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Obsessive-compulsive disorder and behavioral therapy: A rational-choice perspective

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  • Yaniv, Gideon

Abstract

Obsessive-compulsive disorder (OCD) is a mental syndrome characterized by intrusive thoughts that trigger some repetitive action the individual feels driven to perform in order to relieve the anxiety engendered by the disturbing thoughts. A natural measure for the severity of OCD is the duration of the repetitive ritual. This paper presents a dynamic model of rational OCD that determines the optimal number of compulsory repetitions over the individual's lifecycle through the choice of therapy intensity. The analysis reveals that in the case of mild disorder, compulsory repetitions rise steadily along the rationally optimal trajectory. In the case of severe disorder, the rationally optimal trajectory is U-shaped, with compulsory repetitions declining for some time before turning around and rising again. Recent studies suggest, however, that the majority of patients experience a waning and waxing course of illness. In particular, symptoms are often worse during times of psychological stress. Incorporating stress into the model, the paper shows that a waning and waxing course may be the outcome of rational coping with the emergence of stress.

Suggested Citation

  • Yaniv, Gideon, 2008. "Obsessive-compulsive disorder and behavioral therapy: A rational-choice perspective," Mathematical Social Sciences, Elsevier, vol. 55(3), pages 405-415, May.
    • Handle: RePEc:eee:matsoc:v:55:y:2008:i:3:p:405-415
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    References listed on IDEAS

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    1. Brian S. Ferguson, 2000. "Interpreting the rational addiction model," Health Economics, John Wiley & Sons, Ltd., vol. 9(7), pages 587-598, October.
    2. Yaniv, Gideon, 1998. "Phobic disorder, psychotherapy, and risk-taking: an economic perspective," Journal of Health Economics, Elsevier, vol. 17(2), pages 229-243, April.
    3. Levy, Amnon, 2002. "Rational eating: can it lead to overweightness or underweightness?," Journal of Health Economics, Elsevier, vol. 21(5), pages 887-899, September.
    4. Suranovic, Steven M. & Goldfarb, Robert S. & Leonard, Thomas C., 1999. "An economic theory of cigarette addiction," Journal of Health Economics, Elsevier, vol. 18(1), pages 1-29, January.
    5. Becker, Gary S & Murphy, Kevin M, 1988. "A Theory of Rational Addiction," Journal of Political Economy, University of Chicago Press, vol. 96(4), pages 675-700, August.
    6. Gideon Yaniv, 2004. "Insomnia, biological clock, and the bedtime decision: an economic perspective," Health Economics, John Wiley & Sons, Ltd., vol. 13(1), pages 1-8, January.
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