 415
References 416
Chapter 22 Symmetry and Ordering in Youth with Obsessive Compulsive Disorder 419
Clinical Presentation 419
Case Vignettes 420
Clinical Correlates 421
Diagnostic Considerations and Comorbidities 422
Developmentally Normative Behaviors 422
Overlap with Autism Spectrum Disorders 423
Overlap with Tic Disorders 423
Treatment 424
Pharmacological Treatment 424
Psychological Treatment 425
Applying CBT to Symmetry/Ordering Symptoms 426
Case Vignettes: Illustration of Treatment 427
Clinical Issues and Troubleshooting 429
References 430
Chapter 23 Repugnant Obsessions: Phenomenology, Etiology, and Treatment 435
Phenomenology 436
Prevalence and Cultural Differences 437
Clinical Severity, Comorbidity, and Symptom Differentiation 437
Conceptual Models of Repugnant Obsessions 438
Cognitive Appraisal of Repugnancy 438
Self-Construal Theory 440
Autogenous Obsessions 442
Treatment Outcome 443
Cognitive Behavioral Case Formulation 443
Concealment 444
Egodystonicity 445
Thought–Action Fusion (TAF) – Morality 445
Importance/Control of Thoughts 446
Reasoning Errors 447
Heightened Selfhood Sensitivity 447
Feared Self 448
Cognitive Behavior Treatment: Special Considerations 448
Imaginal Exposure 448
Neutralization Prevention 449
Cognitive Restructuring: Normalization 450
Cognitive Restructuring: Self-construal Modification 450
References 451
Chapter 24 Unacceptable Obsessional Thoughts in Children and Adolescents 455
Phenomenology 456
Aggressive Obsessions 456
Sexual Obsessions 457
Religious and Moral Obsessions 457
Clinical Features of Youth Who Experience Aggressive, Sexual or Religious Obsessions 458
Assessment of Aggressive, Sexual, and Religious/Moral Obsessions in Youth 459
Methods of Assessment 459
Assessment Challenges and Considerations with Youth 461
Treatment 463
Types of Exposure Tasks 463
Role of Family 465
References 466
Chapter 25 Mental Contamination 471
Forms of Contamination 472
Case Illustration of Mental Contamination 472
Current Evidence 476
Phenomenology 476
Associations with Psychopathology 478
Assessment of Mental Contamination 479
Treatment of Mental Contamination 479
A Case Illustration of the Treatment of Mental Contamination 482
Conclusions and Future Research 483
Acknowledgments 485
References 485
Chapter 26 Obsessive-Compulsive Problems in Very Young Children 488
Phenomenology of Obsessive-Compulsive Problems in Very Young Children 489
Assessment of Obsessive-Compulsive and Related Problems in Very Young Children 491
OCD and Related Disorders in Very Young Children 493
Impact of OCD 494
Family Accommodation 494
Treatment of Obsessive-Compulsive Problems in Very Young Children 495
Expanding the Reach of Family-based CBT for OCD in Very Young Children 498
Conclusions 499
References 500
Chapter 27 Insight in Obsessive-Compulsive Disorder 506
Clinical Characteristics and Phenomenology 507
Demographic Variables 507
Familial Variables 508
Functional Impairment 509
Association with OCD Symptoms 510
OCD Symptom Onset and Chronicity 510
OCD Symptom Severity 510
OCD Symptom Dimensions 511
Impact of Comorbidities 511
Neuropsychological/Neurobiological Implications 513
Assessment of Insight 514
Impact of Insight on Assessments 514
Measures to Assess Levels of Insight 515
Treatment Implications 517
Pharmacotherapy 517
Cognitive-Behavioral Therapy 518
Combination Treatment 518
Conclusion 519
References 519
Chapter 28 Postpartum Obsessive-Compulsive Disorder 525
Clinical Presentation 525
Description of Symptoms 525
Comorbidity 527
Case Vignette 528
Prevalence 529
