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Results for “Compulsive Personality Disorder”

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PubMed1980

The value of reconstruction in adult psychoanalysis.

Some of the factors that influence an analyst to choose one construction rather than another are explored. Such choices may be based on the analyst's insights and development, or his biases, past training and personal pathology; or the patient's attempts to influence the analyst in a particular direction. Construction may overemphasize the part played by the patient's innate propensities or his environment. Freud's interpretation of the Oedipus myth is re-examined in the light of these thoughts. Reconstruction is considered to be of therapeutic value only through the analysis of the repetition compulsion in the transference. The clinical examples include consideration of the repetition of an early folie à deux phenomenon manifest in the transference. The nature of the internal objects that 'go with' the patient in exploration and distortion of truths is examined. New developments in analysis need to be integrated with creative constructions of the past, forming the foundation of new constructions. The view is held that in times of crisis patients revert to past systems; recognition of this factor implies that the work of reconstruction will be an on-going process after the analysis is terminated, and forms part of the patient's equipment for future self analysis.

Adult↗
PubMed1980

Topography of sensory evoked potentials in depressive disorders.

This study investigated differences in evoked potential (EP) topography between psychotic depressives, nonpatient controls, chronic schizophrenics, and neurotic depressives. Somatosensory (SEP), visual, and auditory EPs were recorded from 14 scalp leads. Locations (latencies) of consecutive EP peaks in a given subject were identified visually in key leads; these latencies were used for computer measurements of amplitude in all leads. Four sets of age- and sex-matched groups were compared by multivariate profile analysis. Amplitude differences between groups agreed well with findings obtained by comparing group sum EPs, indicating convergence between the two measurement methods. Topographic differences involved mainly SEP peaks. Distributions of SEP peaks P90 (positivity at 90 msec), N130, and P290 showed more posterior maxima in psychotic depressives than controls, while P185 was maximal more anteriorly in depressives. Distribution of SEP peaks N20, N60, N130, and P185 differed between psychotic depressives and chronic schizophrenics. The topographic approach appears to provide new EP information of pyschiatric relevance.

Adolescent↗
PubMed1980

Behavior completion mechanisms rather than primary drives maintain behavioral patterns.

Anxiety is identified with a state of high arousal. Agoraphobia is differentiated from specific phobias which are inherent responses to situations which threatened primitive man. In agoraphobia, attacks of high arousal are produced by situations which delay ongoing activity. It is hypothesised that such delays produce arousal by activating behavior completion mechanisms. Evidence is reviewed which indicates desensitization has a specific effect in agoraphobia but not in specific phobias. It is suggested that desensitization reduces the arousal produced by behavior completion mechanisms. -- Aversive therapy in homosexuality reduces the subjects' drive to carry out compulsive sexual behaviors but does not alter sexual orientation. It is suggested that the compulsive sexual behaviors are not activated by primary sexual drive but by behavior completion mechanisms. Aversive therapy reduces the arousal produced by the behavior completion mechanisms. -- A similar mode of action is advanced for desensitization and aversive therapy. Both inhibit arousal by establishing a focal experimental neurosis which results from alternation of excitatory and inhibitory impulses.

Agoraphobia↗
PubMed1995

[Compulsive disorder and Gilles de la Tourette syndrome. On the differential diagnosis of organic and psychogenic compulsive symptoms].

A high prevalence of obsessions and compulsions is recognized in patients with Gilles-de-la-Tourette syndrome. Comparison of a group of patients with Gilles-de-la-Tourette syndrome with a group with obsessive-compulsive disorder, using the diagnostic criteria of the DSM-III-R, showed significantly higher scores in both groups of patients in the Hamburg obsessive-compulsive inventory (short version) than in a control group. When selected items from this Inventory were entered in a discriminant analysis, it was shown that there were specific differences in the obsessive-compulsive symptoms in the Gilles-de-la-Tourette syndrome compared to an obsessive-compulsive disorder. Eighty-eight percent of the patients were correctly classified with respect to their diagnosis with eight items of the Hamburg obsessive-compulsive inventory. This result leads to the conclusion that differential observation of the psychopathology of obsessions and compulsions can contribute to the differential diagnosis in obsessive-compulsive disorder and Gilles-de-la-Tourette syndrome, which is still underdiagnosed in Germany compared to epidemiological data in the USA. Moreover, the different psychopathology may reflect differences between a neurotic and an organic basis for obsessions and compulsions.

Adult↗
PubMed1995

Dimensions of somatization and hypochondriasis.

A significantly large group of patients who communicate their psychosocial distress in the form of physical symptoms are called somatizers. They tend to overuse medical services. The syndromes with which they present have indistinct boundaries, and there tends to be some fluidity of their symptomatic presentations. Underlying psychiatric disorders such as mood disorders, anxiety disorders (including obsessive compulsive disorder), and personality disorders are frequently present.

Conversion Disorder↗
PubMed1995

[Obsessive-compulsive symptoms in structural ego defects--a study exemplified by anorexia and bulimia nervosa].

