An Integrative Model for Understanding Obsessive-Compulsive Disorder: Merging Cognitive Behavioral Theory with Insights from Clinical Neuroscience

Eyal Kalanthroff*, Michael G. Wheaton

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Several models have been proposed for the emergence and maintenance of obsessive-compulsive disorder (OCD). Although these models have provided important insights and inspired treatment development, no single model has yet sufficiently accounted for the complexed phenotype of the disorder. In the current paper, we propose a novel model that integrates elements from cognitive behavioral models of OCD with neurocognitive approaches to the disorder. This Reciprocal Interaction Model (RIM) for OCD is based on two assumptions: (a) similar observed symptoms can stem from different etiological processes; and (b) neuropsychological deficits (such as reduced response inhibition and overreliance on the habit formation system) and cognitive behavioral processes (such as temporary reduction in anxiety after engaging in compulsive behaviors) mutually affect each other such that abnormalities in one system influence the second system and vice-versa—creating a vicious cycle of pathological processes. Indeed, the bidirectional inhibitory connection between anxiety/obsessions and executive control is at the heart of the model. We begin by briefly reviewing the current models for OCD. We then move on to describe the RIM, the supporting evidence for the model, the model’s predictions, and potential clinical implications.

Original languageAmerican English
Article number7379
JournalJournal of Clinical Medicine
Volume11
Issue number24
DOIs
StatePublished - 12 Dec 2022

Bibliographical note

Publisher Copyright:
© 2022 by the authors.

Keywords

  • cognitive behavioral therapy (CBT)
  • executive control
  • exposure and response prevention (EX/RP)
  • habit
  • inhibition
  • obsessive-compulsive disorder (OCD)

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