7.3 Obsessive Compulsive Disorder and Hoarding

Question 1

Obsession

Answer 1

• Recurrent thoughts, impulses, or images experienced as intrusive and stressful, and unable to be expunged by logic or reasoning.
• Obsessive Compulsive Disorder (OCD) is the presence of obsession, compulsion or both significant enough to cause distress or impairment in social/occupational functioning

Question 2

Compulsion

Answer 2

• Repetitive ritualistic behaviors or mental acts that an individual feels the need to preform which are intended to reduce anxiety associated with obsessive thought.
• These behaviors are not connected in a realistic way to neutralize anxiety.

Question 3

OCD

Answer 3

• Individual recognizes that their behavior is excessive but is compelled to do the act.

Common Compulsions
- Hand washing
- Ordering/Checking/Praying/Counting
- Repeating words silently

Question 4

OCD Cycle

Answer 4

Obsession
- Unwanted distressing thoughts, urges, and mental images. “What if”

Anxiety
- Distress, fear, worry, disgust. It is a false alarm. Individuals feel they need to do something

Compulsion
- Any behavior preformed to make the anxiety go away (includes checking)

Relief
- Temporary relief until obsessions come back (usually sooner)

Question 5

Common Compulsions

Answer 5

• Excessive cleaning or handwashing
• Ordering/arranging things in a particular precise way
• Repeatedly checking something (is the door locked or is the oven off)
• Compulsive counting (repeating words silently)

Question 6

Common Obsesssions

Answer 6

• Fear of germs/contamination
• Thoughts of sex, religion, and harm
• Aggressive thoughts towards self and others

Question 7

Hoarding Disorder

Answer 7

• Persistent difficulties with discarding possessions regardless of actual value
• May also include excessive need to continue to acquire items

Manifestations
- Collect items until virtually all surfaces within a home are covered.
- May only be narrow pathways winding through stacks of clutter.

ASSOCIATED SYMPTOMS
- Perfectionism
- Indecisiveness
- Anxiety/Depression
- Distractibility
- Difficulty planning and organizing tasks

Comorbidities of OCD and Hoarding
- Dependent, avoidant, schizotypal and paranoid personality disorders.

• IMPACTS MEN MORE THAN WOMEN
• Also more common in older adults
• Symptoms worsen with each decade