EXAM 2 - OCD Flashcards
Definition of an Obsession
Recurrent and persistent THOUGHTS, impulses, or images that are intrusive and inappropriate and cause distress or anxiety
Not excessive worries about real-life problems
Person tries to ignore or suppress them
Person recognizes they are a product of their own mind
Definition of a Compulsion
Repetitive behaviors, mental acts that person feels driven to perform in response to an obsession or according to rules that must be applied rigidly
The behaviors or mental acts are aimed at preventing or reducing distress or a dreaded event. (Not realistic)
Prevalence of OCD
Lifetime prevalence is about 2.5%
Typically begins in adolescence or early adulthood.
Average age of onset is 19
Age of onset tends to be earlier in males.
Occurs equally in males and females by adolescence
OCD DSM-5 Diagnostic Criteria
Diagnostic Criteria for Obsessive-Compulsive Disorder
A. Presence of obsessions, compulsions or both:
Obsessions are defined by 1 and 2:
1. Recurrent and persistent thoughts, urges, or im-ages that are experienced, at some time during the disturbance, as intrusive and inappropriate and that in most individuals cause marked anxiety or distress
2. The individual attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
Compulsions are defined by 1 and 2:
1. Repetitive behaviors (e.g., handwashing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession, or according to rules that must be applied rigidly
2. The behaviors or mental acts are aimed at prevent-ing or reducing distress or preventing some dreaded event or situation; however, these behaviors or men-tal acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive
B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day), or cause clinically significant distress or impairment in social, occupational or other important areas of functioning.
C. The disturbance is not due to the direct physiological ef-fects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
D. The disturbance is not better explained by the symp-toms of another mental disorder (e.g., excessive wor-ries, as in generalized anxiety disorder, or preoccupation with appearance, as in body dysmorphic disorder).
Specify if:
With good or fair insight: the individual recognizes that obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be true.
With poor insight: The individual thinks obsessive-compulsive disorder beliefs are probably true.
With absent insight/delusional: the person is completely convinced that obsessive-compulsive disorder beliefs are true.
Specify if:
Tic-related: The individual has a current or past history of a tic disorder.
Treatment of OCD
CBT
E/RP
Thought Suppression is ineffective
OCD-Cognitive Behavioral Therapy
Do a careful identification of all obsessions and compulsions
Plan exposure trials starting with least anxiety provoking and prevent compulsions.
Exposure to anxiety triggering stimuli
Exposure needs to last about 45 minutes or until SUD’s ratings start to decrease, and you need to do it daily
OCD-Medication
SSRI’s, such as Prozac, Zoloft
Anafranil, a Tricyclic Antidepressant
Psychosurgery (cingulotomy)
Body Dysmorphic Disorder (BDD)
A preoccupation with some imagined defect in appearance
Comorbid with OCD 10%
Onset – early adolescence through 20s
BDD and plastic surgery
Fully 76.4% had sought this type of treatment and 66% were receiving it
8% to 25% of all patients who request plastic surgery may have BDD
Treatment for Body Dysmorphic Disorder
cognitive behavioral therapy
Hoarding Disorder
Excessively collecting and keeping items with minimal value, leading to cluttering and disruption of living space
It is often associated with Obsessive Compulsive Personality Disorder (OCPD)
Trichotillomania (Hair Pulling Disorder)
The urge to pull out one’s own hair from anywhere on the body
Leads to noticeable hair loss on scalp, eyebrows, arms, pubic region, etc.
Behavioral Habit Reversal treatment is the most effective treatment
Excoriation (Skin Picking Disorder)
Repetitive and compulsive picking of the skin, leading to tissue damage
Face is common target for
1- 5% prevalence rate
Behavioral Habit Reversal treatment is the most effective treatment
DSM5-Diagnostic Criteria for Body Dysmorphic Disorder
Diagnostic Criteria for Body Dysmorphic Disorder
A. Preoccupation with one or more defects or flaws in physical appearance that are not observable or appear slight to others.
B. At some point during the course of the disorder, the individual has performed repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking, reassurance seeking) or mental acts (e.g., comparing his or her appearance with that of others) in response to the appearance concerns.
C. The preoccupation causes clinically significant distress or impairment in social, occupational, or other impor-tant areas of functioning.
D. The appearance preoccupation is not better explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder.
Specify if:
With good or fair insight:The individual recognizes that the body dysmorphic disorder beliefs are definitely or probably not true or that they may or may not be true.
With poor insight:The individual thinks that the body dysmorphic disorder beliefs are probably true.
With absent insight/delusional beliefs: the individual is completely convinced that the body dysmorphic disorder beliefs are true. With muscle dysmorphia:The individual is preoccupied with the idea that his or her body build is too small or insufficiently muscular.This specifier is used even if the individual is preoccupied with other body areas, which is often the case.
