anxiety disorders - OCD

Question 1

obsessions

Answer 1

1) recurrent & persistent thought, urges, images that are experienced as intrusive/unwanted that cause anxiety and distress
- egodystonic

2) attempts to suppress /ignore/neutralize w some other thought or action

Question 2

compulsions

Answer 2

1) repetitive behavior
(eg: checking, ordering, hand washing)
mental acts
eg: praying, counting, repeating words

2) -> aimed at preventing/ reducing anxiety or dreadful event
however not connected realistically with what they designed to prevent

Question 3

diagnostic

Answer 3

more than 1 hour a day engaging in compulsion

interfere with ability to function in life

Question 4

behavioural causal factors

Answer 4

Mowrer’s two factor theroy (1947): explain origin and maintenance of OCD

classical conditioning
obsession-> situation/behaviour -> anxiety
(linked contiguous pairing)->
operant conditioning
anxiety-> compulsion/avoidance (decrease anxiety)-> temporary reduction of anxiety
–> reinforcing anxiety related obsession

problem: doesn’t explain why we have obsessions

Question 5

exposure with response prevention (ERP)

Answer 5

50% recovery but most patient dropout

• exposure to stimuli that provoke obsessions
• prevention of compulsions

building hierarchic from least to most challenging, go through them

Question 6

why we have obsessions

Answer 6

Salkovskis 1985
cognitive perspective

obsessions (egodystonic) -> automatic thought (egosyntonic)
when you attribute them with a sense of responsibility for having strange thoughts -> activate ->
dysfunctional scheme, responsibility -> compulsions: prevention correction

Question 7

advanced model of OCD

Answer 7

Salvoskis et al., 1998

early experiences(->core beliefs about responsibility)
critical incident ->activates responsibility schemas-> obsessions -> trigger misinterpretation responsibility:
-information processing bias (overstimate threat, hyper vgiliance, rumination)
-mood changes (depression, distress, sleep disorder, physiological responses)
- safety strategies (avoidance, thought control)
-compulsions

Question 8

responsibility schemas- cognitive vulnerablity

Answer 8

recurrent experiences:

• growing up in rigid rules of conduct
• shielded from responsibility/overprotected parents
• raised w sense of responsibility to avoid harm
• responsibility for fam member protection.

isolated experiences:
incident in which one caused harm or erroneously believes that it did

Question 9

what are the common misinterpretation of responsability??

Answer 9

1) thinking same as acting
2) failure to prevent other/self from harm same as being responsible for that harm
3) responsibility not attenuated by low probs factor
4) people can/must control their own thoughts

Question 10

overestimation of threat

Answer 10

lack of self-serving positivity attributional bias

• overestimate harm befalling them
• less relief about low frequency of harmful events

Question 11

CBT in OCD

Answer 11

identification key distorted beliefs (responsibility)
construction of non-threatening alternative account of obsessional fear
- challenge responsibility appraisal
-question power of obsession

Question 12

mindfulness based cbt

Answer 12

• > strategies to facilitate exposure to intruisive thoughth
• noticing &sitting w difficult thoughts w curiosity and acceptance
• > strategies to tolerate anxiety during ERP
• observe /accept unpleasant physical sensations of anxiety
• > strategies to choose best way of responding to compulsive urges instead of automatic reaction
• awareness on behavioural choices available to response to event