Cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) has proven to be an effective treatment modality for children with obsessive-compulsive disorder (OCD). Less research exists demonstrating efficacy for this treatment modality among children with comorbid diagnoses of OCD and autism spectrum disorder (ASD), and virtually, nothing has been reported examining intensive interventions for the most severe cases. As such, this article discusses the treatment of an adolescent male with severe OCD comorbid with ASD, attention deficit hyperactivity disorder (ADHD), generalized anxiety disorder (GAD), and chronic tic disorder using a cognitive behavioral approach and ERP. We conclude with recommendations for continued clinical research to understand approaches to help nonresponders to standard therapeutic approaches with this challenging population.

Emetophobia, or a specific phobia of vomiting, is an underresearched disorder characterized by extensive avoidance and safety-seeking behaviors. Extant literature has primarily focused on online support groups and qualitative investigations, thereby limiting the generalizability of results. As such, this study sought to examine the clinical correlates, phenomenology, and impairment related to emetophobia in 436 undergraduate students. About 5% of the sample exhibited significant emetophobia symptoms (n = 21), with all participants in this subsample reporting an age of onset prior to adulthood. In addition, participants’ most distressing aspects of emetophobia were reported to be the somatic sensations of vomiting and the social impact of the disorder. For the entire sample (N = 436), emetophobia symptoms were associated with heightened anxiety, somatization, and depressive symptoms. In addition, functional impairment was observed across home/family, school/work, and social domains of life, even after controlling for the effects of anxiety and depressive symptoms. Detailed results and implications of the findings are discussed, and suggestions for future studies are presented.