Diet and Doubt: A Clinical Case Study of Inference-Based Therapy for Bulimia Nervosa

2016 ◽  
Vol 30 (4) ◽  
pp. 263-276
Author(s):  
Magali Purcell Lalonde ◽  
Kieron O’Connor ◽  
Marie-Eve St-Pierre-Delorme ◽  
Valérie Perreault ◽  
Samantha Wilson
Keyword(s):  
Eating Disorders ◽  
Body Weight ◽  
Bulimia Nervosa ◽  
Clinical Case ◽  
Psychological Characteristics ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Clinical Case Study

There is a recognized overlap between eating disorders (EDs) and obsessive-compulsive disorder (OCD) in terms of diagnosis, phenomenology, epidemiology, and psychological characteristics related to the disorder. In light of these similarities, a cognitive inference-based therapy (IBT) program, shown to be effective in treating OCD, was adapted for EDs. This case study describes the application of IBT treatment for a 35-year-old woman diagnosed with bulimia nervosa who also demonstrated overvalued ideation related to her body weight and shape. Over a 20-week period, the client’s ED pathology significantly decreased. Notably, the frequency of binge episodes was reduced by 90% from pre- to posttreatment and by 100% at 6-month follow-up. Significant reductions were also observed in dietary restriction and overvalued ideation. This case study has important implications for the treatment of individuals with both an ED and strong overvalued ideas.

Exposure and Ritual Prevention, Clomipramine, or Their Combination for Obsessive-Compulsive Disorder

2018 ◽  
Author(s):  
Brandon M. Kitay ◽  
Michael H. Bloch
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Behavior Therapy ◽  
Cognitive Behavior Therapy ◽  
Clinical Management ◽  
Clinical Case ◽  
Cognitive Behavior ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Landmark Study

This chapter provides a summary of a landmark study on the management of obsessive-compulsive disorder (OCD) in adults. Is the combination of exposure and ritual prevention (a cognitive behavior therapy based intervention) along with clomipramine more efficacious than monotherapy with either treatment for OCD? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study interventions, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications for clinical management, and concludes with an exemplary clinical case applying the evidence.

Puerperal psychoses: A clinical case study with follow-up

1992 ◽  
Vol 26 (1) ◽  
pp. 25-30 ◽  
Author(s):  
P. Benvenuti ◽  
P.L. Cabras ◽  
P. Servi ◽  
S. Rosseti ◽  
G. Marchetti ◽  
...  
Keyword(s):  
Clinical Case ◽  
Clinical Case Study

EMDR in the Treatment of Adolescent Obsessive-Compulsive Disorder: A Case Study

2018 ◽  
Vol 12 (4) ◽  
pp. 242-254
Author(s):  
Angela Cusimano
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Stress Disorder ◽  
Current Level ◽  
Practice Setting ◽  
Large Effect Size ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Insight Into

Most of the empirical evidence supporting the efficacy of eye movement desensitization and reprocessing (EMDR) has been with individuals suffering from posttraumatic stress disorder (PTSD). This case study reports on the successful treatment of obsessive-compulsive disorder (OCD) in a 13-year-old male using the standard three-pronged approach of EMDR in a private practice setting. The current protocol addressed the initial touchstone event, the current level of distress related to that event, as well as anticipation and planning for future feared events. The participant received 15 sessions of EMDR. At 90-day posttreatment follow-up, there was a substantial decrease in OCD symptoms (from moderate to subclinical) as measured by the Children’s Yale-Brown Obsessive–Compulsive Scale, indicating a large effect size (d = 0.81). The current study provides insight into treating OCD in adolescence and how using the three-pronged approach (past, present, and future) of EMDR can be an effective tool. Study limitations and suggestions for future clinical research are discussed.

scholarly journals Advances in Diagnosis and Treatment of Anorexia Nervosa and Bulimia Nervosa*

