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Extra resources for Clinical Handbook of Obsessive-Compulsive and Related Disorders: A Case-Based Approach to Treating Pediatric and Adult Populations

Example text

1. 1 Kyle’s sexual exposure hierarchy Pre-SUDSa Post-SUDSb Final SUDSc 10. Being alone with niece 99 50 15 9. Repeating “I will enjoy molesting my niece” 99 40 25 8. Repeating “I will touch my niece’s nipple” 99 40 20 7. Repeating “I want to touch that child” 90 40 5 6. Holding a young child 85 40 5 5. Looking at pictures of niece naked 80 25 20 4. Visualizing giving a bath to niece 80 35 15 3. Sitting in room full of children 75 35 0 2. Looking at pictures of niece 75 30 0 1. Looking at pictures of children 70 10 5 a Pre-SUDS is the level of anxiety rated by Kyle during the intake session b Post-SUDS is the level of anxiety rated by Kyle at the end of the exposure session that involved the item on the hierarchy listed c Final SUDS is the level of anxiety rated by Kyle at the end of treatment SUDS subjective units of distress 32 SUDS ratings, the final SUDS rating taken at the end of the exposure, and the SUDS rating given at the end of treatment are reported.

Unfortunately, all of these factors amplify interference in the treatment of sexual obsessions or compulsions as therapists must be willing to discuss sexually explicit content and conduct exposures that are challenging to design and implement due to their sexual nature. Taken together, it is not surprising that sexual (as well as religious) obsessions and compulsions have worse response to behavioral treatment than other domains such as harm, contamination, and symmetry (Mataix-Cols et al. 2002) in adult OCD.

2014). Preditors of quality of life and functional impairment in obsessive-compulsive disorder. Comprehensive Psychiatry. 1016/j. 011. Kessler, R. , Merikangas, K. , & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602. Liebowitz, E. , Panza, K. , & Bloch, M. H. (2012). Family accommodation in obsessive compulsive disorder. Expert Review of Neurotherapeutics, 12, 229–238.

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