Prenatal OCD Prevalence 529
Postpartum OCD Prevalence 529
Theoretical Models 530
Biological Models 530
Cognitive-Behavioral Models 530
Treatment 531
Pharmacological Treatment 532
Psychological Treatment 533
Case Illustration 535
Special Considerations 537
Summary and Conclusions 538
References 538
Chapter 29 Understanding and Treating Scrupulosity 541
Religion and OCD 542
Conceptualizations of Scrupulosity 543
Cognitive-Behavioral Model 543
Existential and Self-threat 544
Treatment of Scrupulosity 545
Treatment Outcome 545
Overall Treatment Approach 545
ERP Modified 546
Summary 556
Acknowledgment 556
References 557
Chapter 30 Assessment and Treatment of Relationship-Related OCD Symptoms (ROCD): A Modular Approach 561
Development and Maintenance Mechanisms in ROCD 562
Self-vulnerabilities in ROCD 563
Maladaptive Beliefs in ROCD 564
Attachment Insecurities and ROCD 565
Compulsive Behaviors and ROCD Symptoms 565
Relational Commitment and ROCD 566
ROCD: Assessment and Treatment 566
Psychoeducation and Case Formulation 567
Symptom Evaluation and Monitoring 569
ROCD and Maladaptive Beliefs 570
ROCD-related Self-vulnerabilities 572
ROCD and Attachment Insecurities 573
ROCD and Relational Commitment 575
Concluding Remarks 576
References 576
Chapter 31 Exposure Therapy 579
How Does ERP Work? 580
Implementing ERP 581
Psychoeducation and Presenting the Treatment Rationale 581
Devising an Exposure Task List 582
Types of Exposure 582
Response Prevention 585
Out of Session Exposures 585
Ending an Exposure Task 586
Concluding Treatment 587
Termination and Relapse Prevention 587
How Effective is ERP? 588
Barriers to Treatment Success 589
Client Factors 589
Therapist Factors 590
Conclusions and Future Directions 590
References 591
Chapter 32 Cognitive Therapy for Obsessive-Compulsive Disorder 595
Overview of Cognitive Therapy for OCD 595
Psychoeducation about the Cognitive Model 596
Strategies for Addressing Cognitive Domains 598
Overimportance of Thoughts and Need to Control Thoughts 598
Overestimation of Threat and Inflated Responsibility 601
Need for Certainty and Perfectionism 603
Concealment 605
Review of the Treatment Outcome Studies on Cognitive Therapy 606
Conclusions 607
References 607
Chapter 33 Acceptance and Commitment Therapy for OCD 610
Functional Contextualism 610
Foundations in Basic Science 611
Behavior Analysis 611
Relational Frame Theory 611
Rule-governed Behavior 612
Processes of Change and Middle-Level Terms 613
Data Supporting ACT and ACT Components 615
ACT as a Unified Model 615
Processes of Change 615
Psychological Flexibility 616
Data Supporting ACT for OCD 616
The ACT Approach to Clinical Practice 617
ACT as a Treatment for OCD 617
Initial Sessions: Setting Up Treatment 618
Sessions 3–7: Acceptance, Defusion, Present Moment Awareness, Self as Context, and Committed Action 620
Session 8: Values and Larger Behavioral Commitments 623
Exposure from an ACT Perspective 624
Conclusions 624
References 625
Chapter 34 Family-Based Conceptualization and Treatment of Obsessive-Compulsive Disorder 628
The Impact of OCD on Family Members 629
Impact of OCD on Parents 629
Impact of OCD on Siblings 629
Difficult Child Behaviors Associated with OCD 630
Summary 630
Family Accommodation 631
Summary 632
Additional Family Factors Implicated in OCD 632
Parenting Style 632
Parenting Style and OCD 632
Expressed Emotion 633
Family Environment 634
Summary 635
The Importance of a Family-based Conceptualization 636
Family-based Treatment of OCD 636
Do Clinical Practice Guidelines Recommend Family Involvement in CBT? 636
