Compulsive washing in the absence of phobic and illness anxiety

doi:10.1016/0005-7967(95)00079-8

Behaviour Research and Therapy

Volume 34, Issue 4, April 1996, Pages 361-362

https://doi.org/10.1016/0005-7967(95)00079-8 Get rights and content

Abstract

A new typology of washing compulsions has been proposed: those that arise from a sense of dirtiness, those that arise from a sense of mental pollution, and finally, those that arise from a fear of illness. A case series is reported suggesting that a further class of washing behaviour can be described attributable to the personality trait of perfectionism.

References (6)

S. Rachman
Pollution of the mind
Behaviour, Research and Therapy
(1994)
P. van Oppen et al.
Cognitive therapy for obsessive compuslive disorder
Behaviour Research and Therapy
(1994)
D. Burns
Feeling Good: The New Mood Therapy
(1980)

There are more references available in the full text version of this article.

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Shorter communicationCompulsive washing in the absence of phobic and illness anxiety

Abstract

Behaviour, Research and Therapy

Behaviour Research and Therapy

Feeling Good: The New Mood Therapy

Shorter communication
Compulsive washing in the absence of phobic and illness anxiety