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Related Concept Videos

Obsessive-Compulsive Disorder01:28

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by recurrent obsessions, compulsions, or both, which consume significant time and interfere with daily functioning. Obsessions involve persistent, intrusive, and unwanted thoughts, images, or urges that evoke anxiety. Common examples include irrational fears of contamination or harm. Compulsions are repetitive behaviors or mental acts performed to reduce the anxiety caused by obsessions. For instance, individuals...
Treatment Strategies for Psychological Disorders01:24

Treatment Strategies for Psychological Disorders

Treatment approaches for psychological disorders fall into three main categories: psychological, biological, and sociocultural. Each approach targets different aspects of mental health, requiring varying levels of education and training.
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Operant Conditioning Intervention

Operant conditioning serves as a foundational principle in therapeutic interventions aimed at modifying maladaptive behaviors. Central to this approach is the notion that behaviors, both adaptive and maladaptive, are learned through reinforcement. By analyzing the environmental factors that reinforce problematic behaviors, clinicians can design interventions to weaken these reinforcements and replace maladaptive behaviors with healthier alternatives.
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Personality Disorders: Dependent and Obsessive-Compulsive01:24

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Dependent personality disorder and obsessive-compulsive personality disorder are two separate psychological conditions that influence behavior, relationships, and overall life functioning. Though both involve maladaptive behaviors, their core characteristics and motivations differ significantly.
 Dependent Personality Disorder
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Social Anxiety Disorder01:28

Social Anxiety Disorder

Social anxiety disorder, also known as social phobia, is characterized by an intense fear of social situations where one might face humiliation, rejection, embarrassment, or negative evaluation. This disorder leads individuals to avoid activities like casual conversations, public speaking, or seemingly simple tasks such as eating, signing documents, or swimming, in public settings. Its impact extends beyond discomfort, often significantly interfering with daily functioning and quality of life.
Panic Disorder01:27

Panic Disorder

Panic disorder is an anxiety disorder characterized by recurrent and sudden minutes-long episodes of intense fear, known as panic attacks. These attacks may feel like heart attacks and often happen without warning or a specific cause. They can include symptoms such as rapid heart rate, shortness of breath, chest pain, trembling, sweating, dizziness, and a sense of helplessness. During a panic attack, individuals may feel as though they are experiencing a heart attack or are in a...

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Protocol for Repetitive Transcranial Magnetic Stimulation with Symptom Provocation to Treat Obsessive-compulsive Disorder
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Stepped care for obsessive-compulsive disorder: An open trial.

Christina M Gilliam1, Gretchen J Diefenbach, Sara E Whiting

  • 1Anxiety Disorders Center, The Institute of Living, Hartford Hospital, CT 06106, USA. cgilliam@harthosp.org

Behaviour Research and Therapy
|August 24, 2010
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Summary

This study shows a stepped care approach using exposure and response prevention (EX/RP) is effective for obsessive-compulsive disorder (OCD). Many patients improved, with some benefiting from initial self-directed treatment, reducing overall costs.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Behavioral Therapy

Background:

  • Obsessive-compulsive disorder (OCD) is a debilitating mental health condition.
  • Exposure and Response Prevention (EX/RP) is a leading cognitive-behavioral therapy for OCD.
  • Stepped care models offer a potentially cost-effective and efficient treatment delivery system.

Purpose of the Study:

  • To evaluate the effectiveness and treatment costs of a stepped care protocol using EX/RP for OCD.
  • To assess patient response at different stages of the stepped care model.
  • To determine the long-term maintenance of treatment gains.

Main Methods:

  • An open trial involving 14 patients with OCD was conducted.
  • Step 1 involved six weeks of self-directed EX/RP with minimal therapist guidance.
  • Step 2 consisted of 15 sessions of twice-weekly therapist-directed EX/RP for non-responders.

Main Results:

  • An overall response rate of 88% was observed among treatment completers.
  • A 60% reduction in Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) scores was noted in completers.
  • Forty-five percent of participants responded after Step 1, indicating reduced treatment costs.
  • All Step 1 responders maintained their gains at follow-up.

Conclusions:

  • Stepped care EX/RP shows promise for treating OCD, offering a flexible and potentially cost-saving approach.
  • Self-directed EX/RP can be effective for a subset of OCD patients, reducing the need for more intensive therapy.
  • Further research with larger sample sizes is warranted due to limitations including high attrition.