Abstract
Although obsessive-compulsive disorder (OCD) is the least prevalent of the anxiety disorders, it is often one of the more severe, extracting a heavy toll in personal and social debilitation. As a diagnostic entity it is easily recognizable, and Esquirol, as early as 1838, described the disorder. More systematic defi nitions were offered by Janet (1908), Schneider (1925), and Lewis (1966). In this chapter, we will review and summarize the clinical syndrome, theories, relationships to other conditions, and contemporary treatments. An exhaustive review, however, is beyond the scope of this chapter, and the reader may refer to Rachman and Hodgson (1980), Beech (1974), and Mavissakalian, Turner, and Michelson (in preparation) for comprehensive critiques.
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References
Akhtar, S., Wig, N. H., Verna, V. K., Pershod, D., &Verna, S. K. A phenomenological analysis of symptoms in obessive-compulsive neuroses. British Journal of Psychiatry ,1975, 127 ,342–348.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (2nd ed.). Washington, D. C: Author, 1968.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, D. C: Author, 1980.
Ananth, J. Clomipramine in obsessive neurosis: A review. In M. Mavissakalian, S. M. Turner, &L. Michelson (Eds.), Obsessive-compulsive disorder: Psychological and pharmacologi cal treatment. New York: Plenum, in preparation.
Ananth, J. &Van den Steen, N. Systematic studies in the treatment of obsessive-compulsive neurosis with tricyclic anti-depressants. Current Therapeutic Research ,1977, 21 ,495–500.
Ananth, J., Solyom, L., Bryntwick, S., &Krishnappa, U. Chlorimipramine therapy for obsessivecompulsive neurosis. American Journal of Psychiatry ,1979, 136 ,700–701.
Andrasik, F., Turner, S. M., &Ollendick, T. H. Self-report and physiological responding during in vivo flooding. Behaviour Research and Therapy ,1980, 18 ,593–595.
Beaumont, G. Clomipramine (Anafranil) in the treatment of obsessive-compulsive disorders-A review of the work of Dr. G. A. Collins. Journal of International Medical Research ,1973, 1 ,423–424.
Beech, H. R. Ritualistic activity in obsessional patients. Journal of Psychosomatic Research ,1971, 75, 417–422.
Beech, H. R. Approaches to understanding obsessional states. In H. R. Beech (Ed.), Obsessional states. London: Methuen, 1974.
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.
Beech, H. R. &Perigault, J. Toward a theory of obsessional disorder. In H. R. Beech (Ed.), Obsessional states. London: Methuen, 1974.
Beech, H. R. &Vaughan, M. Behavioral treatment of obsessional states. New York: Wiley, 1978.
Black, A. The natural history of obsessional neurosis. In H. R. Beech (Ed.), Obsessional states. London: Methuen, 1974.
Boulougouris, J. &Bassiakos, L. Prolonged flooding in cases with obessive-compulsive neurosis. Behaviour Research and Therapy ,1973, 11 ,227–231.
Boulougouris, J., Rabavilas, A., &Stefanis, C. Psychophysiological responses in obsessive-compulsive patients. Behaviour Research and Therapy ,1977, 75, 221–230.
Bick, P. A. Obsessive-compulsive behavior associated with dexamethasone treatment. Journal of Nervous and Mental Disease ,1983, 777, 253–254.
Carey, G. &Gottesman, I. I. Twin and family studies of anxiety, phobic and obsessive disorders. In D. F. Klein &J. G. Rabkin (Eds.), Anxiety: New research and changing concepts. New York: Raven Press, 1981.
Catts, S. &McConaghy, N. Ritual prevention in the treatment of obsessive-compulsive neurosis. Australian and New Zealand Journal of Psychiatry ,1975, 9, 37–41.
Cawley, R. H. Psychotherapy and obsessional disorders. In H. R. Beech (Ed.), Obsessional states. London; Methuen, 1974.
