Anxiety Disorders: de Silva P

de Silva P. · Institute of Psychiatry, King's College, University of London, UK. · Int Rev Psychiatry. · Pubmed #16753667 No free full text.

Abstract: This paper discusses the tsunami disaster in Sri Lanka with special reference to Buddhism, which is the majority religion in the island. The role of religious beliefs and of religion in general in strengthening coping skills is well known. Buddhism, with its specific views on the human condition and its use of psychological strategies, is almost unique among world religions. The Buddhist responses to the tsunami have been discussed widely, if largely informally, in Sri Lanka, and many concepts and practices have been highlighted and focused on. This paper provides an overview of the relationship between culture and traumatic experiences, with a brief discussion of the role of religion in mental health. It then goes on to explore some relevant Buddhist concepts and practices which can be used in clinical settings.

de Silva P. · Department of Psychology, Institute of Psychiatry, London, UK. · Behav Res Ther. · Pubmed #10402702 No free full text.

Abstract: This paper discusses the work on thought-starting, a clinical technique developed by Durac, over many years. Much clinical work has taken place in using and further developing this approach, and some research has also been carried out. This paper attempts a review of these developments. A selective account of some of the major developments is given. The implications of these developments are also briefly discussed.

de Silva P, Menzies RG, Shafran R. · Department of Psychology, Institute of Psychiatry, King's College London, De Crespigny Park, SE5 8AF, London, UK. · Behav Res Ther. · Pubmed #12547375 No free full text.

Abstract: It is well established that many patients with obsessive-compulsive disorder have covert, or internal, compulsions. Empirical studies of this phenomenon, however, are limited. The present study followed the paradigm developed by Rachman and his colleagues for the study of overt compulsions. Patients with urges to carry out covert compulsions underwent an experimental procedure in which their compulsive urges were provoked, followed by a period of response prevention. The strength of the compulsive urges and associated discomfort were monitored. There was marked, and relatively rapid, spontaneous decay of both the compulsive urges and the discomfort. Implications of these results are discussed.

Lavender A, Shubert I, de Silva P, Treasure J. · Department of Psychology, Institute of Psychiatry, King's College London, UK. · Br J Clin Psychol. · Pubmed #17147100 No free full text.

Abstract: OBJECTIVES: Similarities in patterns of cognition and behaviour between patients with eating disorders and those with obsessive-compulsive disorder (OCD) have long been recognized, and comorbidity between these disorders has been shown to be high. However, there has been little investigation of the cognitive content shared between eating disorders and OCD. It has been suggested that a cognitive analysis of the overlap between the disorders may help to increase understanding of each, and have potentially useful clinical implications. The present study aimed to investigate the presence of obsessive-compulsive beliefs and magical ideation (MI) in a group of eating-disordered participants. METHOD: One hundred seventy-seven volunteers with a history of or current eating disorder completed the Obsessive Beliefs Questionnaire (OBQ), the Interpretation of Intrusions Inventory (IlI) and the Magical ideation scale (MIS). RESULTS: Eating-disordered participants demonstrated levels of the beliefs measured comparable to or higher than those with OCD. CONCLUSIONS: The results supported the hypothesis that the belief domains investigated are relevant to eating-disordered individuals. This has interesting theoretical and clinical implications. Further research will be required to elucidate the role of these types of cognitions in the relationship between eating disorders and OCD, and to clarify their role in the psychopathology of eating disorders.

Radomsky AS, de Silva P, Todd G, Treasure J, Murphy T. · Department of Psychology, University of British Columbia, Vancouver, Canada. · Behav Res Ther. · Pubmed #12375725 No free full text.

Abstract: Cognitive biases and cognitive distortions have been implicated as important factors in the development and maintenance of many disorders. The concept of thought-shape fusion (TSF) in eating disorders was developed by Shafran, Teachman, Kerry, and Rachman (British Journal of Clinical Psychology 38 (1999) 167) as a variant of thought-action fusion, described by Shafran, Thordarson and Rachman (Journal of Anxiety Disorders 10 (1996) 379). TSF occurs when thinking about eating certain types of food increases a person's estimate of their shape and/or weight, elicits a perception of moral wrongdoing, and/or makes the person feel fat. Shafran et al. (1999) examined both the psychometric and experimental properties of TSF in an undergraduate sample. This paper reports an extension of this work to a clinical group (N=20) of patients with anorexia nervosa. After completing a set of relevant questionnaires, participants were asked to think about a food which they considered extremely fattening. They were then asked to write out the sentence, "I am eating--.", inserting the name of the fattening food in the blank. After being asked to rate their anxiety, guilt, feelings about their weight, morality, etc., participants were given the opportunity to neutralize their statement in any way they chose. The majority of the participants neutralized in ways consistent with the findings of Shafran et al. (1999). The results are discussed in terms of cognitive-behavioural formulations of eating disorders, and of the influence of cognitive biases and cognitive distortions on the processing of information relevant to food, weight and shape in anorexia nervosa.

de Silva P, Marks M. · Department of Psychology, University of London, UK. · Behav Res Ther. · Pubmed #10472711 No free full text.

Abstract: This paper discusses the role of traumatic stress in the genesis of obsessive-compulsive disorder. While the early classical conditioning theory of the onset of obsessive-compulsive disorder has only limited empirical support, authorities have always recognised the role of stress in precipitating this disorder, and in triggering relapse in those who have been successfully treated. Here, clinical cases are cited that show a causal link between severe trauma and the onset of obsessive-compulsive disorder. The nature of the traumatic reaction and the possible mechanisms by which it leads to frank obsessive-compulsive disorder are discussed. The apparent links between this and posttraumatic stress disorder are also explored. Finally, implications for therapy are considered.