Obsessive-Compulsive Disorder

Behavioral Treatment for OCD: Review of the Literature

OCD is an anxiety disorder most commonly characterized by intrusive and uncontrollable thoughts accompanied by a need to perform specific acts repeatedly (usually termed "ritualistic behavior."). A number of stimuli can trigger ritualistic behavior with the severity of the urge differing from stimulus to stimulus. In many studies, treatment is said to be successful to the extent that the triggering stimuli are no longer responded to with ritualistic behavior; in other studies, success is said to include not only the reduction of ritualistic behavior but also the reduction of secondary symptoms such as mood.

As noted by Emmelkamp and Kraanen (1977), in vivo exposure (the direct exposure of the patient to stimuli that elicits ritualistic behavior, usually in hierarchial order) has been associated with relatively good success rates. In their study of in vivo exposure for the treatment of OCD, Emmelkamp and Kraanen sought to expand the existing research in this area through an examination of whether the success of in vivo exposure significantly differed depending upon whether exposure to the triggering stimuli was c

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n it throughout its course. In another study of behavioral treatment for OCD, Emmelkamp, van der Helm, van Zanten and Plochg (1980), gave a small sample of patients (N=15) either: (1) in vivo exposure and relaxation training; or (2) in vivo exposure, relaxation training and self-instruction training (self-statements of one's ability to cope) in order to determine treatment efficacy of both procedures. All patients were pretested, posttested and followed up at one month and six month intervals using measures of anxiety, avoidance, mood, depression and obsessional behavior. While for both groups, treatment resulted in the reduction of ritualistic behavior, anxious mood and depression, only one significant difference was found between groups. Specifically, the exposure/relaxation group, at posttest, produced less avoidance behavior than the exposure/relaxation/self-instruction group. It was concluded that self-instruction training did not augment the therapeutic gains made in its absence. While the methods in the study seem sound overall, once again groups were very small, making it difficult to place strong confidence in conclusions regarding the non-efficacy of self-instruction training. Moreover, Emmelkamp and associates
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Approximate Word count = 2186
Approximate Pages = 9 (250 words per page)

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