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4 results

  • 14 - Other Specified and Unspecified Obsessive-Compulsive and Related Disorders

  • from Part Three - Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder and Associated Disorders
  • Edited by Gillian Todd, University of East Anglia, Rhena Branch, University of East Anglia
  • Book:
    Evidence-Based Treatment for Anxiety Disorders and Depression
    Published online:
    06 January 2022
    Print publication:
    13 January 2022, pp 269-294

  • Summary

    This chapter aims to give an overview of what cognitive behavioral therapy (CBT) has to offer in the treatment of several DSM-5 “other specified” obsessive-compulsive and related disorders (OCRDs): obsessional jealousy, body-focused repetitive behavior disorders – not otherwise specified (e.g., repetitive nail biting), body dysmorphic disorder with a visible defect, and olfactory reference syndrome. Issues in diagnosis, assessment, formulation, and treatment are considered, with an emphasis on ready translation into clinical practice. We reflect not just on how traditional CBT approaches can be tailored to the unique features of each condition but also on the application and integrative potential of newer approaches, such as from the “third wave” and inference-based therapy.

  • A twin study of body dysmorphic concerns

  • B. Monzani, F. Rijsdijk, M. Anson, A. C. Iervolino, L. Cherkas, T. Spector, D. Mataix-Cols
  • Journal:
    Psychological Medicine / Volume 42 / Issue 9 / September 2012
    Published online by Cambridge University Press:
    30 November 2011, pp. 1949-1955
  • Background

    Dysmorphic concern refers to an excessive preoccupation with a perceived or slight defect in physical appearance. It lies on a continuum of severity from no or minimal concerns to severe concerns over one's appearance. The present study examined the heritability of dysmorphic concerns in a large sample of twins.

    Method

    Twins from the St Thomas UK twin registry completed a valid and reliable self-report measure of dysmorphic concerns, which also includes questions about perceived body odour and malfunction. Twin modelling methods (female twins only, n=3544) were employed to decompose the variance in the liability to dysmorphic concerns into additive genetic, shared and non-shared environmental factors.

    Results

    Model-fitting analyses showed that genetic factors accounted for approximately 44% [95% confidence intervals (CI) 36–50%] of the variance in dysmorphic concerns, with non-shared environmental factors and measurement error accounting for the remaining variance (56%; 95% CI 50–63%). Shared environmental factors were negligible. The results remained unchanged when excluding individuals reporting an objective medical condition/injury accounting for their concern in physical appearance.

    Conclusions

    Over-concern with a perceived or slight defect in physical appearance is a heritable trait, with non-shared environmental factors also playing an important role in its causation. The results are relevant for various psychiatric disorders characterized by excessive concerns in body appearance, odour or function, including but not limited to body dysmorphic disorder.

  • 18 - Delusions of Body Malodour: The Olfactory Reference Syndrome

  • from Section III - Assessment and Disorders of Olfaction
  • Edited by Warrick J. Brewer, Mental Health Research Institute of Victoria, Melbourne, David Castle, University of Melbourne, Christos Pantelis
  • Foreword by Peter Doherty
  • Book:
    Olfaction and the Brain
    Published online:
    17 August 2009
    Print publication:
    19 October 2006, pp 334-354

  • Summary

    The olfactory reference syndrome (ORS) is an under-recognised type of delusional disorder that has been described for more than a century. This chapter discusses ORS's history, clinical features, prevalence, treatment response, possible pathogenesis, nosological status and relationship to other psychiatric disorders, including mood disorders, schizophrenia, social phobia, and obsessive compulsive disorder (OCD). ORS can be associated with significant academic, occupational and most frequently social impairment. Impairment has been noted to result from the large amount of time spent thinking about the odour and engaging in behaviours aimed at diminishing the smell. The distress caused by ORS has been reported to lead to psychiatric hospitalisation, depression, suicidal ideation, suicide attempts and completed suicide. Most reports on medications for ORS focus on antipsychotics or antidepressants. A range of psychological approaches have been adopted in treating ORS, including individual psychotherapy, analytic psychotherapy, relaxation, paradoxical intention and behavioural therapy, such as exposure.