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Compulsive Behaviors and Thinking

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By Bonnie Harken, Founder and CEO, Crossroads Programs for Women

For people who define themselves, their thoughts, or their behaviors as compulsive, life is often a daily struggle against overwhelming anxiety and shame. The phrase obsessive-compulsive has become part of everyday language, and is often used in an informal manner to describe someone who is excessively meticulous, perfectionist, absorbed, or otherwise fixated on a subject, object, or person. Even if the thoughts and behaviors do not indicate a clinical disorder but are causing stress, anxiety, and interfering with living the life you desire, is there effective help?

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by:
• Intrusive thoughts that produce uneasiness, apprehension, fear, or worry
• Repetitive behaviors aimed at reducing the associated anxiety
• A combination of such obsessions and compulsions

Obsessive-compulsive disorder affects children and adolescents, as well as adults. Roughly one third to one half of adults with OCD report a childhood onset of the disorder, suggesting the continuum of anxiety disorders across the lifespan. OCD is a psychiatric diagnosis, which must meet specific criteria and be diagnosed by a mental health professional

Although these signs are present in obsessive-compulsive disorder, a person who exhibits them does not necessarily have OCD but may have another disorder or no clinical condition at all. Multiple psychological and biological factors may be involved in causing obsessive-compulsive behaviors. These symptoms can be alienating and time-consuming, and often cause severe emotional and even financial distress. It is important to distinguish OCD from other types of anxiety, including the routine tension and stress that appear throughout life.

Compulsive acts may appear paranoid and potentially psychotic. However, sufferers generally recognize their obsessions and compulsions as irrational and may become further distressed by this realization. Despite the irrational behavior, OCD is sometimes associated with above-average intelligence. Its sufferers commonly share personality traits such as high attention to detail, avoidance of risk, careful planning, an exaggerated sense of responsibility, and a tendency to take time in making decisions.

Two new studies published in Biological Psychiatry shed light on the propensity for habit formation in obsessive-compulsive disorder (OCD). These studies suggest that a tendency to develop habits, i.e., the compulsive component of the disorder, may be a core feature of the disorder rather than a consequence of irrational beliefs. Habits also appear to be defining characteristics of psychiatric disorders with prominent behavioral components, such as alcoholism, drug addiction, pathological gambling, and eating disorders. These new studies support the view that habit formation is also an important component of OCD.

Also new global research shows that 94 percent of people experience unwanted, intrusive thoughts, images, and/or impulses. The study of people on six continents, found that the thoughts, images, and impulses symptomatic of obsessive-compulsive disorder (OCD) are widespread. An international study, which was co-authored by Concordia psychology professor Adam Radomsky and published in the Journal of Obsessive-Compulsive and Related Disorders, examined people on six continents. The researchers assessed 777 university students in 13 countries across six continents, including in Canada, Argentina, Australia, France, Greece, Hong Kong, Iran, Israel, Italy, Sierra Leone, Spain, Turkey, and the United States.

Participants were questioned about whether they had experienced at least one unwanted, intrusive thought in the three months prior. To ensure participants reported intrusions, researchers worked with them to distinguish between lingering worries, ruminations about previous events, and unwanted intrusions. These can be a phrase (“Did I lock the front door?”), an image (a mental picture of the subject’s house on fire) or an urge (for instance, a desire to hurt someone). Contamination, aggression, and doubt were among the many types of intrusive thoughts reported by participants.

Radomsky and his colleagues found that the thoughts, images, and impulses symptomatic of obsessive-compulsive disorder (OCD) are widespread. For researchers developing effective evidence-based mental health treatments, recognizing how widespread intrusive thoughts are can offer encouragement to use cognitive and behavioral therapies cross culturally.

The “take away” from these studies is that if you suffer from overwhelming compulsive behaviors and thoughts or even meet criterion for a full-blown diagnosis of OCD, there is hope! Mental health professionals who practice cognitive and behavioral interventions can help you.

Bonnie Harken is CEO and founder of Crossroads Programs for Women in Pekin, IL, which offers intensive outpatient programs for women. She serves as the executive director of The International Association of Eating Disorders Professionals Foundation Inc. (iaedp), a 700-member professional organization that trains and certifies professionals to treat eating disorders. She has been in the mental health field since 1987. Visit www.crossroadsprogramsforwomen.com. Call today! 1-800-348-0937.

Sources upon request.
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