Chapter 9 OCD disorders Flashcards
Describe how obsessive compulsive disorder presents.
Plagued by obsessive thoughts that cause compulsions that cause the individual to capitulate time consuming, repetitive behavior that last more than an hour per day with an obsession on order and cleanliness.
Memory Note: Think Melvin Udall (Jack Nicholson) from As Good as it Gets. He is textbook OCD
Describe how body dysmorphic disorder presents.
An otherwise normal looking person seeing and being obsessed with part of their body looking hideous. Honestly, I know this one all too well. I believed I was hideous. Thanks Lauren.
These people are emotionally distressed and will often spend 3-5 hours concerning themselves with their appearance, they will shop for beauty products obsessively and even get plastic surgery.
True or False, People with Birth Defects and Burn Marks can have Body Dysmorphic disorder
False: While people with birth defects and burn marks worry about their looks. People with BDD often see physical deformities that are not there or overemphasize small flaws.
Muscle dysmorphia
when a person believes their body is too small or not jacked enough. They will often engage in steroid use, have poor life quality and even have high suicide attempts.
Describe how hoarding disorder presents.
A persistent over accumulation of possessions that is illogical and has paranoia about anything being lost or unkept and results in excessive cluttering and even disgusting habitation. Asking to clean out the clutter often reposts significant distress to the client.
Mental Note: Ruth. Think about Both her houses.
Define obsessions and compulsions. Provide a list of examples of each thought/behavior.
Obsessions are intrusive thoughts, urges or images that invade a persons sense of being and will not quit unless a person capitulates.
Compulsions are obsessive behaviors as a result of the obsessions such as washing hands 5 times or making sure everything is orderly.
Give examples of characteristics that would not be consistent with a body dysmorphic disorder diagnosis.
People with normal appearance adherence such as getting ready for a date. Burn victims and people with birthmarks
Describe the epidemiology of OCD.
OCD’s onset is usually younger at 19 but can start as early as 14 with 25% of cases. Women have higher rates than men and effects 1.2% of US adults
Describe the epidemiology of body dysmorphic disorder.
Effecting women more than men with a prevalence rate for 2.4% of US adults. Men are more concerned with build, dick size and baldness while women are concerned with looking fat, and small feminine features such as tis and ass.
Honestly there is a bit of Leka here
Describe the epidemiology of hoarding disorder.
Females more than males and tends to be 3 times as worse in older individual like Ruth. Effecting maybe 1.5-6% of the US population but these numbers are hard to track
Ruth really fit the docket here
Gender Differences of OCD and BDD
Women tend to have higher rates of both OCD and body dysmorphia. Though with OCD, boys are more often diagnosed when they are young vs girls.
Compare the Prevalence Rate of OCD,BDD and hoarding
OCD is 1.2% in the US and Worldwide, Body Dysmorphia is 2.4% in the US and 1.7-2.9% worldwide, Hoarding is harder to measure but its believed 1.5-6% of US adults hoard.
Describe the comorbidity of OCD.
-High comorbidity with all anxiety disorders especially panic disorders, nearly 76%.
-41% of those with OCD are comorbid with bipolar and depressive disorders, also tic disorders particularly in men.
What mental illnesses are commonly tested for OCD since they are often linked or comorbid
-Schizophrenia, bipolar, eating disorders, body dysmorphic disorder and Tourette’s
What are the most common comorbidities for OCD? Be specific.
Anxiety disorders such as GAD, panic disorder, social anxiety disorder, phobias and often mood disorders such as bipolar and depressive disorders
What is the OCD triad in children? What two other disorders complete this triad?
OCD, tic disorder and ADHD in kids which leads there to believe there is a neurobiological fault here. Children also have a different presentation of OCD than adults due to this fact and will show the triad
Which disorder is body dysmorphic disorder most comorbid with?
MDD, Social anxiety disorder, and substance abuse
Hoarding Comorbidity
Highly comorbid with anxiety and some degree of MDD
Is there a hereditary (genetic) relationship with OCD
twin studies show a strong link to OCD and genetics with an 80% concordance rate with identical twins and 50% with fraternal twins. First family members have a five fold increase as well.
Interesting, family relations to OCD patients have strong obsessive tendencies but not always compulsive tendencies
Is there a genetic relationship with Body Dysmorphic disorder and hoarding?
With BDD and hoarding with genetics plays a role, environmental factors seems to be far more involved.
What Neurotransmitters are involved in OCD disorders?
Serotonin is a contributing factor. Increasing levels of serotonin help with OCD and depressive symptoms. Antidepressants that did not address serotonin were not effective in alleviating symptoms.
Glutamate, GABA and dopamine may be involved in the maintenance of OCD but more research is needed
Brian structures involved with OCD
The orbitofrontal cortex which is responsible in impulse control and mediating emotions which sends signals through the caudate nuclei then through the thalamus to decide what to do about the thought. With OCD it is believed to be an overactivation of the orbitofrontal cortex and a lack of filtering by the caudate nuclei and thus overloads the thalamus with compulsion
Mental Note: This neurocircuitry was really interesting. Usually lack of impulse control is the issue with most disorders but in this case the OBF is the problem
OBF-CNT (Orbitofrontal Cortex- Caudate Nucleus, Thalamus)
Do all those with intrusive thoughts have OCD?
We all have an intrusive thought of double checking something important such as “did I leave the oven on?” But people with OCD cannot escape these thoughts and think about them repeatedly and as a detriment to their life
Mental Note: Chad and Abe believed they have OCD but they don’t
What is the cognitive therapy understanding of OCD
People with OCD are more sensitive to thoughts about overestimation about the probability of harm, loss of control and uncertainty and disaster rehearse negative consequences.
They also experience deconformation bias where they seek out info that proves their failure. This leads to an inability to trust their instincts.
Capitulating to obsessions with compulsions reduces anxiety thus creating a feedback loop
