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Treatment of Perfectionism-Related Obsessive-Compulsive Disorder

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Clinical Handbook of Obsessive-Compulsive and Related Disorders

Abstract

Perfectionism has been identified as a vulnerability factor in the onset and maintenance of several psychological disorders and is particularly prominent in obsessive-compulsive disorder (OCD). Evidence indicates that there is a subgroup of OCD associated with high perfectionism that is characterized by greater frequency of obsessions and compulsions related to symmetry, ordering, repeating, cleaning, and hoarding. Although perfectionism-related OCD can be particularly resistant to treatment, exposure and response prevention (ERP) has been shown to be an efficacious psychological intervention. The case vignette described in this chapter illustrates the implementation of a comprehensive cognitive behavioral assessment, case formulation, and treatment plan for OCD characterized by perfectionism-driven symmetry, ordering, checking, and reassurance seeking. A detailed account of ERP is described, including constructing a multi-themed exposure hierarchy, in-session exposure practices, and expansion of between-session exposure practices to a lifestyle-management approach to challenge his obsessive thoughts across a range of situations and triggers throughout the day. Complicating factors associated with the enduring, pervasive, ego-syntonic nature of these difficulties are presented, along with strategies for building motivation, assessing therapy-interfering behaviors, and challenging obstacles in treatment.

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Author information

Authors and Affiliations

  1. Department of Psychology, Ryerson University, 350 Victoria Street, M5B 2K3, Toronto, ON, Canada

    Martin M. Antony PhD

  2. Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1280 Main Street West, L8S 4K1, Hamilton, ON, Canada

    Heather K. Hood MA

  3. Homewood Health Centre, 150 Delhi Street, N1E 6K9, Guelph, ON, Canada

    Heather K. Hood MA

Authors
  1. Heather K. Hood MA
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  2. Martin M. Antony PhD
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Correspondence to Martin M. Antony PhD .

Editor information

Editors and Affiliations

  1. Department of Pediatrics, Health Policy & Management, Psychiatry & Behavioral Neurosciences, and Psychology, University of South Florida, St. Petersburg, Florida, USA

    Eric A. Storch

  2. Departments of Pediatrics, Psychiatry and Psychology, University of South Florida, Tampa, Florida, USA

    Adam B. Lewin

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Hood, H., Antony, M. (2016). Treatment of Perfectionism-Related Obsessive-Compulsive Disorder. In: Storch, E., Lewin, A. (eds) Clinical Handbook of Obsessive-Compulsive and Related Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-17139-5_7

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