L6 - OCD Flashcards
1
Q
What are obsessions?
A
- Recurrent and persistent thoughts, urges or images that are experienced at some time during the disturbance as intrusive and unwanted and that in most individuals cause marked anxiety or distress
- Individual attempts to ignore/suppress such thoughts, urges or images to neutralise them with some other thought or action
2
Q
What are compulsions?
A
- Repetitive behaviours or mental acts that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly
- Behaviours or mental acts aimed at preventing or reducing anxiety or preventing some dreaded events or situation, but these are not connected in a realistic way with what they are designed to neutralise/prevent
3
Q
What are obsessions and compulsions together?
A
- Thought to have an evolutionary adaptive function
- Contamination, order, doubt, and the need to check
- Sometimes aggressive impulses to harm someone
- Egodystonic thoughts = not in line with who we are or what we believe (conflict with ego)
4
Q
What are features of OCD?
A
- Not an anxiety disorder - has genetic underpinning
- