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Reconceptualization of Behavior Therapy for Obsessive-Compulsive Disorder from a Learning and Neurochemical Perspective

Published online by Cambridge University Press:  07 November 2014

Fugen Neziroglu  and
Curtis Hsia
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Abstract

The etiology and treatment of obsessive-compulsive disorder has been explained from a social learning and neurobiological model. In this article a third model is proposed: the biobehavioral model, which encompasses a learning and neurochemical viewpoint. The authors suggest that behavior therapy and medications may operate in the same manner and that behavior therapy may need to be reconceptualized. Animal and human research supporting the interaction of behavioral change and neurochemical processes is presented. The authors also posit that urges precede anxiety and that compulsions are performed in response to the anxiety. Also, obsessions are viewed as secondary to compulsions. The mechanism of how behavior and cognitive-behavioral therapy may produce neurochemical changes is discussed.

Type
Feature Articles
Information
CNS Spectrums , Volume 3 , Issue 7: Novel Neuropsychiatric Conceptualizations , August 1998 , pp. 47 - 53
Copyright
Copyright © Cambridge University Press 1998

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References

REFERENCES

1. Watson, JB, Rayner, R. Conditioned emotional reactions. J Exp Psychol Gen. 1920;3:1–14.Google Scholar
2. Seligman M, E, Groves, DP. Nontransient learned helplessness. Psychonomic Science. 1970;19:191–192.Google Scholar
3. Seligman, ME, Maier, SF, Geer, JH. Alleviation of learned helplessness in the dog. J Abnorm Psychol. 1968;73(pt 2):256–262.Google Scholar
4. Seligman, ME, Rosellini, RA, Kozak, MJ. Learned helplessness in the rat: time course, immunization, and reversibility. J Comp Psychol. 1975:88:542–547.CrossRefGoogle ScholarPubMed
5. Levine, M, Rotkin, L, Jankovic, IN, Pitchford, L. Impaired performance by adult humans: learned helplessness or wrong hypotheses? Cognit Ther Res. 1977;1:275–285.CrossRefGoogle Scholar
6. Dollard, J, Miller, NE. Personality and Psychotherapy: An Analysis in Terms of Learning, Thinking, and Culture. New York, NY: McGraw-Hill; 1950.Google Scholar
7. Mowrer, OH. On the dual nature of learning-a reinterpretation of “conditioning” and “problem solving.” Harvard Educational Review. 1947;17:102–148.Google Scholar
8. Mowrer, OH. Two-factor learning theory: summary and comment. Psychol Rev. 1951;58:350–354.Google Scholar
9. Watts, J. An Investigation of Imaginal Desensitization as an Habituation Process. London, UK: University of London; 1971. PhD thesis.Google Scholar
10. Teasdale, YD. Learning models of obsessional-compulsive disorder. In: Beech, HR, ed. Obsessional States. London, UK: Methuen; 1979.Google Scholar
11. Hernstein, RJ. Method and theory in the study of avoidance. Psychol Rev. 1969;76:49–69.Google Scholar
12. Gray, JA. The Psychology of Fear and Stress. New York, NY: McGraw-Hill; 1971.Google Scholar
13. Yaryura-Tobias, JA, Neziroglu, F. Bio-behavioral Treatment of Obsessive Compulsive Spectrum Disorders. Boston, Mass: Norton Publishing Co; 1997.Google Scholar
14. Yaryura-Tobias, JA, Neziroglu, F. Obsessive-Compulsive Disorder Spectrum: Pathogenesis, Diagnosis and Treatment. Washington, DC: American Psychiatric Press; 1997.Google Scholar
15. Yaryura-Tobias, JA, Bebirian, RJ, Neziroglu, FA, Bhagavan, HN. Obsessive-compulsive disorders as a serotonergic defect. Res Commun Psychol Psychiatry Behav. 1977;2:279–286.Google Scholar
16. Yaryura-Tobias, JA, Neziroglu, F. The action of chlorimipramine in obsessive compulsive neurosis: a pilot study. Curr Ther Res. 1975;17:111–116.Google Scholar
17. Yaryura-Tobias, JA, Neziroglu, F, Bergman, L. Chloimpramine for obsessive-compulsive neurosis: an organic approach. Curr Ther Res. 1976;20:541–548.Google Scholar
18. Neziroglu, F, Steele, J, Yaryura-Tobias, JA, Hitri, A, Diamond, B. Effect of behavior therapy on serotonin level in obsessive-compulsive disorder. In: Stefanis, CN, ed. Psychiatry: A World Perspective. New York, NY: Evelvier Science Publishers; 1990.Google Scholar
19. Gottesman, II, Shields, JA. A critical review of recent adoption, twin, and family studies of schizophrenia: behavioral genetics perspectives. Schizophr Bull. 1976;2:360–461.Google Scholar
