Diagnostic Differential Between Pedophilic-OCD and Pedophilic Disorder: An Illustration with Two Vignettes.

Despite the prevalence of atypical sexual thoughts in OCD presentations, research suggests that treatment providers often misclassify OCD with pedophilic obsessions (P-OCD) as pedophilic disorder. Such misdiagnoses can have adverse effects including inappropriate treatment, worsening of symptoms, and potential legal complications. Given these iatrogenic effects, clinicians must be competent in differentiating between these two conditions. To clarify the difficult differential between P-OCD and pedophilic disorder, the current paper provides readers with two vignettes that illustrate the differential process. These vignettes highlight important distinctions in symptom presentations and common pitfalls when assessing for P-OCD and pedophilic disorder. The first vignette describes a 32-year-old married woman who experienced pedophilic-themed intrusive thoughts, leading her to avoid children and certain interactions with her daughter. The second vignette describes a 42-year-old married man who experienced ego-dystonic attraction toward minors, particularly 8-10-year-old girls. Following these vignettes, treatment implications and forensic implications are discussed. Finally, recommendations for future clinical and empirical work are made.

Obsessive-Compulsive Personality Disorder: A Review of Symptomatology, Impact on Functioning, and Treatment.

Obsessive-compulsive personality disorder (OCPD) is a chronic condition that involves a maladaptive pattern of excessive perfectionism, preoccupation with orderliness and details, and the need for control over one's environment. It is one of the most common personality disorders in the general population, with an estimated prevalence ranging from 1.9% to 7.8%. Despite the fact that patients with OCPD often present for treatment, there is little empirical research on treatments for OCPD, and there is no definitive empirically supported treatment for the condition. This review provides an overview of OCPD, its core features, its common presentation style types, and its impact on functioning. We review the limited treatment research to date and focus on cognitive-behavioral approaches targeting core aspects of OCPD that directly affect functioning in these patients, emphasizing take-home points for clinicians. We also address questions and controversies related to OCPD and its treatment.

Meta-analysis of cognitive-behavioral treatments for adult ADHD.

OBJECTIVE: We conducted a meta-analysis of cognitive-behavioral treatment (CBT) studies for adult attention-deficit/hyperactivity disorder (ADHD), examining effects versus control and effects pre-to-post treatment to maximize the clinical and research utility of findings from this growing literature. METHOD: Eligible studies tested adults meeting criteria for Diagnostic and Statistical Manual of Mental Disorders ADHD as determined by interview or using a standardized rating scale and measured ADHD symptoms or related impairment at baseline and posttreatment. We analyzed data from 32 studies from published and unpublished sources available through December 2015. Effect size calculations included up to 896 participants. RESULTS: Using a random effects model, we found that CBTs had medium-to-large effects from pre- to posttreatment (self-reported ADHD symptoms: g = 1.00; 95% confidence interval [CI: 0.84, 1.16]; self-reported functioning g = .73; 95% CI [0.46, 1.00]) and small-to-medium effects versus control (g = .65; 95% CI [0.44, 0.86] for symptoms, .51; 95% CI [0.23, 0.79] for functioning). Effect sizes were heterogeneous for most outcome measures. Studies with active control groups showed smaller effect sizes. Neither participant medication status nor treatment format moderated pre-to-post treatment effects, and longer treatments were not associated with better outcomes. CONCLUSIONS: Current CBTs for adult ADHD show comparable effect sizes to behavioral treatments for children with ADHD, which are considered well-established treatments. Future treatment development could focus on identifying empirically supported principles of treatment-related change for adults with ADHD. We encourage researchers to report future findings in a way that is amenable to meta-analytic review. (PsycINFO Database Record