L3 - Obsessive Compulsive and Related Disorders Flashcards
Name some OC and related Disorders
OCD Body Dysmorphic Disorder Hoarding disorder Trichotillomania Excoriation
What is Obsessive-Compulsive Disorder?
- Obsessions and compulsions that are recurrent and persistent
- The individual recognises they are unreasonale
- O’s and C’s are distressing and time consuming (over an hour a day) and impair the person’s functioning and relationships
What is an obsession?
persistent thoughts, impulses or images that are intrusive, inappropriate or distressing.
The person must attempt to ignore or neutralise the thoughts by engaging in some mental routine/beaviour.
The person recognises the thoughts are a product of their mind and not a delusion.
What are some common obsessions?
Fears of contamination, Repeated doubts to do with safety, having things in particular order.
What are compulsions?
Repetitive behaviours/mental rituals that the person feels compelled to perform in response to an obsession or strict rules, to reduce/prevent anxiety.
- ritualised behaviour. Magical thinking.
What are some common compulsions?
Checking, cleaning, repeating.
Often there is no logical connection between compulsion and obsession, but it relieves their anxiety. - MAGICAL THINKING
Epidemiology of OCD
- no gender diff in prevalence, marital status, education or urbancity.
Usually fluctuating course, with stress levels.
Chronic course in 50% of cases.
Average age of onset - F : 25, M : 27
OCD comorbidities?
80% of people have another disorder.
most often MDD.
social phobia, specific phobia and GAD.
Neuropsychological Model of OCD?
OCD involves the orbitofrontal-subcortical circutes, caudate nucleus and thalamus.
frontal lobes and/or basal ganglia.
these are regions responsible for memory and reg of behaviour.
possible dysfunc in serotonin.
Risk Factors of OCD?
- FAMILY HISTORY: dominant and codominant mode of transmission
- EARLY CHILDHOOD EXPERIENCE & CRITICAL LEARNING INCIDENTS –> maladaptive beliefs about responsiility and threat.
- PERSONALITY FACTORS - neuroticism, psychoticism and sensitivity to punishment
What is the dominant model for explaining OCD?
The Cognitive Behavioural Model
Explain the Cognitive Behavioural Model of OCD?
- Intrusive thoughts are normal
- Some individuals place meaning on these thoughts, and thus respond with avoidance, suppression or rituals.
- These responses increase vigilance for the intrusive thought and protects the meaning of the intrusion.
VICIOUS CYCLE
TRIGGER-> OBSESSION /INTRUSION –> ANXIETY –> COMPULSIVE BEHAVIOUR / AVOIDANCE –> RELIEF…. until it happens again..
the relief reinforces the intrusive idea.
What are some ways intrusive thoughts might become obsessions? In terms of thoughts..
When the thoughts are evaluated as…
- overly important
- highly threatening
- requiring complete control
- necessitating a high degree of certainty
- associated with a state of perfection
What is BDD?
Body Dysmorphic Disorder.
A. Preoccupation with one or more perceived flaws in someone’s physical appearance that can barely be noticed by others.
B. Repetitive behaviours or mental acts - mirror checking, skin picking, comparing looks to others.
C. This causes significant stress and impacts on daily functioning
BDD Onset and course?
Mean age of onset - 16-17, but usually diagnosed 10-15 years later
25% suicide - more likely in patient with onset before 18 yrs.
usually chronic course, but improvement is likely.