How and Why are Families Involved in CBT? 637
Does Involving Families in CBT for OCD Enhance Outcomes? 638
Other Family-based Interventions for OCD 639
Summary 640
References 640
Chapter 35 An Interpersonal Perspective on the Conceptualization and Treatment of OCD 646
The Nature of OCD 646
OCD from the Individual’s Perspective 646
OCD from an Interpersonal Perspective 647
Treatment of OCD from an Interpersonal Perspective 649
Assessment of Symptom–System Fit 651
Psychoeducation 652
Partner-assisted Exposure 652
Reducing Accommodation 653
General Couple Therapy 654
Case Examples 654
Lauren 654
Conclusions 656
References 656
Chapter 36 Metacognitive Model and Treatment of OCD 658
The Metacognitive Model of OCD 658
Metacognitive Therapy (MCT) 660
MCT for Children and Adolescents 665
Developmental Adaptations of MCT 665
Family-oriented Interventions 667
Empirical Support for the Metacognitive Model of OCD 667
The Metacognitions Questionnaire 667
Thought–Fusion Beliefs 668
Metacognitive versus Non-metacognitive Beliefs 670
Evidence of Treatment Efficacy 671
Conclusion 673
References 673
Chapter 37 Computer-Aided Interventions for Obsessive-Compulsive Spectrum Disorders 677
What are CCBT and ICBT? 678
CCBT for ADULTS with OCD 679
Cost-effectiveness of CCBT for Adult OCD 680
Predictors and Moderators of Treatment Response in CCBT 680
ICBT for Adults with OCD 680
Efficacy of ICBT in Adults with OCD 681
Long-term Efficacy OF ICBT and Additional Effects by Adding an Internet-based Booster 683
Cost-effectiveness of ICBT for Adults with OCD 684
Predictors and Moderators of ICBT for Adults with OCD 684
ICBT for Youths with OCD 684
CCBT and ICBT for OC-related Disorders 686
Summary and Future Directions 688
Acknowledgements 690
References 690
Chapter 38 Neurosurgical Treatments for Obsessive Compulsive Disorder 695
Neurocircuitry of Obsessive-Compulsive Disorder 696
Candidate Selection for Neurosurgery for OCD 697
Stereotactical Neurosurgery 698
Anterior Cingulotomy 698
Anterior Capsulotomy 699
Subcaudate Tractotomy 699
Limbic Leukotomy 699
Deep Brain Stimulation 700
Anterior Limb of Internal Capsule and Ventral Capsule/Ventral Striatum 700
Unilateral Nucleus Accumbens 702
Subthalamic Nucleus 702
Inferior Thalamic Peduncle 702
DBS Programming 703
Conclusion 704
References 705
Volume 2 711
Title Page 713
Copyright Page 714
Contents 715
List of Contributors 718
Chapter 39 Obsessive Compulsive Disorder and Comorbidity: Rates, Models, and Treatment Approaches 723
Section 1: Patterns of Psychiatric Comorbidity in OCD 724
Comorbidity between OCD and Related Disorders in DSM-5 724
Epidemiological and Clinical Estimates of Psychiatric Comorbidities in OCD 725
The Timing of Comorbid OCD and Mood Disorders 727
Models of Comorbidity 728
Biological Models of Comorbidity 728
Personality Models of Comorbidity 730
Cognitive Models of Comorbidity 730
Section II: Treatment of Comorbidity in OCD 732
Exposure and Response Prevention (ERP) for OCD and Depression 732
Cognitive Therapy for OCD and Depression 736
Pharmacotherapy of Comorbid OCD and MDD 736
Other Comorbidities and CBT for OCD 737
Integrative Approaches to Treating Comorbidity 737
Transdiagnostic Approaches to Treating Comorbidity 738
Sequential Delivery of Disorder?Specific Approaches for OCD and Comorbid Conditions 738
Clinical Case 739
Summary 742
Conclusions 743
Acknowledgements 743
References 743
Chapter 40 Obsessive Compulsive Personality Disorder 752
Phenomenology 752
Diagnostic Criteria 752
Prevalence 755
