Ladouceur R, Freeston M H, Gagnon F, Thibodeau N, Dumont J
Ecole de Psychologie, Université Laval, Québec, Canada.
J Behav Ther Exp Psychiatry. 1993 Dec;24(4):301-10. doi: 10.1016/0005-7916(93)90054-z.
Despite impressive improvement in the behavioral treatment of obsessive-compulsive disorder over the last 15 years, progress has been slower for obsessional thoughts with few or no overt rituals. Encouraging case reports suggest that exposure to obsessional thoughts combined with covert response prevention is an effective treatment. Three cases are presented that required adaptation from the guidelines laid out by Salkovskis and Westbrook (1989). They provide clear evidence of the need to adopt a creative and flexible approach to exposure that enables access and activation of fear structures.
尽管在过去15年里强迫症的行为治疗取得了令人瞩目的进展，但对于那些几乎没有或没有明显仪式行为的强迫观念，进展一直较为缓慢。令人鼓舞的病例报告表明，暴露于强迫观念并结合隐蔽的反应预防是一种有效的治疗方法。本文介绍了三个案例，这些案例需要根据Salkovskis和Westbrook（1989年）制定的指导方针进行调整。它们提供了明确的证据，表明需要采用创造性和灵活的暴露方法，以便能够触及并激活恐惧结构。