Cooper, J. The Leyton Obsessional Inventory. Psychological Medicine ,1970, 1 ,48–64.
Cooper, J. E., Gelder, M. G., &Marks, I. M. Results of behaviour therapy in 77 psychiatric patients. British MedicalJournal ,1965, 1 ,1222–1225.
de Silva, P., Rachman, S., &Seligman, M. E. P. Prepared phobias and obsessions: Therapeutic outcome. Behaviour Research and Therapy ,1977, 15 ,54–77.
Dollard, J. &Miller, N. Personality and psychotherapy. New York: McGraw-Hill, 1950.
Flor-Henry, P., Yeudall, L. T., Koles, Z. J., &Howarth, B. G. Neuropsychological and power spectral EEG investigations of the obsessive compulsive syndrome. Biological Psychiatry ,1979, 14 ,119–130.
Foa, E. B. &Goldstein, A. Continuous exposure and complete response prevention in the treat ment of obsessive-compulsive neurosis. Behavior Therapy ,1978, 9 ,821–829.
Foa, E. B. &Steketee, G. Emergent fears during treatment of three obsessive-compulsives: Symptom substitution or de-conditioning. Journal of Behavior Therapy and Experimental Psychiatry ,1977, 8 ,353–358.
Foa, E. B., Steketee, G. S., &Ozarou, B. J. Behavior therapy with obsessive-compulsives: From theory to treatment. In M. Mavissakalian, S. M. Turner, &L. Michelson (Eds.), Obsessive compulsive disorder: Psychological and pharmacological treatment. New York: Plenum, in preparation.
Foulds, G. A. Personality and personal illness. London: Tavistock, 1965.
Foulds, G. A. &Caine, T. M. Psychoneurotic symptom clusters, trail clusters and psychological tests. Journal of Mental Science. 1958, 104 ,722.
Foulds, G. A. &Caine, T. M. Symptom clusters and personality types among psychoneurotic men compared with women. Journal of Mental Science ,1959, 105 ,469.
Freeman, W. &Watts, J. W. Psychosurgery (2nd ed.). Oxford: Oxford University Press, 1950.
Fürst, J. B. &Cooper, A. Failure of systematic desensitization in two cases of obsessive-compulsive neurosis marked by fears of insecticide. Behaviour Research and Therapy ,1970, 8 ,203–206.
Gittleson, N. C. The effects of obsessions on depressive psychosis. British Journal of Psychiatry ,1966, 112 ,253–258.
Grimshaw, L. Obsessional disorder and neurological illness. Journal of Neurology, Neurosur gery and Psychiatry ,1964, 27 ,229–231.
Grimshaw, L. The outcome of obsessional disorder: A follow-up study of 100 cases. British Journal of Psychiatry ,1965, 111 ,1051–1056.
Hare, E., Price, J., &Slater, E. Age distribution of schizophrenia and neurosis: Findings in a national sample. British Journal of Psychiatry ,1971, 119 ,445–458.
Hodgson, R. &Rachman, S. The effects of contamination and washing in obsessional patients. Behaviour Research and Therapy ,1972, 10 ,111–117.
Hodgson, R. J., &Rachman, S. Obsessional-compulsive complaints. Behaviour Research and Therapy ,1977, 15 ,389–395.
Ingram, I. M. Obsessional illness in mental hospital patients. Journal of Mental Science ,1961, 197 ,382–402.
Ingram, I. &McAdam, W. EEG, obsessional illness and obsessional personality. Journal of Mental Science ,1960, 106 ,686–691.
Insel, T. R., Gillin, C., Moore, A., Mendelson, W. B., Lowenstein, R. J., &Murphy, D. J. The sleep of patients. Archives of General Psychiatry ,1982, 39 ,1372–1377.
Jacob, R. G., Turner, S. M., Szekely, B. C., &Eidelman, B. H. Predicting outcome of relaxation therapy in headaches: The role of “depression.” Behavior Therapy ,1983, 14 ,457–465.