1992 ◽  
Vol 37 (5) ◽  
pp. 309-315 ◽  
Author(s):  
Sidney H. Kennedy ◽  
Paul E. Garfinkel
Keyword(s):  
Substance Abuse ◽  
Eating Disorders ◽  
Anorexia Nervosa ◽  
Bulimia Nervosa ◽  
Psychiatric Comorbidity ◽  
High Rate ◽  
Obsessive Compulsive ◽  
Related Disorder ◽  
Compulsive Disorder ◽  
Cognitive Behavioural

This paper reviews four areas of research into anorexia nervosa (AN) and bulimia nervosa (BN). First, in terms of diagnosis, the psychological concerns about weight and shape are now addressed in BN, bringing it more in line with the related disorder, anorexia nervosa. Second, studies of psychiatric comorbidity confirm the overlap between eating disorders and depression, obsessive compulsive disorder, substance abuse, and personality disorder. Nevertheless, there are reasons to accept the distinct qualities of each syndrome, and eating disorders are not merely a variant of these other conditions. Third, treatment advances in BN involve mainly cognitive-behavioural or interpersonal psycho-therapies and pharmacotherapies primarily with antidepressants. The effect of combining more than one approach is beginning to be addressed. Finally, outcome studies involving people with both AN and BN have shown that the disorders “cross over” and that both conditions have a high rate of relapse. A renewed interest in the treatment of AN is needed.

scholarly journals The Efficacy of Exposure and Response Prevention for Geriatric Obsessive Compulsive Disorder: A Clinical Case Illustration

2012 ◽  
Vol 2012 ◽  
pp. 1-5
Author(s):  
Mairwen K. Jones ◽  
Bethany M. Wootton ◽  
Lisa D. Vaccaro
Keyword(s):  
Older Adults ◽  
Obsessive Compulsive Disorder ◽  
Clinical Case ◽  
Psychological Treatment ◽  
Response Prevention ◽  
Exposure And Response Prevention ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Clinical Case Study ◽  
History Of

Obsessive compulsive disorder (OCD) is one of the most frequently occurring psychiatric conditions in older adults. While exposure and response prevention (ERP) is considered the most effective psychological treatment for children and adults with OCD, research investigating its effectiveness for older adults is scarce. This clinical case study investigates the effectiveness of ERP in an 80-year-old man with a 65-year history of OCD. The client received 14 individual, 50-minute ERP treatment sessions. Clinician-based Y-BOCS scores reduced by 65% from 20 (moderate) at pretreatment to 7 (subclinical) at 7-month posttreatment followup. OCI-R total scores reduced by 45% from 38 at baseline to 21 at 7-month follow-up. Despite his long history of the disorder, ERP was effective and well tolerated. The application of ERP for older adults with OCD, including age-specific modifications that may be required for this treatment approach, is discussed.

scholarly journals Treatment of Limerence Using a Cognitive Behavioral Approach: A Case Study

2021 ◽  
Vol 8 ◽  
pp. 237437352110608
Author(s):  
Brandy E Wyant
Keyword(s):  
Subjective Assessment ◽  
Significant Loss ◽  
Behavioral Approach ◽  
Cognitive Behavioral ◽  
Obsessive Compulsive ◽  
Healthy Relationships ◽  
Compulsive Disorder ◽  
Thought Patterns

Limerence is an underresearched condition of unknown prevalence that causes significant loss of productivity and emotional distress to sufferers. Individuals with limerence display an obsessive attachment to a particular person or “limerent object” (LO) that interferes with daily functioning and the formation and maintenance of healthy relationships. The current study proposes a conceptualization of the condition in a 28-year-old individual and describes a treatment approach using cognitive-behavioral techniques, most notably exposure responsive prevention as used in the treatment of obsessive-compulsive disorder. The number and type of compulsive rituals performed by the treated individual were notably decreased at 9-month follow-up after treatment, and a subjective assessment of dysfunctional thought patterns related to the LO also suggested improvement. A novel screening instrument is presented, as validated screening instruments do not yet exist. Implications for diagnosis and treatment are discussed.

