Jonathan Abramowitz

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Jonathan Abramowitz
Abramowitz giving presidential address at ABCT.jpg
Abramowitz delivers the Presidential Address at the 2015 ABCT Convention
Born
Jonathan Stuart Abramowitz

(1969-06-11) June 11, 1969 (age 55)
Education
Occupation(s) Clinical psychologist, professor, researcher, author
Organization University of North Carolina at Chapel Hill
Known forExpertise in the treatment and study of OCD and anxiety disorders
Website

Jonathan Stuart Abramowitz (born June 11, 1969) is an American clinical psychologist and Professor in the Department of Psychology and Neuroscience at the University of North Carolina at Chapel Hill (UNC-CH). [1] He is an expert on obsessive-compulsive disorder (OCD) and anxiety disorders whose work is highly cited. [2] He maintains a research lab and currently serves as the Director of the UNC-CH Clinical Psychology PhD Program. Abramowitz approaches the understanding and treatment of psychological problems from a cognitive-behavioral perspective.

Contents

Academic career

Abramowitz earned his B.A. in Psychology from Muhlenberg College in 1991, his M.A. in Psychology from Bucknell University in 1993, and his Ph.D. in Clinical Psychology from the University of Memphis in 1998. He completed both a predoctoral internship and postdoctoral fellowship at the Center for Treatment and Study of Anxiety at the University of Pennsylvania. He was a staff psychologist and Associate Professor at the Mayo Clinic (Rochester, Minnesota) from 2000 until 2006. He moved to North Carolina in the summer of 2006.

Abramowitz's research focuses on the development and evaluation of cognitive-behavioral treatments (CBT) for OCD and other anxiety-related problems, as well as on understanding the nature and psychopathology of these problems. He is the author of approximately 300 publications, including more than 10 books and over 250 peer reviewed journal articles and book chapters. He has also worked extensively as a book and journal editor. Abramowitz has given invited lectures around the world and served in numerous editorial and advisory roles for scientific journals and organizations.

Abramowitz is board certified by the American Board of Behavioral Psychology and is a licensed psychologist in North Carolina. In his clinical practice, he specializes in providing outpatient consultation and cognitive-behavioral treatment of OCD and other anxiety-related problems.

Research areas and contributions

Treatment of OCD and anxiety: A major focus of Abramowitz's research is the treatment of OCD. His work primarily addresses exposure and response prevention (ERP; a form of cognitive-behavioral therapy [CBT]) and he has conducted treatment outcome studies and meta-analytic reviews of this therapy. [3] [4] He has also investigated factors that predict good and poor outcomes. [5] [6]

Abramowitz has helped to develop an OCD treatment program combining ERP with Acceptance and Commitment Therapy (ACT). [7] He has also helped to develop couple-based ERP programs for OCD and Body Dysmorphic Disorder. [8]

Abramowitz has written about, and is conducting research to better understand, how to enhance the outcome of exposure therapy/ERP by optimizing extinction learning. [9] [10] [11] This work is drawn from inhibitory learning models of exposure.

Nature and symptoms of OCD: Abramowitz's research also focuses on trying to understand the complex symptomatology of OCD. [12] [13] His work has identified 4 subtypes/dimensions of this disorder that involve somewhat distinct cognitive and behavioral phenomena: (a) contamination, (b) responsibility for harm/mistakes, (c) unacceptable thoughts, and (d) incompleteness/symmetry. [14] He has also contributed to the re-conceptualization of hoarding as separate from OCD. [15]

Abramowitz has argued that OCD symptoms lie on a continuum with normal everyday experiences, and that one’s learning history (and to a lesser extent, their biology) influence the frequency, intensity, and duration of OCD symptoms. [16] [17] He has also criticized the DSM-5’s re-classification of OCD as separate from the anxiety disorders and as overlapping with conditions such as Hair Pulling Disorder and Skin Picking Disorder. [18] Abramowitz is generally critical of biomedical models which view problems such as OCD and anxiety as brain diseases or genetic disorders. [19]

