Behavioral therapy shown to be effective in treatment of OCD

When he was six or seven, Philip Idell, a second-year music history student, exhibited mild obsessive and compulsive behavior. Among other symptoms, he could not step on lines and had to take eight steps within each block of concrete.

“Imagine you have to do something that is completely absurd, and you know it’s absurd, but you have to do it anyway. I knew all the things I had to do were ridiculous, but I just had to do it,” Idell said.

There are frequent misunderstandings about Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder, for which the clinical term OCD is used loosely. Unlike OCD, OCPD is characterized by perfectionism ““ rigid black-and-white thinking that involves high standards and repetition until success is achieved, said Dr. Kate B. Wolitzky-Taylor, a post-doctoral research fellow at the UCLA Anxiety Disorders Research Center.

OCD, if anything, is probably underdiagnosed, so researching the ways to ameliorate existing treatment efficacy as well as the understanding of OCD is of value, she added.

OCD is a two-part anxiety disorder in which a person will first experience obsessive thoughts about certain subjects and then act compulsively to reduce the anxiety on the subject, said Dr. Bonnie Zucker, a clinical psychologist at the UCLA Counseling and Psychological Services Center.

The symptoms for the disorder exist on a broad spectrum that ranges from mild to severe, depending on the level of interference with a person’s life, Zucker said.

Diagnostic criteria for OCD include either obsession, compulsion or both that cause distress for at least one hour of the day, Wolitzky-Taylor said.

Although the onset of OCD begins in either the childhood or college-age years, the prevalence rate is not significantly higher in older populations, Zucker said. About 2.5 percent of the U.S. population will have OCD at some point in there lives, Zucker added.

“If you look at a cross-section of one year, about 1 percent of people ages 18 and up will have OCD,” Wolitzky-Taylor said.

OCD patient anxiety is directed toward a multitude of subjects, Zucker said.

“Someone could be excessively concerned by germs (or) dirt, or someone else could have concerns about feeling responsible about (locking) the door, (turning) off the stove, or have thoughts about causing harm to other people,” Zucker said. Idell said that his mild symptoms included a need to eat fries and chips in pairs.

OCD is the product of a combination of biological, temperamental and external environmental factors, Wolitzky-Taylor said. Tentative findings show that people with a shorter allele for certain genes are at greater risk for anxiety disorders.

Very often, people with any one anxiety disorder are more likely to have another anxiety disorder or medical condition. For example, a person might have both OCD and depression, Zucker said.

Idell added that when he demonstrated symptoms of OCD, he also had autism, for which he took medication that may have treated his OCD symptoms.

Cognitive Behavioral Therapy, Acceptance and Commitment Therapy and medication are the three forms of treatment on which the Anxiety Disorders Research Center focuses, said Wolitzky-Taylor. Typically, the treatment of choice for OCD is an aspect of Cognitive Behavioral Therapy called exposure and response prevention, Wolitzky-Taylor added.

First, the obsession and the compulsion are identified and the patient is gradually introduced to the type of situation that would produce anxiety. The compulsion is then prevented, allowing anxiety levels to naturally decrease over time. The response-prevention aspect is key, and practice outside of treatment is essential, Zucker said.

In Acceptance and Commitment Therapy, the cognitive element is approached differently and a patient is taught to accept his or her thoughts. Research is ongoing regarding this treatment method at the Anxiety Disorders Research Center, Wolitzky-Taylor said.

Dr. Zucker added that a UCLA study from the 1990s showed that with OCD treatment, neurotransmitter processing changes. Frequently combined with other treatment, medication such as Selective Serotonin Reuptake Inhibitors can be prescribed, Wolitzky-Taylor said.

“I think in my case of mild OCD, it is something you can grow out of. But obviously with severe cases, it’s not necessarily true. I’m not sure how things got better and if the (medication I was taking for autism) treated the symptoms, but I started getting a lot better,” Idell said.

Anxiety disorders are definitely responsive to treatment, and the earlier a person is treated, the better the success rate will be, Zucker said.