Search PubMed⌕ Search

Biomedical subjects

G Steketee

Publications and source records attributed to G Steketee.

32 records · Page 2Linked to original sources

Sexual history, attitudes and functioning of obsessive-compulsive patients.

An exploratory investigation of sexual history, attitudes and functioning was conducted with 44 obsessive-compulsive outpatients seeking behavioral therapy. Prior to treatment, patients completed a life history questionnaire which requested information about personal and parental attitudes toward sex, current sexual functioning, sexual obsessions, and sexual history. Pretreatment measures of obsessive-compulsive symptomatology revealed a severely obsessional group who were moderately depressed and introverted. Obsessive-compulsives did not appear to differ from normative samples in sexual history or attitudinal variables. One-third of the present sample reported obsessions related to sexual themes. Symptomatology interferred with sexual satisfaction, particularly for those concerned with bodily secretions. Sexual dysfunction, however, was relatively uncommon. Categorizing patients according to the type of obsession (bodily secretion vs. other obsession) or their religious affiliation (Catholic vs. non-Catholic) yielded no differences with respect to sexual history, attitudes and treatment outcome. Some association of early sexual experiences with current sexual dysfunction was observed.

Adult↗

Effects of imipramine on depression and obsessive-compulsive symptoms.

Most of the controlled studies on the efficacy of medical treatments of obsessive-compulsive disorder (OCD) have involved clomipramine, a tricyclic antidepressant reputed to have anti-obsessional properties. To test the possibility that the drug's antidepressant action mediates the reduction of obsessive-compulsive symptoms, we treated 37 OCD patients with imipramine (mean dose = 233 mg/day) or placebo for 6 weeks and assessed improvement on both obsessive-compulsive and depressive symptoms. Imipramine reduced depression in highly depressed OCD patients, but did not affect obsessive-compulsive symptoms in these or in less depressed patients.

Adolescent↗

Measurement of obsessive-compulsive symptomatology: utility of the Hopkins Symptom Checklist.

The Hopkins Symptom Checklist (HSCL) was administered to 62 obsessive-compulsive and 49 nonobsessional patients to examine the reliability and validity of the obsessive-compulsive scale as well as four additional subscales identified in previous research. Test-retest correlation coefficients were generally below acceptable levels. Analyses of construct validity suggested that the obsessive-compulsive scale correlated significantly with other measures of such symptomatology only after treatment when the range of scores was broader than before treatment. The HSCL detected change following treatment on the total score and on four of the five clusters. The obsessive-compulsive scale effectively discriminated obsessive-compulsive patients from other anxious-neurotic patients but a reliable cut-off score that did not misclassify a substantial percentage of patients could not be found.

Adolescent↗

Recent advances in the behavioral treatment of obsessive-compulsives.

The last decade has witnessed remarkable progress in the treatment of obsessive-compulsives, with the introduction of response prevention and deliberate exposure to feared situations in vivo and in imagination. In a series of studies, the effects of the single components of this program were investigated. The results suggest that the optimal treatment includes a combination of all three procedures. It appears that in vivo exposure mainly affects anxiety/discomfort associated with cues for ritualizing; response prevention affects primarily compulsive behavior; and imaginal exposure assists in maintenance of treatment gains, perhaps through its impact on fears of future catastrophes associated with obsessions.

Adolescent↗

Hoarding, compulsive buying and reasons for saving.

Two studies examined hypotheses about compulsive hoarding, compulsive buying and beliefs about saving and discarding derived from the cognitive-behavioral model of compulsive hoarding [Frost, R. O. and Hartl, T. (1996). A cognitive behavioral model of compulsive hoarding. Behaviour Research and Therapy, 34, 341-350.]. Study 1 examined the hypotheses in a college student population, while study 2 compared members of a support group for hoarding and clutter-related problems with a nonclinical control. Across studies the hypotheses were supported. Compulsive hoarding was associated with compulsive buying and the frequency of acquisition of possessions discarded by others, suggesting that compulsive acquisition may be a broader construct than compulsive buying among people with hoarding problems. Regarding its association with OCD symptoms, hoarding was most closely associated with the impaired mental control features of OCD. Finally, offa hoarding-related task, hoarding was associated with a greater frequency of reasons to save, but was not associated with fewer reasons to discard a target possession.

