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Related Experiment Videos

Do "flashbacks" represent obsessional imagery?

J F Lipinski1, H G Pope

  • 1Obsessive-Compulsive Disorder Clinic, Massachusetts General Hospital, Boston.

Comprehensive Psychiatry
|July 1, 1994
PubMed
Summary
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Obsessive-compulsive disorder (OCD) patients experiencing intrusive images, often misdiagnosed as trauma flashbacks, showed significant symptom improvement with serotonin reuptake antagonists. This suggests these images may be common OCD obsessions, not repressed memories.

Area of Science:

  • Psychiatry
  • Neuroscience
  • Clinical Psychology

Background:

  • Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts and compulsive behaviors.
  • Misdiagnosis of OCD symptoms can occur, particularly when intrusive images are interpreted as repressed trauma.
  • Previous therapeutic approaches focused on uncovering repressed memories for such symptoms.

Observation:

  • Three patients meeting DSM-III-R criteria for OCD presented with vivid, intrusive obsessional images.
  • These images were previously diagnosed as "flashbacks" of repressed childhood trauma by other clinicians.
  • Patients were encouraged to engage in psychotherapy to explore potential repressed memories.

Findings:

  • Treatment with serotonin reuptake antagonists led to rapid remission of the intrusive images.

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  • Associated obsessional and compulsive symptoms also resolved promptly with this pharmacological intervention.
  • This response suggests a neurobiological basis for the intrusive images in these OCD patients.

    • Implications:

    • The findings challenge the interpretation of certain intrusive images in OCD as repressed trauma.
    • Serotonin reuptake antagonists may be an effective treatment for OCD patients experiencing these specific types of obsessional images.
    • This highlights the importance of accurate diagnosis in differentiating OCD from trauma-related disorders.