Course 755
Relationship to OCD 756
Other Psychiatric Comorbidity 757
Impairment 758
Treatment Utilization 758
Etiological and Conceptual Models 759
Biological Models 759
Psychological Models 760
Treatment 761
Medication 761
Psychodynamic Psychotherapy 762
Cognitive Therapy 762
Alternative Psychotherapies 763
Conclusions and Directions for Future Research 763
References 764
Chapter 41 Pediatric Acute-onset Neuropsychiatric Syndrome 769
Group A Streptococcus 770
Sydenham’s Chorea 771
Sudden Onset OCD: The Birth of PANDAS 773
Does PANDAS Exist? Does GAS cause PANDAS? 774
Evidence for a Causal Relationship between GAS and PANDAS 774
Evidence that PANDAS is Caused by an Autoimmune Reaction 776
Characterizing PANDAS Patients 777
Symptoms 777
Neuropsychological Functioning 778
Neurology 778
Family History 779
CANS, PANS, PANDAS? 779
PANS Assessment 780
Clinical History 780
Evaluation for Current Infections 780
Streptococcal Antibody Tests 780
Consultations 781
Treatment 782
Acute Treatment for GAS Pharyngitis 782
Prophylactic Antibiotics for GAS 782
Tonsillectomy 782
Immunomodulatory Procedures 782
Pharmacotherapy 783
Cognitive Behavior Therapy (CBT) 783
Summary 783
References 784
Chapter 42 Phenomenology of Tourette Syndrome 788
Phenomenology 788
Trajectory 790
Premonitory Urges 790
Impairment 792
Comorbidity 793
Cross-Cultural Presentation 794
Conclusion 795
References 795
Chapter 43 Body Dysmorphic Disorder 800
Clinical Presentation 800
Diagnostic Criteria 803
Epidemiology and Course 804
Differential Diagnostics 805
Comorbidity 806
Impairment 807
Etiology 807
Individualized Etiological Model 809
(Self-)Identification of Individuals with BDD 810
Summary and Outlook 810
References 811
Chapter 44 Phenomenology of Health Anxiety 816
Case Example 816
What is Health Anxiety? 816
Why is Health Anxiety Important? 817
Developmental Perspective 817
Somatic Symptoms are Common 817
Health-related Life Experiences 818
Health Coverage in the Media 818
Health Care Utilization 818
Health Anxiety Cuts across Diagnostic Categories 818
Dimensional versus Categorical Views of Health Anxiety 819
Diagnostic Classification of Health Anxiety 819
Health Anxiety and the Anxiety Disorders 820
Health Anxiety and Mood Disorders 821
Epidemiology of Health Anxiety 822
Historical Accounts of Health Anxiety 823
The Cognitive-behavioral Model of Health Anxiety 824
Internal Triggers 825
External Triggers 825
Illness-related Thoughts 826
Bodily Sensations and Hypervigilance 826
Safety Behaviors 827
Checking and Reassurance?seeking 827
Safety Signals 828
Avoidance of Illness and Death?related Situations 828
Health Anxiety in Children 829
References 829
Chapter 45 Phenomenology of Excoriation (Skin Picking) Disorder 832
Prevalence and Epidemiology 832
Clinical Presentation 833
Comorbidity and Differential Diagnosis 835
Relevant Scales 836
Illustrative Case Study 837
Demographics and Family History 837
Disorder Course 838
Clinical Presentation 839
Summary 840
References 840
Chapter 46 Phenomenology of Trichotillomania 843
Defining the Problem 843
Epidemiology 844
Gender-related Issues 845
Age of Onset/Course 845
Phenomenological Characteristics 846
Topography 846
Tactile Processes and Consequences 846
Affective Precursors and Consequences 847
Styles of Pulling 847
Impairment 848
Comorbidity 849
Cultural Considerations 851
Conclusions 852
References 852
Chapter 47 Phenomenology of Hoarding Disorder 858
Criteria and Associated Features 858
Biological and Etiological Factors 859
Prevalence 860
