Treating a Case of Disgust-Based Contamination Obsessive-Compulsive Disorder Using a Functional Approach to Exposure...

Area of Science:

• Psychiatry
• Clinical Psychology
• Behavioral Therapy

Background:

• Disgust-based contamination obsessive-compulsive disorder (OCD) presents treatment challenges due to unique neurological and behavioral factors.
• Short-term habituation is often inhibited in patients with disgust-based OCD, complicating traditional therapeutic approaches.

Purpose of the Study:

• To present a case study detailing a novel functional approach to exposure and response prevention (ERP) for disgust-based OCD.
• To evaluate the efficacy of integrating acceptance and commitment therapy (ACT) concepts and judicious safety behaviors within ERP.

Main Methods:

• A 39-year-old male patient with disgust-based contamination OCD was treated using a novel functional ERP approach.
• The treatment incorporated facilitated practice in avoided situations, ACT principles, and strategic use of safety behaviors.
• Psychotherapy was combined with a period of self-directed patient practice.

Main Results:

• The patient experienced a 56% reduction in OCD severity, as measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).
• The treatment course was short, involving psychotherapy and self-directed practice over a 5-month period.
• The patient achieved remission of OCD symptoms by the end of the posttreatment period.

Conclusions:

• The novel functional approach to ERP, integrating ACT and safety behaviors, shows promise for treating challenging disgust-based OCD.
• Facilitating practice in avoided situations is a key component for successful habituation and symptom reduction.
• This case study suggests that this integrated therapeutic strategy can lead to significant symptom improvement and remission in a relatively short timeframe.