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combination of behavioral, cognitive, and drug therapies. Ac- 12/10/09 11:16:36 AM :// 129 Bella C. Laudauer Collection of Business and Advertising Art, The New York Historical Society Anxiety Disorders cording to research, such combinations often yield higher levels of symptom reduction
and bring relief to more clients than do each of the approaches alone—improvements
that may continue for years (Kordon et al., 2005; Rufer et al., 2005).
Obviously, the treatment picture for obsessive-compulsive disorder has improved
greatly over the past 15 years, and indeed, this disorder is now helped by several forms
of treatment, often used in combination. In fact, at least two studies suggest that the behavioral, cognitive, and biological approaches may ultimately have the same effect on the
brain. In these investigations, both participants who responded to cognitive-behavioral
treatments and those who responded to antidepressant drugs showed marked reductions
in activity in the caudate nuclei (Stein & Fineberg, 2007; Baxter et al., 2000, 1992). SUMMING UP
People with obsessive-compulsive disorder experience obsessions and/or perform
compulsions. Compulsions are often a response to a person’s obsessive thoughts.
According to the psychodynamic view, obsessive-compulsive disorder arises
out of an overt battle between id impulses and ego defense mechanisms. Behaviorists, on the other hand, believe that compulsive behaviors develop through chance
associations. The leading behavioral treatment combines prolonged exposure with
response prevention. Cognitive theorists believe that obsessive-compulsive disorder
grows from a normal human tendency to have unwanted and unpleasant thoughts.
The misguided efforts of some people to understand, eliminate, or avoid such
thoughts actually lead to obsessions and compulsions. Cognitive therapy for this disorder includes correcting and helping clients change their misinterpretations of their
unwanted thoughts. Research suggests that a combined cognitive-behavioral approach often is more effective than either cognitive or behavioral therapy alone.
Biological researchers have tied obsessive-compulsive disorder to low serotonin
activity and abnormal functioning in the orbitofrontal cortex, the caudate nuclei, or
other regions in the obsessive-compulsive brain circuit. Antidepressant drugs that
raise serotonin activity are a useful form of treatment. Sprinkle lightly
In the early twentieth century, drug
companies did not have to prove the
safety or value of their products. Brain
Salt, a patent medicine for anxiety and
related difficulties, promised to cure
nervous disability, headaches, indigestion, heart palpitations, and sleep
problems. PUTTING IT... together
Diathesis-Stress in Action
Clinicians and researchers have developed many ideas about generalized anxiety disorder,
phobias, panic disorder, and obsessive-compulsive disorder. At times, however, the sheer
quantity of concepts and findings makes it difficult to grasp what is really known about
Overall, it is fair...
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