Age of Onset and Progression of HD Symptoms 861
Reasons for Saving 863
Demographics 864
Age Differences 864
Gender Differences 865
Marital Status 866
Income 867
Psychiatric and Medical Comorbidities 867
Neuropsychological Features 868
Consequences of Hoarding 869
Conclusions 869
References 869
Chapter 48 Obsessive-Compulsive and Related Disorders in Ethnoracial Minorities: Attitudes, Stigma, and Barriers to Treatment 873
Cultural Considerations in African Americans 874
Attitudes about Mental Health 874
Stigma and Shame 875
Barriers to Treatment 875
Help-seeking for OCRDs 876
Cultural Adaptations to Treatment of OCRDs 877
Cultural Considerations in Hispanic/Latino Americans 878
Attitudes about Mental Health 878
Stigma and Shame 879
Barriers to Treatment 880
Help-seeking for OCRDs 880
Cultural Adaptations to Treatment of OCRDs 881
Cultural Considerations in Asian Americans and Indian Americans 882
Attitudes about Mental Health 882
Stigma and Shame 883
Barriers to Treatment 884
Help-seeking for OCRDs 884
Cultural Adaptations to Treatment of OCRDs 885
Cultural Considerations in Native Americans 885
Attitudes About Mental Health 885
Stigma and Shame 886
Barriers to Treatment 886
Help-seeking for OCRDs 887
Cultural Adaptations to Treatment of OCRDs 887
Cultural Considerations in Arab Americans 888
Attitudes about Mental Health 888
Stigma and Shame 888
Barriers to Treatment 889
Help-seeking for OCRDs 890
Cultural Adaptations to Treatment of OCRDs 890
Conclusion 891
References 891
Chapter 49 Diagnostic and Severity Measures for Adults with Obsessive-Compulsive Related Disorders 899
Diagnostic Interviewing 899
Assessing Obsessive-Compulsive Disorder 901
Clinician-administered Interviews 901
Self-Report Symptom Measures 902
Assessing Hoarding Disorder 903
Clinician-administered Interviews 903
Self-report Measures 904
Assessing Trichotillomania 905
Clinician-administered Interviews 905
Self-report Measures 906
Assessing Excoriation Disorder 906
Clinician-administered Interviews 907
Self-report Measures 907
Assessing Body Dysmorphic Disorder 908
Clinician-administered Interviews 908
Self-report Measures 908
Assessing Other Related Disorders 909
Tourette’s Disorder and Other Tic Disorders 909
Health Anxiety 910
Perfectionism 910
Conclusion 911
References 911
Chapter 50 Diagnostic and Severity Measures for Children and Adolescents with Obsessive-Compulsive and Related Disorders 916
Obsessive-Compulsive Disorder (OCD) 916
OCD Symptoms and Diagnosis 917
Assessing OCD Symptom Severity 918
Assessing Impairment, Family Accommodation, and Insight 920
Recommendations for an Evidence-based Assessment 920
Body Dysmorphic Disorder (BDD) 922
BDD Symptoms and Diagnosis 922
Assessing BDD Symptom Severity 923
Assessing Insight 923
Recommendations for an Evidence-based Assessment 924
Hoarding Disorder (HD) 924
HD Symptoms and Diagnosis 924
Assessing HD Symptom Severity 925
Assessing Family Accommodation and Insight 926
Recommendations for an Evidence-based Assessment 926
Hair Pulling Disorder/Trichotillomania (TTM) 926
TTM Symptoms and Diagnosis 927
Assessing TTM Symptom Severity 927
Recommendations for an Evidence-based Assessment 929
Excoriation/Skin Picking Disorder (SPD) 929
SPD Symptoms and Diagnosis 930
Assessing SPD Symptom Severity 930
Recommendations for an Evidence-based Assessment 930
Conclusion 931
References 931
Chapter 51 Functional Assessment of Obsessive-Compulsive Related Disorders 938
Operant Conditioning Principles and OCRDs 939
Conducting a Functional Assessment of OCRD Behaviors 940
