Postscript: Problems With the Security Motivation Model Remain Largely Unresolved

Postscript: Problems With the Security Motivation Model Remain Largely Unresolved: Response to Woody and Szechtman (2005)
[COMMENT]
Taylor, Steven1,4; McKay, Dean2; Abramowitz, Jonathan S.3
1Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
2Department of Psychology, Fordham University
3Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.
4Correspondence concerning this article should be addressed to Steven Taylor, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, British Columbia, V6T 2A1, Canada. E-mail: taylor@unixg.ubc.ca
Received Date: February 4, 2005; Revised Date: February 8, 2005; Accepted Date: February 8, 2005
In our previous commentary, we raised many important problems with Szechtman and Woody's (2004) security motivation model of obsessive-compulsive disorder (OCD), such as the following: (a) The model is built on a selective and unrepresentative review of the literature (e.g., the model erroneously emphasizes compulsions and fails to consider a good deal of empirical work on OCD, such as experimental and neuropsychological research); (b) the model assumes what needs to be empirically demonstrated (e.g., that OC symptoms reflect “biologically primitive concerns regarding self-preservation and preservation of species,” p. 113); (c) the model fails to explain many different OC phenomena and fails to account for the heterogeneity of OCD; (d) the model fails to distinguish OCD from generalized anxiety disorder; (e) a number of the model's predictions are ambiguous, and the central feature of the model—the existence of a putative security motivation system—is unfalsifiable; (f) several other predictions from the model have been refuted by previous research (e.g., predictions about the types of dysfunction associated with OCD); (g) the model often relies on ad hoc assumptions to attempt to explain the various aspects of OCD; and (h) the model has no demonstrable treatment relevance, apart from a couple of predictions that have been previously refuted in the literature (Taylor, McKay, & Abramowitz, 2005). In their response to our concerns, Woody and Szechtman (2005) (a) ignored many of these problems (e.g., the fact that the model is unfalsifiable) and continue to assume what remains to be proved, (b) resorted to what we consider to be specious analogies (aspirin, thermostats) and additional ad hoc assumptions in an attempt to address other problems, and (c) called for further research on issues that their model apparently cannot explain.
Space limitations do not permit us to comment on all of these issues. Instead, we highlight one problem with their model that Woody and Szechtman (2005) seem to think is unimportant: the treatment relevance of their model. They used the analogy of aspirin and colds, stating that administering aspirin improves the symptoms of a cold, but a cold is not some kind of aspirin deficiency, nor do a cold's viral origins explain why aspirin works” (p. 660). We believe that this analogy is misleading. Models of the mechanisms of colds have a great deal of treatment relevance; for example, they explain how some symptoms arise as a result of virus-induced inflammation (mediated by prostaglandins), and therefore the models suggest that drugs that block the production of prostaglandins should have anti-inflammatory properties and thereby produce symptomatic relief. Thus, such models have important treatment relevance and have led to the development of the family of NSAID drugs, of which aspirin is a member. To our knowledge, all leading models of psychiatric disorders have treatment relevance. For example, Beck's (1967) model of depression and Clark's (1986) model of panic disorder both led to new, effective treatments. Treatment relevance is an important goal because one of the major purposes of psychiatric research is to alleviate human suffering. A good model of OCD also should have treatment relevance. In our critique, we pointed out that the security motivation model has deficiencies in this regard. Rather than grappling with this important problem, Woody and Szechtman (2005) attempted to sidestep the issue.
References
Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. New York: Hoeber. [Context Link]
Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24, 461–470. [Context Link]
Szechtman, H., & Woody, E. (2004). Obsessive-compulsive disorder as a disturbance of security motivation. Psychological Review, 111, 111–127. Ovid Full Text [Context Link]
Taylor, S., McKay, D., & Abramowitz, J. S. (2005). Is obsessive-compulsive disorder a disturbance of security motivation? Comment on Szechtman and Woody (2004). Psychological Review, 112, 650–657. Ovid Full Text [Context Link]
Woody, E. Z., & Szechtman, H. (2005). Motivation, time course, and heterogeneity in obsessive-compulsive disorder: Response to Taylor, McKay, & Abramowitz (2005). Psychological Review, 112, 658–661. Ovid Full Text [Context Link]
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