Assessment of OCD: Abramowitz led a team of researchers in 2010 that developed the Dimensional Obsessive-Compulsive Scale (DOCS), a 20-item self-report instrument designed to measure the severity of the four types of OCD symptoms (see above). [12] The DOCS has been translated into multiple languages for use worldwide. [20] [21] [22] [23]

Cognitive-behavioral factors and models of OCD and anxiety: The cognitive-behavioral model is the leading conceptual approach to understanding OCD and anxiety disorders. [24] [25] Abramowitz conducts cross-sectional, experimental, and prospective (longitudinal) research that has helped to clarify and advance this conceptual model. His work focuses on cognitive biases such as anxiety sensitivity, [26] thought-action fusion, [27] intolerance of uncertainty, [28] and attentional biases [29] that factor in the persistence of OCD and irrational fear. With his team at UNC, he has developed experimental paradigms for studying thought-action fusion and intolerance of uncertainty. [30] [31] His work has also demonstrated that cognitive factors prospectively predict the escalation of intrusive thoughts into obsessions. [32]

Abramowitz also conducts studies on cognitive-behavioral factors in other anxiety and related problems, including health/illness anxiety, shy bladder syndrome, panic disorder, and hoarding. [33] [34] [35]

Scrupulosity: Abramowitz has conducted studies on, and developed a cognitive-behavioral model of, scrupulosity (religious obsessions and compulsions). [36] He also developed the Penn Inventory of Scrupulosity (PIOS) to measure this phenomenon. [37]

Prevention of postpartum OCD: Abramowitz developed and evaluated a prevention program for OCD symptoms in new parents. [38] This work was derived from previous studies led by Abramowitz showing that certain types of cognitive/psychological phenomena (such as the tendency to catastrophically misinterpret unwanted thoughts) predict the development of OCD symptoms in the postpartum. [32] The prevention program, known as "Baby PREP", can be delivered as part of perinatal education classes and was shown to be more effective than a credible placebo control program in preventing OCD symptoms among vulnerable expecting/new parents. [38]

Cross-cultural factors: Abramowitz has conducted research on cultural, religious, and racial differences in the expression of anxiety and OCD symptoms and related phenomena. [39] He is part of a multi-national collaborative effort studying the nature of intrusive obsessional thoughts in cultures and countries around the world. [40] [41] [42]

Awards, recognition, and leadership

Abramowitz's contributions to the fields of OCD, anxiety disorders, and clinical psychology are recognized by his colleagues, peers, and the media through numerous honors, awards, and appearances. He is a Fellow and Past President of the Association for Behavioral and Cognitive Therapies (ABCT) [43] [44] and serves on the International OCD Foundation Scientific and Clinical Advisory Board. [45] He is the recipient of a Muhlenberg College Alumni Achievement Award, [46] the David Shakow Early Career Award for Outstanding Contributions to the Science and Practice of Clinical Psychology (from Division 12 of the American Psychological Association), [47] and the Mayo Clinic Department of Psychiatry and Psychology Outstanding Contributions to Research Award.

Abramowitz has served on the Editorial Boards of several scientific journals and as Associate Editor of Journal of Cognitive Psychotherapy (2008–present) and Associate Editor of Behaviour Research and Therapy (2006-2015). He is the Editor-in-Chief of the Journal of Obsessive-Compulsive and Related Disorders . His ResearchGate score is higher than 97.5% of this site's members. [48]

Abramowitz was invited by colleagues in Norway to help train and supervise 30 OCD treatment teams in that country. The training is part of an initiative funded by the Norwegian government to ensure that all individuals with OCD in Norway have access to effective treatment. [49]

Abramowitz has twice been appointed as Associate Chair of the University of North Carolina at Chapel Hill Department of Psychology and Neuroscience, a position he held from 2007-2017.[ citation needed ]

Selected works

Books

Journal articles

Related Research Articles

<span class="mw-page-title-main">Cognitive behavioral therapy</span> Type of therapy to improve mental health

Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. Cognitive behavioral therapy is one of the most effective means of treatment for substance abuse and co-occurring mental health disorders. CBT focuses on challenging and changing cognitive distortions and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed to treat depression, its uses have been expanded to include many issues and the treatment of many mental health and other conditions, including anxiety, substance use disorders, marital problems, ADHD, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.

