Obsessive-compulsive disorder (OCD) and substance-use disorders (SUDs) co-occur at high rates, which is related to poorer psychosocial outcomes. Prior work suggests that, among veterans in the Veterans Health Administration (VHA), OCD is underdiagnosed and undertreated, which can compound negative effects of OCD and SUD co-occurrence. This study identified patterns of OCD and specific SUD co-occurrence and their effect on mental health and substance-use screening measures and mental healthcare utilization. Using VHA administrative data, we identified veterans with an OCD diagnosis from 2010 to 2016 (N = 38,157); 36.70% also had a SUD diagnosis. Specific SUD rates are alcohol-use disorder, 17.17%; cannabis-use disorder, 5.53%; opioid-use disorder, 3.60%; amphetamine-use disorder, 1.49%; cocaine-use disorder, 3.37%; and tobacco-use disorder, 26.50%. Veterans with co-occurring OCD and SUD used more mental health services throughout the data capture period. Findings suggest that OCD and SUD co-occur at high rates within the VHA, and that this is associated with more burden to the healthcare system. Targeted screening and treatment efforts may help address the needs of this population.

Obsessive-compulsive disorder (OCD) can be effectively treated by cognitive behavioral therapy (CBT) with exposure and response prevention (ERP). Yet, little is known about the long-term effects of inpatient CBT up to one decade after treatment. Thirty patients who had been treated with 12 weeks of intensive inpatient CBT with ERP were examined 8–10 years after their stay in hospital with regard to obsessive-compulsive symptoms, secondary outcomes, and use of healthcare services. Significant (p < .001) improvements in OC symptoms with medium and large effects compared to baseline on the Yale-Brown-Obsessive-Compulsive Scale (Y-BOCS) and on the Obsessive-Compulsive Inventory (OCI-R) could still be observed, with 20% of the patients reaching remission status. Continuation of exposure exercises after the inpatient stay was the sole significant factor for improved scores at follow-up. The results suggest that OCD does not necessarily take a chronic course. However, maintenance of exposure training seems to be crucial for sustained improvement.

Older adults with obsessive-compulsive disorder (OCD) may benefit from cognitive-behavioral therapy (CBT), but the disorder has been understudied in this population (Calamari, Pontarelli, Armstrong, & Salstrom, 2012; Grenier, Préville, Boyer, & O'Connor, 2009). This article presents a course of Exposure and Response Prevention (ERP) for an older White male veteran of WWII who had been a frequent utilizer of the emergency room for maladies that could be treated in the outpatient setting. The course of treatment for OCD comprised 14 sessions and was delivered in the veteran's home as a part of his care in the Veteran Affairs (VA) home-based primary care (HBPC) service. Adaptations were made to accommodate age-related cognitive deficits, treatment barriers related to mental health care access, stigma, safety concerns, and misperceptions regarding OCD and its treatment. Following ERP, significant reduction in self-reported distress related to OCD was observed. Recommendations for utilizing ERP within a HBPC context are offered.

There is a recognized overlap between eating disorders (EDs) and obsessive-compulsive disorder (OCD) in terms of diagnosis, phenomenology, epidemiology, and psychological characteristics related to the disorder. In light of these similarities, a cognitive inference-based therapy (IBT) program, shown to be effective in treating OCD, was adapted for EDs. This case study describes the application of IBT treatment for a 35-year-old woman diagnosed with bulimia nervosa who also demonstrated overvalued ideation related to her body weight and shape. Over a 20-week period, the client’s ED pathology significantly decreased. Notably, the frequency of binge episodes was reduced by 90% from pre- to posttreatment and by 100% at 6-month follow-up. Significant reductions were also observed in dietary restriction and overvalued ideation. This case study has important implications for the treatment of individuals with both an ED and strong overvalued ideas.

