EXPOSURE AND RESPONSE
Obsessive-compulsive disorder (OCD) is the fourth most common psychiatric disorder (Rasmussen & Eisen, 1992) and the tenth leading cause of disability in the world (World Health Organization, 1996). With a lifetime prevalence estimated at 2% to 3%, OCD is seen across the lifespan, and remains a significant social and health service concern with high degrees of personal disability, co-morbidity (especially with depression and other anxiety disorders), and relatively poor long-term prognosis (Eisen et al., 1999; Rasmussen & Eisen, 1992; Skoog & Skoog, 1999; Welkowitz et al., 2000).
As discussed at length in Chapters 1 and 2, OCD is characterised by marked distress associated with: (a) recurrent, persistent, and intrusive ideas, thoughts, impulses, or images (obsessions), and/or (b) repetitive or ritualised and often bizarre overt behaviours or mental acts (compulsions) frequently aimed at neutralising distress or alleviating danger concerns caused by obsessions [Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV); American Psychiatric Association (APA), 1994]. Obsessions have been found to increase anxiety and physiological reactions such as heart rate and skin conductance, while compulsions are thought to lead to short-term reduction in such discomfort (Boulougouris et al., 1977; Hodgson & Rachman, 1972; Rabavilas & Boulougouris, 1974). On the other hand, neutralisation also leads to long-term increases in anxiety (Salkovskis et al., 1997). Both obsessions and compulsions interfere considerably with
Obsessive-Compulsive Disorder: Theory, Research and Treatment.
Edited by Ross G. Menzies and Padmal de Silva. © 2003 John Wiley & Sons, Ltd.