<span class="mw-page-title-main">Anxiety disorder</span> Cognitive disorder with an excessive, irrational dread of everyday situations

Anxiety disorders are a group of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause physical and cognitive symptoms, such as restlessness, irritability, easy fatigue, difficulty concentrating, increased heart rate, chest pain, abdominal pain, and a variety of other symptoms that may vary based on the individual.

<span class="mw-page-title-main">Hypochondriasis</span> Medical condition

Hypochondriasis or hypochondria is a condition in which a person is excessively and unduly worried about having a serious illness. Hypochondria is an old concept whose meaning has repeatedly changed over its lifespan. It has been claimed that this debilitating condition results from an inaccurate perception of the condition of body or mind despite the absence of an actual medical diagnosis. An individual with hypochondriasis is known as a hypochondriac. Hypochondriacs become unduly alarmed about any physical or psychological symptoms they detect, no matter how minor the symptom may be, and are convinced that they have, or are about to be diagnosed with, a serious illness.

<span class="mw-page-title-main">Obsessive–compulsive personality disorder</span> Personality disorder involving orderliness

Obsessive–compulsive personality disorder (OCPD) is a cluster C personality disorder marked by a spectrum of obsessions with rules, lists, schedules, and order, among other things. Symptoms are usually present by the time a person reaches adulthood, and are visible in a variety of situations. The cause of OCPD is thought to involve a combination of genetic and environmental factors, namely problems with attachment.

<span class="mw-page-title-main">Hoarding disorder</span> Behavioral pattern

Hoarding disorder (HD) or Plyushkin's disorder, is a mental disorder characterised by persistent difficulty in parting with possessions and engaging in excessive acquisition of items that are not needed or for which no space is available. This results in severely cluttered living spaces, distress, and impairment in personal, family, social, educational, occupational, or other important areas of functioning. Excessive acquisition is characterized by repetitive urges or behaviours related to amassing or buying property. Difficulty discarding possessions is characterized by a perceived need to save items and distress associated with discarding them. Accumulation of possessions results in living spaces becoming cluttered to the point that their use or safety is compromised. It is recognised by the eleventh revision of the International Classification of Diseases (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).

Scrupulosity is the pathological guilt and anxiety about moral issues. Although it can affect nonreligious people, it is usually related to religious beliefs. It is personally distressing, dysfunctional, and often accompanied by significant impairment in social functioning. It is typically conceptualized as a moral or religious form of obsessive–compulsive disorder (OCD). The term is derived from the Latin scrupus, a sharp stone, implying a stabbing pain on the conscience. Scrupulosity was formerly called scruples in religious contexts, but the word scruple now commonly refers to a troubling of the conscience rather than to the disorder.

<span class="mw-page-title-main">Intrusive thought</span> Unwelcome involuntary thought, image or idea

An intrusive thought is an unwelcome, involuntary thought, image, or unpleasant idea that may become an obsession, is upsetting or distressing, and can feel difficult to manage or eliminate. When such thoughts are associated with obsessive-compulsive disorder (OCD), Tourette's syndrome (TS), depression, body dysmorphic disorder (BDD), and sometimes attention-deficit hyperactivity disorder (ADHD), the thoughts may become paralyzing, anxiety-provoking, or persistent. Intrusive thoughts may also be associated with episodic memory, unwanted worries or memories from OCD, post-traumatic stress disorder, other anxiety disorders, eating disorders, or psychosis. Intrusive thoughts, urges, and images are of inappropriate things at inappropriate times, and generally have aggressive, sexual, or blasphemous themes.

The Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) is a test to rate the severity of obsessive–compulsive disorder (OCD) symptoms.

Sexual obsessions are persistent and unrelenting thoughts about sexual activity. In the context of obsessive-compulsive disorder (OCD), these are extremely common, and can become extremely debilitating, making the person ashamed of the symptoms and reluctant to seek help. A preoccupation with sexual matters, however, does not only occur as a symptom of OCD, they may be enjoyable in other contexts.

