Extra - OCD

Question 1

Obsessions

Answer 1

Recurrent, obsessive, intrusive thoughts that create serious anxiety in the person
Person attempts to ignore/suppress them with other thoughts/actions
Recognized as a product of a person’s mind

Question 2

Common themes of obsession - their characteristics

Answer 2

Contamination fears
Repeated doubts
Fear of harming oneself/others
Lack of symmetry
Sexual/religious (against their beliefs)

Consistent cross-culturally
Tend to be egodystonic
Can take the form of extreme doubting, procrastination, indecision
Most people with OCD keep the content/frequency of their obsession secret for years

Question 3

Compulsions

Answer 3

Repetitive behaviour/mental act performed in response to obsession or according to rigid rules
Aimed at reducing/preventing distress or preventing occurrence of feared event
Activity is not realistically connected with its apparent purpose and is clearly excessive
Does help to stop the obsessions

Question 4

Common types of compulsions

Answer 4

Cleaning/washing
Checking (doors, oven)
Repeating
Ordering/Arranging
Counting
Hoarding

Question 5

4 characteristics of OCD

Answer 5

1. Obsessions OR compulsions
2. Insight: at some point, the person recognizes as excessive or unreasonable
3. Distress/impairment: time consuming, cause marked distress or significant impairment
4. Specificity: if another disorder is present, the content of obsessions/compulsions is not restricted to it

Question 6

What is the role of anxiety in OCD

Answer 6

Compulsions reduce anxiety
Obsessions increase it
Fear something terrible will happen to themselves or someone around them if they are not doing the compulsion

Used to be considered an anxiety disorder
Not anymore: not everyone who has OCD has anxiety - but most do
It has a different “flavour” than anxiety

Question 7

Prevalence/onset/comorbid

Answer 7

2.5% prev
10-15% show subsyndromal behaviour
Onset in adolescence/early adult
Affect both genders
Comorbid with MD, anxiety, body dysmorphic

Question 8

Body dysmorphic disorder

Answer 8

people feel like some part of their body is not working like it should, or it’s wrong
They end up going to the gym excessively or going to a plastic surgeon
May want to constantly check it OR avoid looking at it (ex: big nose)

Question 9

Psychosocial factors of OCD

Answer 9

1. Thought-action fusion: inflated sense of responsibility (just thinking about unpleasant events increases the chances of them happening; at a moral level, thinking something unpleasant is the same as having carried it out)
2. Cognitive biases: attentional distortions
3. Paradoxical effect of thought suppression (the more you try to ignore a thought the more it pops up, the more you think about it)

Question 10

Biological factors for OCD

Answer 10

Moderate genetic component
Dysfunctional orbitofrontal-caudate-thalamic pathway
Lower serotonin, BUT SSRIs don’t help 60%
Encephalitis, brain injury/tumors associated with OCD
Higher activation in frontal lobe
Link with basal ganglia (linked to motor behaviour control, Tourette’s also linked with it, and they also have OCD as well)

Question 11

Treatments for OCD

Answer 11

Behavioural therapy (exposure and response prevention)
SSRIs, slow and high relapse
Neurosurgery

Question 12

Exposure and response prevention for OCD

Answer 12

Person exposes himself to situations causing the compulsions and refrains from doing them - (assumption of negative reinforcement) - extinguish the anxiety that comes with it through exposure

Low treatment compliance - unpleasant

Question 12

Exposure and response prevention for OCD

Answer 12

Person exposes himself to situations causing the compulsions and refrains from doing them - (assumption of negative reinforcement) - extinguish the anxiety that comes with it through exposure

Low treatment compliance - unpleasant