Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-23T06:38:55.488Z Has data issue: false hasContentIssue false
  • English
  • Français

Obsessive–Compulsive Contamination Fears and Anorexia Nervosa: The Application of the New Psycho-Educational Treatment of Danger Ideation Reduction Therapy (DIRT)

Published online by Cambridge University Press:  22 February 2012

Lynne M. Drummond  and
Peter Kolb
Lynne M. Drummond*
Affiliation:
University of London, United Kingdom
Peter Kolb
Affiliation:
Springfield University Hospital, London, United Kingdom
*
*Address for correspondence: Dr Lynne M. Drummond, Consultant Psychiatrist and Senior Lecturer, St George's, University of London, Cranmer Terrace, London SW17 ORE, United Kingdom. Email: [email protected]
Get access

Abstract

The case history of a woman with severe and enduring anorexia nervosa and obsessive–compulsive disorder (OCD) with contamination fears is presented. These contamination fears centred on her fear of contamination by fat and fatty substances as she worried about gaining weight. Previous treatment with graded exposure had shown no clinically significant benefits. She was admitted to a specialist unit for the treatment of OCD as an inpatient. Due to the previous failure of the recognised psychological treatments for OCD it was decided to use the new psychoeducational approach of danger ideation reduction therapy (DIRT). This treatment resulted in an improvement in her OCD symptoms despite the fact that the emphasis of the treatment was on the risk of bacteria and dirt. It is believed that this is the first documented case of DIRT being used for a patient with anorexia nervosa and OCD.

Type
Shorter Communication
Information
Behaviour Change , Volume 25 , Issue 1 , 01 April 2008 , pp. 44 - 50
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.Google Scholar
Beck, A.T. (1978). The Depression Inventory. San Antonio, Texas: Psychological Corporation.Google Scholar
Cottraux, J., Note, I., Yao, S.N., Lafont, S., Note, B., Mollard, E., et al. (2001). A randomized controlled trial of cognitive therapy versus intensive behaviour therapy in obsessive-compulsive disorder. Psychotherapy and Psychosomatics, 70, 288–297.Google Scholar
Drummond, L.M. (1993). The treatment of severe, chronic, resistant obsessive-compulsive disorder: An evaluation of an inpatient programme using behavioural psychotherapy in combination with other treatments. British Journal of Psychiatry, 163, 223–229.CrossRefGoogle ScholarPubMed
Drummond, L.M., & Fineberg, N.A. (2007). Obsessive-compulsive disorders. In G., Stein (Ed.), College seminars in adult psychiatry (pp. 270–286). London: Gaskell.Google Scholar
Drummond, L.M., Pillay, A., Rani, R.S., & Kolb, P.J. (2007). Specialised inpatient treatment for severe, chronic resistant obsessive-compulsive disorder (OCD); A naturalistic study of clinical outcomes. Psychiatric Bulletin, 31, 49–52.Google Scholar
Dubois, F.S. (1949). Compulsion neurosis with cachexia. American Journal of Psychiatry, 106, 107–115.Google Scholar
Ellis, A. (1962). Reason and emotion in psychotherapy. New York: Lyle Stuart. Google Scholar
Fahy, T.A., Osacar, A., & Marks, I. (1993). History of eating disorders in female patients with obsessive- compulsive disorder. International Journal of Eating Disorders, 14 (4), 439–443.3.0.CO;2-6>CrossRefGoogle ScholarPubMed
Fineberg, N.A., & Gale, T. (2005). Evidence-based pharmacological treatments for obsessive compulsive disorder. International Journal of Neuropsychopharmacology, 8, 107–129.Google Scholar
Foa, E.B., & Goldstein, A. (1978). Continuous exposure and complete response prevention in the treatment of obsessive-compulsive neurosis. Behavior Therapy, 9, 821–829.CrossRefGoogle Scholar
Goodman, W.K., Price, L.H., Rasmussen, S.A., Mazure, C., Fleischmann, R.L., Hill, C.L., et al. (1989). The Yale-Brown Obsessive Compulsive Scale, I: Development, use, and reliability. Archives of General Psychiatry, 46, 1006–1011.Google Scholar
Govender, S., Drummond, L.M., & Menzies, R.G. (2006). The use of danger ideation reduction therapy in the treatment of severe chronic resistant obsessive-compulsive disorder. Behavioural and Cognitive Psychotherapy, 34, 1–4.Google Scholar
Hsu, L.K., Kaye, W.H., & Weltzin, T. (1993). Are the eating disorders related to obsessive compulsive disorder? International Journal of Eating Disorders, 14 (3), 305–318.Google Scholar
James, I.A., & Blackburn, I.M. (1995). Cognitive therapy with obsessive-compulsive disorder. British Journal of Psychiatry, 166, 444–450.Google Scholar
Jones, M.K., & Menzies, R.G. (1997). The cognitive mediation of obsessive-compulsive handwashing. Behaviour Research and Therapy, 35, 843–850.CrossRefGoogle ScholarPubMed
Jones, M.K., & Menzies, R.G. (1998). Danger ideation reduction therapy (DIRT) for obsessive-compulsive washers. A controlled trial. Behaviour Research and Therapy, 36, 121–125.CrossRefGoogle ScholarPubMed
Kaye, W.H., Bulik, C.M., Thornton, L., Barbarich, N., & Masters, K. (2004). Comorbidity of anxiety disorders with anorexia and bulimia nervosa. American Journal of Psychiatry, 161 (12), 2215–2221.Google Scholar
Krochmalik, A., Jones, M.K., & Menzies, R.G. (2001). Danger ideation reduction therapy (DIRT) for treatment resistant compulsive washing. Behaviour Research and Therapy, 39, 897–912.CrossRefGoogle ScholarPubMed
Marks, I.M., Hodgson, R., & Rachman, S. (1975). Treatment of chronic obsessive-compulsive disorder by in vivo exposure. British Journal of Psychiatry, 12, 349–364.Google Scholar
McDougle, C.J., & Goodman, W.K. (1991). Obsessive-compulsive disorder: Pharmacotherapy and pathophysiology. Current Opinion in Psychiatry, 4, 267–272.Google Scholar
McLean, P.D., Whittal, M.L., Thordarson, D.S., Taylor, S., Sochting, K.O., Koch, W.J., Paterson, R., & Anderson, K.W. (2001). Cognitive versus behaviour therapy in group treatment to obsessive-compulsive disorder. Consulting and Clinical Psychology, 69, 205–214.Google Scholar
Palmer, H.D., & Jones, M.S. (1939). Anorexia nervosa as a manifestation of compulsion neurosis. Archives of Neurology and Psychiatry, 41, 856–858.Google Scholar
Salkovskis, P.M. (1999). Understanding and treating obsessive-compulsive disorder. Behaviour Research and Therapy, 37(suppl. 1), 29–52.Google Scholar
Sanavio, E. (1988). Obsessions and compulsions: The Padua Inventory. Behaviour Research and Therapy, 26,169–177.Google Scholar
Thiel, A., Broocks, A., Ohlmeier, M., Jacoby, G.E., & Schussler, G. (1995). Obsessive-compulsive disorder among patients with anorexia nervosa and bulimia nervosa. American Journal of Psychiatry, 152 (1), 72–75.Google Scholar