Cognitive-Behavioral Models of OCD

It has been argued that the best way to develop effective psychological interventions is to understand the development and maintenance of the disorder in question, and then to devise treatments that reverse the maintaining mechanisms (Clark, 1997). Such an approach has proven successful in a range of psychological disorders including panic disorder (eg, Clark, 1986), bulimia nervosa (Wilson & Fairburn, 2002), and OCD (Abramowitz, 1997). This chapter first describes the purpose of cognitive-behavioral models of OCD and then goes on to discuss five cognitive-behavioral models that have been proposed to account for OCD symptomatology. Each of these models is presented in detail, and the empirical evidence evaluating them is reviewed. The existing research incorporates a range of methods including questionnaire studies and controlled experimental laboratory research. It is concluded that the data are largely consistent with the cognitive-behavioral approaches, but that important questions remain to be addressed. Implications of these models for the conceptualization and treatment of OCD are also discussed.