Integrating family therapy into exposure-based CBT for a Spanish patient with obsessive scrupulosity

2018 ◽  
Vol 82 (4) ◽  
pp. 308-325 ◽  
Author(s):  
Ana Isabel Rosa-Alcázar ◽  
Marina Iniesta-Sepúlveda

Obsessive-compulsive symptom profiles vary widely among individuals and may be affected by cultural backgrounds. In the case of scrupulosity, moral and religious principles are the target of obsessive-compulsive symptoms. Cognitive biases and beliefs have special relevance in the origin and maintenance of obsessive scrupulosity. In addition, rigid and exaggerated beliefs about morality are held by these patients. Moral and religious principles are mainly transmitted by family. These influences may be more prominent in cultures, such as the Spanish culture, where family and religion are important values for individuals. The authors describe the treatment of a Spanish patient with obsessive scrupulosity. Family therapy strategies were integrated into exposure-based CBT in order to facilitate the modification of beliefs, behaviors, and pathological family relationships. The patient exhibited clinically significant improvements in OCD symptoms. Findings from this case show the need for individualized interventions that take into consideration cultural, social, and family factors.

2020 ◽  
Vol 84 (1) ◽  
pp. 53-78
Author(s):  
Rachel Ojserkis ◽  
Dean McKay ◽  
Se-Kang Kim

Obsessive-compulsive (OC) symptoms have been associated with trauma exposure. Although no studies have specified relations between type of trauma and OC symptom presentations, this information may inform personalized care for this complex population. Thus, this study used profile analysis via multidimensional scaling to characterize typical OC symptom profiles in individuals exposed to interpersonal versus noninterpersonal traumas. Profiles were also correlated with self-reported disgust and mental contamination, which have been related to OC symptoms and interpersonal trauma in prior research. The interpersonal trauma group revealed two profiles: (1) Obsessing (high obsessing, low neutralizing), and (2) Ordering (high ordering, low obsessing). The noninterpersonal trauma group showed two profiles: (1) Hoarding/Ordering (high hoarding and ordering, low washing), and (2) Hoarding Only (high hoarding, low ordering). No significant correlations were found between OC profiles and disgust-related constructs. Clinical implications, limitations, and future directions are explored.


2019 ◽  
Vol 33 (1) ◽  
pp. 46-57 ◽  
Author(s):  
Amanda M. Raines ◽  
C. Laurel Franklin ◽  
Michele N. Carroll

Sleep disturbances are a prevalent and pernicious correlate of most emotional disorders. A growing body of literature has recently found evidence for an association between sleep disturbances and obsessive-compulsive disorder (OCD). Though informative, this link has yet to be explored in a veteran population. Further, the degree to which this relationship is accounted for by relevant third variables is limited. The current study investigated the relationship between self-reported insomnia and OCD symptoms after controlling for probable depression and posttraumatic stress disorder (PTSD) using an unselected sample of veterans (N = 57). Most of the sample reported clinically significant OCD (61%) and insomnia symptoms (58%). Results revealed associations between insomnia and OCD unacceptable thoughts/neutralizing compulsions, but not contamination obsessions/washing compulsions, responsibility for harm obsessions/checking compulsions, or symmetry obsessions/ordering compulsions. Findings highlight the need for more research on OCD and sleep problems and clinical work focused on sleep for patients reporting increased OCD symptoms, particularly veterans.


1999 ◽  
Vol 4 (6) ◽  
pp. 5-6

Abstract Personality disorders are enduring patterns of inner experience and behavior that deviate markedly from those expected by the individual's culture; these inflexible and pervasive patterns reflect issues with cognition, affectivity, interpersonal functioning and impulse control, and lead to clinically significant distress or impairment in social, occupational, or other important areas of functioning. The AMA Guides to the Evaluation of Permanent Impairment, Fourth Edition, defines two specific personality disorders, in addition to an eleventh condition, Personality Disorder Not Otherwise Specified. Cluster A personality disorders include paranoid, schizoid, and schizotypal personalities; of these, Paranoid Personality Disorder probably is most common in the legal arena. Cluster B personality disorders include antisocial, borderline, histrionic, and narcissistic personality. Such people may suffer from frantic efforts to avoid perceived abandonment, patterns of unstable and intense interpersonal relationships, an identity disturbance, and impulsivity. Legal issues that involve individuals with cluster B personality disorders often involve determination of causation of the person's problems, assessment of claims of harassment, and assessment of the person's fitness for employment. Cluster C personality disorders include avoidant, dependent, and obsessive-compulsive personality. Two case histories illustrate some of the complexities of assessing impairment in workers with personality disorders, including drug abuse, hospitalizations, and inpatient and outpatient psychotherapy.


