This book is set out in five sections. The first, consisting of two chapters, explores the nature of obsessive-compulsive disorder (OCD). In Chapter 1, Krochmalik and Menzies examine the history of descriptions of the disorder, from the earliest references right through to contemporary accounts. Considerable attention is given to current classificatory and diagnostic criteria, with an examination of the differences between obsessive thinking, general worry, overvalued ideation and delusions. In Chapter 2, de Silva provides an exploration of the phenomenology of the condition, with multiple case descriptions that help capture the essential features of the disorder. It is hoped that a careful reading of the two chapters of Section 1 will provide clinical trainees, beginning practitioners and researchers with a solid foundation for the theoretical chapters that follow.
Section II considers various conceptual and theoretical aspects of the disorder. The Section opens with Frampton's review of neuropsychological models (Chapter 3). Much of the experimental work in this area is shown to suffer from crippling methodological weaknesses, including the failure to control for multiple comparisons, co-morbid depression, medication and general speed deficits. In addition, there has been a general lack of underlying theory to guide experimentation. However, on a positive note, Frampton concludes that recent studies have begun to address these weaknesses and structural and functional neuroimaging have begun to strengthen theory and experimental design.
Frampton's chapter is followed by Salkovskis and MacGuire's review of higher-level cognitive models of the disorder (Chapter 4). Considerable emphasis is given to the way in which contemporary cognitive models may explain all of the symptomatology of the condition, rather than simply accounting for anxiety and avoidance. There can be no doubt that, in terms of the ability to account for the broad range of symptoms seen in OCD, cognitive models are well advanced on current neuropsychological explanations.
In Chapter 5, Davey, Field and Startup detail the way in which mood and cognitive decision rules may combine to produce perseverative, debilitating and ever-worsening rumination. Their thorough review of novel,