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The role of avoidance in the phenomenology of obsessive-compulsive disorder.

Abstract：

BACKGROUND:Pathologic levels of ritualistic avoidance (also known as active avoidance) are common in the clinical presentation of obsessive-compulsive disorder (OCD). Despite its clinical relevance, there has been little examination of active avoidance as a ritualistic compulsion in adults with OCD. OBJECTIVE:The objective of this study is to determine if adults with OCD who engage in ritualistic avoidance have greater obsessive-compulsive, anxiety, and depressive symptom severity and different comorbidity patterns than adults who do not engage in ritualistic avoidance. METHOD:Adults with OCD (n = 133) completed an evaluation that included clinician ratings of obsessive-compulsive severity; overall illness severity; and self-reported ratings of anxiety, depression, and obsessive-compulsive severity. RESULTS:Ritualized avoidance was endorsed by greater than 25% of the sample. Avoidant subjects and, more specifically, contaminant avoidant and reading-writing avoidant subjects presented with elevated levels of obsessive-compulsive symptom severity and greater overall clinical severity than comparison patients who did not engage in each respective avoidance ritual. CONCLUSIONS:Patients who engage in ritualized avoidance exhibited greater obsessive-compulsive symptom severity than patients who did not. These findings suggest that ritualized avoidance functions as a compulsion for adults with OCD and that avoidance should receive careful consideration in assessment and treatment.

journal_name

Compr Psychiatry

journal_title

Comprehensive psychiatry

authors

McGuire JF,Storch EA,Lewin AB,Price LH,Rasmussen SA,Goodman WK

doi

10.1016/j.comppsych.2011.03.002

subject

Has Abstract

pub_date

2012-02-01 00:00:00

pages

187-94

issue

2

eissn

0010-440X

issn

1532-8384

pii

S0010-440X(11)00030-7

journal_volume

53

pub_type

杂志文章

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