Communications: electrical – Condition responsive indicating system – Specific condition
Reexamination Certificate
2002-06-20
2004-07-13
Mullen, Jr., Thomas J (Department: 2632)
Communications: electrical
Condition responsive indicating system
Specific condition
C607S045000, C607S058000
Reexamination Certificate
active
06762687
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates generally to apparatus for persons suffering from obsessive compulsive spectrum disorders (OCSDs) or habit disorders and, more particularly, to a biofeedback device and associated methods of use which anticipate an impending movement of one body part towards another as being indicative of undesirable behavior typical of such disorders.
BACKGROUND OF THE INVENTION
Obsessive compulsive spectrum disorders (OCSDs) are potentially disabling conditions that can persist throughout a person's life. These include impulse control disorders typified by a failure to control physical impulses that are generally harmful towards self or others, including trichotillomania (hair pulling), onychophagia (nail biting), skin picking (dermatillomania), gambling and kleptomania. This invention is particularly concerned with OCSDs that are of a physically self injurious nature, such as hair pulling, skin picking, and nail biting, as well as the treatment of obsessive compulsive disorders that involve physical rituals, such as hand washing.
For many years, mental health professionals thought of OCSDs as rare diseases because only a small minority of their patients had the condition. These disorders often went unrecognized because many of those afflicted, in efforts to hide their unusual and sometimes embarrassing behaviors, declined to seek treatment. This led to underestimates in the number of people with these disorders. However, a survey conducted in the early 1980s by the National Institute of Mental Health (NIMH) showed that OCSDs affect more than 2 percent of the population, meaning that these afflictions are more common than mental illnesses such as schizophrenia, bipolar disorder, or panic disorder. OCSDs strike people of all ethnic groups. Males and females are equally affected. The social and economic costs of OCSDs are measured in billions of dollars.
The most classic OCSDs are true obsessive compulsive disorders. In this case, obsessions are unwanted ideas or repetitive impulses such as persistent fears that harm may come to one's self or a loved one, an unreasonable concern with becoming contaminated, or an excessive need to do things correctly or perfectly. Again and again, the individual experiences disturbing and sometimes bizarre thoughts, such as, “My hands may be contaminated—I must wash them”; “I may have left the gas on”; or “I am going to injure my child.” Obsessional thoughts may be violent or sexual in nature, or hypochondriacal—among people who are not predisposed towards abnormal violent or sexual behavior, and have no history of serious illness. Such thoughts are intrusive, unpleasant, and produce a high degree of anxiety—to the extent that they disrupt normal daily functioning.
In response to these obsessional thoughts, most people with OCSDs develop repetitive behaviors called compulsions. The most common of these are washing and checking. Other compulsive behaviors include counting (often while performing another compulsive action such as hand washing), repeating, hoarding, and endlessly rearranging objects in an effort to keep them in precise alignment with each other. Mental problems, such as mentally repeating phrases, list-making, or checking are also common. These behaviors serve the immediate function of temporarily reducing the anxiety associated with the obsession or irrational thought. While such behaviors as hair pulling and skin picking are not ritualized, they also function to reduce irrational anxiety. In this way the behavior reinforces itself—the more gratifying the behavior (no matter how strange) the more likely it will recur. As with the obsessional thoughts, the ritualized behaviors are also themselves very disruptive to daily functioning.
For most people with OCSDs, the urge to engage in the behavior after the anxiety producing thought is so powerful that it is almost impossible to function until this occurs. For example people with washing rituals may have to interrupt their activities 50 or 60 times a day to wash their hands, and often develop skin infections as a result of excessive drying and chapping of the skin. Some behaviors, such as skin picking and hair pulling, may be less disruptive in the moment, but may lead to social and physical consequences (baldness, abdominal infections, septic skin infections, and scarring) as disruptive as any other OCSD.
Although OCSD symptoms typically begin during the teenage years or early adulthood, recent research shows that some children develop the illness at earlier ages, even during the preschool years. Studies indicate that at least one-third of OCSDs in adults began in childhood. Suffering from OCSDs during early stages of a child's development can cause severe problems for the child. It is important that the child receive evaluation and treatment by a knowledgeable clinician to prevent the child from missing important opportunities because of this disorder. OCSDs, while somewhat amenable to treatment, are notoriously difficult to truly eradicate in clinical practice. Clinical and animal research sponsored by NIMH and other scientific organizations has provided information leading to both pharmacologic and behavioral treatments that can benefit the person with OCSDs, but what is certain is that there is no one cure, and that multiple approaches are a must in treating this difficult and emotionally painful disease. One patient may benefit significantly from behavior therapy, while another will benefit from pharmacotherapy. Some others may use both medication and behavior therapy. Others may begin with medication to gain control over their symptoms and then continue with behavior therapy. Which therapy to use should be decided by the individual patient in consultation with his or her therapist.
Traditional psychotherapy, aimed at helping the patient develop insight into his or her problem, is generally not helpful for OCSDs. Sufferers of OCSDs are typically well-aware of the oddity of their thoughts and behaviors, and this awareness in fact may contribute to their sense of distress. However, studies of behavior therapy for OCSDs have found this to be a successful approach for the majority of patients who are able to complete treatment. Furthermore, the positive effects of behavior therapy typically endure once treatment has ended. The most common behavioral approach is known as ‘exposure with response prevention’—which consists of exposing or allowing the OCSD sufferer to experience the anxiety or obsessional thoughts, while preventing the ritual or anxiety reducing behaviors. While this sounds simple, it is actually quite an aversive process for the average OCSD sufferer. But, it does work. A recent compilation of outcome studies indicated that, of more than 300 OCSD patients who were treated by exposure and response prevention, an average of 76 percent still showed clinically significant relief from 3 months to 6 years after treatment (Foa & Kozak, 1996). Another study has found that incorporating relapse-prevention components in the treatment program, including follow-up sessions after the intensive therapy, contributes to the maintenance of improvement (Hiss, Foa, and Kozak, 1994).
One study provides new evidence that cognitive-behavioral therapy may also prove effective for OCSDs. This variant of behavior therapy emphasizes changing the OCSD sufferer's beliefs and thinking patterns. Additional studies are required before the promise of cognitive-behavioral therapy can be adequately evaluated. The ongoing search for causes, together with research on treatment, promises to yield even more hope for people with OCSD and their families.
Certain OCSDs, including trichotillomania (hair pulling), onychophagia (nail biting), thumb sucking, skin scratching (dermatillomania), and so forth, involve self-inflicted harm. There are a number of products available to help alleviate the discomfort and distress associated with such conditions, these being primarily certain drugs and physical impediment devices such as special gloves. These articl
Gilford, Krass, Groh, Sprinkle, Anderson & Citkowski, PC
Mullen, Jr. Thomas J
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