The prevalence of obsessive-compulsive disorder (OCD) is higher among young people with autism spectrum disorders (ASD). Case studies and randomized controlled trials show that modified cognitive behavioral therapy (CBT) can be effective for young people with OCD and co-morbid ASD. This case study describes modified CBT for an adolescent with severe, treatment-resistant OCD and co-morbid ASD, and highlights the importance of family accommodation and parental mental health in pediatric OCD. Modifications to the standard evidence-based CBT for OCD protocol included extended psychoeducation, visual session material, mini exposure and response prevention hierarchies and parallel parent sessions to address familial accommodation and parental mental health. Progress was measured at seven times points throughout treatment using clinician administered, youth and parent self-report measures. Outcome data indicated significant improvements in OCD symptoms, general functioning, and maternal mental health as well as significant reductions in family accommodation. Gains were maintained over a 12-month follow-up period. This case study illustrates that modified CBT can be effective in youth with OCD and ASD and discusses the importance of familial accommodation and parental mental health.

Obsessive-compulsive disorder (OCD) is a debilitating psychological condition that impacts millions of people globally. The front-line psychological intervention for OCD is exposure/response prevention (ERP), however, many individuals do not respond to this treatment approach. Eye movement desensitization and reprocessing (EMDR) is a new therapeutic option which could be effective in treating OCD. This review examined the initial evidence for the effectiveness of EMDR in reducing OCD symptoms. Nine studies were included in the review, including six case studies and three group studies. Results indicate that EMDR is a promising candidate for treating OCD, with all studies showing EMDR therapy resulted in reduced symptoms from baseline. Results also indicated that EMDR may be as effective as ERP, and more effective than selective serotonin reuptake inhibitors (SSRIs) in treating OCD.

Research consistently demonstrates that individuals with anxiety symptoms exhibit attentional biases toward threatening stimuli using various computer-based tasks. However, the presence of attentional biases across obsessive-compulsive symptom presentations has been mixed and requires clarification. This study was the first to use the dot probe paradigm to investigate the association between scrupulosity symptoms (obsessions and compulsions having to do with religion and morality) and selective attention to scrupulosity-relevant lexical stimuli. Contrary to hypotheses, individuals with higher levels of scrupulosity did not selectively attend (i.e., have faster reaction times) to scrupulosity-specific threat words (e.g., hell) more so than to general threat or neutral words. Various potential explanations for these null findings, as well as directions for future research, are discussed.

Pregnancy and postpartum periods are associated with increased risk for onset and exacerbation of obsessive-compulsive disorder (OCD) symptoms. Common themes of the obsessive thoughts in this period are fears of accidently or intentionally harming the baby. Postpartum OCD may go underdiagnosed or misdiagnosed due to lack of standardized screening and potential shame associated with reporting these symptoms. Without treatment, OCD symptoms often persist and continue to impair mother's quality of life and interactions with the child. Literature on treatment specific to postpartum OCD is limited to case series and small studies. Exposure and response prevention (ERP), a gold-standard treatment for OCD, seems to be effective for this particular manifestation of OCD. This article presents a case history and ERP treatment course for a patient presenting with sudden onset of OCD following the birth of her child. Key differential diagnostic features, specific treatment strategies, and practice points are also explored.

Thought–action fusion (TAF) refers to maladaptive beliefs about the relationship between mental events and behaviors, and is associated with obsessional problems. Currently, the self-report Thought–Action Fusion Scale (TAFS) is the most widely used measure of TAF, but a single assessment modality limits research that can be conducted on this phenomenon. This study evaluated the validity of an in vivo paradigm that assesses both Moral TAF (the belief that thoughts are the moral equivalent of actions) and Likelihood TAF (the belief that thinking about a negative event increases the probability of the event itself). In this paradigm, participants were asked to contemplate two negative events involving a beloved relative: (a) I hope (relative) is in a car accident today and (b) I hope I have sex with (relative). Participants then provided in vivo ratings of anxiety, estimates of likelihood, and moral wrongness related to the negative thoughts. Results provided evidence for the convergent validity of the in vivo ratings for both sentences. These findings are discussed in terms of clinical care, the assessment of TAF, and the implications for future research on this theoretically important construct.

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.