Future Directions in the Assessment and Treatment of Obsessive-Compulsive Disorder

  • Matig Mavissakalian
  • Samuel Turner
  • Larry Michelson

Abstract

The preceding chapters have offered detailed and clear exposés of the nature and various treatment modalities of obsessive-compulsive disorder (OCD). However, several questions relating to the internal cohesiveness of the syndrome, OCD’s relationship to depressive disorder and other anxiety disorders, and the significance of advances in current therapeutics remain. These are fascinating and problematic areas requiring further elucidation, and an attempt will be made here to discuss them as well as to suggest possibilities for future research.

Keywords

Anxiety Disorder Panic Attack Compulsive Behavior Response Prevention Compulsive Symptom 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Akhtar, S., Wig, N. N., Verma, V. J., Pershad, D., & Verma, S. K. A phenomenological analysis of symptoms in obsessive-compulsive neurosis. British Journal of Psychiatry, 1975, 127, 342–348.PubMedCrossRefGoogle Scholar
  2. Akiskal, H. External validating criteria for psychiatric diagnosis: Their application in affective disorder. Journal of Clinical Psychiatry, 1980, 41 (12), 6–15.PubMedGoogle Scholar
  3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders ( 3rd ed. ). Washington, DC: American Psychiatric Association, 1980.Google Scholar
  4. Beech, H. R. Ritualistic activity in obsessional patients. Journal of Psychosomatic Research, 1971, 15, 417–422.PubMedCrossRefGoogle Scholar
  5. Beech, H. R., & Liddell, A. Decision making, mood states, and ritualistic behavior among obsessional patients. In H. R. Beech (Ed.) Obsessional states. London: Methuen, 1974.Google Scholar
  6. Black, A. The natural history of obsessional patients. In H. R. Beech (Ed.), Obsessional states. London: Methuen, 1974.Google Scholar
  7. Boulougouris, J. C., & Bassiakos, L. Prolonged flooding in cases with obsessive-compulsive neuroses. Behaviour Research and Therapy, 1973, 11, 227–231.PubMedCrossRefGoogle Scholar
  8. Boulougouris, J. C., Rabavilas, A. D., & Stefanis, C. Psychophysiological responses in obsessive-compulsive patients. Behaviour Research and Therapy, 1977, 15, 221–230.PubMedCrossRefGoogle Scholar
  9. Carey, G., & Gottesman, I. I. Twin and family studies of anxiety, phobic and obsessive disorders. In D. F. Klein & J. Rabkin (Eds.), Anxiety: New research and changing concepts. New York: Raven, 1981.Google Scholar
  10. de Silva, P., Rachman, S., & Seligman, M. Prepared phobias and obsessions: Therapeutic outcome. Behaviour Research and Therapy, 1977, 15, 54–77.Google Scholar
  11. Fenichel, O. The psychoanalytic theory of neurosis. London: Routledge & Kegan Paul, 1946.Google Scholar
  12. Foa, E. B. Failure in treating obsessive-compulsives. Behaviour Research and Therapy, 1979, 17, 169–176.PubMedCrossRefGoogle Scholar
  13. Foa, E. G., & Tillmanns, A. The treatment of obsessive-compulsive neurosis. In A. Goldstein & E. G. Foa (Eds.), Handbook of behavioral interventions: A clinical guide. New York: Wiley, 1980.Google Scholar
  14. Freud, S. Character and anal erotism. Collected Papers,(Vol. 2). Hogarth Press, 1924. (Originally published, 1908.)Google Scholar
  15. Grimshaw, L. The outcome of obsessive disorder: A follow-up study of 100 cases. British Journal of Psychiatry, 1965, 111, 1051–1056.PubMedCrossRefGoogle Scholar
