chapter 6 Flashcards
OCD
what is the prevalence of OCD?
affects women and men equally
typical age of onset around
late onset very rare
what are obsessions?
intrusive and recurring thought, impulses and images
what forms can obsessions take?
extreme doubt, procrastination and indecision
what is a violent obsession?
though or image of using knife at dinner to stab someone near by
what are examples of obsessions?
sexual obsessions (grating someones privates)
religious obsessions (often sexual content)
symmetry
what are compulsions?
repetitive behaviours/mental acts that person feels driven to preform to reduce distress
its excessive
what makes compulsions worse?
three multipliers:
1. sense of personal responsibility
2. probability of harm if checking doesn’t take place
3. predicted seriousness of harm
what is the ethology of OCD (behavioural and cognitive theories)
inability to remember actions accurately, distinguish btw actual behaviour and imagined one
what are possible defects of OCD (behavioural and cognitive theory)?
defects in prospective memory (remembering to remember) and non-verbal memory
what is the Rachman’s theory of obsessions in OCD?
many cognitive factors
inflated sense of personal responsibility
cognitive bias involving thought action fusion
what is thought cation fusion?
- thinking about unpleasant events increase likelihood of it happening
- moral level: thinking something unpleasant is same as actually having carried it out
what are meta-cognitions on OCD?
have highly developed cognitive self-consciousness, reflects on own cognitive process
(too much thinking about thinking)
what is the ethology of OCD (genetic evidence)
higher rates of anxiety among 1st degree relatives
possible genetic marker but no genome significant findings
what are the Biological factors?ethology of OCD?
encephalitis, head injuries, brain tumours
increase activation in frontal lobe, basal ganglia (increased dopamine)
people with Tourette often have OCD
what are the testing and treatment for OCD associated with biological factors?
neuropsychological testing research
hypotheses related to SSRI drug treatment
what is neuropsychological testing research?
long term OCD show attention and memory defects
show impairment in executive functions
what is the hypothesis related to SSRI drug treatment?
suggests OCD related to decrease in serotonin but SSRI treatment doesn’t work for many with OCD
what is PANDAS syndrome?
autoimmune condition that affects the brain
sudden onset of anxiety, moodiness and ODC, ADHD
affects kids
what is the ethology of ODC through psychoanalytic theory?
obsessions and compulsions are viewed as similar
result from instinctual forces, sexual or aggressive
feelings of incompetence due to inferiority complex (helicopter parents)
how do people with ODC condition themselves to escape and have avoidance behaviours?
through negative reinforcements
how do people with OCD escape distressing feelings/thoughts ?
engage in a ritual or set of rituals
(temporarily reduce or get ride of destress)
what is the behavioural approach to treat OCD?
exposure and response prevention (ERP)
what is exposure and response prevention?
expose themselves to situations that elicit compulsive act (anxiety provoking), then refrain from performing rituals
lasts 90 mins
17-19% refuse treatment
what is the cognitive approaches to treat OCD?
combine CBT required when treating
what does CBT do?
evaluate id preforming compulsive ritual has catastrophic consequences
what can cognitive procedures eliminate?
dysfunctional beliefs that contribute to faulty appraisals
what is CBT-I?
inference based approach
identifying and letting go obsessional inference
what is the effectiveness of CBT in treating OCD?
group based treatments are effective
no difference btwn group and individual approaches
what are the other issues in OCD treatment?
CBT is effective but high dropout rates
what are biological approaches for treating OCD?
psychosurgery
cingulotomy (destroying matter in cingulum)
Deep brain stimulation nucleus
what is the psychoanalytic treatment approach for OCD
attempt to uncover repressive conflicts
what is hoarding?
- the aquisition of and failure to discard
- world wide phenomenon
- strong genetic component
when is hoarding disorder is diagnosed?
when person has difficulty discarding objects and clutter dominates their life
what is the prevalence of hoarding disorder?
onset in 2/3 before age 20
severity increases with age
associated with depression
15% have OCD
what are cognitive factors in hoarding?
faulty information processing
sees beauty in things are are not
leads to social isolation
what are the pharmacotherapy for hoarding disorder?
SSNRI meds
(increase serotonin and more-epinephrone)
what are CBT for hoarding disorder?
exposure for not acquiring items and discarding items
focuses on organizing problem solving and decision making
therapists make home visits for intense exposure
what is the definition of body dysmorphic disorder (BDD)
person imagined to exaggerate defects in appearance (mostly the face)
what are the characteristics of BDD?
spend hours checking on defects
may avoid reminders of defects (make up, remove mirrors)
how many BDD patients reach full remission?
1 in 5
what are the ethology of BDD (biological factors)
genetic link
decrease volume in right orbitofrontal cortex and left anterior cingulate cortex
what are the cognitive factors in BDD?
catastrophic interpretations of appearance
focus on unwanted thoughts
avoid social situations
what is treatment for BDD (behavioural intervention)?
focus on exposure and response prevention (like OCD)
treatment of BDD (cognitive interventions)
evaluates accuracy of negative thoughts and irrational beliefs
identifying maladaptive self defeating thoughts
goal to assist in development of more realistic thoughts and beliefs
what is the efficacy of treatment of BDD?
CBT (works better then medication) and SSRI treatment are effective
what is trichotillomani
hair pulling disorder
what do people with trichotillomania experience?
experience intense shame after hair pulling episode
what is the onset of trichotillomania?
in adolescence
thought to be related to body image
what is excoriation?
skin picking
must be chronic –> leads to lesions
co occurs with trichotillomania
what are ethology of body focused repetitive disorders?
genetics: found to be influenced by the same genetic factor
what is emotion regulation model and hair puling and skin picking
triggered by negative emotions
behaviours serve to decrease negative emotions
what is the frustrated action model?
triggered by frustration and boredom
engaging in behaviours alleviates stats
what is habit reversal training?
treatment used for body focused repetitive behaviour disorders and other impulse control disorder
