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Exaggerated illness and appearance concerns and related compulsive behaviors are seen in the psychiatric disorders of hypochondriasis (HYP), body dysmorphic disorder (BDD), and obsessive-compulsive disorder (OCD). It has been argued that these conditions may cluster in clinical samples and that our current categorical diagnostic policies, which assume independence of these disorders, are arbitrary and fail to capture the dimensional nature of these disorders.
Methods:
We present retrospective clinical data on 21 randomly selected patients who presented with symptoms that involved anxiety about illness and appearance and who were evaluated for cognitive-behavioral treatment or pharmacotherapy. We also review the symptoms, associated features, and response to treatment of three patients from the sample who were each diagnosed with all three of these disorders (HYP, BDD, and OCD).
Results:
Three patients met criteria for HYP, BDD, and OCD, and the other 18 patients met criteria for at least two of the above conditions. The most frequently reported source of anxiety had to do with one's hair. Nine out of the 12 patients treated with behavioral therapy were considered to be responders, and the one treated solely with medication was “very much improved.” Of the eight treated with a combination of behavioral therapy and medication, five were judged to be responders.
Conclusions:
Overlap in phenomenology, associated features, and treatment response suggests that these three disorders may be difficult to distinguish from each other and that a “cluster analysis” model may prove helpful in evaluating clinical samples.
Long recognized as 'America's theologian', Jonathan Edwards (1703–1758) is seen as instrumental in the Great Awakening of the 1740s that gripped much of New England and that laid the groundwork for an American Protestant religious identity. This Cambridge Companion offers a general, comprehensive introduction to Jonathan Edwards and examines his life and works from various disciplinary perspectives including history, literature, theology, religious studies, and philosophy. The book consists of seventeen chapters written by leading religious scholars, historians and literary critics on Edwards' life, work, and legacy. The Companion will be an invaluable aid to teachers and scholars and will be imminently accessible to those just encountering Edwards for the first time.