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PubMed1977

Obsessional phenomena and the concept of intentionality.

Obsessional phenomena exist in a variety of character types. The particular phenomena may be of limited value in total personality assessment. Some speculative links are made between obsessional phenomena and preanal developmental steps. It is suggested that the concept of intentionality of thought and action be examined in these patients to distinguish obsessionals with core conflicts that are primarily neurotic and triadic, from those with more significant, earlier difficulty in the oral period. The concept of intentionality is related to self-object distinction, the use of projections, the sense of self, pathologic ego-superego condensation, and the existence of the ability to tolerate and recognize aggressiveness within. More accurate and rapid diagnostic distinction among obsessionals has implications for different treatment approaches.

Adult↗
PubMed1980

Behavioral and pharmacological treatment of obsessive-compulsive disorders.

Single-case experimental designs were used to evaluate behavioral and pharmacological treatments in obsessive-compulsive disorders. Four patients were treated in variants of ABAB withdrawal design using behavioral and self-report data as dependent variables. Three of the four patients responded to behavioral or pharmacological treatment, whereas one patient responded to neither intervention.

Adolescent↗
PubMed1991

A standardized behavioral group treatment program for obsessive-compulsive disorder: preliminary outcomes.

This paper provides outcome data about the efficacy of a behavioral group therapy program for obsessive-compulsive disorder (OCD). Thirty-six patients completed a 7-week outpatient treatment program which provides: (1) education about OCD and its treatment, (2) instruction in a cognitive and behavioral approach to the self-treatment of OCD and (3) guided behavioral treatment. Significant improvement in obsession, compulsion, and depression scores were observed at completion of the group and at 3 month follow-up. Significant improvement in obsessions and compulsions was observed for both patients taking anti-obsessional medications and those who did not.

Adult↗
PubMed2001

Feather picking and self-mutilation in psittacine birds.

Feather-picking and self-mutilation behaviors are common in psittacine birds. These behaviors are best defined as stereotypic behaviors or obsessive compulsive disorders. There is likely a genetic predisposition for these behaviors as reflected in the overrepresentation of a number of species of psittacines. Stereotypies most often result from a high level of arousal and the inability to respond with the appropriate natural behaviors. More specifically, conflict may be induced by the absence of releasing stimuli or target objects. On a chemical level, stereotypic behavior appears to be related to an increased dopaminergic activity and an increased dopamine turnover. Feather-picking and self-mutilation patients are challenging to treat and are most likely to respond to treatment at an early stage of development. The best results are obtained by identifying and removing the cause of conflict, enhancing the environment, using appropriate drugs when indicated, and employing counter-conditioning.

Animals↗
PubMed1998

Behavioral versus pharmacological treatments of obsessive compulsive disorder: a meta-analysis.

The goal of the study was to provide a quantitative analysis of the relative efficacy of all five currently available serotonin reuptake inhibitors (SRIs) and behavior therapy [exposure and response prevention (ERP)] for obsessive compulsive disorder. The relationship between effect size and methodological characteristics was also empirically examined. A search was conducted of several computerized databases covering the dates from 1973 to 1997. Seventy-seven studies were identified, yielding 106 treatment comparisons involving 4641 patients. Effect sizes were analyzed between individual interventions and between intervention class [SRI, ERP or the combined treatment of an SRI with ERP(ERP/SRI)]. Data were analyzed both before and after controlling for methodological variables. The effect size for clomipramine (CMI) was significantly greater than the other SRIs, with the exception of fluoxetine (FLX). CMI was not significantly greater than ERP or ERP/SRI. As a class, ERP was significantly greater than SRIs as a whole. Effect sizes were larger for studies without a control group or random assignment, for self-reported outcome measures, and varied significantly by method of effect size calculation. Year of publication was significantly related to effect size. When controlling for these methodological variables, CMI was not significantly greater than FLX or fluvoxamine (FLV), and ERP was no longer significantly greater than the SRIs as a whole. No significant difference was found between CMI and the other SRIs as a group in head to head trials. No differences in drop-out rates were found. CMI stands out from the other SRIs. This difference is probably not clinically significant enough to warrant first choice treatment, given CMI's greater lethality in overdose. The choice between an SRI or ERP is dominated primarily by the infrequent availability of ERP and to a lesser degree by personal preference. Methodological differences significantly impact effect size.

Behavior Therapy↗
PubMed1988

Use of a portable computer program to assist behavioral treatment in a case of obsessive compulsive disorder.

This case study describes the development and use of a portable computer program to assist in behavioral treatment of obsessive compulsive disorder. A 58-year-old female with a 37-year history of compulsive checking rituals, who had mild improvement following 36 months of standard behavioral techniques and pharmacotherapy, showed improved compliance with behavioral treatments of exposure and response prevention following use of the portable computer program. Computer records indicated marked reductions in frequency of checking rituals and a 91-week follow-up indicated that treatment effects were maintained at home where the patient had resumed using the laptop computer. She had stopped using the pocket computer outside the home, and there her checking rituals had returned to baseline levels.

Behavior Therapy↗
PubMed1993

Tendency toward controlling behavior in adult children of problem drinkers: an experimental study.

Several clinicians have remarked on an obsessive need to control among adult children of alcoholics. In an experimental test of this hypothesis 30 adult children of problem drinkers and 31 control subjects performed a computer-simulated coin-tossing task. On half of the trials the outcome of the coin toss was open to control; the outcome was random on the remainder of the trials. The children of problem drinkers and the control group did not differ in their success on the task, but in comparison to control subjects the children of problem drinkers tended to perceive a greater difference between controllable and random trials in the coin-tossing task's openness to control. Of the two groups, the control subjects proved to be more realistic in their assessment of the control they had exercised during the task. These findings are discussed in terms of the theme of control in the lives of the adult children of alcoholics.