The present study reports findings concerning the hypothesis whether patients with narcissistic self-system disturbances show more obsessive-compulsive (OC) symptoms as compared to patients without such disturbances. Ninety-one patients meeting DSM-III-R criteria for anorexia nervosa (AN) or bulimia nervosa (BN) were investigated using the Narzissmusinventar (NI), the Hamburger-Zwangsinventar (HZI), the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Eating Disorder Inventory (EDI). The NI-data demonstrated a great variance of self-system disturbances in AN and BN; a cluster analysis identified two different clinical features. In comparison to eating disorder patients without concomitant disturbances of the self-system (n = 34) the patient group with such narcissistic deficits (n = 57) showed significantly higher Y-BOCS and HZI-scores indicating more and severer OC symptoms. These patients also had significantly higher and hence pathologic means on seven of eight EDI scales. The results suggest that OC behaviour may be an unconscious attempt to stabilize the self-system equilibrium, i.e. counteracting narcisstic desintegration. Regulatory processes of the self-system and OC symptoms may present additional prognostic factors and lead to new approaches in psychotherapy research.

Adolescent↗
PubMedDate not supplied

[Obsessive-compulsive disorder in the child and adolescent: developmental aspects and therapeutic strategies].

The obsessive-compulsive disorder has only recently been recognized as a specific pathological entity in children, despite the fact that the first descriptions of pediatric manifestations date back to the beginning of this century (P. Janet, 1903) with further reports having been published regularly since that time. The first assessment of the complete epidemiologic, clinical and functional repercussions of the obsessive-compulsive disorder was reported by the Pediatric Psychiatric Group of the NIMH (Pr Judith Rapoport); of their various publications, one is well known in France: The Child who Couldn't Stop Washing (17). Among possible reasons for this delayed recognition are the special conditions for diagnosis and the frequent underestimation of its importance by the family, and sometimes by doctors. This underassessment could be due to confusion between the normal developmental rituals which are frequently seen between the ages of 3 and 5 years, and which do not cause any particular handicaps, and a more severe symptomatology which interferes with normal academic and social adaptation, presenting a substantially worse long-term prognosis. Having recognized the disorder, questions have arisen as to its possible linkage with the form seen in adults. There are numerous convergent argument suggesting a certain long-term persistence of this disorder throughout development and later life: 1) the relative stability of the incidence and prevalence of the disorder; 2) phenomenologic and developmental similarities; 3) most recently, comparable efficacy of treatments for pediatric and adult obsessive-compulsive disorder, whether by the behavioral modification approaches or by pharmacologic treatment, notably with the serotonin re-uptake inhibitors (clomipramine, fluoxetine, fluvoxamine).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Phenomenology of intentional repetitive behaviors in obsessive-compulsive disorder and Tourette's disorder.

BACKGROUND: Recent evidence suggests that obsessive-compulsive disorder (OCD) and Tourette's disorder are related and have overlapping clinical features. The purpose of this study was to test the following hypotheses regarding intentional repetitive behaviors in these two disorders: (1) In OCD without comorbid Tourette's, they are preceded by cognitive phenomena and autonomic anxiety, but not sensory phenomena, and (2) in Tourette's without comorbid OCD, they are preceded by sensory phenomena, but not cognitive phenomena nor autonomic anxiety. METHOD: Fifteen adult OCD outpatients without tics and 17 adult Tourette's outpatients without OCD were evaluated with a structured interview. Questions assessed cognitive, sensory, and affective experiences related to intentional repetitive behaviors. RESULTS: Five of 17 Tourette's subjects were excluded because they had only unintentional or occasionally intentional tics. All OCD patients reported some cognitions preceding their intentional repetitive behaviors, whereas only 2 of 12 Tourette's patients reported cognitions. In comparison, all Tourette's patients reported sensory phenomena preceding repetitive behaviors, and none of the OCD patients reported such sensations. In addition, 13 OCD patients reported at least mild autonomic anxiety associated with their repetitive behaviors, whereas no Tourette's patients reported such symptoms. CONCLUSION: Intentional repetitive behaviors in OCD differ from those in Tourette's and are associated with cognitive and autonomic phenomena. Sensory phenomena preceded intentional repetitive behaviors in Tourette's but not in OCD patients. The dimensions examined in this study (cognition, sensory phenomena, and autonomic anxiety) may represent valid clinical factors for characterization of repetitive behaviors in OCD and Tourette's.

Adult↗
PubMed1995

ECT for OCD.

Explore the source record for details and available documents.

Comorbidity↗
PubMed1994

Predictors of treatment response in obsessive-compulsive disorder: multivariate analyses from a multicenter trial of clomipramine.

There have been many attempts to find predictors of the therapeutic response to the clomipramine treatment of obsessive-compulsive disorder. The majority of studies have failed to identify such predictors. Possible reasons for this failure include the small sample size of most studies, samples homogeneous with respect to the study factors of interest, and the use of statistical procedures that are insensitive to individual differences or that inadequately control for confounding. We have reanalyzed data from Ciba-Geigy's large, multicenter clinical trial of clomipramine for obsessive-compulsive disorder, using stratification and regression techniques to identify multiple prognostic factors and control for confounders. We assessed the relationship between therapeutic response and baseline measures such as severity of symptoms, type of symptoms (obsessions, compulsions, depression), length of illness, age of onset, and other demographic factors (age, race, and sex). We found age of onset to be a strong predictor of response to clomipramine: people who develop obsessive-compulsive disorder later in life have a better chance of responding than do those who become ill earlier, independent of length of illness. We also found that baseline depression is associated with response, but the association appears to be nonlinear.

Adolescent↗