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Tijdschrift voor Psychiatrie 51 (2009) 4, 227 - 237

Review article

A new explanatory model for obsessive-compulsive disorder

H.A.D. Visser, H.J.G.M. van Megen, P. van Oppen, A.J.L.M. van Balkom

background Ever since the first descriptions of obsessive-compulsive disorder (ocd) there have been discussions about how the phenomenology of the disorder should be understood. Over the past 50 years the main emphasis has been on the phobic elements of ocd. A new psychological model, called the Inference Based Approach (iba), focuses on an underexposed aspect of the disorder, namely the strange convictions of the patient.
aim To compare the new model with the existing cognitive behavioral theories of ocd.
method Literature research was conducted using Medline.
results According to the iba it is assumed that patients with ocd feel anxious because their testing of reality is imperfect. Patients would not feel any anxiety if they were able to integrate adequately information obtained via their senses. In that case ocd would be a cognitive disorder, not an anxiety disorder. Although the model provides an attractive explanation for the symptoms of ocd and some of the research results seem to support the model, many questions still remain unanswered. conclusion There are indications that, at least in some ocd patients, anxiety might be only a part of the disorder rather than the core.


keywords anxiety disorder, appraisal, belief disorder, obsessive-compulsive disorder, reasoning