Lelliott P T, Noshirvani H F, Başoğlu M, Marks I M, Monteiro W O
Department of Experimental Psychopathology, Institute of Psychiatry, London.
Psychol Med. 1988 Aug;18(3):697-702. doi: 10.1017/s0033291700008382.
Of 49 compulsive ritualizers one-third perceived their obsessive thoughts as a rational and felt that their rituals warded off some unwanted or feared event (the content of their obsessions). The more bizarre the obsessive belief the more strongly it was defended and 12% of cases made no attempt to resist the urge to ritualize. Neither fixity of belief nor resistance to compulsive urges were related to duration of illness. Patients with bizarre and fixed obsessive beliefs responded as well to treatment (all but three received exposure), as did patients whose obsessions were less bizarre and recognized as senseless. There was no difference in outcome between patients who initially found it hard to control their obsessions or never resisted the urge to ritualize and those who initially could control obsessions or resist rituals. One year after starting treatment, patients whose obsessions and compulsions had improved with treatment recognized their irrationality more readily and controlled their compulsive urges more easily. Beliefs appeared to normalize as a function of habituation.
在49名强迫性仪式行为者中，三分之一的人认为他们的强迫观念是合理的，并觉得他们的仪式行为能避免一些 unwanted 或令人恐惧的事件（他们强迫观念的内容）。强迫信念越离奇，其被捍卫得就越强烈，12%的病例没有试图抵抗仪式化的冲动。信念的固定程度和对强迫冲动的抵抗都与病程无关。有离奇且固定强迫信念的患者对治疗的反应（除三人外均接受了暴露疗法）与那些强迫观念不那么离奇且被认为无意义的患者一样。最初难以控制强迫观念或从未抵抗仪式化冲动的患者与最初能够控制强迫观念或抵抗仪式行为的患者在治疗结果上没有差异。开始治疗一年后，强迫观念和强迫行为经治疗有所改善的患者更容易认识到自己的不合理性，也更容易控制强迫冲动。信念似乎随着习惯化而趋于正常。
