The Unified Protocol for Obsessive-Compulsive and Related Disorders

2017 ◽  
pp. 53-66
Author(s):  
Johanna Thompson-Hollands
Keyword(s):  
Emotional Disorders ◽  
Obsessive Compulsive Disorder ◽  
Cognitive Reappraisal ◽  
Family Members ◽  
Intrusive Thoughts ◽  
Obsessive Compulsive ◽  
Transdiagnostic Treatment ◽  
Compulsive Disorder ◽  
Unified Protocol

The case of a 25-year-old male with obsessive-compulsive disorder (OCD) is presented in this chapter. The patient, “Luke,” had primary obsessions related to harm befalling his family and girlfriend, as well as fears of contamination. His primary compulsions included mental “undoing,” in his words, and repeating actions. He engaged in significant avoidance around potential contaminants. The text reviews Luke’s course of treatment with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), including the application of each treatment module and attention to challenging issues that arose in this case. Specific attention is devoted to the use of cognitive reappraisal in the UP for OCD, managing symptom accommodation by family members, and exposure in the context of intrusive thoughts and mental rituals.

The Unified Protocol for Complex, Highly Comorbid Cases

2017 ◽  
pp. 231-251
Author(s):  
Heather Murray Latin ◽  
Clair Cassiello-Robbins
Keyword(s):  
Emotional Disorders ◽  
Clinical Settings ◽  
Obsessive Compulsive ◽  
Transdiagnostic Treatment ◽  
Compulsive Disorder ◽  
Hyperactivity Disorder ◽  
Unified Protocol ◽  
Evidence Based Treatments ◽  
Transdiagnostic Factors ◽  
High Comorbidity

Given the high comorbidity rates among the emotional disorders, effective evidence-based treatments need to be able to address the presence of comorbid disorders in an integrated fashion. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was created in part to address the comorbidity often seen in clinical settings and may be uniquely suited to do so, given its emphasis on transdiagnostic factors that contribute to the development and maintenance of emotional disorders (i.e., experience of strong negative emotions, aversive reactions to these emotions, and attempts to avoid or suppress these experiences). This chapter illustrates the use of the UP with a patient who presented with panic disorder, agoraphobia, generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), major depressive disorder (MDD), and other specified attention deficit hyperactivity disorder (ADHD). This case is used to illustrate the application of the UP transdiagnostic framework to a case with extensive comorbidity.

Obsessive-Compulsive Disorder and Tic Disorder/Tourette Syndrome

2021 ◽  
pp. 41-60
Author(s):  
Ashley M. Shaw ◽  
Elizabeth R. Halliday
Keyword(s):  
Randomized Controlled Trial ◽  
Emotional Disorders ◽  
Obsessive Compulsive Disorder ◽  
Tourette Syndrome ◽  
Controlled Trial ◽  
Habit Reversal ◽  
Obsessive Compulsive ◽  
Tic Disorder ◽  
Transdiagnostic Treatment ◽  
Compulsive Disorder

The Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A) have clinical relevance for youth with obsessive-compulsive disorder (OCD) and Tourette syndrome, particularly when comorbid anxiety and depression are present. Within this population, the UP-C/A can be applied either as standalone interventions or in conjunction with exposure and response prevention or habit reversal techniques. However, their efficacy and utility in these populations have never been examined in a randomized controlled trial. This chapter outlines recommendations for how to apply the UP-C/A to youth with OCD and related disorders. For example, applying module content in a flexible order is recommended, such as generating a list of emotional behaviors early in treatment, and checking in about opposite actions throughout treatment. Introducing nonjudgmental awareness and exposures early in treatment is also recommended.

OCD

2018 ◽  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Intrusive Thoughts ◽  
Repetitive Behaviours ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

People with Obsessive Compulsive Disorder (OCD) experience unpleasant and intrusive thoughts, images, doubts or urges (called obsessions) and repetitive behaviours (called compulsions). Compulsions are usually carried out as a way of reducing the distress caused by obsessions. OCD takes many different forms and causes distress and interference to day-to-day life. 

The Role of Family Members in the Maintenance of Obsessive-Compulsive Disorder

2018 ◽  
pp. 329-356
Author(s):  
Angelo Maria Saliani ◽  
Teresa Cosentino ◽  
Barbara Barcaccia ◽  
Francesco Mancini
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Family Members ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

scholarly journals A Systematic Review of Behavioral, Physiological, and Neurobiological Cognitive Regulation Alterations in Obsessive-Compulsive Disorder

2020 ◽  
Vol 10 (11) ◽  
pp. 797
Author(s):  
Sónia Ferreira ◽  
José Miguel Pêgo ◽  
Pedro Morgado
Keyword(s):  
Systematic Review ◽  
Obsessive Compulsive Disorder ◽  
Brain Activity ◽  
Intrusive Thoughts ◽  
Network Activity ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Cognitive Regulation ◽  
Frontoparietal Network ◽  
Pubmed Database

Obsessive-compulsive disorder (OCD) is characterized by cognitive regulation deficits. However, the current literature has focused on executive functioning and emotional response impairments in this disorder. Herein, we conducted a systematic review of studies assessing the behavioral, physiological, and neurobiological alterations in cognitive regulation in obsessive-compulsive patients using the PubMed database. Most of the studies included explored behavioral (distress, arousal, and frequency of intrusive thoughts) and neurobiological measures (brain activity and functional connectivity) using affective cognitive regulation paradigms. Our results pointed to the advantageous use of reappraisal and acceptance strategies in contrast to suppression to reduce distress and frequency of intrusive thoughts. Moreover, we observed alterations in frontoparietal network activity during cognitive regulation. Our conclusions are limited by the inclusion of underpowered studies with treated patients. Nonetheless, our findings support the OCD impairments in cognitive regulation of emotion and might help to improve current guidelines for cognitive therapy.

scholarly journals Altered emotion regulation in obsessive–compulsive disorder as evidenced by the late positive potential

2015 ◽  
Vol 46 (1) ◽  
pp. 137-147 ◽  
Author(s):  
S. Paul ◽  
D. Simon ◽  
T. Endrass ◽  
N. Kathmann
Keyword(s):  
Emotion Regulation ◽  
Obsessive Compulsive Disorder ◽  
Sustained Attention ◽  
Cognitive Reappraisal ◽  
Late Positive Potential ◽  
Healthy Controls ◽  
Emotional Stimuli ◽  
Obsessive Compulsive ◽  
Positive Potential ◽  
Compulsive Disorder

Background.Obsessive–compulsive disorder (OCD) is associated with marked anxiety, which triggers repetitive behaviours or mental rituals. The persistence of pathological anxiety and maladaptive strategies to reduce anxiety point to altered emotion regulation. The late positive potential (LPP) is an event-related brain potential (ERP) that reflects sustained attention to emotional stimuli and is sensitive to emotion-regulation instructions. We hypothesized that patients with OCD show altered electrocortical responses during reappraisal of stimuli triggering their symptoms.Method.To test our hypothesis, ERPs to disorder-relevant, generally aversive and neutral pictures were recorded while participants were instructed to either maintain or reduce emotional responding using cognitive distraction or cognitive reappraisal.Results.Relative to healthy controls, patients with OCD showed enhanced LPPs in response to disorder-relevant pictures, indicating their prioritized processing. While both distraction and reappraisal successfully reduced the LPP in healthy controls, patients with OCD failed to show corresponding LPP modulation during cognitive reappraisal despite successfully reduced subjective arousal ratings.Conclusions.The results point to sustained attention towards emotional stimuli during cognitive reappraisal in OCD and suggest that abnormal emotion regulation should be integrated in models of OCD.

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