Adult↗
PubMed1991

Stereotypic or obsessive-compulsive disorders in dogs and cats.

Stereotypic and obsessive-compulsive behaviors are defined, and examples are given for both dogs and cats. The cause of these behaviors is discussed; and it is maintained that they result from conflict and are influenced by genetics, early experience, and learning. Treatment options, such as changes in environment and management, behavior modification, and the use of various drugs are reviewed.

Animals↗
PubMed2006

Identifying risk factors in stalking: a review of current research.

Stalking is a behaviour which can cause substantial damage to its victims, whether the perpetrator is violent or not. Victims face a range of risks including not only assault, but persistent or recurrent stalking and varying degrees of psychological and social damage. The responsibility for assessing and managing these risks often falls to the mental health professional, yet the emerging stalking risk assessment literature is at too early a stage to provide clinicians with empirically derived evidence upon which to base their clinical practice. This paper reviews existing research to identify those factors currently believed to be associated with increased risk of physical and sexual assault; with persistent and/or recurrent stalking; and, with psychological and social damage.

Crime↗
PubMed1979

The clinical evaluation of obsessionality: a development of the Leyton Obsessional Inventory.

The Leyton Obessional Inventory gives both an indication of the range of obsessional symptoms present and the degree of resistance and interference associated with each symptom. A new method is described in which the covariation of resistance and interference is represented in the form of a matrix. The results, using this method, can give a unique picture of the quality of the patient's symptoms from the clinical standpoint and provide useful guidelines for treatment and follow up. Automatic data-provessing is offered for the convenience of clinicians and researchers wishing to utilize the test in this form.

Compulsive Behavior↗
PubMed2006

Tourette's syndrome (TS): cognitive performance in adults with uncomplicated TS.

Tourette's syndrome (TS) is a neurodevelopmental disorder associated with frontostriatal dysfunction. The extent of any cognitive impairment associated with uncomplicated TS is unclear, as comorbid psychiatric symptomatology is thought to contribute to cognitive deficits. Previous studies have found evidence of mild performance deficits, most commonly on tasks that involve inhibitory processes. The present study evaluated this in carefully screened adult participants with TS. The findings showed the TS group to perform more poorly on one test involving behavioral inhibition (sentence completion), but did not provide strong support for an interpretation based solely on inhibitory deficits, and there was no evidence of impairment on another behavioral inhibition task (flanker test). There were also no differences between the groups on tasks involving working memory (n-back), task switching, or object alternation learning. The findings provide further evidence that uncomplicated TS is associated with only mild, circumscribed impairment. The nature of any impairment is discussed.

Adult↗
PubMed1996

Fluvoxamine in prevention of relapse in bulimia nervosa: effects on eating-specific psychopathology.

In a double-blind, placebo-controlled study of 72 patients with bulimia nervosa treated successfully with inpatient psychotherapy, the efficacy of fluvoxamine in maintaining improvement was tested. Fluvoxamine and placebo, respectively, were given over a period of about 15 weeks (2-3 weeks inpatient titration phase, 12 weeks outpatient relapse-prevention [maintenance] phase). The variables assessed concerned bulimic behavior and other aspects of eating disorders, global status, depression, anxieties, obsessive-compulsive behavior, and other aspects of psychopathology. Because the dropout rate was relatively high (N = 27 [33%]) and because it was considerably higher in the fluvoxamine group (19 out of 37 subjects), analyses were performed on the intent-to-treat sample (ideally including all 72 subjects). Results of the completer sample analyses (including only those subjects who finished the study) are briefly presented for comparison. In both the intent-to-treat and the completer analyses, the following scales showed fluvoxamine to have a significant effect in reducing the return of bulimic behavior: (1) self-ratings: Eating Disorder Inventory (EDI)-bulimia, urges to binge in previous week and the number of actual binges in the previous week; (2) expert ratings: Psychiatric Status Rating Scales for Bulimia nervosa, Structured Interview for Anorexia and Bulimia nervosa (SIAB)-"total score," SIAB-subscale "fasting," and SIAB-subscale "vomiting." Two further variables (EDI-total score and SIAB-subscale "bulimia") showed the superior relapse prevention effects of fluvoxamine compared with placebo for the completer sample, while they did not reach significance for group-by-time interactions in the intent-to-treat sample. During a final, short (4-week) off-medication phase, no effect of the discontinuation of medication was observed.

Adolescent↗
PubMed1984

Hoarding in anorexia nervosa.

A case study of hoarding in a woman with anorexia nervosa is reported. Obsessional and borderline personality characteristics, exacerbated by starvation, may be determinants of hoarding in anorexia nervosa.

Adult↗
PubMed2000

A descriptive study of child and adolescent obsessional followers.

This study is a preliminary descriptive investigation of the phenomenon of stalking in children and adolescents. Data on offender characteristics, victim characteristics, and stalking patterns were examined in a sample of 13 obsessional followers ranging in age from 9 to 18. Many research findings from investigations on adults who stalk were replicated in this study, including the fact that most stalking offenders are male, most victims are female, and about half of stalking cases involve threats made toward the victim. In addition, the rate of violence was 31% in this sample of juvenile stalking offenders and the most common methods of stalking were physical approach, telephone calls, and letter writing. Some interesting trends in the data emerged which require further study and suggest some differences may exist between juvenile and adult stalking offenders. The results are preliminary and suggest directions for future research.

Adolescent↗