Exposure therapy is a technique in behavior therapy to treat anxiety disorders. Exposure therapy involves exposing the patient to the anxiety source or its context. Doing so is thought to help them overcome their anxiety or distress. Numerous studies have demonstrated its effectiveness in the treatment of disorders such as generalized anxiety disorder (GAD), social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and specific phobias.

Primarily obsessional obsessive–compulsive disorder, also known as purely obsessional obsessive–compulsive disorder, is a lesser-known form or manifestation of OCD. It is not a diagnosis in the DSM-5. For people with primarily obsessional OCD, there are fewer observable compulsions, compared to those commonly seen with the typical form of OCD. While ritualizing and neutralizing behaviors do take place, they are mostly cognitive in nature, involving mental avoidance and excessive rumination. Primarily obsessional OCD takes the form of intrusive thoughts often of a distressing, sexual, or violent nature.

<span class="mw-page-title-main">Obsessive–compulsive disorder</span> Mental and behavioral disorder

Obsessive–compulsive disorder (OCD) is a mental and behavioral disorder in which an individual has intrusive thoughts and feels the need to perform certain routines (compulsions) repeatedly to relieve the distress caused by the obsession, to the extent where it impairs general function.

The biology of obsessive–compulsive disorder (OCD) refers biologically based theories about the mechanism of OCD. Cognitive models generally fall into the category of executive dysfunction or modulatory control. Neuroanatomically, functional and structural neuroimaging studies implicate the prefrontal cortex (PFC), basal ganglia (BG), insula, and posterior cingulate cortex (PCC). Genetic and neurochemical studies implicate glutamate and monoamine neurotransmitters, especially serotonin and dopamine.

In psychology, relationship obsessive–compulsive disorder (ROCD) is a form of obsessive–compulsive disorder focusing on close or intimate relationships. Such obsessions can become extremely distressing and debilitating, having negative impacts on relationships functioning.

The delayed-maturation theory of obsessive–compulsive disorder suggests that obsessive–compulsive disorder (OCD) can be caused by delayed maturation of the frontal striatal circuitry or parts of the brain that make up the frontal cortex, striatum, or integrating circuits. Some researchers suspect that variations in the volume of specific brain structures can be observed in children that have OCD. It has not been determined if delayed-maturation of this frontal circuitry contributes to the development of OCD or if OCD is the ailment that inhibits normal growth of structures in the frontal striatal, frontal cortex, or striatum. However, the use of neuroimaging has equipped researchers with evidence of some brain structures that are consistently less adequate and less matured in patients diagnosed with OCD in comparison to brains without OCD. More specifically, structures such as the caudate nucleus, volumes of gray matter, white matter, and the cingulate have been identified as being less developed in people with OCD in comparison to individuals that do not have OCD. However, the cortex volume of the operculum (brain) is larger and OCD patients are also reported to have larger temporal lobe volumes; which has been identified in some women patients with OCD. Further research is needed to determine the effect of these structural size differences on the onset and degree of OCD and the maturation of specific brain structures.

The University of Florida Obsessive–Compulsive Disorder Program is a treatment and research clinic in the Department of Psychiatry at the University of Florida. The clinic is located in Gainesville, Florida.

Safety behaviors are coping behaviors used to reduce anxiety and fear when the user feels threatened. An example of a safety behavior in social anxiety is to think of excuses to escape a potentially uncomfortable situation. These safety behaviors, although useful for reducing anxiety in the short term, might become maladaptive over the long term by prolonging anxiety and fear of nonthreatening situations. This problem is commonly experienced in anxiety disorders. Treatments such as exposure and response prevention focus on eliminating safety behaviors due to the detrimental role safety behaviors have in mental disorders. There is a disputed claim that safety behaviors can be beneficial to use during the early stages of treatment.

