The Scientific Review of Mental Health Practice

Objective Investigations of Controversial and Unorthodox Claims in Clinical Psychology, Psychiatry, and Social Work

What Is OCD and What Is Not?

An Alternative Treatment for Fear

Jonathan S. Abramowitz - Department of Psychiatry and Psychology, Mayo Clinic
Arthur C. Houts - Department of Psychology, University of Memphis

Author Note:
Correspondence concerning this article should be addressed to Jonathan S. Abramowitz, Mayo Clinic, Department of Psychiatry and Psychology, 200 First St. SW, Rochester, MN 55905; E-mail:

A "spectrum" of disorders thought be related to obsessive-compulsive disorder (OCD) and representing a wide range of psychiatric conditions has been identified. Inclusion of disorders in the proposed "OCD spectrum" appears to be based chiefly on the presence of repetitive thoughts or behaviors. Advocates of the OCD spectrum concept argue that each of these disorders results from similar neurobiological deficits, possesses similar associated features, and responds preferentially to antiobsessional medication and behavior therapy. In this article we critically review the arguments for a spectrum of OCD-related disorders. Despite superficial topographical similarities (e.g., repetitive behaviors), behavioral analyses and research findings suggest that very few of the putative spectrum disorders are related to OCD. In addition, arguments that OCD spectrum disorders each respond preferentially to similar medications and behavior therapies are (a) unsupported by research data or clinical experience and (b) indicative of confusion concerning behavioral therapy procedures. We conclude that the OCD spectrum concept is not particularly useful, and may even undermine efforts to understand and treat OCD.

You can read the full text of this article in
The Scientific Review of Mental Health Practice, vol. 1, no. 2 (Fall/Winter 2002).
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