Adult↗

Group and multifamily behavioral treatment for obsessive compulsive disorder: a pilot study.

Recent trends toward managed care in mental health settings require investigation of the efficacy and cost-effectiveness of treatments conducted over shorter time frames or with less therapist involvement. Findings are presented in an uncontrolled trial of two types of group behavioral treatments of OCD: group (GBT) and multifamily (MFBT). Seventeen patients (10 women and 7 men) diagnosed with OCD received a partially manualized GBT delivered by co-therapy teams in three groups of ten 2-hr sessions. Mean interview-based YBOCS scores reduced significantly at posttest and at 1-year follow-up, as did measures of overall functioning on the Sheehan Disability Scale at posttest and follow-up. A second cohort of 19 patients (14 women and 5 men) was treated with MFBT that included spouses/partners and parents in three co-therapy groups. Two groups received ten 2-hr sessions and one received twelve 2-hr sessions. YBOCS scores reduced significantly at posttest and at 1-year follow-up, with corresponding gains in disability scores. Both group treatments showed large effects comparable to those reported for a more intensive individual behavioral treatment. Comparisons of treatments indicated that similar proportions of subjects were reliably changed at posttest and follow-up respectively, but more MFBT than GBT participants were clinically significantly improved. These promising cost effective group treatments remain to be tested in a controlled trial.

Adolescent↗

Beliefs in obsessive-compulsive disorder.

Several types of beliefs have been hypothesized to be associated with obsessive-compulsive disorder (OCD), including responsibility for harm, need to control thoughts, overestimates of threat, intolerance of uncertainty, and beliefs about the consequences of anxiety and capacity to cope. The present study compared 62 subjects with OCD, 45 with other anxiety disorders (AD) and 34 controls, using 3 measures of OCD-related beliefs. OCD subjects scored higher than AD and control samples on 2 general belief measures. A closer analysis of specific belief domains indicated that OCD subjects scored higher than AD and control subjects on all 6 specific belief domains (responsibility, control, estimation of threat, tolerance of uncertainty, beliefs about the consequences of anxiety, and the capacity to cope). Four of the 6 domains showed reasonable convergent and discriminant validity with measures of OCD symptoms compared to other psychopathology; anxiety and coping beliefs were the exceptions. In regression analyses, cognitive measures contributed significant explanatory power beyond mood state and worry with uncertainty predicting severity of OCD symptoms above all other belief domains. Further research on OCD-relevant belief domains in etiology, maintenance and treatment is warranted.

Adaptation, Psychological↗

Effects of axis I and II comorbidity on behavior therapy outcome for obsessive-compulsive disorder and agoraphobia.

The impact of concurrent axis I diagnoses and axis II traits on the efficacy of a 22-session exposure-based treatment program for 43 outpatients with panic disorder and agoraphobia (PDA) and 63 with obsessive-compulsive disorder (OCD) was examined. Trained interviewers used the Structured Clinical Interview for DSM-III-R (SCID) to assess axis I diagnoses and the SCID-II to identify the number of axis II criteria met for anxious, dramatic, and odd clusters. Among axis I diagnoses, secondary major depressive disorder (MDD), dysthymia, social phobia, and generalized anxiety disorder (GAD) were present in sufficient numbers to study their effects on treatment outcome. Outcomes were assessed on self-rated target fears and functioning and on a behavioral avoidance test at post-treatment and at 6 months follow-up. Only GAD comorbidity predicted dropout, whereas MDD and all three personality cluster traits predicted post-treatment outcomes. Follow-up analyses showed significant effects of MDD and GAD, but axis II cluster criteria were not predictive.

Adolescent↗