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OCD and families

Obsessive Compulsive Disorder is a often a disorder that frustrates the sufferer as well as the family. People with OCD frequently ask for reassurance from those who care about them. Unfortunately, reassurance actually can make the obsession or compusion worse. Why? Because telling someone with OCD that everything is going to be okay gives that person a temporary sense of relief. It feels good. Whenever something feels good we all tend to do it again. So, the reassurance asking increases, becomes a repeated pattern, and can even turn into part of the OCD cycle. LS

New Article on OCD consistent with our book Obsessive Compulsive Disorder For Dummies

Ken Pop, Ph.D. passed along the abstract to this new article. It shows that treatment for OCD works and confirms the statements we made about treatment efficacy in OCD For Dummies.

Clinical Psychology Review* (vol 28, #8) Psychological treatment of obsessive-compulsive disorder: A meta-analysis.

Authors: Ana Rosa-Alcazar, Julio Sanchez-Meca, Antonia Gomez- Conesa, & Fulgenzio Marin-Martinez:

Abstract: “The benefits of cognitive-behavioral treatment for obsessive-compulsive disorder (OCD) have been evidenced by several meta- analyses.  However, the differential effectiveness of behavioral and cognitive approaches has shown inconclusive results. In this paper a meta-analysis on the effectiveness of psychological treatment for OCD is presented by applying random- and mixed-effects models.  The literature search enabled us to identify 19 studies published between 1980 and 2006 that fulfilled our selection criteria, giving a total of 24 independent comparisons between a treated and a control group.  The effect size index was the standardized mean difference in the posttest.  The effect estimates for exposure with response prevention (ERP) alone (d-super(+) = 1.127), cognitive restructuring (CR) alone (d-super(+) = 1.090), and ERP plus CR (d-super(+) = 0.998) were very similar, although the effect estimate for CR alone was based on only three comparisons.  Therapist- guided exposure was better than therapist-assisted self-exposure, and exposure in vivo combined with exposure in imagination was better than exposure in vivo alone.  The relationships of subject, methodological and extrinsic variables with effect size were also examined, and an analysis of publication bias was carried out.  Finally, the implications of the results for clinical practice and for future research in this field were discussed.”

Negative Results and Publication

Just received this as a forward from Ken Pope, Ph.D.–CE

Wiley-Blackwell, the publisher of the *Cochrane Library*, issued the following news release:

Clinical trials: Unfavourable results often go unpublished

Trials showing a positive treatment effect, or those with important or striking findings, were much more likely to be published in scientific journals than those with negative findings, a new review from The Cochrane Library has found.

“This publication bias has important implications for healthcare. Unless both positive and negative findings from clinical trials are made available, it is impossible to make a fair assessment of a drug’s safety and efficacy,” says lead researcher, Sally Hopewell of the UK Cochrane Centre in Oxford, UK.

The international team of researchers carried out a systematic review of all the existing research in this area. In addition to showing that negative results were published less often, they found that if these results were eventually published, they would take between one and four more years to appear in journals than studies showing positive results.

Results from one of the five studies in the review indicated that investigators and not editors might be to blame. The reasons most commonly given for not publishing were that investigators thought their findings were not interesting enough or did not have time. “The registration of all clinical trial protocols before they start should make it easier to identify where we are missing results,” says Kay Dickersin from Johns Hopkins University in Baltimore, USA, another of the researchers on this project.

One of the other researchers, Kirsty Loudon, based in Scotland, adds, “Registration of trials and their results would help people conducting systematic reviews to look at both published and unpublished evidence, to reach reliable conclusions.”

The researchers say their study also highlights the need for a worldwide commitment to the disclosure of the findings of clinical trials. Mike Clarke of Trinity College Dublin in Ireland, says, “The World Health Organisation recently found widespread support for the development of such a process.”

Andy Oxman from the Norwegian Knowledge Centre for Health Services concludes, “Healthcare decisions need to be based on all the evidence, not just the most exciting results.”

Stressed out and demented

Recent research looked at a large sample of older people who did not have any memory problems. They gave them a couple of personality tests. The group that tended to get easily stressed and were socially isolated had higher rates of dementia some years later than those who were more socially engaged and less neurotic. So, take it easy and stay connected if you don’t want to be demented! LS

Television Coverage

Okay, like most people I was glued to the TV coverage today. How many people love watching 400 high school bands parade by? I felt sorry for our new president and his family. But, his ability to stand tall and smile under incredible pressure was quite obvious. Hopefully those kids will get their dog.   

Counting, colors, and VW bugs

Did you ever spend hours in the car as a kid and make up games to pass the time? We used to count white cars or VW bugs. There was some predetermined number to reach for the winner. These games filled up the long hours prior to video equipped cars or personal IPODS, gameboys and such. It is interesting that many people with OCD have colors or cars or happenings that they must count. The OCD reason is something like “I must count or something bad will happen.” The function of the car game is more I am bored so I must do something to distract myself. Both feel some distress (boredom or anxiety). Interesting.

OCD For Dummies

I think OCD is arguably the most interesting of all emotional disorders. But it’s also a little complicated. That’s why we enjoyed writing OCD For Dummies so much–so we could distill this complexity and help people really understand the problem as well as what to do about it. By the way, you can buy used copies from Amazon and save some bucks. We’d rather you get the help than collect a small royalty. CE

Ego and I

When I read about psychology a million years ago, Freud talked about three parts of a person, the EGO, ID, and SuperEgo. I was pretty sure that my superego was well developed. Basically the Id was considered the primitive desires that we all have, the Super Ego was the ways we are socialized so as not to express the Id. The Ego was the balanced portion, acting in a manner that served the Id but took care not to offend the Super Ego. Since Freud, lots of other psychologists and philosophers have changed the nomenclature but most remain consistent with a three factor approach. People tend to be over controlled or under controlled or balanced. What do you think?

Applied relaxation

The ability to relax on command is called applied relaxation. It successfully helps people with anxiety disorders, fears, phobias, and chronic pain. The key to this approach is to find a method (such as progressive muscle relaxation or autogenic training) that you find helps you relax. Practice the technique for a week or so then try to get that same feeling with a couple of deep breaths or a word or two. For more information see our book Overcoming Anxiety for Dummies.

OCD Treatment Works!!

Many people with OCD believe that the problem can’t be treated. Perhaps it’s because they received some sort of treatment and it didn’t work for them. Well, it’s true, not all treatments work for OCD and not all mental health professionals have been trained in and provide the treatments known to work for OCD.

However, the treatments that work for OCD not only work, they work very well. The gold standard treatment is called Exposure and Response Prevention (it goes by various acronyms, but ERP, ExRP are the most common). ERP is very effective, sometimes so much so that medications can be avoided. Other times, you will want to combine ERP with medications and/or other types of therapy such as Cogitive Therapy that has been specifically designed for OCD. We discuss all of these treatments in detail in Obsessive Compulsive Disorder For Dummies.

But the bottom line is, if you have OCD, get treatment from someone with considerable training and expertise in the treatment of OCD. You’ll be glad you did. CE