The Dimensional Obsessive-Compulsive Scale (DOCS) is a 20-item self-report instrument that assesses the severity of Obsessive-Compulsive Disorder (OCD) symptoms along four empirically supported theme-based dimensions: (a) contamination, (b) responsibility for harm and mistakes, (c) incompleteness/symmetry, and (d) unacceptable (taboo) thoughts. The scale was developed in 2010 by a team of experts on OCD led by Jonathan Abramowitz, PhD to improve upon existing OCD measures and advance the assessment and understanding of OCD. The DOCS contains four subscales that have been shown to have good reliability, validity, diagnostic sensitivity, and sensitivity to treatment effects in a variety of settings cross-culturally and in different languages. As such, the DOCS meets the needs of clinicians and researchers who wish to measure current OCD symptoms or assess changes in symptoms over time.

Inferential confusion is a meta-cognitive state of confusion that becomes pathological when an individual fails to interpret reality correctly and considers an obsessional belief or subjective reality as an actual probability. It causes an individual to mistrust their senses and rely on self-created narratives ignoring evidence and the objectivity of events. These self-created narratives come from memories, information, and associations that aren't related- therefore, it deals with the fictional nature of obsessions. It causes the individual to overestimate the threat.

Bunmi O. Olatunji is an American psychologist who is Gertrude Conaway Vanderbilt Chair in Social Sciences at Vanderbilt University. He is Director of the Emotion and Anxiety Research Laboratory and Associate Dean of Academic Affairs for the Vanderbilt University Graduate School. Olatunji studies the psychopathology of obsessive–compulsive disorder.

References

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  33. Blakey, Shannon M.; Reuman, Lillian; Jacoby, Ryan J.; Abramowitz, Jonathan S. (2015-06-19). "Tracing "Fearbola": Psychological Predictors of Anxious Responding to the Threat of Ebola". Cognitive Therapy and Research. 39 (6): 816–825. doi:10.1007/s10608-015-9701-9. ISSN   0147-5916. PMC   7088101 . PMID   32214559.
  34. Deacon, Brett J.; Lickel, James J.; Abramowitz, Jonathan S.; McGrath, Patrick B. (2012-09-01). "Development and Validation of the Shy Bladder Scale". Cognitive Behaviour Therapy. 41 (3): 251–260. doi:10.1080/16506073.2012.658852. ISSN   1650-6073. PMID   22452544. S2CID   34747567.
  35. Wheaton, Michael G.; Abramowitz, Jonathan S.; Franklin, Joseph C.; Berman, Noah C.; Fabricant, Laura E. (2010-10-16). "Experiential Avoidance and Saving Cognitions in the Prediction of Hoarding Symptoms". Cognitive Therapy and Research. 35 (6): 511–516. doi:10.1007/s10608-010-9338-7. ISSN   0147-5916. S2CID   419377.
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  40. Radomsky, Adam S.; Alcolado, Gillian M.; Abramowitz, Jonathan S.; Alonso, Pino; Belloch, Amparo; Bouvard, Martine; Clark, David A.; Coles, Meredith E.; Doron, Guy (2014). "Part 1—You can run but you can't hide: Intrusive thoughts on six continents". Journal of Obsessive-Compulsive and Related Disorders. 3 (3): 269–279. doi:10.1016/j.jocrd.2013.09.002.
  41. Moulding, Richard; Coles, Meredith E.; Abramowitz, Jonathan S.; Alcolado, Gillian M.; Alonso, Pino; Belloch, Amparo; Bouvard, Martine; Clark, David A.; Doron, Guy (2014). "Part 2. They scare because we care: The relationship between obsessive intrusive thoughts and appraisals and control strategies across 15 cities". Journal of Obsessive-Compulsive and Related Disorders. 3 (3): 280–291. doi:10.1016/j.jocrd.2014.02.006.
  42. Clark, David A.; Abramowitz, Jon; Alcolado, Gillian M.; Alonso, Pino; Belloch, Amparo; Bouvard, Martine; Coles, Meredith E.; Doron, Guy; Fernández-Álvarez, Hector (2014). "Part 3. A question of perspective: The association between intrusive thoughts and obsessionality in 11 countries". Journal of Obsessive-Compulsive and Related Disorders. 3 (3): 292–299. doi:10.1016/j.jocrd.2013.12.006.
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