Janet, P. Les obsessions et la psychasthénie (2nd ed.). Paris: Paillière, 1908.
Jaspers, K. General psychopathology. Chicago: University of Chicago, 1963.
Kenny, F. T., Solyom, L., &Solyom, C. Faradic disruption of obsessive ideation in the treatment of obsessive neurosis. Behavior Therapy ,1973, 4 ,448–451.
Kenny, F. T., Mowbray, &Lalani, S. Faradic disruption of obsessive ideation in the treatment of obsessive neurosis: A controlled study. Behavior Therapy ,1978, 9, 209–221.
Kirk, J. Behavioural treatment of obsessional-compulsive patients in routine clinical practice. Behaviour Research and Therapy ,1983, 21 ,57–62.
Kringlen, E. Obsessional neurotics: A long-term follow-up. British Journal of Psychiatry ,1965, 111, 709–722.
Lang, P. J., &Lazovick, A. D. Experimental desensitization of a phobia. Journal of Abnormal and Social Psychology ,1963, 66 ,519–525.
LeBoeuf, A. An automated aversion device in the treatment of a compulsive hand-washing ritual. Journal of Behavior Therapy and Experimental Psychiatry ,1974, 5 ,267–270.
Lewinsohn, P. M., Lobitz, C., &Wilson, S. Sensitivity of depressed individuals to adversive psychology. Journal of Abnormal Psychology, 1973, 81 ,259–263.
Lewis, A. J. Obsessional disorder. In R. Scott (Ed.), Price’s textbook of the practice of medicine. (10th Ed.). London: Oxford University Press, 1966.
Lishman, W. A. Brain damage in relation to psychiatric disability after head injury. British Journal of Psychiatry ,1968, 114 ,373–410.
Lo, W. A follow-up study of obsessional neurotics in Hong Kong Chinese. British Journal of Psychiatry ,1967, 773, 823–832.
Lombardo, T. W., &Turner, S. M. Use of thought-stopping to control obsessive rumination in a chronic schizophrenic patient. Behavior Modification ,1979, 3 ,267–272.
Lopez-Ibor, J. J. Ensayo clínico, la monoclomi prámina (Paper read at the Fourth World Con gress of Psychiatry, Madrid, 1966). Congress Proceedings ,1966, 3 ,2159–2161.
Mahoney, J. M. The self-management of covert behavior: A case study. Behavior Therapy ,1971, 2 ,575–578.
Maier, N. R. F. Frustration: The study of behaviour without a goal. New York: McGraw-Hill, 1949.
Maier. N. R. F., &Ellen, P. Studies of abnormal behaviour in the rat: The prophylactic effects of guidance in reducing rigid behaviour. Journal of Abnormal and Social Psychology ,1952, 47 ,109–116.
Maier, N. R. F., &Klee, I. B. Studies of abnormal behaviour in the rat: XVII. Guidance versus trial and error in the alterations of habits and fixations. Journal of Psychology ,1945, 19 ,133–163.
Marks, I. M. Patterns of meaning in psychiatric patients. New York: Oxford University Press, 1965.
Marks, I. Behavioral treatment of phobic and obsessive-compulsive disorders: A critical appraisal. In M. Hersen, R. M. Eisler, &P. M. Miller (Eds.), Progress in Behavior Modification. New York: Academic, 1975.
Marks, I. M., Crowe, M., Drewe, E., Young, J., &Dewhurst, W. G. Obsessive-compulsive neurosis in identical twins. British Journal of Psychiatry ,1969, 775, 991–998.
Marks, I. M., Hodgson, R., &Rachman, S. Treatment of chronic obsessive-compulsive neurosis by in vivo exposure. British Journal of Psychiatry. 1975, 727, 349–364.
Marshall, W. K. Treatment of obsessional illnesses and phobic anxiety state with clomipramine. British Journal of Psychiatry ,1971, 779, 467–468.