  16. Hackman, A., & McLean, C. A comparison of flooding and thought stopping in the treatment of obsessional neurosis. Behaviour Research and Therapy, 1975, 13, 263–269.CrossRefGoogle Scholar
  17. Hodgson, R. J., & Rachman, S. The effects of contamination and washing in obsessional patients. Behaviour Research and Therapy, 1972, 10, 111–117.PubMedCrossRefGoogle Scholar
  18. Hodgson, R. J., & Rachman, S. Obsessional-compulsive complaints. Behaviour Research and Therapy, 1977, 15, 389–395.PubMedCrossRefGoogle Scholar
  19. Ingram, I. M. Obsessional illness in mental hospital patients. Journal of Mental Science, 1961, 107, 382–402.PubMedGoogle Scholar
  20. Ingram, I. M. Obsessional personality and anal-erotic character. Journal of Mental Science, 1961, 107, 1035–1042.Google Scholar
  21. Insel, T. R., Gillin, J. C., Moore, A., Mendelson, W. B., Loewenstein, R. J., & Murphy, D. L. The sleep of patients with obsessive-compulsive disorder. Archives of General Psychiatry, 1982, 39, 1372–1377.PubMedCrossRefGoogle Scholar
  22. Insel, T, Kalin, N. H., Guttmacher, L. B., Cohen, R. M., & Murphy, D. L. The Dexamethasone Suppression Test in patients with primary obsessive-compulsive disorder. Psychiatry Research, 1982, 6, 153–160.PubMedCrossRefGoogle Scholar
  23. Kelly, D. Anxiety and emotions: Physiological basis and treatment. Springield, IL: Charles C Thomas, 1980.Google Scholar
  24. Kirk, J. W. Behavioral treatment of obsessional-compulsive patients in routine clinical practice. Behaviour Research and Therapy, 1983, 21, 57–62.PubMedCrossRefGoogle Scholar
  25. Kringlen, E. Obsessional neurotics: A long term follow-up. British Journal of Psychiatry, 1965, 111, 709–722.PubMedCrossRefGoogle Scholar
  26. Lader, M. The peripheral and central role of the catecholamines in the mechanisms of anxiety. Internal Journal of Pharmacopsychiatric Medicine, 1974, 9, 125–137.Google Scholar
  27. Lader, M. H. Physiological research in anxiety. In H. M. van Praag (Ed.), Research in neurosis. New York: SP Medical & Scientific Books, 1978.Google Scholar
  28. Lewis, A. J. Problems of obsessional illness. Proceedings of the Royal Society of Medicine, 1936, 29, 325–336.PubMedGoogle Scholar
  29. Lewis, A. J. Obsessional illness. Acta Neuropsiquintrica Argentina, 1957, 3, 323–335.Google Scholar
  30. Lewis, A. J. Obsessional disorder. In R. Scott (Ed.), Price’s textbook of the practice of medicine (10th ed.). London: Oxford University Press, 1966.Google Scholar
  31. Lo, W. H. A follow-up study of obsessional neurotics in Hong Kong Chinese. British Journal of Psychiatry, 1997, 113, 823–832.CrossRefGoogle Scholar
  32. Makhlouf-Norris, F., & Norris, H. The obsessive compulsive syndrome as a neurotic device for the reduction of self-uncertainty. British Journal of Psychiatry, 1972, 121, 277–288.Google Scholar
  33. Marks, I. M., Crowe, M., Drewe, E., Young, J., & Dewhurst, W. G. Obsessive compulsive neurosis in identical twins. British Journal of Psychiatry, 1969, 115, 991–998.PubMedCrossRefGoogle Scholar
  34. Marks, I. M., Stern, R. S., Mawson, D., Cobb, J., & McDonald, R. Clomipramine and exposure for obsessive-compulsive rituals: I. British Journal of Psychiatry, 1980, 136, 1–25, 1980.CrossRefGoogle Scholar
  35. Mavissakalian, M. Functional classification.of obsessive-compulsive phenomena. Journal of Behavioral Assessment, 1979, 1, 271–279.CrossRefGoogle Scholar
  36. Mavissakalian, M. Antidepressants in the treatment of agoraphobia and obsessive-compulsive disorder. Comprehensive Psychiatry, 1983, 24 (3), 278–284.PubMedCrossRefGoogle Scholar
