Obssessive-Compulsive Disorder

A wieczne prawo gniecie ziemi syny, że nikt żywota nie przejdzie bez winy." Każdy człowiek w swoim życiu zetknął się z pewnymi formami przymusu -kazano nam myć zęby dwa razy dziennie, jeść warzywa, siedzieć spokojnie na ławce w poczekalni, chodzić do szkoły czy też na mityngi rodzinne. Każdorazowo przymus przychodził jednak z zewnątrz. Źródłem represji byli rodzice, dziadkowie, opiekunowie czy też nauczyciele. Przymus, o którym traktuje niniejszy artykuł, jest sprawą zgoła odmienną, gdyż pochodzi w przybliżeniu (i dużym uproszczeniu) z wewnątrz i w ten sposób przyczynia się do diagnozowania zaburzenia psychicznego (Aleksandrowicz, 2002, s. 69-76; Jaroszyński, 1993, s. 72-74). W artykule mowa będzie o zespole schorzeń znajdującym swoje miejsce w klasyfikacji ICD-10 jako zaburzenie obsesyjno-kompulsywne (grupa F42 75 ). W niniejszej pracy chcemy przedstawić kilka ciekawych hipotez odnoszących się do możliwego wyjaśniania etiologii tego schorzenia, które dotychczas nie były przedmiotem poszerzonej refleksji w polskojęzycznej literaturze przedmiotu. Szczególny nacisk położony zostanie na związek pomiędzy symptomami chorobowymi a zachowaniami zbliżonymi u osób zdrowych psychicznie, stąd analizie poddamy obecność natrętnych myśli religijnych w przebiegu choroby oraz zwrócimy uwagę na zbieżności pomiędzy kompulsjami a rytuałami. 75 F42.0 Zaburzenie z przewagą myśli czy ruminacji natrętnych; F42.1 Zaburzenie z przewagą czynności natrętnych (natrętne rytuały); F42.2 Myśli i czynności natrętne; F42.8 Inne zaburzenia obsesyjno-kompulsyjne. Por. Costa E Silva, 1999. 76 Ciekawe aczkolwiek długie -obejmujące całą książkę -studium przypadku (autoanaliza):

Introduction: Obsessive–compulsive disorder (OCD) is a disabling psychopathology. The mainstay of treatment includes cognitive–behavioural therapy (CBT) and medication management. However, individual suffering, functional impairments as well as the direct and indirect costs associated with the disease remain substantial. New treatment programmes are necessary and the brief strategic therapy (BST) has recently shown encouraging results in clinical practice but no quantitative study has as yet been conducted.
Methods and analysis: The clinical effectiveness of the OCD specific BST protocol will be evaluated in a one-group observational study. Participants will be sequentially recruited from a state community psychotherapy clinic in Dublin, Ireland. Outcome measures will be the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Beck Depression Inventory-II (BDI-II). Data will be collected at baseline, at treatment termination and at 3 month follow-up. The statistical significance of the post-treatment effect will be assessed by the paired-sample Student t test, while clinical significance will be evaluated by means of the equivalence testing method, which will be also used to assess the maintenance of effect at follow-up.
Ethics/dissemination: The present study is approved by the Hesed House Ethics Board in Dublin. Findings will enhance the evidence-based knowledge about the clinical effectiveness of BST in treating OCD symptoms, prior to assessing its efficacy in a randomised and controlled clinical trial, and will be disseminated through publication in peer-reviewed journals and conference presentations.

Obsessional states show an average point prevalence of 1%-3% and a lifetime prevalence of 2%-2.5%. Most treatment-seeking patients with obsessions continue to experience significant symptoms after 2 years of prospective follow-up. A significant burden of impairment, distress, and comorbidity characterize the course of the illness, leading to an increased need for a better understanding of the nature and management of this condition. This review aims to give a representation of the current pharmacological and psychotherapeutic strategies used in the treatment of obsessive-compulsive disorder. Antidepressants (clomipramine and selective serotonin reuptake inhibitors) are generally the first-line choice used to handle obsessional states, showing good response rates and long-term positive outcomes. About 40% of patients fail to respond to selective serotonin reuptake inhibitors. So far, additional pharmacological treatment strategies have been shown to be effective, ie, administration of high doses of selective serotonin reuptake inhibitors, as well as combinations of different drugs, such as dopamine antagonists, are considered efficacious and well tolerated strategies in terms of symptom remission and side effects. Psychotherapy also plays an important role in the management of obsessive-compulsive disorder, being effective for a wide range of symptoms, and many studies have assessed its long-term efficacy, especially when added to appropriate pharmacotherapy. In this paper, we also give a description of the clinical and psychological features likely to characterize patients refractory to treatment for this illness, with the aim of highlighting the need for greater attention to more patient-oriented management of the disease.

The Slender Man made his first appearance in 2009 on the Something Awful Forums website, where participants competed to take ordinary photographs and create eerie images by doctoring the photos. Seen lurking in the background of a playground full of children, the faceless, multi-armed, and freakishly tall figure wearing a dark business suit was the creation of Eric Knudsen (also known as “Victor Surge”). Like Frankenstein’s creature, Knudsen’s monster soon exceeded its creator’s control and took on a life of its own. The character began popping up in online “creepypasta” stories, in online artwork, and in several Web-based video series. What accounts for The Slender Man’s meteoric success as a Web meme? The Slender Man is a liminal figure who flourishes in: (1) the space between chaotic nature and orderly culture; (2) the space between folkloric traditions (The Grim Reaper) and quasi-scientific popular culture (The Men in Black); and (3) the space between relatively stable 20th century technologies (industrialization) and evolving 21st century technologies (digital media). The Slender Man is a boogeyman for the Information Age, one who embodies primal fears (death) and modern horrors (being ground up by impersonal industrialization) as well as postmodern paranoia (“they” are watching us through the technologies we use every day).

There are certain 'hard cases' of weakness of will that seem to occur, indeed to be common, but are very difficult to give a non-paradoxical account of.  It is just not clear how they are possible.  This paper is largely an attempt to get them in focus.  What conditions must such weak-willed actions satisfy?  In what sense must they be intentional, for example?  And must the weak-willed agent thinks his action objectively worse than some alternative action open to him?  And must that alternative action actually be open to him?  The paper concludes by considering the condition that a clear case of weakness of will must be in certain sense non-procrastinatory and this turns out to be particularly difficult to satisfy.  Other explanations, ones that do not postulate weakness of will (though they may involve paradoxes of their own), always seem to be available.