Marshall, W. K., &Micev, V. The role of intravenous clomipramine in the treatment of obsessional and phobic disorders. Scottish Medical Journal ,1973, 20 ,49–53.
Mavissakalian, M., Turner, S. M., &Michelson, L. M. (Eds.). Obsessive-compulsive disorder: Psychological and pharmacological treatment. New York: Plenum, in preparation.
Mawson, D., Marks, I. M., &Ramm, L. Clomipramine and exposure for chronic obsessivecompulsive rituals: III. Two year follow up and further findings. British Journal of Psy chiatry ,1982, 140 ,11–18.
Meyer, V. Modification of expectancies in a case with obsessional rituals. Behaviour Research and Therapy ,1966, 4 ,273–280.
Meyer, V. &Levy, R. Modification of behavior in obsessive-compulsive disorders. In H. E. Adams &P. Unikel (Eds.), Issues and trends in behavior therapy. Springfield, 111.: Charles C Thomas, 1973.
Mills, H., Agras, S., Barlow, D., &Mills, J. Compulsive rituals by response prevention. Archives of General Psychiatry ,1973, 28 ,524–529.
Mowrer, O. H. A stimulus response theory of anxiety. Psychological Review ,1939, 46 ,553– 565.
Mowrer, O. H. Two-factor learning theory: Summary and comment. Psychological Reports, 1951, 58 ,350–354.
Murray, R. M., Cooper, S. E., &Smith, A. The Leyton Obsessional Inventory: An analysis of the response of 73 obsessional patients. Psychological Medicine ,1979, 9 ,305–311.
Philpott, R. Recent advances in the behavioral measurement of obsessional illness: Difficulties common to these and other measures. Scottish Medical Journal ,1975, 20 ,33–40.
Pollitt, J. Natural history of obsessional states. British Medical Journal ,1957, 1 ,195–198.
Rabavilas, A., &Boulougouris, J. Physiological accompaniments of ruminations, flooding and thought-stopping in obsessive patients. Behaviour Research and Therapy ,1974, 12 ,239– 244.
Rachman, S. Obsessional-compulsive checking. Behaviour Research and Therapy ,1976, 14, 269–277.
Rachman, S. The conditioning theory of fear acquisition. A critical examination. Behaviour Research and Therapy ,1977, 15 ,375–387.
Rachman, S. &Hodgson, R. Synchrony and desynchrony in fear and avoidance. Behaviour Research and Therapy ,1974, 12 ,311–318.
Rachman, S. &Hodgson, R. Obsessions and compulsions. Englewood Cliffs, N. J.: Prentice Hall, 1980.
Rachman, S. &Seligman, M. E. P. Unprepared phobias: “Be prepared.” Behaviour Research and Therapy ,1976, 14 ,333–338.
Rachman, S., Hodgson, R., &Marks, I. The treatment of chronic obsessional neurosis. Behaviour Research and Therapy ,1971, 9 ,237–247.
Rachman, S., Marks, I., &Hodgson, R. The treatment of chronic obsessive-compulsive neurosis by modeling and flooding in vivo. Behaviour Research and Therapy ,1973, 11, 467–471.
Rachman, S., Cobb, J., Grey, S., MacDonald, B., Mawson, D., Sartory, G., &Stern, R. The behavior treatment of obsessional-compulsive disorders, with and without clomipramine. Behaviour Research and Therapy ,1979, 17 ,467–478.
Rack, P. Clomipramine in the treatment of obsessive states. Journal of International Medical Research ,1973, 1 ,397–399.
Reed, G. F. Some formal qualities of obsessional thinking. Psychiatric Clinic ,1968, 1 ,382– 392.
Reed, G. F. Obsessionality and self-appraisal questionnaires. British Journal of Psychiatry, 1969, 115 ,205–209.