scholarly journals Can an intervention based on a serious videogame prior to cognitive behavioral therapy be helpful in bulimia nervosa? A clinical case study

2015 ◽  
Vol 6 ◽  
Author(s):  
Cristina Giner-Bartolomé ◽  
Ana B. Fagundo ◽  
Isabel Sánchez ◽  
Susana Jiménez-Murcia ◽  
Juan J. Santamaría ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Bulimia Nervosa ◽  
Clinical Case ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Clinical Case Study

Danger Ideation Reduction Therapy (DIRT) for Intractable, Adolescent Compulsive Washing: A Case Study

2004 ◽  
Vol 21 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Margot O'Brien ◽  
Mairwen K. Jones ◽  
Ross G. Menzies
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Health Centre ◽  
Inpatient Admission ◽  
Self Report ◽  
Published Data ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Oppositional Defiant

AbstractThis paper describes the first trial of danger ideation reduction therapy (DIRT) in an adolescent patient with severe, treatment resistant obsessive-compulsive disorder (OCD). This case study also represents the first published data on DIRT for any individual outside the Anxiety Disorders Clinic at the University of Sydney, where the treatment package was originally developed. KP was a 16-year-old girl with a 4-year history of obsessive-compulsive disorder. She was primarily concerned with contamination and presented with associated washing and avoidance behaviour. KP met Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association [APA], 1994) criteria for OCD, oppositional defiant disorder and major depressive disorder. She had also had previous diagnoses of attention-deficit/hyperactivity disorder and motor tics. KP had received considerable treatment for OCD prior to the current trial, including 12 months of outpatient treatment at the local community health centre, a 4-week inpatient admission to a private hospital in Sydney and a 16 week inpatient admission to Rivendell Adolescent Unit in Sydney. All previous treatments involved a combination of pharmacotherapy (clomipramine [up to 125mg[, sertraline [up to the 200mg], fluvoxamine [up to 200 mg], risperidone [up to 2.5 mg] and chlorpromazine [25-50 mg prn]), and attempts to administer exposure-based treatment. KP had failed to benefit from all previous treatment attempts. However, following 16 sessions of DIRT, KP experienced substantial improvement, approximating symptom-free status on all measures. Importantly, these improvements were maintained at 12-month follow-up. The DIRT package was also effective in reducing depression and anxiety scores on self-report measures over the follow-up period. There were no substantial differences between posttreatment and 12-month follow-up scores on any of the measures given.

Adults who Report Childhood Ritualistic Abuse

1992 ◽  
Vol 20 (3) ◽  
pp. 188-193 ◽  
Author(s):  
Ruth E. Shaffer ◽  
Louis J. Cozolino
Keyword(s):  
Eating Disorders ◽  
Spiritual Development ◽  
Clinical Case ◽  
Clinical Case Study ◽  
Number Of Patients ◽  
Patient Reported ◽  
Psychiatric Sequelae ◽  
Perceived Impact ◽  
Adult Functioning

Therapists are finding an increasing number of patients uncovering memories of ritualistic forms of abuse from childhood. To gain a fuller understanding of this phenomenon, twenty outpatients reporting memories of ritualistic abuse were interviewed. Questions focused on the nature of the abuse and its perceived impact on interpersonal, occupational, and spiritual development. Reasons for entering psychotherapy as well as the nature and course of treatment were also discussed. Subjects entered therapy with similar psychological complaints. Reported psychiatric sequelae included dissociative, affective, somatization, and eating disorders. Abuse experiences were reported to have affected every aspect of their adult functioning. Subjects began therapy with little or no knowledge of the phenomenon of ritualistic abuse, and only one patient reported vague memories of ritualistic abuse before entering therapy. Reports from this sample reflect striking convergence among subjects and with data from previous research and clinical reports. A composite clinical case study is presented based on these data.

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