777 final OCD PTSD Flashcards
Obsessive-Compulsive and Related Disorders
Obsessive-Compulsive and Related Disorders
Obsessive -Compulsive Disorder (OCD)
Repetitive thoughts and urges (obsessions)
Repetitive behaviors and mental acts (compulsions)
Body Dysmorphic Disorder
Repetitive thoughts and urges about personal appearance
Hoarding Disorder
Repetitive thoughts about possessions
Obsessions
Intrusive, persistent, and uncontrollable thoughts or urges
Experienced as irrational
Most common:
Contamination, sexual and aggressive impulses, body problems
Compulsions
Impulse to repeat certain behaviors or mental acts to avoid distress
e.g., cleaning, counting, touching, checking
Extremely difficult to resist the impulse
May involve elaborate behavioral rituals
Compulsive gambling, eating, etc. NOT considered compulsions, since pleasurable
DSM-5 Criteria for Obsessive-Compulsive Disorder
Obsessions (recurrent, intrusive, persistent, unwanted thoughts, urges, or images that the person tries to ignore, suppress, or neutralize) or
Compulsions (repetitive behaviors or thoughts that a person feels compelled to perform to prevent distress or a dreaded event or that a person feels driven to perform in response to an obsession)
The obsessions or compulsions are time consuming (e.g., require at least 1 hour per day), or cause clinically significant distress or impairment
Obsessive-Compulsive Disorder
Develops either before age 10 or during late adolescence/early adulthood
More common in women 1.5 times more common than in men OCD often chronic Only 20% complete recovery 75% have comorbid anxiety disorder 66% have major depression 33% have hoarding symptoms Substance abuse is common
Body Dysmorphic Disorder
Preoccupied with an imagined or exaggerated defect in appearance
Perceive themselves to be ugly or “monstrous”
Women focus on: skin, hips, breasts, legs
Men focus on: height, penis size, body hair, muscularity
Engage in compulsive behaviors
Check their appearance in mirrors often
Camouflage their appearance (tanning, makeup, plastic surgery)
High levels of shame, anxiety, and depression
Occurs slightly more often in women
2% prevalence rate; 5-7% for women seeking plastic surgery
Nearly all have another comorbid disorder
DSM-5 Criteria for Body Dysmorphic Disorder
Preoccupation with a perceived defect or markedly excessive concern over a slight defect in appearance
The person has performed repetitive behaviors or mental acts (e.g., mirror checking, seeking reassurance, or excessive grooming) in response to the appearance concerns
Preoccupation is not restricted to concerns about weight or fat
Hoarding Disorder
Persistent difficulty or parting with possessions, regardless of their actual value.
This difficulty is due to a perceived need to save the items and to distress associated with discarding them.
The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (eg. Family members, cleaners, authorities).
The hoarding causes clinically significant distress or impairment in social, occupational or other important areas of functioning including ( including maintaining a safe environment for self and others).
The hoarding is not attributable to another medical condition (eg., brain injury, cerebrovascular disease, PraDer-Willis syndrome).
The hoarding is not better explained by the symptoms of another mental disorder (eg. Obsessions in obsessive-compulsive disorder, delusions in schizophrenia or another psychotic disorder, cognitive deficits in major neurocognitive disorder, restricted interests in autism spectrum disorder).
Treatment of the Obsessive-Compulsive and Related Disorders
Medications
SSRI’s (Serotonin reuptake inhibitors)
Tricyclic antidepressants: Anafranil (clomipramine)
Exposure plus response prevention (ERP)
Not performing the ritual exposes the person to the full force of the anxiety provoked by the stimulus
The exposure results in the extinction of the conditioned response (the anxiety)
Cognitive therapy
Challenge beliefs about anticipated consequences of not engaging in compulsions
Usually also involves exposure
Posttraumatic Stress Disorder (PTSD)
Extreme response to severe stressor
Anxiety, avoidance of stimuli associated with trauma, emotional numbing
Exposure to a traumatic event that involves actual or threatened death or injury
e.g., war, rape, natural disaster
Trauma leads to intense fear or helplessness
Symptoms present for more than a month
Women and PTSD
Sexual Assault most common type of trauma
Intrusively re-experiencing the traumatic event
Nightmares, intrusive thoughts, or images
Avoidance of stimuli
e.g., refuse to walk on street where rape occurred
Other signs of mood and cognitive changes
Memory loss, negative thoughts and emotions, self-blame, blaming others, withdrawal
Increased arousal and reactivity
Irritability, aggressiveness, recklessness or self-destructiveness, insomnia, difficulty concentrating, hypervigilance, exaggerated startle response
chronic
Higher risk of suicide and self-injuries
Acute Stress Disorder (ASD)
Symptoms similar to PTSD
Duration shorter
Symptoms occur between 3 days and 1 month after trauma
As many as 90% of rape victims experience ASD
ASD predicts higher risk of PTSD with 2 years
Psychological Treatment of PTSD
Exposure to memories and reminders of the original trauma
More effective than medication or supportive therapy
Treatment can be difficult at first
Possible increase in symptomatology
Cognitive therapy
Enhance beliefs about coping abilities
Adding CT to exposure does not improve treatment response
Treatment of ASD may prevent PTSD
Shows benefits even 5 years after the traumatic event
