title: Posttraumatic obsessive-compulsive disorder: a three-factor model.
abstract: 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.
authors.affiliation: Department of Psychology, Boston University, MA, USA. dinn@bu.edu
authors.forename: W M
authors.initials: WM
authors.lastname: Dinn
authors.forename: C L
authors.initials: CL
authors.lastname: Harris
authors.forename: R C
authors.initials: RC
authors.lastname: Raynard
mesh_terms: 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*