Abnormal Week 5 Flashcards
OCD is uniquely associated with what risk
mortality - natural and unnatural causes
suicide ideation and attempts
OCRD related disorder features
repetitive thoughts and behaviors and inability to resist impulses and urges
obsessive-compulsive disorder OCD
is a chronic disorder where the mind is flooded with persistent and uncontrollable thoughts (obsessions) and the individual is compelled to repeat certain acts again and again (compulsions), suffering significant distress and interference with everyday functioning
descriptive statistics of who OCD affects
- affects women and men equally
- can occur in children but typical onset is 20
- developing OCD later in life is very rare
The obsessive-compulsive and related disorders
types
body dysmorphia
hoarding disorder
trichotillomania (hair pulling)
excoriation (skin picking)
what is a compulsion
a repetitive behaviour or mental act that a person feels driven to perform to reduce the distress caused by obsessive thoughts or to prevent some calamity from occurring
- typically done in order to decrease the anxiety associated with an obsession
three “multipliers” that increase the intensity and frequency of compulsive checking are:
1) sense of personal responsibility
2) probability of harm if checking does not take place
3) predicted seriousness of harm
behavioural accounts of compulsions consider them as _______
learned behaviours reinforced by fear reduction
in addition to reducing fear, what else can compulsion result from (based on behavioural accounts)
memory deficits in non-verbal communication
- harder to distinguished between an imaginary and actual behaviour
the ability to remember events and experiences
retrospective memory
the ability to look forward to remember at the right place or time to perform an intended action
prospective memory
difference between normal individuals and OCD individuals when it comes to unwanted thoughts
they both have them but the normal people can ignore or dismiss unwanted thoughts but individuals with OCD interpret these thoughts as having great concern and feel cpmplusions to counteract the unwanted thoughts
a cognitive theory of obsessions
unwanted intrusive thoughts are the roots of obsessions and that obesessions often involve catastropihic misinterpretations of the importance and significance of negative intrusive thoughts
Rachman’s thought-action fusion involves what two beliefs
- the mere act of thinking about unpleasent events increases the perceived likelhood that they will actually happen
- at a moral level, thinking something unpleasent is the same as actually having carried it out
the role of genetics in OCD
some evidence of genetic predisposition can effect people 9
brain activation in OCD patients
abnormal brain activation in early phase of OCD and long term persistence of OCD may result in the decline of cognitive function
enhanced activation of the ______ has been found in clients with OCD
basal ganglia
psychoanalystic theory of OCD
obsessions and compulsions are viewed as resulting from instinctual, sexual, or aggressive forces that are not under control becaus of overly harsh toilet training –> fixation at the anal stage
- struggle between id and defence mechanisms
ex: resit urge to soil and become compulsively neat, clean, and orderly
Albert Adler’s view on OCD
results from feelings of incompetence
- develop inferiority complex and may unconsciously adopt compulsive rituals in order to carve out a domain in which they exert control and can feel proficient
most widely used and generally accepted behavioural approach to treating OCD is ________
- explain
exposure and response prevention (ERP)
- behavioural approach
- a person exposes himself to situations that elicit the compulsive act then refrains from performing the accustomed ritual
- preventing the person from performing the ritual wil expose him to the anxiety provoking stimulus and thereby allow the anxiety to be extinguished
- sessions can last over 90 minutes with 15-20 sessions within 3 weeks
the success rate of exposure and response preventiong
the treatment is at least partially effective for more the 50% of OCD clients
In a recent meta analsysis on OCD treatments, Roas-Alcazar et al. (2008), conlcuded that __________ is better than therapist-assisted self-guided exposure and in vivo exposure compbined and ___________ being superior to exposure in vivo alone
therapised-guided exposure is better than therapist-assisted self-guided exposure and invivo combined
exposure via imagination is superior to exposure in vivo alone
cognitive approach to OCD treatment
- effectiveness
CBT –> need exposure and reponse prevention
- focus on clients convictio that imaginary events may actuall come true
- CBT effectiveness –> looks better than pharmacological treatment
exercise for OCD?
phsyical exercide , in one study, helped clients better than CBT
biological OCD treatment
SSRIs are useful finrst-line for treatments for OCD
- but up ton 50% of people with OCD do not respond to SSRI treatment
- destroying 2-3 cm of white matter near corpus callosum - last resort
- deep brain stimulation for severe OCD
psychoanalytic approach to OCD treatment
lifing repression and allowing the client to confront what he or she (presumably) truly fears
- analytic clinicians mostly use analytic understanding more as a way to increase compliance with behaviour prodcedures
hoarding disorder is diagnosed when
the person has difficulty discarding objects and the clutter has come to dominate his or her life; safety of themselves or others becomes an issue
what distinguishes OCD and hoarding disorder in the DSM-5?
people with hoarding disorder are excited by their obsession with objects while people with OCD are distressed when they have an obsession with objects
definition of hoarding disorder
the acquisition of and the failure to discard
prevalence of hoarding disorder
2-5% of general populations …. twice as prevalence as OCD
Hoarding vs collecting
collectors are more selective, collecting a narrower range of items. More likely to organize their collections and not have significant clutter associated wit hoarding disorder. Clutter does not significantly impair collectors lives
factors that contribute to hoarding disorder
genetic
cognitive - faulty processing, meaning of possessions, misguided attachments
treatment of hoarding disorders include
pharma –> SSNRIs
CBT –> similar to OCD and anxiety disorders
when is it easier to treat hoarding disorder
when the person is young
definition of body dysmorphic disorder
a person is preoccupied with an imagined or exaggerated defect In appearance, frequently in the face
BBD
prevalence in gender
comorbidity
curable
women more than men
very co morbid
usually chronic
1 in 5 patients achieve full remission but have a high relapse probability
Brain volume in BDD vs healthy individuals
BBD had lower brain volumes in right orbitofrontal cortex and left anterior cingulate cortex
treatments of body dysmorphic disorder
CBT
Medication-SSRIs
the main feature of ______ is hair pulling
trichotillomania
trichotillomania onset
- prevalence in gender
- general prevalence
adolescence - related to body image;
boys and girls represented equally- but in adults, women is more common
- prevalence 1-2%
- high comorbidity
the main feature of ____ is skin-picking
excoriation
for a diagnosis of skin picking:
the skin picking behaviour must be chronic to the point of lesions on the skin
excoriation often co occurs with ____
body dysmorphic disorder
have Excoriation and trichotillomania been influenced by the same genetic factors as OCD, hoarding disorder and BDD
no
the two models on what triggers body focused repetitive behaviours
a) emotion regulation but decreasing negative emotions
b) frustration action model - triggered by frustration and boredom
what is habit reversal training and what does it treat
a behavioural approach to treating body-focused repetitive behaviour disorders; identification of triggers and competing Reponses
- self monitoring, awareness training and identification of competing responses are commonly used components
does CBT work to treat body focused repetitive behaviours
yes
