By David A. Clark

This authoritative booklet experiences present cognitive-behavioral versions of OCD and delineates an leading edge, theoretically and empirically grounded method of review and remedy. prime scientist-practitioner David A. Clark first elaborates and refines current theories of obsessions and compulsions. He then spells out potent suggestions for assessing shopper wishes, constructing a transparent case formula, enforcing an array of cognitive and behavioral interventions, and troubleshooting strength problems. Illustrated with large medical fabric, the quantity is useful and undemanding. Reproducible appendices characteristic over a dozen ranking scales, customer handouts, and homework projects.

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Like the findings on obsessions, these results support a dimensional perspective on OCD. , pathological gambling, overeating, alcoholism), or other impulse-control disorders. However, the main difference is that some degree of pleasure seeking is evident in these other behavioral patterns, whereas it is entirely absent in compulsions (Foa & Steketee, 1979; Hollander & Wong, 2000). Another clinical phenomenon that can be confused with compulsions is multiple tic disorder. O’Connor (2001) noted that tics are involuntary, impulsive, and purposeless movements, whereas compulsions are more likely to be intentional or voluntary and to be preceded by intrusive thoughts.

1999). However, factor analytic results of a new obsessive–compulsive symptom measure that my colleagues and I developed revealed that ob- 40 THE NATURE OF OCD sessions and compulsions items formed clearly distinct dimensions (Clark, Antony, Beck, Swinson, & Steer, 2003). These latter findings, then, support the clinical practice of treating obsessions and compulsions as functionally related, but distinct, clinical phenomena. Compulsions are not restricted to clinical OCD samples. Many nonclinical individuals report that they sometimes or often perform ritualistic behaviors involving (1) checking, (2) cleaning, washing, and ordering, (3) “magical” protective behaviors, or (4) avoidance of particular objects (Muris, Merckelbach, & Clavan, 1997; see also Burns, Formea, Keortge, & Sternberger, 1995).

Fluctuations in insight are to be expected. , the 4% in the DSM-IV field trial who were convinced of their obsessional fears). For these individuals, the obsession may have developed into an overvalued idea (OVI) or possibly even worse, a delusion. Wernicke first introduced the term OVI in 1900 to refer to a solitary belief that a person felt justified in holding and that strongly determined the person’s behavior (see Kozak & Foa, 1994). Jaspers (1963) later elaborated the concept by noting that overvalued ideas involve strong personal identification and fairly intense affect.

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Cognitive-Behavioral Therapy for OCD by David A. Clark
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