20. Gottesman, II, Shields, J, Hanson, DR. Schizophrenia: the Epigenetic Puzzle. New York, NY: Cambridge University Press; 1985.Google Scholar
21. Yaryura-Tobias, JA, Neziroglu, F. Gilles de la Tourette's syndrome: a new clinico-therapeutic approach. Progress of Neuro-Psychopharmacology. 1977;1:335–338.Google Scholar
22. Ageel, AM, Ginawi, OT. The effect of neurotransmitters reuptake inhibition on conditioned avoidance responding. Res Commun Psychol Psychiatry Behav. 1988;13:241–247.Google Scholar
23. Alkon, DL, Sakakibara, M, Naito, S, Heldman, E, Lederhendler, I. The role of nuerochemical modulation in learning. Neurosci Res. 1986,3:487–498.Google Scholar
24. Bernibeu, R, Stein, ML, Fin, C, Izquierdo, I, Medina, J. Role of hipocampal NO in the acquisition and consolidation of inhibitory avoidance learning. Learning and Memory. 1995;6:1498–1500.Google Scholar
25. Joffe, R, Segal, Z, Singer, W. Change in thyroid hormone levels following response to cognitive therapy for major depression. Am J Psychiatry. 1996;153:411–413.Google ScholarPubMed
26. Helm-Hylkema, H, Orlebeke, J, Enting, L, Thussen, J, Van Ree, J. Effects of behavior therapy on migraine and plasma B-endorphin in young migraine patients. Psychoneuroendocrinology. 1990;15:39–45.CrossRefGoogle Scholar
27. Abelson, J, Weg, J, Nesse, R, Curtis, G. Neuroendocrine responses to laboratory panic: cognitive intervention in the doxapram model. Psychoneuroendocrinology. 1996;21:375–390.Google Scholar
28. Curtis, G, Nesse, R, Buxton, M, Lippman, D. Plasma growth hormone: effect of anxiety during flooding in vivo. Am J Psychiatry. 1979;134:410–414.Google Scholar
29. Curtis, G, Nesse, R, Buxton, M, Wright, J, Lippman, D. Flooding in vivo as research tool and treatment method for phobias: a preliminary report. Compr Psychiatry. 1976;17:153–160.Google Scholar
30. Nesse, R, Curtis, G, Brown, G, Rubin, R. Anxiety induced by flooding therapy for phobias does not elicit prolactin secretory response. Psychosom Med. 1980;42:25–31.CrossRefGoogle Scholar
31. Eysenck, HJ. Anxiety, learned helplessness, and cancer. J Anxiety Disorders. 1987;1:87–104.CrossRefGoogle Scholar
32. Eysenck, HJ. Personality as a predictor of cancer and cardiovascular disease, and the application of behaviour therapy in prophylaxis. The European Journal of Psychiatry. 1987;1:29–41.Google Scholar
33. Baxter, J, Schwartz, J, Mazziotta, J, et al.Cerebral glucose metabolic rates in nondepressed patients with obsessive compulsive disorder. Am J Psychiatry. 1988;145:1560–1563.Google Scholar
34. Baer, L. Discontinuing obsessive-compulsive disorder medication with behavior therapy. Am J Psychiatry. 1994;151:1842.Google ScholarPubMed
35. Neziroglu, F. A combined behavioral-pharmacotherapy approach to obsessive compulsive disorders. In: Obiols, J, Ballus, C, Gonzales-Monclus, E, Pujol, J, eds. Biological Psychiatry Today. Amsterdam, the Netherlands: Elsevier; 1979:591–596.Google Scholar
36. Baer, L. Behavior therapy: Endogenous serotonin therapy? J Clin Psychiatry. 1996;57(suppl 6):33–35.Google Scholar
37. Baxter, LR, Schwartz, JM, Bergman, KS, et al.Caudate glucose metabolism rate changes with both drug and behavior therapy for obsessive-compulsive disorder. Arch Gen Psychiatry. 1992;49:681–689.Google Scholar
38. Schwartz, J, Stoessel, P, Baxter, L, Martin, K, Phelps, M. Systematic changes in cerebral glucose metabolic rate after successful behavior medificatioin treatment of obssessive compulsive behavior. Arch Gen Psychiatry. 1996;53:109–113.CrossRefGoogle Scholar
39. Groves, PM, Lynch, GS. Mechanisms of habituation in the brain stem. Psych Rev. 1972;79:237–244.CrossRefGoogle ScholarPubMed
40. Schacter, S, Singer, J. Cognitive, social, and physiological determinants of emotinoal state. Psychological Rev. 1962;69:379–399.Google Scholar
41. Abelson, JL, Weg, JG, Nesse, RM, Curtis, GC. Neuroendocrine responses to laboratory panic: cognitive internvention in the doxapram model. Psychoneuroendocrinology. 1996;21:375–390.CrossRefGoogle ScholarPubMed
42. Schwartz, JM, Stoessel, PW, Baxter, LR. Systematic changes in cerebral glucose metabolic rate after successful behavior medification treatment of obsessive-compulsive disorder. Arch Gen Psychiatry. 1996;53:109–113.Google Scholar