Berman et al. (2016) CBT for OCD

Question 1

Notes

Answer 1

• Uncommon: Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus (PANDAS)
• Environmental factors: pregnancy (stress!) and traumatic experiences
o DD: individuals who experienced acute trauma may present with OCD-like symptoms (e.g. repeated washing or checking)
• Diagnostic interviews
o Structured clinical interview for DSM-IV (SCID-I)
o Anxiety disorders interview schedule for DSM-IV (ADIS-IV)
• Meta-cognitive measures
o Obsessional beliefs questionnaire (OBQ)
o Thought action fusion scale (TAFS)
• Strategies against overestimation of danger
o Role play by arguing against the other perspective and generating alternative hypotheses
o Would patient be willing to bet large sum of money on event occurring
o Calculate probability of harm by identifying steps/events necessary for disastrous outcome
o Use downward arrow technique to identify beliefs underlying overestimation
o Use mindfulness-based strategies, e.g. let thoughts come and go
• Hierarchical fear exposure: builds patient’s sense of success and enhances confidence to tackle more difficult exposures later on in treatment
• Imaginal exposure with recorded tapes, should last 60-90 sec, listen to it repeatedly and track anxiety
• Preliminary imagined exposure: conducted prior to in vivo exposure