OCD and ERP Treatment Overview

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Questions and Answers

What is an effective treatment for Hoarding Disorder?

Exposure and Response Prevention

Motivational interviewing (correct)

Cognitive Behavioral Therapy

Systematic desensitization

Which of the following disorders is NOT effectively treated with ERP?

Obsessive-Compulsive Disorder (OCD)

Generalized Anxiety Disorder (GAD)

Hoarding Disorder (correct)

Body Dysmorphic Disorder (BDD)

What impact did the introduction of ERP have on the treatment outcomes for OCD?

It made little difference in treatment outcomes.

It significantly improved outcomes. (correct)

It was only effective in severe cases.

It replaced psychoanalytic approaches entirely.

What findings were reported in the Abramowitz Meta-Analysis regarding ERP?

Improvements from ERP persisted at follow-up. Signup and view all the answers

What relationship does ERP aim to weaken in patients with OCD?

Between obsessional stimuli and anxiety Signup and view all the answers

What has misclassifying disorders under OCRDs potentially led to?

Inappropriate treatments and misuse of ERP Signup and view all the answers

Which of the following is NOT a characteristic of compulsions in OCD?

They are resistible to the individual. Signup and view all the answers

Which technique is emphasized in the effective treatment of Hoarding Disorder?

Decision-making skills Signup and view all the answers

What significant advancement in the treatment of OCD occurred in the 1960s?

The introduction of Exposure and Response Prevention (ERP) Signup and view all the answers

What is the effect size (ES) reported for ERP compared to relaxation controls?

1.18 Signup and view all the answers

Which of the following is NOT a mechanism through which ERP works for OCD?

Reinforce compulsive behaviors to provide a sense of safety Signup and view all the answers

What research did the Abramowitz Meta-Analysis review to support ERP’s efficacy?

24 studies with over 800 patients Signup and view all the answers

What is a key similarity between Body Dysmorphic Disorder (BDD) and OCD?

Both involve persistent, anxiety-provoking thoughts Signup and view all the answers

In the context of OCD, what is true about compulsive behaviors?

They temporarily reduce anxiety but maintain it through negative reinforcement Signup and view all the answers

How do the behaviors in Trichotillomania (TTM) differ from those in OCD?

They are positively reinforced and not fear-driven Signup and view all the answers

What conclusion did the Van Balkom Meta-Analysis reach regarding standalone exposure techniques?

They had significant effects on both self-reported and assessor-rated symptoms Signup and view all the answers

Study Notes

OCD and ERP (Exposure and Response Prevention)

Before the 1960s, OCD was considered unresponsive to psychotherapy.
The introduction of ERP in the 1960s significantly improved OCD treatment outcomes.
Numerous studies confirmed ERP's high efficacy.

Abramowitz Meta-Analysis (1975-1995)

Reviewed 24 studies with over 800 patients.
Found large pre-post treatment effect sizes (ES): 1.16 (self-reported) and 1.31 (interviewer-assessed).
Improvements were sustained at follow-up.

Specific Effects of ERP

ERP's effectiveness surpasses nonspecific factors like time, attention, and therapeutic relationships.
Compared to relaxation controls in RCTs, ERP showed a significantly larger effect size (ES = 1.18).

Van Balkom Meta-Analysis (86 studies)

Standalone exposure techniques demonstrated large effects on symptoms: 1.46 (self-reported) and 1.47 (assessor-rated).
Results strongly support the effectiveness of ERP alone or combined with cognitive techniques.

Mechanism of Exposure Therapy in OCD

OCD involves a unique relationship between obsessional fears and compulsive behaviors.
Obsessional fears are triggered by situations or thoughts, not objectively dangerous.
Compulsions are rituals reducing anxiety but maintaining it through negative reinforcement.
ERP helps patients understand the excessive nature of obsessive fears, the unnecessary need for compulsions for safety, and the tolerability of anxiety and obsessive thoughts.
ERP reduces the association between obsessive stimuli and anxiety, and compulsive rituals and relief.

Challenges for Other OCRDs

Body Dysmorphic Disorder (BDD): BDD shares similarities with OCD, involving persistent appearance-related anxieties and compulsive behaviors. However, ERP can be an effective treatment for confronting appearance fears and reducing compulsive rituals in BDD.
Trichotillomania (TTM) and Skin Picking: These disorders are distinct, as behaviors are positively reinforced (pleasurable), not fear-driven. Other treatment strategies like habit reversal and cue avoidance are usually used instead of ERP.
Hoarding Disorder: Hoarding behaviors are ego-syntonic (not resisted), unlike OCD's compulsions . Poor insight and emotional attachment to possessions are common hindering factors for ERP. Motivational interviewing, skill development in organization, and decision-making are key to treatment effectiveness.

Conclusion

ERP is highly effective for OCD and moderately effective for BDD.
ERP doesn't apply to TTM, skin picking, or hoarding disorder due to varying psychological mechanisms.
Misclassifying these disorders can lead to inappropriate treatments.

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Description

This quiz covers the history and effectiveness of Exposure and Response Prevention (ERP) for treating Obsessive-Compulsive Disorder (OCD). It highlights key studies and meta-analyses that showcase ERP's superior outcomes compared to traditional therapies. Test your knowledge on the advancements in OCD treatment and the significant findings from various research efforts.