Beyond Reasonable Doubt Reasoning Processes

Traditionally, obsessive-compulsive disorder has been classified as an anxiety disorder, but there is increasing evidence that it has schizotypal features in other words it is a belief disorder. This book describes the ways in which reasoning can be applied to OCD for effective treatment regimes. It moves comprehensively through theoretical, experimental, clinical and treatment aspects of reasoning research, and contains a detailed treatment manual of great value to practitioners, including assessment and treatment protocols and case studies

Kieron O’Connor completed his research and clinical training in psychology at the University of Sussex and the Institute of Psychiatry and Maudsley Hospital London (UK). In 1988 he was awarded the first of a series of fellowships by the Fonds de la Recherche en Santé du Québec, and established a clinical research program at the Fernand-Seguin Research Center, Louis-H. Lafontaine Hospital, University of Montreal. The multidisciplinary research program, which focuses on obsessive-compulsive disorder, Tourette and tic disorder, and delusional disorder, is currently funded by the Canadian Institutes of Health Research. Kieron O’Connor is also Associate Research Professor at the Psychiatry Department of the University of Montreal and is scientific advisor to the Quebec OCD Foundation. He has over 100 scientific publications. Forthcoming publications include Cognitive Behavioral Treatment of Tic Disorders (Wiley, in press).

Frederick Aardema studied clinical psychology at the University of Groningen and the University of Amsterdam in the Netherlands under the supervision of Prof. P.M.G. Emmelkamp in affiliation with the Fernand-Seguin Research Center located in Montreal, Canada. He currently resides in Canada and has published in international journals in the field of obsessive-compulsive disorder. In particular, his research interests include psychometric and experimental methods in the measurement of reasoning processes in OCD, as well as the application of inference and narrative based models to obsessions without overt compulsions. He is a licensed psychologist and has a private practice in Montreal, Quebec.

Marie-Claude Pélissier studied psychology at the University of Quebec at Montreal in Canada and did most of her clinical training in London, England. She has been working for almost eight years in clinical research on obsessive-compulsive disorder and other OCD related disorders, which has resulted in publications in two international journals. As a licensed psychologist, she recently started her own private practice. She is also actively involved in local mental health community groups where she teaches and acts as scientific consultant on OCD.

About the Authors

vii

Preface

ix

Foreword by Paul M.G. Emmelkamp

xiii

Acknowledgments

xv

1 Cognitive Approaches to Obsessive-Compulsive Disorder: An Overview

1

(16)

Obsessive-Compulsive Disorder

1

(3)

Cognitive Approaches to OCD

4

(6)

Intrusions and Inferences in OCD

10

(2)

Phobic and Non-Phobic Models of Development in OCD

12

(1)

Treatment Considerations

13

(3)

Conclusion

16

(1)

2 Reasoning in Everyday Life

17

(36)

Formal Logic and Informal Thinking

17

(15)

Making Sense of the Senses

32

(21)

3 Reasoning and Narrative

53

(28)

Conversation and Conviction

53

(14)

Inference and Imagination

67

(13)

Conclusion

80

(1)

4 Reasoning and Psychopathology

81

(32)

Reasoning in Clinical Populations

81

(15)

Reasoning Therapy

96

(14)

General Conclusion

110

(3)

5 An Inference-Based Approach to Obsessive-Compulsive Disorder

113

(36)

Clinical and Phenomenological Investigations into Inferential Confusion

113

(2)

Critical Concepts in an Inference-Based Model

115

(6)

Psychometric Measurement of Inferential Confusion

121

(10)

Experimental Studies of Inferential Confusion

131

(9)

Clinical Trials of an Inference-Based Approach to Therapy (IBA)

140

(6)

Conclusion

146

(3)

6 Using the IBA Treatment Manual

149

(50)

Introduction to Treatment

149

(1)

Step-by-Step Program

149

(17)

Common Queries from Clients

166

(4)

Troubleshooting Guide

170

(8)

Case Studies

178

(21)

7 Future Directions

199

(16)

IBA and Other Cognitive Therapy

199

(12)

Future Development in IBA

211

(2)

A Final Comment

213

(2)

Appendix 1 Overview of Our Treatment Program for Obsessive-Compulsive Disorder

215

(12)

Appendix 2 Worksheets, Exercise Sheets and Training Cards

227

(52)

Appendix 3

279

(2)

Appendix 4

281

(4)

References

285

(16)

Index

301

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Beyond Reasonable Doubt Reasoning Processes in Obsessive-Compulsive Disorder and Related Disorders

Summary

Author Biography

Table of Contents

Supplemental Materials