Chapter 7 Flashcards
Obsessive-Compulsive Disorders
Diagnosis based on presence of obsessions or compulsions
Most people experience both
Obsessions
Intrusive and persistent thoughts, images, or impulses that are uncontrollable
Often experienced as irrational
Typically, a person spends hours immersed in obsessions
*Most common:
Contamination, responsibility for harm, sex and morality, violence, religion, and symmetry/order
Compulsions
*Repetitive, clearly excessive behaviors or mental acts to reduce anxiety
*Extremely difficult to resist the impulse
May involve elaborate behavioral rituals
Compulsive gambling, eating, etc. NOT considered compulsions, because they are pleasurable
Compulsions are motivated by desire to reduce anxiety
OCD often begins before the age of _____
OCD often begins before the age of 14
DSM-5 Criteria for Obsessions
*Obsessions are defined by
Recurrent, intrusive, persistent unwanted thoughts, urges, or images
The person tried to ignore, suppress or neutralize the thoughts, urges, or images
DSM-5 Criteria for Compulsions
Compulsions are defined by
Repetitive behaviors or thoughts that the person feels compelled to perform to prevent distress or a dreaded event
The person feels driven to perform the repetitive behaviors or thoughts in response to obsessions or according to rigid rules
The acts are excessive or unlikely to prevent the dreaded situation
The obsessions or compulsions are time consuming (e.g., at least one hour per day) or cause clinically significant distress or impairment
The obsessions or compulsions are time consuming (e.g., at least one hour per day) or cause clinically significant distress or impairment
Risk Factors Common Across Disorders
All three involve :
*OCD, BDD, and hording disorder share some genetic vulnerability
- All three involve the front-striatal circuit
- Orbitofrontal cortex
- Caudate nucleus
- Anterior cingulate
Etiology of OCD: Cognitive Behavioral Model
Previously functional responses for reducing threat become habitual
These responses are difficult to override after the threat is gone
Once people with OCD develop a conditioned response, they are slower to change their response
Exposure and Response Prevention (ERP): OCD
*Exposure to situations that elicit obsessions
-Exposes person to full force of anxiety
*Prevention from engaging in compulsive behaviors
-Promotes extinction of conditioned response
*Exposure hierarchy : Begins with tackling less threatening stimuli
Progresses to more threatening stimuli
*69-75% show significant improvement
-Among people with OCD, 1/3 unwilling to begin ERP
-Among those enrolled, 1/3 drop out of treatment
treating ocd with medication
*Antidepressant are most common
- SSRIs (serotonin reuptake inhibitors)
- Recommended as a first line treatment due to less severe side effect profile
- May require more time (up to 12 weeks) and higher doses compared to treating depression
- Most people with OCD continue to experience mild symptoms
Body Dysmorphic Disorder (BDD)
Preoccupation with one or more imagined or exaggerated defect in appearance
Perceive themselves to be ugly or “monstrous”
Women focus on: skin, hips, breasts, legs
Men focus on: height, penis size, body hair, muscularity
People with BDD find it difficult to stop thinking about their concerns
On average, 3-8 hours per day
Compelled to engage in certain behaviors to reduce distress (e.g., checking appearance in mirror)
Symptoms are extremely distressing
About 1/3 have little insight into overly harsh views
As many as 1/5 endure plastic surgery
Little evidence that surgery reduces concerns
About 1/3 endorse history of suicidal ideation
20% attempted suicide
Interferes with functioning
Symptoms and outcomes are similar across cultures
The body part of focus may differ by culture
If shape and weight concerns are the only foci, the symptoms are better explained by eating disorders
T/F BDD is found in America but not many other cultures
FALSE
DSM-5 Criteria: Body Dysmorphic Disorder
Preoccupation with one or more perceived defects in appearance
Others find the perceived defect(s) as slight or unobservable
The person has performed repetitive behaviors or mental acts (e.g., mirror checking, seeking reassurance, or excessive grooming) in response to the appearance concerns
Preoccupation is not restricted to concerns about weight or body fat
ERP: BDD
Exposure to situations that elicit obsessions
E.g., interact with people critical of their looks
Prevention from engaging in compulsive behaviors
E.g., avoid activities used to reassure themselves about their appearance
Many people continue to experience at least mild symptoms after treatment
Etiology of BDD
People with BDD are usually detail oriented, which influences how they look at features
Instead of looking at the whole, they examine one feature at a time
Consider attractiveness more important than others
Self-worth is exclusively dependent on appearance
Hoarding Disorder
The need to acquire is excessive
Extremely attached to possessions
Very resistant to efforts to get rid of them
Many are unaware of severity of problem
75% engage in excessive buying
33% engage in animal hoarding
Often begins in childhood or early adolescence