Identifying the Target Behavior 941
Collecting Data on OCRD Behaviors 942
Conducting a Functional Assessment 942
Additional Considerations in the Functional Assessment of OCRD Behaviors 945
Treatment Based on Functional Assessment 946
Conclusion 946
References 947
Chapter 52 Assessment of Obsessive-Compulsive Related Disorders from an International Perspective 950
Cultural Competence and Evidence-based Assessment Process 950
Initial Screening 951
Diagnosis Establishment 952
Differential Diagnosis and Comorbidity 952
Rating Symptoms and Severity 953
Examining Functional Impairment 953
Hoarding 953
Tic Disorders and Tourette Syndrome 955
Body Dysmorphic Disorder 956
Trichotillomania 958
Excoriation (Skin Picking) Disorder 959
Summary and Final Considerations 961
References 962
Chapter 53 Psychological Treatment of Tourette Syndrome 967
Overview and Rationale for a Comprehensive Behavioral Intervention for Tics (CBIT) 967
The Early Habit Model of Tics 967
The Integrative Behavioral Model of Tics 968
Components of the CBIT Protocol 970
Psychoeducation 970
Function-based Assessment and Intervention (FBAI) 970
Relaxation Training 973
Habit Reversal Training (HRT) 973
Describing and Prioritizing Target Tics 973
Awareness Training (AT) 974
Competing Response Training (CRT) 977
Habit Control Motivation 979
Generalization Training 980
Evidence Base for HRT and CBIT 980
Overview of Exposure and Response Prevention (ERP) 981
Evidence Base for ERP 982
Common Challenges to Treatment 982
Dissemination and Utilization 982
Choosing Appropriate Treatment Targets 984
Patient and Parent Readiness and Compliance 984
Conclusions 984
References 985
Chapter 54 Treatment of Body Dysmorphic Disorder 988
Nature and Pathogenesis 989
Hypothesized Causes and Correlates 989
Classification and Relation to OCD 990
Conceptualization and Treatment 992
Cognitive-Behavioral Model of BDD 992
Treatment 993
Limitations in Current Treatment 997
Conclusions and Future Directions 998
References 998
Chapter 55 Treatment of Health Anxiety 1003
Conceptual Basis for Contemporary Treatments for Health Anxiety 1003
Efficacy of Treatments 1004
Meta-Analysis of Randomized Controlled Trials 1004
Narrative Review of Treatment Research 1005
Cognitive-Behavior Therapy: Applications and Illustrative Examples 1007
Cognitive Restructuring 1008
Behavioral Exercises 1009
Stress Management Exercises 1009
Attention Retraining, Mindfulness, and Other Approaches 1010
Case Vignette 1010
Conclusion 1013
References 1013
Chapter 56 Psychological Treatment of Excoriation Disorder 1016
Clinical Description 1017
Symptom Presentation 1017
Gender Ratio, Age at Onset, and Course 1017
Distress and Impairment 1017
Assessment 1018
Diagnosing SPD 1018
Assessing Symptom Severity 1019
Functional Assessment 1019
Psychological Treatments 1021
Motivational Enhancement 1021
Habit Reversal Training 1021
Stimulus Control 1023
Cognitive Therapy 1024
Acceptance and Commitment Therapy 1024
Dialectical Behavior Therapy 1025
Relaxation Training 1025
Evidence for Treatment Efficacy 1026
Cognitive-Behavioral Interventions 1026
Other Treatment Approaches 1028
Clinical Recommendations 1029
What Treatment Works? 1029
Issues Regarding Subpopulations 1030
Conclusion and Future Directions 1031
References 1031
Chapter 57 Psychological Treatment of Trichotillomania 1035
Habit Reversal Training 1035
Awareness Training 1036
Self-Monitoring 1037
Competing Response Training 1037
Social Support 1038
Stimulus Control 1038
Acceptance and Commitment Therapy (ACT) 1039
Dialectical Behavioral Therapy (DBT) 1041
