Topic 7 Psychotherapies
Melvyn W.B. Zhang, Cyrus S.H. Ho, Roger C.M. Ho, Basant K. Puri in Get Through, 2016
Psychological treatments: NICE guidelines recommend evoked response prevention (ERP) and CBT for OCD and body dysmorphic disorder. For the initial treatment of OCD, ERP (up to 10 therapist hours per client), brief individual CBT using self-help materials and telephone and group CBT should be offered.For adults with OCD with mild-to-moderate functional impairment, more intensive CBT (including ERP) (more than 10 therapist hours per client) is recommended.For children and young people with OCD with moderate-to-severe functional impairments, CBT (including ERP) is a first-line treatment option.
The who, what, where, when, why and how of picking, pulling and biting behaviors
Stacy K. Nakell in Treatment for Body-Focused Repetitive Behaviors, 2023
While there are fundamental differences between my understanding of BFRBs and that of the researchers in the CBT field, we do agree that hair pulling and skin picking, along with cheek lip and nail-biting, would fit best in their own diagnostic category. Stein et al. (2010), some of whom are on the Scientific Advisory Board of TLC Foundation for BFRBs, advocated for the creation of a Body-Focused Repetitive Behaviors category in the Diagnostic and Statistical Manual (DSM) before the DSM 5 was published (APA, 2013). BFRBDs have more in common with one another than with either their impulsive counterparts such as kleptomania or those under the obsessive-compulsive umbrella (OCD). They also are often found to co-occur (Roberts et al., 2013). Commonalities include physiological sensitivity and sensory processing disorder, as well as common comorbid conditions including depression, anxiety, body dysmorphic disorder (BDD), post-traumatic stress disorder, autism spectrum disorder and attention-deficit/hyperactivity disorder (ADHD).
Where the Thread Began
Mark B. Constantian in Childhood Abuse, Body Shame, and Addictive Plastic Surgery, 2018
This is not only a theoretical question. It is not hard to find papers on body dysmorphic disorder in which the deformity was evaluated by “panels of nonmedical people,” “friends and family,” or “objective observers.” Many studies report BDD diagnoses based on self-reporting by the patients themselves, using Phillips’ Body Dysmorphic Disorder Questionnaire,7 Cash’s Body Image Disturbance Questionnaire,8 or other useful tools. As a result, even the best BDD literature contains statements such as this: “With the exception of 6 patients, who had slight physical anomalies about which they were excessively concerned, all body parts of concern appeared normal to the investigators.”9 (Italics mine)
Body dysmorphic disorder and its associated psychological and psychopathological features in an Italian community sample
Published in International Journal of Psychiatry in Clinical Practice, 2018
Silvia Cerea, Gioia Bottesi, Jessica R. Grisham, Marta Ghisi
Body Dysmorphic Disorder (BDD) is a psychiatric condition characterized by concerns regarding one or more perceived defects in physical appearance that are not observable or appear slight to others (American Psychiatric Association, 2013); the preoccupation is time-consuming and causes significant distress or impairment in the individual’s functioning (Cororve & Gleaves, 2001; Marques et al., 2011). The most common areas of concern in individuals with BDD are the skin (presence of acne or scars), the hair (hair loss, thinning, or excessive facial or body hair), and the nose (shape or size; Buhlmann et al., 2010; Phillips, 2006; Phillips & Diaz, 1997; Phillips, McElroy, Keck, Pope, & Hudson, 1993; Schieber, Kollei, de Zwaan, & Martin, 2015; Veale et al., 1996). Appearance concerns, however, may involve any body areas (Phillips, 2006; Phillips et al., 1993; Veale, 2000), and individuals with BDD may be concerned with multiple body parts at the same time (Phillips et al., 1993; Phillips, Menard, Fay, & Weisberg, 2005).
The Nepean Belief Scale: preliminary reliability and validity in obsessive–compulsive disorder
Published in International Journal of Psychiatry in Clinical Practice, 2018
Vlasios Brakoulias, Vladan Starcevic, Denise Milicevic, Anthony Hannan, Kirupamani Viswasam, Christopher Brown
Belief is a difficult concept to measure, with relatively ill-defined characteristics (Brakoulias & Starcevic, 2010; Kozak & Foa, 1994). Abnormal beliefs are commonly associated with a wide range of psychiatric diagnoses. Delusions are relatively easy to identify and assess in a person with schizophrenia due to their bizarre and illogical nature. The assessment of beliefs in obsessive–compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder, hypochondriasis or severe mood disturbance is more challenging and may be aided by an appropriate assessment tool. The importance of the role of beliefs in psychiatric disorders is being increasingly recognised, with the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) (American Psychiatric Association, 2013) introducing belief-related insight specifiers for a number of disorders.
Review of epidemiology, clinical presentation, diagnosis, and treatment of common primary psychiatric causes of cutaneous disease
Published in Journal of Dermatological Treatment, 2018
J. A. Krooks, A. G. Weatherall, P. J. Holland
The DSM-5 groups OCD and obsessive-compulsive-related disorders (OCRDs) into the same chapter due to their overlap in diagnostic symptoms and comorbidity (20). Indeed, due to their comorbidity, clinicians should screen for other disorders in this category in patients already diagnosed with one or more related conditions (Table 4) (20). Specific disorders include OCD, body dysmorphic disorder (BDD), hoarding disorder, body-focused repetitive behavior disorders (BFRBDs), substance/medication-induced OCRD, OCRD due to another medical condition, and other specified OCRD and unspecified OCRD (20). Disorders in this category that most commonly present to dermatologists include olfactory reference syndrome (ORS); BDD; and BFRBD’s, particularly excoriation disorder (ExD), and trichotillomania (TTM).
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