Week 3 Reading: Journal of Obsessive-Compulsive and Related Disorders

Question 1

What was the primary aim and methodology of this study?

Answer 1

Aim:
The aim of the paper was to review randomised controlled trials (RCTs) of psychological treatments for OCD in adults using the criteria proposed by Chambless and Hollon (1998).

Studies were included if they met the following criteria:

(a) they included adults who met criteria for OCD according to a formal diagnostic system;
(b) used random assignment to treatment (or control) condition;
(c) provided a clear account of the treatment approach;
(d) change in OCD diagnosis/symptom severity or functioning/impairment was reported and analyzed; and
(e) the findings were reported in a peer-reviewed journal.

Methodology:
Material was sought through on PsychInfo and PubMed using key terms. Inclusionary criteria initially set out by the paper. Classified based on the definitions (in the following q).

Question 2

Briefly outline the definitions of ‘efficacious and specific’, ‘efficacious’ and ‘possibly efficacious’ treatments?

Answer 2

Efficacious and specific: two or more independent groups found that the treatment led to a better outcome than others or non-specific treatments.

Efficacious: two or more independent groups found that that treatment is better than no treatment

Possibly efficacious: one group shows support

Question 3

What would be the ‘treatment of choice’ for a person with OCD? Why?

Answer 3

Exposure Response Prevention (ERP):
A behavioural technique that involves exposing patients to a stimulus that brings on the response, then prevent them from giving in to their impulsions. Let them sit with it and talk through it with them.

Why:
It reduced OCD symptoms and provided better results that alternative treatments - efficacious and specific therefore was specific, long lasting, enhanced by medication, and assisted in substance abuse patients too.
Had a better effect size than CBT.

Question 4

What were the main symptom dimensions, or themes, of OCD according to DSM-IV? Are any of these less responsive to treatment? Has there been a treatment developed specifically for any of these dimensions?

Answer 4

Obsessive and intrusive thoughts & Impulsive behaviour patterns
subtypes inc:
- contamination (obsessions with washing-cleaning rituals)
- checking (reassurance seeking rituals)
- obsessions (need for symmetry, exactness or arranging rituals)
- Unacceptable thoughts with covert mental rituals (violent thoughts)
- hoarding (STILL DEBATED) (has it’s own domain in DSM-5, as needs to be treated differently, has different commodities etc)