Advancements in Cognitive-Behavioral Modeling and Treatment of OCD

Abstract

I am grateful for the opportunity to bring together a number of recently completed studies that develop and test new cognitive and behavioral constructs that expand our understanding of factors relevant to the maintenance of obsessive-compulsive (O-C) cycles and their treatment. Obsessive compulsive disorder (OCD) is a debilitating disorder characterized by distressing obsessive thoughts and/or images and compulsive behaviors. OCD occurs in approximately 2% of the population, tends to be chronic with a waxing and waning of symptoms over time, and leads to a variety of significant functional impairments and decreased quality of life, establishing it as the 10th leading cause of disability worldwide. Exposure response prevention (ERP) is the most wellresearched and recognized psychotherapeutic intervention for OCD and is consistently included as a frontline treatment in clinical guidelines (NICE, 2006). Less frequently studied or well established than ERP as a treatment for OCD, the aim of cognitive therapy is to reduce obsessions and compulsions by targeting the maladaptive appraisals and dysfunctional beliefs that are implicated in the development and persistence of symptoms. The majority of meta-analyses and controlled trials have examined ERP versus cognitive therapy and found them to be equally efficacious treatments on outcome measures at post-treatment and follow-up and recent studies have increasingly tested and shown support for their integration as a combined CBT intervention. The papers included in this Special Issue address different aspects of the O-C cycle within an integrated cognitive-behavioral therapy (CBT) frameworkbeliefs and appraisals, safety behaviors, and developments in mindfulness-based approaches that introduce new ways of conceiving of O-C symptom maintenance and change.In the first article, Riskind et al. (2018) address the role of negative appraisals of unwanted intrusive thoughts, not from the customary self-perspective (e.g., being bad J Cogn Ther (2018) 11:1-3 https://doi.