Roper, G. &Rachman, S. Obsessional-compulsive checking: Experimental replication and development. Behaviour Research and Therapy ,1976, 14 ,25–32.
Roper, G., Rachman, S., &Hodgson, R. An experiment on obsessional checking. Behaviour Research and Therapy ,1973, 11, 271–277.
Rosen, I. A clinical significance of obsessions in schizophrenia. Journal of Mental Science ,1957, 103 ,773–786.
Rosenberg, C. Familial aspects of obsessional neurosis. British Journal of Psychiatry ,1967, 113, 405–413.
Rubin, R. D., &Merbaum, M. Self-imposed punishment versus desensitization. In R. D. Rubin, H. Fensterheim ,A. A. Lazarus, &C. M. Franks (Eds.), Advances in behaviour therapy. New York: Academic ,1971.
Sandler ,J. &Hazari ,A. The obsessional: Or the psychological classification of obsessional char acter traits and symptoms. British Journal of Medical Psychology ,1960, 33 ,113–122.
Sheilds ,J. Heredity and psychological abnormality. In H. J. Eysenck (Ed.) ,Handbook of abnor mal psychology (2nd ed.). London: Pitmans ,1973.
Schneider ,K. Schwangszustände in Schizophrenic Archiv Für Psychiatrie und Nervenkrankheiten ,1925, 74 ,93–107.
Seligman ,M. E. P. On generality of the law of learning. Psychological Review ,1970, 77 ,406–418.
Seligman ,M. E. P. Phobias and preparedness. Behavior Therapy ,1971, 2 ,307–320.
Sifneos ,P. Psychotherapeutic interventions in obsessive disorders. In M. Mavissakalian ,S. M. Turner ,&L. Michelson (Eds.), Obsessive-compulsive disorder: Psychological and pharmacological treatment. New York: Plenum ,in preparation.
Snowdon ,J. A comparison of written and postbox forms of the Leyton Obsessional Inventory. Psychological Medicine ,1980, 10 ,165–170.
Solyom ,L. A case of obsessive neurosis treated by aversion relief. Canadian Psychiatric Association Journal ,1969, 14 ,623–626.
Solyom ,L., Zamanyadeh ,D., Ledwich ,B., &Kenny ,F. Aversion relief treatment of obsessional neurosis. In R. Rubin (Ed.) ,Advances in behavior therapy. New York: Academic Press ,1971.
Spielberger ,C. D., Pollans ,C. H., &Worden ,T. J. Anxiety disorders. In S. M. Turner &M. Hersen (Eds.), Adult psychopathology and diagnosis. New York: Wiley ,1984.
Steinberg ,M. Physical treatments in obsessional disorders. In H. R. Beech (Ed.) ,Obsessional states. London: Methuen ,1974.
Steketee, G., Foa, E. B., &Grayson, J. B. Recent advances in the behavioral treatment of obsessive-compulsives. Archives of General Psychiatry ,1982, 39 ,1365–1371.
Stern, R. Treatment of a case of obsessional neurosis using thought-stopping technique. British Journal of Psychiatry ,1970, 117 ,441–442.
Stern ,R. S., Lipsedge ,M., &Marks ,I. Obsessive ruminations: A controlled trial of a thoughtstopping technique. Behaviour Research and Therapy ,1973, 11 ,659–662.
Sturgis ,E. &Meyer ,V. Obsessive-compulsive disorder. In S. M. Turner ,K. S. Calhoun ,&H. E. Adams (Eds.), Handbook of clinical behavior therapy. New York: Wiley ,1981.
Sykes ,M. &Tredgold ,R. Restricted orbital undercutting. British Journal of Psychiatry ,1964 ,770,609–640.
Templer ,D. I. The obsessive compulsive neurosis: Review of research findings. Comprehensive Psychiatry ,1972, 13 ,375–383.
