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2 results

  • 12 - CBT for OCD:

  • from Part Three - Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder and Associated Disorders
  • Edited by Gillian Todd, University of East Anglia, Rhena Branch, University of East Anglia
  • Book:
    Evidence-Based Treatment for Anxiety Disorders and Depression
    Published online:
    06 January 2022
    Print publication:
    13 January 2022, pp 222-251

  • Summary

    Contamination concerns and checking remain two of the most prevalent forms of presentation in OCD, reported by 25–50% of sufferers, with checking the most common compulsion. Since they cover a broad spectrum of concerns and complexity, the assessment and treatment of contamination and checking carries its own challenges for the therapist. This chapter explores the nature of contamination and checking concerns and provides an overview of recent research. Practical advice and guidance will guide the therapist from initial assessment to formulation and the development of an effective treatment protocol. The prevalence of covert safety-seeking behaviors such as rumination is discussed as a frequent obstacle in treatment. It advocates a move away from graded hierarchies for exposure and considers what effective exposure should consist of, encouraging the use of creativity and playfulness. A range of both common and less common presentations is used to illustrate key concepts.

  • Inversion of the “Unrealistic Optimism” Bias Contributes to Overestimation of Threat in Obsessive-Compulsive Disorder

  • Steffen Moritz, Lena Jelinek
  • Journal:
    Behavioural and Cognitive Psychotherapy / Volume 37 / Issue 2 / March 2009
    Published online by Cambridge University Press:
    06 January 2009, pp. 179-193
    Print publication:
    March 2009

  • Background: Overestimation of threat (OET) is ascribed a pathogenetic role in obsessive-compulsive disorder (OCD). Aims: We hypothesized that OCD patients overestimate their personal but not the average risk for OCD-related events. Specifically, an attenuation of the common “unrealistic optimism” bias (UO) was expected for OCD patients. UO refers to the phenomenon that the subjective likelihood to personally experience a positive event is enhanced compared to other persons and vice versa for negative events. Method: Fifty-three participants with OCD as well as 40 healthy and 23 psychiatric controls participated in an internet survey. They were asked several questions about different event types (positive, negative, and OCD-related): the probability that this event will happen to oneself (block 1), to another person (block 2), comparison between oneself versus another person (block 3), appraisal of consequences (block 4), and prior encounters with event (block 5). Results: No evidence was obtained in OCD to overestimate the overall probability of negative or OCD-related events. However, whereas healthy participants displayed an UO bias, OCD participants perceived themselves as more vulnerable to experience OCD-related events. Conclusions: Results indicate that OCD is associated with inflated personal vulnerability and that this bias is not fully available to the consciousness of OCD participants.