Impulsive Compulsive Spectrum Disorders

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Traditionally, impulsive and compulsive behaviors have been categorized as fundamentally distinct. However, patients often exhibit both of these behaviors. This common comorbidity has sparked renewed interest in the factors contributing to the disorders in which these behaviors are prominent. Impulsivity and Compulsivity applies a provocative spectrum model to this psychopathology. The spectrum model is consistent with a dimensional model for psychopathology and considers the dynamic interaction of biopsychosocial forces in the development of impulsive and compulsive disorders. In this important work on impulsive/compulsive psychopathology, leading researchers and clinicians share their expertise on the phenomenological, biological, psychodynamic, and treatment aspects of these disorders. Differential diagnosis, comorbidity of the impulsive-compulsive spectrum of disorders, and assessment by the seven-factor model of temperament and character are discussed. Chapters are also dedicated to the antianxiety function of impulsivity and compulsivity, defense mechanisms in impulsive disorders versus obsessive-compulsive disorders, and the unique aspects of psychotherapy with impulsive and compulsive patients. Clinical researchers and clinicians will be enlightened by this exceptional work. The information provided is supplemented with clinical vignettes, and the final chapter provides a synthetic summary that offers a unified, dynamic approach to impulsive and compulsive behavior.

Obsessive Compulsive Disorder & Comorbidity

The five-year process of preparing for the revision of the Diagnostic and Statistical Manual (DSM) has been organized around a series of conferences convened by the American Psychiatric Association, in collaboration with the World Health Organization and the U.S. National Institutes of Health, to address the future of psychiatric diagnosis. Obsessive-Compulsive Spectrum Disorders: Refining the Research Agenda for DSM-V is the fruit of one of those conferences and presents the most academically sound, thought-provoking, and timely papers from the proceedings. As the conference and book demonstrate, recent advances in psychiatric diagnosis suggest a new approach to obsessive-compulsive disorder (OCD) classification: Research into the pathogenesis of OCD increasingly supports reclassification out of the anxiety disorders and into a separate group of obsessive-compulsive-related disorders (OCRDs). The relationships among OCRDs may be better defined, delineated, and understood if the current categorical diagnostic approach is supplemented with a dimensional approach which assesses obsessive-compulsive symptom domains. Obsessive-compulsive disorders are believed to be underdiagnosed in patients who complain of broad symptoms of anxiety, and reclassification of OCD as an OCRD would promote more careful examination of distinct obsessive-compulsive symptoms, yield more accurate diagnosis, and result in more effective treatments. Reclassification may facilitate future research directions in examining the biological underpinnings of these disorders. In addition to examining the genetic, neurological, and ethno-cultural bases for OCRDs, the book gives special attention to disorders that cross current diagnostic categories, including: Body dysmorphic disorder (BDD) Tourette's syndrome and trichotillomania Impulse-control disorders The process leading to publication of DSM-V is by its nature an exhaustive and complex one, and the conferences play a critical role in reviewing relevant research, assessing the status of scientific knowledge, and advancing that knowledge base. Obsessive-Compulsive Spectrum Disorders: Refining the Research Agenda for DSM-V represents the cutting-edge thinking that will culminate in new diagnoses, classifications, and standards of practice for this debilitating set of disorders. Clinicians and academicians will be fascinated by this glimpse into the next generation of the DSM-V.

Obsessive-compulsive disorder (OCD) is a complex set of thoughts and behaviors that can vary greatly from person to person and can be related to and complicated by a wide range of other disorders. Clinicians are confronted with the challenge of accurately classifying its many variants and developing effective, systematic treatments for them. Some believe that OCD and related problems should be treated as subtypes of one condition; others argue that OCD is composed of a spectrum of many similar conditions that should be treated individually. In this handbook, Jonathan S. Abramowitz, Dean McKay, and Steven Taylor present an approach to diagnosis and treatment that considers subtype and spectrum concepts. They examine specific presentations of OCD—the symptoms—that are often seen in practice as well as the many disorders that may fall within the OCD spectrum. For each symptom and putative spectrum condition, they discuss empirical support, theories of etiology, and treatment issues. The volume covers cognitive-behavioral and biological factors, as well as the latest approaches to psychological and pharmacologic therapy, including complicating factors in treatment. In concluding chapters, the authors critically address the current literature on proposed subtype and spectrum disorders, consider the clinical implications of the literature, and map out a comprehensive, integrated approach for understanding OCD and related conditions. The only work on OCD that covers treatment options for specific symptoms and the full spectrum of related disorders, this handbook is a must-have for clinicians who are dedicated to improving the lives of patients with these challenging mental conditions.

According to recent estimates, one in 50 adults in the United States has obsessive-compulsive disorder and twice that many have had this disorder at some point in their lives. This issue includes articles on the phenomenology of OCD, hypochondriasis, body dysmorphic disorder, genetics and OCD, trichotillomania, Tourette's syndrome, addictive disorders, pharmacotherapy, psychotherapy, and immunology

Few syndromes in psychopathology generate as much popular curiosity and clinical exploration as does obsessive-compulsive disorder (OCD). Since the 1970s, research on OCD has increased exponentially. Speci?c advances include an improved grasp of the heterogeneity of the disorder, identi?cation of putative subtyping schemes, and the development of increasingly sophisticated theoretical models of the etiology and maintenance. Perhaps most importantly, research has led to advances in treatment; andwhereasthe?rstlinetherapies(cognitive-behaviortherapyandserotonergicm- ication) are not entirely effective for every sufferer, they have transformed OCD from an unmanageable lifetime af?iction into a treatable problem that need not reduce quality of life. Despite the aforementioned advances, there have emerged a number of sharp disagreements concerning OCD. Differences have surfaced over phenomenological issues, etiological models, and approaches to treatment, and often occur (but not exclusively) along disciplinary lines between biologically oriented and cogniti- behaviorally oriented authorities. For example, medical approaches posit that abn- mal biological processes cause OCD, whereas psychosocial formulations emphasize the role of learning and dysfunctional cognitions. Yet because theoretical conjecture andempirical?ndingsfromwithineachtraditionaretypicallyaddressedtowardd- tinct and narrow audiences, clinicians, researchers, and students with broad interests are hindered from gaining a clear grasp of the diverse (and sometimes polarized) perspectives.