  37. Mavissakalian, M. R., & Barlow, D. H. Assessment of obsessive-compulsive disorders. In D. H. Barlow (Ed.), Behavioral assessment of adult disorders. New York: Guilford Press, 1981.Google Scholar
  38. Mavissakalian, M., & Michelson, L. Tricyclic antidepressants in obsessive-compulsive disorder: Antiobsessional or antidepressant agents ? Journal of Nervous and Mental Disease, 1983, 171, 301–306.PubMedCrossRefGoogle Scholar
  39. Mawson, D., Marks, I. M., & Ramm, L. Clomipramine and exposure for chronic obsessive-compulsive rituals: III. Two year follow-up and further findings. British Journal of Psychiatry, 1982, 140, 11–18.PubMedCrossRefGoogle Scholar
  40. Monroe, S. M. Assessment of life events: Retrospective vs. concurrent strategies. Archives of General Psychiatry, 1982, 39, 606–610.PubMedCrossRefGoogle Scholar
  41. Monroe, S. M. Life events and disorder: Event-symptoms associations and the course of disorder. Journal of Abnormal Psychology, 1982, 91, 14–24.PubMedCrossRefGoogle Scholar
  42. Pollak, J. M. Obsessive-compulsive personality: A review. Psychological Bulletin, 1979, 86, 225–241.PubMedCrossRefGoogle Scholar
  43. Rabavilas, A. D., & Boulougouris, J. C. Physiological accompaniments of ruminations, flooding, and thought stopping in obsessive patients. Behaviour Research and Therapy, 1974, 12, 239–243.PubMedCrossRefGoogle Scholar
  44. Rabavilas, A. D., Boulougouris, J. C., Perissaka, C., & Stefanis, C. The effect of peripheral beta blockade on psychophysiologic responses in obsessional neurotics. Comprehensive Psychiatry, 1979, 20, 378–383.PubMedCrossRefGoogle Scholar
  45. Rachman, S. Primary obsessional slowness. Behaviour Research and Therapy, 1974, 12, 9–18.PubMedCrossRefGoogle Scholar
  46. Rachman, S. The modification of obsessions: A new formulation. Behaviour Research and Therapy, 1976, 14, 437–443.PubMedCrossRefGoogle Scholar
  47. Rachman, S. The conditioning theory of fear acquisition: A critical examination. Behaviour Research and Therapy, 1977, 15, 375–387.PubMedCrossRefGoogle Scholar
  48. Rachman, S., & de Silva, P. Abnormal and normal obsessions. Behaviour Research and Therapy, 1978, 16, 233–248.PubMedCrossRefGoogle Scholar
  49. Rachman, S. J., & Hodgson, R. J. Obsessions and compulsions. Englewood Cliffs, NJ: Prentice-Hall, 1980.Google Scholar
  50. Rachman, S., & Seligman, M. E. P. Unprepared phobias: “Be prepared.” Behaviour Research and Therapy, 1976, 14, 333–338.PubMedCrossRefGoogle Scholar
  51. Rachman, S., de Silva, P., & Roper, G. The spontaneous decay of compulsive urges. Behaviour Research and Therapy, 1976, 14, 445–453.PubMedCrossRefGoogle Scholar
  52. Rachman, S., Cobb, J., Grey, S., MacDonald, B., Mawson, D., Sartory, G., & Stern, R. The behavioral treatment of obsessive-compulsive disorders, with or without clomipramine. Behaviour Research and Therapy, 1979, 17, 467–468.PubMedCrossRefGoogle Scholar
  53. Reed, G. F. Some formal qualities of obsessional thinking. Psychiatric Clinic, 1968, 1, 382–392.Google Scholar
  54. Roper, G., & Rachman, S. Obsessional-compulsive checking: Experimental replication and development. Behaviour Research and Therapy, 1976, 14, 25–32.PubMedCrossRefGoogle Scholar
  55. Roper, G., Rachman, S., & Hodgson, R. An experiment on obsessional checking. Behaviour Research and Therapy, 1973, 11, 271–277.PubMedCrossRefGoogle Scholar
