Posttraumatic obsessive-compulsive disorder: a three-factor model.
This paper presents a three-factor causal model of obsessive-compulsive disorder (OCD), which posits that exposure to long-term traumatic stress generates an inordinate degree of anxiety during the psychological development of the premorbid OCD child. In response to these conditions the child evolves a distinct cognitive style characterized by exaggerated threat appraisal and magical beliefs, and experiences alterations in brain metabolism. An entire functional brain system (a basal ganglia-orbitofrontal circuit) enters into a state of enhanced responsiveness following exposure to protracted threat. Over time the threshold for stimulation is dramatically lowered, resulting in a hypersensitivity to cues that signify potential harm. Individuals adapt to this hypersensitivity through a variety of strategies, which constitute OCD.
Dinn
W M
WM
Department of Psychology, Boston University, MA, USA. dinn@bu.edu
Harris
C L
CL
Raynard
R C
RC
D000223:Adaptation, Psychological / Q000502:physiology; D001143:Arousal / Q000502:physiology; D001479:Basal Ganglia / Q000503:physiopathology; D003674:Defense Mechanisms; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D009415:Nerve Net / Q000503:physiopathology; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*