Hypnotherapy 1043
Pharmacological Intervention 1044
References 1045
Chapter 58 Psychological Treatment of Hoarding Disorder 1049
Early Attempts to Treat Hoarding 1049
Cognitive-Behavioral Model of Compulsive Hoarding 1050
Core Beliefs and Vulnerabilities 1050
Information Processing Deficits 1050
Beliefs About and Meanings of Possessions 1051
Emotions and their Role in Reinforcing Hoarding Behavior 1051
Insight and Motivation in Hoarding Disorder 1053
Treatment Overview 1055
Treatment Rules 1056
Treating Excessive Acquisition 1056
Sorting and Organizing Skills 1057
Changing Attachments to Possessions 1058
Thought Listing (TL) Exercise 1058
Downward Arrow Exercise 1059
Behavioral Experiments (BEs) 1059
Cognitive Strategies 1060
Extensive Cleanouts 1062
Outcome Research on Treatment for HD 1062
References 1062
Chapter 59 Biological Models and Treatments for Obsessive-Compulsive Related Disorders for Adults 1065
Trichotillomania (Hair Pulling Disorder) and Excoriation (Skin Picking Disorder) 1066
Hoarding Disorder 1068
Body Dysmorphic Disorder 1069
Treatment of OCRD 1070
Medication Treatment with CBT versus CBT Alone 1070
First-line Pharmacological OCRD Treatment 1072
Implementing and Dosing of Meds 1073
Treatment Resistance and Augmentation 1074
Discontinuation vs. Maintenance of SRIs 1080
Summary 1081
References 1081
Chapter 60 Biological Models and Treatments for Obsessive-Compulsive and Related Disorders for Children and Adolescents 1087
Biological Models 1088
Neurotransmitters 1089
Imaging and Neurocircuitry 1090
Genetics 1093
PANDAS/PANS 1097
Biological Treatments 1099
SSRIs 1100
Clomipramine 1101
Antipsychotics 1102
Glutamate-modulating Agents 1104
Miscellaneous Medications 1106
Transcranial Magnetic Stimulation 1106
Deep Brain Stimulation 1107
Pharmacotherapy of Other OCRDs 1107
Summary 1108
References 1108
Chapter 61 The Nature and Management of Older Adults’ Obsessive-Compulsive and Obsessive-Compulsive-Related Disorders 1123
Late-Life Development 1124
The Experience of Obsessive-Compulsive Symptoms and Disorder in Late-Life 1125
Phenomenology and Prevalence of Late-Life Obsessive-Compulsive Disorder 1126
Age at Onset and Late-Life Obsessive-Compulsive Disorder 1128
The Study of Age at Onset of Obsessive-Compulsive Disorder 1128
Can Obsessive-Compulsive Disorder Sometimes Begin in Late-life? 1129
Evaluation and Treatment of Late-Life Obsessive-Compulsive Disorder 1129
Assessment of Late-life Obsessive-Compulsive Disorder 1129
Treatment of Older Adults’ Obsessive-Compulsive Disorder 1131
Compulsive Hoarding in Late-Life 1133
The Developmental Course of Hoarding Disorder 1134
Assessment and Treatment of Late-Life Hoarding Disorder 1135
Assessment of Late-life Hoarding 1135
Psychosocial Treatment of Older Adults with Hoarding Disorder 1137
Chapter Summary 1138
References 1139
Chapter 62 Sensory Phenomena in Obsessive-Compulsive Related Disorders 1145
Clinical Studies 1146
Epidemiological Studies 1149
Neurobiological Studies 1149
Neurochemical Data 1150
Neuroanatomical Data 1151
Genetic Studies 1152
Treatment Studies 1153
Conclusions 1154
References 1154
Chapter 63 Comorbidity in Obsessive-Compulsive and Related Disorders 1159
Comorbidity in Body Dysmorphic Disorder 1160
Comorbidity in Hoarding Disorder 1162
Comorbidity in Trichotillomania (hair pulling disorder) 1165
Comorbidity in Excoriation (Skin Picking) Disorder 1166
Comorbidity in Olfactory Reference Syndrome 1168
Comorbidity in Tourette Syndrome 1168
Conclusion 1171
References 1172
