Behav. Sci. Anxiety 2 Flashcards
OCD criteria
- presence of obsessions and compulsions
- time consuming (more than 1 hr per day)
- significant distress
- not substance induced or explained by another syndrome
obsession definition
recurrent/persistent thoughts, urges, and/or images that are intrusive and unwanted (ego dystonic- know it’s bad) - cause the person anxiety/distress and they try to ignore/suppress these intrusive thoughts OR try to neutralize them with thought or action (counting to 120)
compulsion definition
repetitive behavior or activity that the patient performs in response to an obsession or as a set of rules that must be strictly adhered to (typically undoes or reduces anxiety over an obsession)
occurrence/prognosis of OCD
men and women EQUALLY affected
long but variable course prognosis - hardest anxiety to treat
comorbidities with OCD
MDD, tourette’s syndrome, suicide risk high
treatment of OCD
psychotherapy (CBT, exposure and response prevention, acceptance and commitment therapy (?))
pharm - best results when combined with psychotherapy
-1st line SSRIs (need higher dosage than MDD)
-2nd line clomipramine (TCA - side effects)
-3rd line antipsychotics
which medication does not work at all with OCD?
benzodiazepine sedatives
DD for OCD
- tourette’s (has vocal and/or motor tics with OCD common)
- temporal lobe epilepsy (repetitive motor movements which may look like a compulsion)
- obsessive compulsive personality disorder - have no insight into their behavior as patients with OCD do
OCPD
do not have insight into their behavior - rigid, moralistic, workaholic, list oriented, pattern oriented
don’t really have repetitive discrete behaviors to undo anxiety
what is the most common thing to cause PTSD? most likely thing to cause?
MC: death of loved one
most likely: assault (combat)
greatest variable associated with PTSD?
proximity, harm by another human, severity, repetition
criteria for PTSD
- exposure to actual or threatened traumatic event (death, serious injury, sexual violence)
- symptoms present for more than 1 month
- symptoms cause sig distress/impairment and not result of substance/medical issue
- more than 1 “intrusion symptom” - reliving of event (distressing memories, dreams/nightmares, dissociative reactions during which the patient feels and/or acts as if the events are recurring)
- avoidance of stimuli
- negative changes in cognition and mood
- alterations of arousal//reactivity
modes of exposure in PTSD
directly, witnessing, learning that a family member/friend experienced such an event, directly experiencing repeated/extreme exposure to horrific details of an event
ASD
same as PTSD except only persisting for 3 days-1month after exposure - PTSD precursor
better prognosis for ASD/PTSD if…..
rapid onset of symptoms, good pre-morbid functioning, no other psych conditions
