強迫性障害への認知行動アプローチ : 概観と展望

In the current most influential cognitive-behavioral model of obsessive-compulsive disorder, Salkovskis (1985) views dysfunctional beliefs related to obsessions, especially those about one's own exaggerated responsibility, and subsequent coping strategies, namely, neutralization rather than obsessions themselves as the major pathological factors. This paper describes his model and reviews empirical supports for it. Then I point out the shortcomings of his model and refines it by introducing two new perspectives. First, perfectionism in addition to responsibility is described to be a major cognitive factor. Second, two subtypes of obsessive-compulsive symptoms are proposed, i. e. , Problem-Solving Type and Simple Expression Type, the latter of which does not seem to fit Salkovskis's model and requires different accounts from those of Salkovskis's