Kings College London, Psychology Department, Henry Wellcome Building, De Crespigny Park, London SE5 8AF, UK.
Behav Cogn Psychother. 2012 Jul;40(4):383-99. doi: 10.1017/S1352465812000252.
Mental contamination is a phenomenon whereby people experience feelings of contamination from a non-physical contaminant. Rachman (2006) proposes that standard cognitive behavioural treatments (CBT) need to be adapted here and there is a developing empirical grounding supporting the concept, although suggestions on adapting treatment have yet to be tested.
A single case study is presented of a man with a 20-year history of severe treatment resistant Obsessive Compulsive Disorder (OCD) characterized by mental contamination following the experience of "betrayal". He was offered two consecutive treatments: standard CBT and then (following disengagement with this) a cognitive therapy variant adapted for mental contamination. Clinician and patient rated OCD severity was measured at baseline and the start and end of both interventions.
Six sessions of high quality CBT were initially attended before refusal to engage with further sessions. There were no changes in OCD severity ratings across these sessions. A second course of cognitive therapy adapted for mental contamination was then offered and all 14 sessions and follow-ups were attended. OCD severity fell from the severe to non-clinical range across these sessions.
The need to consider adapting standard treatments for mental contamination is suggested. Limitations and implications are discussed.
精神污染是一种人们从非物理污染物中体验到污染感的现象。拉赫曼（2006）提出，标准的认知行为疗法（CBT）需要在这里进行调整，并且有越来越多的经验证据支持这一概念，尽管关于调整治疗的建议尚未得到验证。
本文呈现了一项单一案例研究，研究对象是一名男子，他患有 20 年严重的强迫症（OCD）病史，其特点是在经历“背叛”后出现精神污染。他接受了两种连续的治疗：标准的 CBT，然后（在拒绝接受这种治疗后）接受了一种针对精神污染的认知治疗变体。临床医生和患者在基线时以及两种干预措施的开始和结束时都对 OCD 严重程度进行了评估。
最初参加了六次高质量的 CBT 治疗，但后来拒绝继续参加治疗。在这些治疗过程中，OCD 严重程度评分没有变化。然后提供了第二种针对精神污染的认知治疗变体，并且所有 14 次治疗和随访都参加了。在这些治疗过程中，OCD 严重程度从严重降至非临床范围。
需要考虑调整针对精神污染的标准治疗方法。讨论了局限性和影响。
