6. OCD

Question 1

OCD criteria

Answer 1

• recurrent, persistent
• excessive, unreasonable
• time consuming, affect functioning

Question 2

what is obsessions

Answer 2

THOUGHTS
persistent ideas
nonsensical, inappropriate
cause distress
interrupts what their current thought is
can be egodistonic (against one's own values)

individual RECOGNISES these as a product of their own mind

Question 3

what is egodistonic thought

Answer 3

against one’s own values

eg: parent want to kill their child.

Question 4

what is compulsions

Answer 4

repetitive behaviour
goal: reduce anxiety
but does not disconfirm the belief

Question 5

rates of OC symptoms

Answer 5

80% population have unpleasant unwanted thoughts (includes those who can dismiss these thoughts)
more than 50% engage in ritualised behaviour (wear lucky charm, checking behaviour)

but people of OCD would not be able to dismiss these thoughts and have to ACT upon it

Question 6

prevalent OC symptoms

Answer 6

most prevalent: checking behaviour

followed by somatic obsessions and then symmetry

Question 7

OCD prevalence

Answer 7

2.3% of the whole population
no difference in m and f
age onset: 19yo
chronic cases is 50% of the 2.3%

Question 8

childhood OCD prevalence

Answer 8

between 1/3 to 1/2 develop OCD in childhood

m > f

Question 9

OCD and gender

Answer 9

no difference in gender in ADULT OCD

m > f in CHILDHOOD OCD

Question 10

OC symptoms and gender

Answer 10

there is a difference in OC symptoms presentations/experience (NOT THE DIAGNOSTIC)
- F more likely than M to develop contamination/cleaning and somatic obsessions

Question 11

OCD Diagnosis and gender

Answer 11

in people ALREADY DIAGNOSED with OCD,

• M are more likely to have symptoms in SEXUAL and religious areas
• W are more likely to have symptoms in aggression/violence and contamination/cleaning

Question 12

OCD comorbidity

Answer 12

common with MDD (28%) and OCPD (25%)

Question 13

causes of OCD

Answer 13

• learned response
• genetic (mutation of hSERT gene)
• environmental (early life traumatic experience)
• brain structure (malfunctions in regions associated with memory and organisation)

Question 14

models of OCD

Answer 14

• behavioural model

- cognitive model

Question 15

what is the behavioural model of OCD

Answer 15

• belief that intrusive thoughts are normal
• place meaning to these thoughts and RESPOND/ACT to it
• responses increase vigilance for intrusive thoughts and protects meaning of thoughts

Question 16

what is the cognitive model of OCD

Answer 16

• trigger (i touched something + belief that dirt = germ)
• obsessive intrusions (i may have been infected)
• anxiety (i might contaminate my family)
• compulsion (handwashing)
• avoidance (avoid touching stuff)
• feel relieved –> but no challenging of thoughts
• cycle back

Question 17

what is the implication to cognitive model of OCD to treatment

Answer 17

1st part of treatment should focus on CHALLENGING beliefs to target trigger
2nd part of treatment should focus on BEHAVIOUR (to stop compulsions, but may increase anxiety)
3rd part of treatment should focus on treating ANXIETY

Question 18

intrusive thoughts become OBSESSIONS if they are evaluated as:

Answer 18

• overly important
• highly threatening (something bad will happen)
• requiring complete control (i need to stop thinking about this - but normally the more u think like this the more it will come back)
• person has intolerance of uncertainty
• idea of perfection

Question 19

body dysmorphic disorder

Answer 19

perceived defects of physical appearance
leads to individual performing repetitive behaviour (mirror checking)
distress caused, social functioning etc

specific type: muscle dysmorphia (m > f)

Question 20

prevalence of body dysmorphic disorder

Answer 20

1.5 %
age onset 16-17yo
generally is a comorbid disorder (secondary disorder)
m = f
however males more likely genital preoccupations and females more likely hv comorbid eating disorder

Question 21

BDD cognitive factors

Answer 21

• self value is centred around physical qualities
• experience more anxiety after mirror checking (however, is a form of compulsion)
• engage in ruminative thinking “why am i so ugly”
• engage in past appearance related experiences “that time in p3 someone called me ugly”

Question 22

hoarding disorder

Answer 22

persistent difficulty to discard stuff regardless of their actual value

Question 23

hoarding disorder prevalence

Answer 23

2-6% ADULTS
m > f
more common in adults than young adults (the contrast to OCD and BDD which are more common in young adults)

Question 24

Hoarding disorder cognitive factors

Answer 24

• control over possessions (i need to know where things are - but actually when you ask where is A, they would get lost)
• memory concern (worry that if get rid of sth, cannot find it)
• responsibility over possessions (i am the only one holding to this, i am responsible to keep it)
• give human qualities to possessions
• for hoarding animals: think that animals give unconditional love, and only him or her can take care and provide the animals with the best care

Question 25

trichotillomania

Answer 25

hair pulling disorder
f > m
repeated attempts to STOP
trichophagia (swallowing it)

Question 26

excoriation

Answer 26

skin picking disorder
f > m
repeated attempts to STOP

Question 27

trichotillomania and excoriation psychological aspects

Answer 27

• pathway 1: gives pleasure/gratification of pulling and picking
• pathway 2: attempt to regulate state of high arousal (extreme anxiety) or low arousal (boredom)

Question 28

2 subtypes of trichotillomania and excoriation

Answer 28

• automatic: unconsciously pulling or picking

- focused: full awareness to urges/negative affective states