Exam 2 - OCD

Question 1

Obsessive Compulsive Disorder

Definition

Answer 1

OCD = The presence of unwanted intrusive thoughts and/or habitual behaviors

Question 2

Obsessive Compulsive Disorder

DSM-5 Criteria

Answer 2

Obsessions:

• Recurrent, persistent and unwanted thoughts, impulses or images
• thoughts are: Intrusive, inappropriate, irrelevant/irrational
• Thoughts are not just excessive worries about real life problems
• Attempt to suppress, ignore thoughts or try to neutralize with some other thought /action (i.e., compulsion)

Compulsions:

• Repetitive behaviors or mental acts that person feels driven to perform in response to an obsession or rule that must be followed

*Acts are done to reduce anxiety or distress or to prevent an obsessive thought
* they are excessive or aren’t realistically connected

Question 3

OCD Facts

Prevalence, Gender, Age of onset, Course

Answer 3

Prevalence: only ~ 1-2% of the population

Gender: Equal effect

• Men = childhood, earlier onset, (possibly more chronic course)

Onset Age = 19.5 years

• 25% of cases start by 14 years

Course: Chronic Condition

• can be extremely severe and debilitating

Question 4

OCD Genetic Influence

Genetics + Comorbidity

Answer 4

Moderate genetic influences

• Twin consistency: MZ twins = 57%, DZ twins = 22%

Comorbidity: Comorbid with mood and substance use disorders

Question 5

OCD Treatment

Answer 5

Medical Treatment:

• SSRIs
  
  • Benefit about 60%
  • Relapse is common when medication is stopped (without therapy)
• Transcranial Magnetic Stimulation (TMS)

Cognitive-Behavioral Therapy:

• Most effective treatment for OCD
• (ERP) Exposure and Response Prevention:
  
  • Very effective
    * BUT… 1/3 unwilling to begin ERP (and 1/3 who start it, drop out)

Deep brain stimulation: Only in extremely severe (treatment resistant) cases

Question 6

OCD Treatment:

Exposure & Response Prevention (ERP)

Answer 6

Set up situations that will trigger compulsions

ERP Therapy + SSRIs = Best/Most effective treatment plan

Question 7

OCD Etiology (causes)

Heritability + Brain

Answer 7

Heritability: range of 40% - 50%

Brain:

• Frontal-Striatal Circuitry: Over activity when shown stimuli that provoke obsessions
• Successful treatment of OCD using ERP (exposure therapy) results in less overactivity in these brain regions reduces

Question 8

OCD Cognitive Model

Answer 8

Cognitive Model: People with OCD try harder to suppress their obsessions than others.

• White Bear Experiment: “Don’t think about the bear!!” → instruction actually makes you think about the bear WAY more.
  
  • Theory: Paradoxical Effect. Actively trying to suppress thoughts makes you think about them more

Question 9

OCD Psychodynamic Model

Answer 9

Obsessions/Compulsions come from unconscious conflict you are trying to suppress