Thoren ,P., Asberg ,M., Bertilsson ,L., Meilstrom ,B., Sjoqvist ,F., &Traskman ,L. Clomipramine treatment of obsessive-compulsive disorder: II. Biochemical aspects. Archives of Gen eral Psychiatry ,1980, 37 ,1289–1294.
Thoren ,P., Asberg ,M., Cronholm ,B., Jorhestedt ,L., &Traskman ,L. Clomipramine treatment of obsessive-compulsive disorder. Archives of General Psychiatry ,1980, 37 ,1281–1285.
Turner ,S. M. Behavioral assessment of drug effects in obsessive-compulsive disorders. Psycho pharmacology Bulletin ,1982, 18 ,41–43. (a)
Turner ,S. M. Behavior modification and black populations. In S. M. Turner and R. T. Jones (Eds.), Behavior modification in black populations: Psychosocial issues and empirical findings. New York: Plenum ,1982. (b)
Turner ,S. M. Patterns of depression and anxiety in patients with anxiety disorders. Unpublished manuscript. University of Pittsburgh ,1983.
Turner ,S. M., Hersen ,M., Bellack ,A. S., &Wells ,K. C. Behavioral treatment of obsessivecompulsive neurosis. Behaviour Research and Therapy ,1979, 17 ,95–106.
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 Men tal Disease ,1980, 168 ,651–657.
Turner, S. M., Holzman, A., &Jacob, R. G. Treatment of compulsive looking by imaginal thought-stopping. Behavior Modification ,1983, 7 ,576–582.
Turner, S. M., Jacob, R. G., &Nathan, R. S. Dexamethasone suppression test in obsessivecompulsive disorder. Unpublished manuscript, University of Pittsburgh, 1983.
Vaughan, M. The relationships between obsessional personality, obsessions and depression and symptoms of depression. British Journal of Psychiatry ,1976, 129 ,36–39.
Videbech, T. Psychopathology of anancastic endogenous depression. Acta Psychiatrica Scandinavia ,1975, 52 ,336–373.
Walker, V. J. &Beech, H. R. Mood states and the ritualistic behavior of obsessional patients. British Journal of Psychiatry ,1969, 115 ,1261–1268.
Walter, C. J. S. Clinical impressions on treatment of obsessional states with intravenous clomipramine. Journal of International Medical Research ,1973, /, 413–416.
Walton, D. The relevance of learning theory to treatment of an obsessive-compulsive state. In H. J. Eysenck (Ed.), Behavior therapy and the neuroses. Oxford: Pergamon, 1960.
Walton, D. &Mather, M. D. The application of learning principles to the treatment of obsessivecompulsive states in the acute and chronic phases of illness. Behaviour Research and Therapy ,1963, 1, 163–174.
Waxman, D. An investigation into the use of anafranil in phobic and obsessional disorders. Scottish Medical Journal ,1975, 20 ,61–66.
Welner, N. &Harwitz, M. Intrusive and repetitive thoughts after a depressing experience. Psychological Reports ,1975, 37 ,135–138.
Wisocki, P. A. Treatment of obsessive-compulsive behavior by covert sensitization and covert reinforcement: A case report. Journal of Behavior Therapy and Experimental Psychiatry ,1970, 1 ,233–239.
Wolpe, J. Psychotherapy by reciprocal inhibition. Stanford, Cal.: Stanford Univerity Press, 1958.
Yaryura-Tobias &Neziroglu, J. A. The action of clomipramine in obsessive-compulsive neurosis: A pilot study. Current Therapeutic Research ,1975, 17 ,111–116.
Yaryura-Tobias, Bebirian, R., Neziroglu, F. A., &Bhagavarn, H. N. Obsessive-compulsive disorders as a serotogenic effect. Research Communications in Psychology, Psychiatry, and Behavior ,1977, 2 ,279–286.
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Turner, S.M., Michelson, L. (1984). Obsessive-Compulsive Disorders. In: Turner, S.M. (eds) Behavioral Theories and Treatment of Anxiety. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-4694-4_6
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