2012 ◽  
Vol 68 (12) ◽  
pp. 1266-1275 ◽  
Author(s):  
Joan Taberner ◽  
Miquel A. Fullana ◽  
Xavier Caseras ◽  
Alberto Pertusa ◽  
Arturo Bados ◽  
...  

2003 ◽  
Vol 48 (2) ◽  
pp. 72-77 ◽  
Author(s):  
Mario Masellis ◽  
Neil A Rector ◽  
Margaret A Richter

Objective: An anxiety disorder severely affects the sufferer's quality of life (QOL), and this may be particularly true of those with obsessive–compulsive disorder (OCD). This study examines the differential impact of obsessions, compulsions, and depression comorbidity on the QOL of individuals with OCD. Method: Forty-three individuals diagnosed with OCD according to DSM-IV criteria and experiencing clinically significant obsessions and compulsions completed measures of QOL, obsessive–compulsive symptom severity, and depression severity. Results: Obsession severity was found to significantly predict patient QOL, whereas the severity of compulsive rituals did not impact on QOL ratings. Comorbid depression severity was the single greatest predictor of poor QOL, accounting for 54% of the variance. Conclusions: Given the importance of these symptoms, treatments that directly target obsessions and secondary depression symptoms in OCD are warranted. However, replication of these findings in a prospective cohort study is required, because although the the current study's cross-sectional design allows for the examination of the associations among obsessions, depression, and QOL, it cannot establish their temporal framework (that is, causal relations).


Author(s):  
Ivana Viani

Obsessive-compulsive disorder (OCD) is characterized by obsessions and/or compulsions that are time-consuming or cause clinically significant distress or impairment in functioning. Obsessions are recurrent and persistent intrusive, unwanted thoughts, urges, or images that cause marked anxiety or distress. Examples of obsessions include worrying about germs, the feeling things need to be “just right,” worrying about bad things happening, and disturbing thoughts or images about hurting others. Compulsions are repetitive behaviors or mental acts that an individual feels compelled to perform in response to an obsession or according to rules that must be applied rigidly. Examples of compulsions include washing, checking, tapping, ordering, and repeating. Young children may not be able to articulate the aims of these repetitive behaviors or mental acts. Selective serotonin reuptake inhibitors (SSRIs) are the first-line class of medications used to treat OCD in children and adolescents. Exposure and response prevention (ERP) therapy is the gold standard psychotherapy treatment for OCD.


2019 ◽  
Vol 44 (1) ◽  
pp. 120-135 ◽  
Author(s):  
Tamara Leeuwerik ◽  
Kate Cavanagh ◽  
Clara Strauss

Abstract Little is known about the role of mindfulness and self-compassion in obsessive-compulsive disorder. This cross-sectional study examined associations of mindfulness and self-compassion with obsessive-compulsive disorder symptoms and with the obsessive beliefs and low distress tolerance thought to maintain them. Samples of treatment-seeking adults (N = 1871) and non-treatment-seeking adults (N = 540) completed mindfulness, self-compassion, obsessive-compulsive disorder, anxiety, depression, obsessive beliefs and distress tolerance questionnaires. Participants with clinically significant obsessive-compulsive disorder symptoms reported lower trait mindfulness and self-compassion compared to participants with clinically significant anxiety/depression and to non-clinical controls. Among the clinical sample, there were medium-large associations between mindfulness and self-compassion and obsessive-compulsive disorder symptoms, obsessive beliefs and distress tolerance. Mindfulness and self-compassion were unique predictors of obsessive-compulsive disorder symptoms, controlling for depression severity. Once effects of obsessive beliefs and distress tolerance were controlled, a small effect remained for mindfulness (facets) on obsessing symptoms and for self-compassion on washing and checking symptoms. Directions for future research and clinical implications are considered in conclusion.


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