  56. Sartorius, N. Epidemiology of anxiety. Pharmacopsychiatry, 1980, 13, 249–253.CrossRefGoogle Scholar
  57. Seligman, M. E. P. On generality of the laws of learning. Psychological Review, 1970, 77, 406–418.CrossRefGoogle Scholar
  58. Seligman, M. E. P. Phobias and preparedness. Behavior Therapy, 1971, 2, 307–320.CrossRefGoogle Scholar
  59. Seligman, M. E. P., & Hager, J. L. Biological boundaries of learning. Englewood Cliffs, NJ: Prentice-Hall, 1972.Google Scholar
  60. Shields, J. Genetic factors in neurosis. In H. M. van Praag (Ed.), Research in neurosis. New York: SP Medical & Scientific Books, 1978.Google Scholar
  61. Stern, R. S. Obsessive thought: The problem of therapy. British Journal of Psychiatry, 1978, 132, 200–205.CrossRefGoogle Scholar
  62. Stern, R. S., & Cobb, J. P. Phenomenology of obsessive-compulsive neurosis. British Journal of Psychiatry, 1978, 132, 233–239.Google Scholar
  63. Stern, R. S., Lipsedge, M. S., & Marks, I. M. Obsessive ruminations: A controlled trial of thought-stopping technique. Behaviour Research and Therapy, 1973, 11, 659–662.PubMedCrossRefGoogle Scholar
  64. Stern, R. S., Marks, I. M., Mawson, D., & Luscombe, D. K. Clomipramine and exposure for compulsive rituals: II. Plasma levels, side effects, and outcome. British Journal of Psychiatry, 1980, 136, 161–166.PubMedCrossRefGoogle Scholar
  65. Thoren, P., Asberg, M., Cronholm, B., Jornestedt, L., & Traskman, L. Clomipramine treatment of obsessive-compulsive disorder. Archives of General Psychiatry, 1980, 37, 1281–1285.PubMedCrossRefGoogle Scholar
  66. Thoren, P., Asberg, M., Bertilsson, L., Mellstom, B., Sjoqvista, F., & Trask-man, L. Clomipramine treatment of obsessive-compulsive disorder. Archives of General Psychiatry, 1980, 37, 1289–1294.PubMedCrossRefGoogle Scholar
  67. Turner, S. M. & Beidel, D. C. Biological factors in obsessive-compulsive disorder. University of Pittsburgh, unpublished manuscript, 1984.Google Scholar
  68. Turner, S. M., Hersen, M., Bellack, A. S., Andrasik, F., & Capparell, H. V. Behavioral treatment of obsessive-compulsive neurosis. Behaviour Research and Therapy, 1979, 17, 95–106.PubMedCrossRefGoogle Scholar
  69. Turner, S. M., Hersen, M., Bellack, A. S., Andrasik, F., & Capparell, H. V. Behavioral and pharmacological treatment of obsessive-compulsive disorders. Journal of Nervous and Mental Disease, 1980, 158, 651–657.CrossRefGoogle Scholar
  70. Turner, S. M., Jacob, R. G., Beidel, D. C., & Himmelhoch, J. Fluoxetine treatment of obsessive-compulsive disorder. University of Pittsburgh, unpublished manuscript, 1984.Google Scholar
  71. Walker, V. J., & Beech, H. R. Mood state and the ritualistic behavior of ob- sessional patients. British Journal of Psychiatry, 1969, 115, 1261–1268.PubMedCrossRefGoogle Scholar
  72. Walton, D., & Mather, M. D. The application of learning principles to the treatment of obsessive-compulsive states in the acute and chronic phases of illness. Behaviour Research and Therapy, 1963, 2, 163–174.CrossRefGoogle Scholar
  73. Wolpe, J. Psychotherapy by reciprocal inhibition. Stanford: Stanford University Press, 1958.Google Scholar

Copyright information

© Springer Science+Business Media New York 1985

Authors and Affiliations

  • Matig Mavissakalian
    • 1
  • Samuel Turner
    • 1
  • Larry Michelson
    • 1
  1. 1.Western Psychiatric Institute and ClinicUniversity of Pittsburgh School of MedicinePittsburghUSA

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