Chapter 5 - OCD Flashcards
What is OCD?
-presence of obsessions and/or compulsions
-obsessions: repetitive thoughts or images (causing anxiety)
-compulsions: repetitive activities (attempt to get rid of anxiety)
What are the DSM-5 Criterias for OCD?
A: Presence of obsessions, compulsions, or both
-obsessions defined by both: recurrent and persistent thoughts, urges, or images experienced as intrusive, unwanted, and cause anxiety or distress; attempts to ignore or suppress or neutralize thoughts, urges or images
-compulsions defined by both: repetitive behaviours or mental acts individual feels driven to perform in response to obsession or according to rules that must be applied rigidly; behaviours or mental acts are aimed at preventing or reducing anxiety or distress or prevent some dreaded event/situation, but are not connected in a realistic way or are clearly excessive
B: Obsessions or compulsions are time consuming (>1 hour per day) or cause significant distress or impairment
What are common obsessions and compulsions (in order of most common)?
-obsessions: contamination, harm, exactness
-compulsions: checking, cleaning/washing, repeating
What is the prevalence of OCD?
-lifetime: 1.6-2.3%
-28.2% report experiencing obsessions and/or compulsions at some point in life
-onset: adolescence/early adulthood (females have a later onset)
-obsessions but not compulsions predict help-seeking behaviours
What are the comorbidity rates of OCD?
-> 90% meet criteria for another disorder
-anxiety disorders: 75.8%
-mood disorders: 63.3%
-impulse-control disorders: 55.9%
-substance use disorders: 38.6%
How does the biological dimension explain OCD?
-genetics
-dysregulation (overactive) of the orbitofrontal-caudate circuit
–orbitofrontal cortex (gives you the feeling something’s wrong), caudate nucleus (ignore what’s wrong/move on; doesn’t work in OCD, stay anxious)
How does the psychological dimension explain OCD?
-Behavioural perspective: obsessive and compulsive behaviours develop because they reduce anxiety (negative reinforcer)
–obsession –> anxiety –> compulsion –> relief (cycle)
-Unique cognitive characteristics: exaggerated estimates of probability of harm; need to control (thoughts); intolerance of uncertainty; thought-action fusion; disconfirmatory bias
What is thought-action fusion?
-distressing thoughts become ‘fused’ with the action, event or object (thoughts of hurting someone is as bad as actually doing it)
What is disconfirmatory bias?
-search for evidence that they performed ritualistic behaviour incorrectly
How does the social dimension explain OCD?
-family variables:
–controlling, overprotective with rigid rules
–low parental warmth, hostile, overly critical
–discouragement of autonomy
How does the sociocultural dimension explain OCD?
-Culture: rates of OCD similar across cultures, but culture may influence how symptoms are expressed; African Americans show more concern about animals and contamination than European
-Gender: females 1.6x more likely; males earlier onset
What are the medications used to treat OCD?
-SSRIs:
–~60% respond;
–relapse if discontinue (50-90%);
–outcome improved when combined with behavioural interventions
What are the psychological treatments for OCD?
-exposure and response prevention (ERP): exposure to a fear-arousing situation; preventing the individual to perform the compulsive behaviour
-CBT: focuses on replacing dysfunctional beliefs (thought/action fusion)
What is the most effective treatment?
-ERP + medication is better than medication alone