Chapter 64 Emotion Regulation in the Obsessive-Compulsive Spectrum Disorders 1178
Emotion Regulation in OCD 1179
Experiential Avoidance 1180
Treatment Implications 1180
Conclusion 1181
Trichotillomania 1181
Emotion Regulation in TTM 1182
Research on Emotion Regulation in TTM 1182
Experiential Avoidance 1183
Implications for Treatment 1183
ACT 1184
Dialectical Behavior Therapy (DBT) 1184
Summary 1185
Compulsive Skin Picking 1185
Experiential Avoidance 1186
Treatment Implications 1186
Summary 1186
Body Dysmorphic Disorder 1187
Conceptualization 1187
CBT Model of BDD 1188
Emotion Regulation in BDD 1188
Experiential Avoidance 1188
Implications for Treatment 1189
Summary 1190
Hoarding 1190
Conceptualization 1190
CBT Model 1191
Emotion Regulation in HD 1192
Experiential Avoidance 1192
Summary 1193
Conclusion 1193
References 1194
Chapter 65 Acceptance and Commitment Therapy for OC-Spectrum Disorders 1201
Functional Contextualism 1201
Basic Science Behind ACT 1202
Behavior Analysis 1202
Relational Frame Theory 1202
Rule-governed Behavior 1203
Translating from Basic Science to Applied Techniques 1204
Psychological Flexibility 1204
Psychological Flexibility and OC-Spectrum Disorders 1204
The Six Processes of ACT 1205
The ACT Model for Focused and Automatic Behaviors 1205
Tailoring ACT to Specific Areas 1206
ACT for OC-Spectrum Disorders 1207
ACT Protocol for OC-Spectrum Disorders 1208
Therapeutic Themes and Stance 1208
Sessions 1 and 2 1209
Sessions 3 and 4 1210
Sessions 5–7 1211
Session 8 1212
Present Moment 1212
Termination 1212
ACT Enhanced Habit Reversal Training 1213
Special Considerations for Younger Clients 1213
Conclusion 1214
Recommended Resources 1215
References 1215
Chapter 66 Family-based Conceptualization and Treatment of Obsessive-Compulsive Related Disorders 1219
Why a Family-based Approach to Obsessive-Compulsive Related Disorders? 1219
Family Accommodation in OCRD 1220
Compulsive Hoarding 1220
Body Dysmorphic Disorder 1221
Tic Disorders, Skin Picking, and Trichotillomania 1221
Reducing Family Accommodation as a Parent-based Intervention for Childhood Disorders 1221
The Space Program: Treatment Process 1224
Setting the Stage 1224
Mapping Family Accommodation 1224
Identifying a Target Accommodation for Modification 1224
Formulating a Plan for Reducing Accommodation 1224
Implementing the Plan and Troubleshooting 1225
Case Illustration: Reducing Accommodation in Hoarding Disorder 1226
Case Presentation and History 1226
Course of Treatment with SPACE 1227
Summary 1231
References 1232
Index 1234
EULA 1275
| Erscheint lt. Verlag | 12.6.2017 |
|---|---|
| Reihe/Serie | Wiley Clinical Psychology Handbooks | Wiley Clinical Psychology Handbooks |
| Sprache | englisch |
| Themenwelt | Geisteswissenschaften ► Psychologie ► Klinische Psychologie |
| Medizin / Pharmazie ► Gesundheitsfachberufe | |
| Schlagworte | Anorexia nervosa • Asperger Syndrome • Attention Deficit Hyperactivity Disorder • Body dysmorphic disorder • Bulimia nervosa • Clinical psychology • compulsions • dermatillomania • generalized anxiety disorder • Klinische Psychologie • <p>OCD • Mental Health • obsessions • Psychologie • Psychology • Psychotherapie • Psychotherapie u. Beratung • Psychotherapy & Counseling • Social Anxiety Disorder • Tourette Syndrome • trichotillomania</p> |
| ISBN-10 | 1-118-89025-6 / 1118890256 |
| ISBN-13 | 978-1-118-89025-7 / 9781118890257 |
| Informationen gemäß Produktsicherheitsverordnung (GPSR) | |
| Haben Sie eine Frage zum Produkt? |
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