characteristics of obsessive-compulsive disorder (OCD)

Question 1

what are the DSM-5 categories of OCD?

Answer 1

• OCD: characterised by either obsessions (recurring thoughts, images etc.) and/or compulsions (repetitive behaviours such as handwashing). most people with a diagnosis of OCD have both obsessions and compulsions
• trichotillomania: compulsive hair-pulling
• hoarding disorder: the compulsive gathering of possessions and the inability to part with anything, regardless of its value
• excoriation disorder: compulsive skin-picking

Question 2

what are the behavioural characteristics of OCD?

Answer 2

compulsive behaviour including:

• compulsions are repetitive
• compulsions reduce anxiety
• avoidance

Question 3

behavioural characteristics of OCD: compulsions are repetitive

Answer 3

• typically people with OCD feel compelled to repeat a behaviour
• a common example is handwashing
• other common compulsive repetition counting, praying and tidying / ordering groups of objects such as CD collections or containers in a food cupboard

Question 4

behavioural characteristics of OCD: compulsions reduce anxiety

Answer 4

• around 10% of people with OCD show compulsive behaviour alone
• however, for the vast majority, compulsive behaviours are performed in an attempt to manage the anxiety produced by obsessions
• eg. compulsive handwashing is carried out as a response to an obsessive fear of germs
• eg. compulsive checking that a door is locked or a gas appliance is switched off, is in response to the obsessive thought that it might have been left unsecured

Question 5

behavioural characteristics of OCD: avoidance

Answer 5

• avoidance as an attempt to reduce anxiety by keeping away from situations that trigger it
• eg. people who wash compulsively may avoid coming into contact with germs
• however, this avoidance can lead to people to avoid very ordinary situations, such as emptying binds, and this can in itself interfere with leading a regular life

Question 6

what are the emotional characteristics of OCD?

Answer 6

• anxiety and distress
• accompanying depression
• guilt and disgust

Question 7

emotional characteristics of OCD: anxiety and distress

Answer 7

• OCD is regarded as a particularly unpleasant emotional experience because of the powerful anxiety that accompanies both obsessions and compulsions
• obsessive thoughts are unpleasant and frightening, and the anxiety that goes with these can be overwhelming
• the urge to repeat a behaviour (a compulsion) creates anxiety

Question 8

emotional characteristics of OCD: accompanying depression

Answer 8

• OCD is often accompanied by depression, so anxiety can be accompanied by low mood and lack of enjoyment in activities you used to enjoy (anhedonia)
• compulsive behaviour tends to bring some relief from anxiety but this is temporary

Question 9

emotional characteristics of OCD: guilt and disgust

Answer 9

• OCD sometimes involves negative emotions as well as anxiety and depression
• this includes irrational guilt eg. over minor moral issues
• disgust, which may be directed against something external like dirt or at the self

Question 10

what is the cognitive approach concerned with?

Answer 10

• the ways in which people process information
• people with OCD are usually plagued with obsessive thoughts but they also adopt cognitive strategies to deal with these

Question 11

what are the cognitive characteristics of OCD?

Answer 11

• obsessive thoughts
• cognitive coping strategies
• insight into excessive anxiety

Question 12

cognitive characteristics of OCD: obsessive thoughts

Answer 12

• for around 90% of people with OCD, the major cognitive feature of their condition is obsessive thoughts ie. thoughts that recur over and over again
• these vary considerably from person to person but are always unpleasant
• eg. worries of being contaminated by dirt and germs
• eg. certainty that a door has been left unlocked and that intruders will enter through it
• eg. impulses to hurt someone

Question 13

cognitive characteristics of OCD: cognitive coping strategies

Answer 13

• obsessions are a major cognitive aspect of OCD, but people respond by adopting cognitive coping strategies to deal with the obsessions
• eg. a religious person tormented by obsessive guilt may respond by praying or meditating
• this may help manage anxiety but can make the person appear abnormal to others and can distract them from everyday tasks

Question 14

cognitive characteristics of OCD: insight into excessive anxiety

Answer 14

• people with OCD are aware that their obsessions and compulsions are not rational
• this is necessary for a diagnosis of OCD; is someone really believed their obsessive thoughts were based on reality, that would be a symptom of a different form of mental disorder
• however, in spite of this insight, people with OCD experience catastrophic thoughts about the worst case scenarios that might result if their anxieties were justified
• they also tend to be hypervigilant, ie. they maintain constant alertness and keep attention focused on potential hazards

Question 15

the cycle of OCD

Answer 15

1. obsessive thought
2. anxiety and distress
3. compulsive behaviour
4. temporary relief