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Test Anxiety Treatment & Diagnostic Considerations

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When considering treatment for test-taking anxiety, make sure that you have a comprehensive diagnostic assessment to rule out other possible causes of your symptoms.  Not all cases of test anxiety are alike, and sometimes symptoms of test anxiety actually reflect a separate, underlying condition.  If you’re located in South Florida (Palm Beach Gardens, Jupiter, West Palm Beach, Fort Lauderdale, Boca Raton, Boynton Beach, & Miami), I would be happy to meet with you to conduct an assessment of your symptoms and provide treatment (if appropriate). Regardless of where you live, here is a short list of factors to consider when getting help for your symptoms: Test Anxiety Diagnosis & Treatment Strategies 1. Don’t assume that just because you have test anxiety that the problem is only test anxiety. Test performance issues may also have an independent panic component. If...

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Test Anxiety & Test-taking Anxiety Myths

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Although most of us (at one point or another) have experienced significant fear, uncertainty, or dread about an upcoming examination or evaluation, oftentimes these milestones pass without incident. We get scared, our hearts race, and we ultimately live to fight another day. For millions of Americans, however, test anxiety poses potentially serious, life-altering problems that can indelibly change the trajectory of one’s career, permanently limit one’s options, and ravage one’s self-confidence. Let’s dispel some common myths about test-taking anxiety. These myths are derived from actual (mis)statements people have made to me in my South Florida (Palm Beach Gardens, Jupiter, West Palm Beach, Fort Lauderdale, Boca Raton, Boynton Beach, & Miami) psychological practice. Test Anxiety Myths Myth #1. Test anxiety is only a problem for students (i.e., once you’re out of school, test anxiety is irrelevant). FALSE. Although test anxiety...

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“Pure-O” OCD: Common Obsessions & Mental Rituals

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As a follow-up to my previous post on Pure-O OCD, I thought it might be helpful to identify some obsessions that are commonly reported by individuals with Pure Obsessional OCD.  These same obsessions may also be experienced by individuals with non-Pure-O forms of the disorder.  Keep in mind that some of these symptoms are quite common (when experienced in a limited form) and may or may not represent an underlying psychological condition.  If you experience symptoms like these, consult with your doctor for clarification.  I am also available to conduct assessments and provide treatment if you’re located in South Florida (Palm Beach Gardens, Jupiter, West Palm Beach, Fort Lauderdale, Boca Raton, Boynton Beach, & Miami). Remember that most people who have Pure-O OCD actually perform compulsions.  These compulsions just tend to be mental rather than behavioral in nature.  Mental rituals...

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Pure-O OCD (Pure Obsessional OCD): Hidden Rituals

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“Pure-O” OCD, or Pure Obsessional OCD, is a relatively less common form of OCD that seemingly differs from classic presentations of the illness.  What distinguishes Pure Obsessional OCD from classic OCD is that in Pure-O OCD, symptoms are predominantly obsessive (rather than compulsive) in nature.  Although individuals with Pure-O OCD frequently experience intense and distressing obsessions, they typically report few (if any) overt compulsive behaviors.  However, in almost all cases, pure obsessionals do engage in a variety of rituals.  These rituals  just manifest as mental compulsions rather than behavioral compulsions. Unfortunately, most psychologists haven’t been trained in how to ask the types of questions that are necessary to identify these “hidden rituals.”  As a consequence, these rituals often go undetected.  Because effective treatment requires consistent response prevention, a failure to recognize and resist mental compulsions makes true exposure and response prevention (ERP) impossible.  Treatment...

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Exposure & Response Prevention (ERP) for OCD: Treatment Mechanism

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How does ERP work?  What mechanism underlies it? Obsessive-compulsive disorder (OCD) is characterized by obsessions and compulsions.  Obsessions are disturbing thoughts, images, or impulses that increase feelings of anxiety. Compulsions (also known as “rituals”) are the strategies that individuals with OCD use to reduce the anxiety associated with obsessions.  Rituals are effective coping strategies in the short-term, in that they lead to fairly rapid decreases in anxiety.  However, rituals are considered maladaptive, because the anxiety relief they bring is short-lived.  Engaging in rituals ultimately increases the likelihood that obsessions will be re-experienced in the future.  This can be thought of as a positive feedback loop, in which compulsive behavior indirectly reinforces obsessions.  This is depicted in the bottom half of the included figure. The treatment of choice for OCD is exposure and response prevention (ERP), which not surprisingly, has...

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Obsessive-Compulsive Disorder (OCD) – Decision Making Abnormalities

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Does OCD affect decision making processes? Now that we have reviewed the neurobiology of OCD and cognitive deficits associated with OCD, what relevance might this have for predicting abnormalities on tasks of decision making? Sachdev and Malhi (2005) recently have drawn attention to the substantial overlap between the circuitry implicated in OCD and the circuitry required for intact performance on simple decision tasks.  They suggest that due to the commonalities of these neural systems, individuals with OCD would be expected to exhibit deficits on tasks of decision making.  Furthermore, they indicate that OCD might even be conceptualized appropriately as a disorder of decision making, given that many of the hallmark features of the disorder seemingly arise from a primary deficit in decision making processes.  For example, OCD doubt and the inability to decide whether or not one’s hands have...

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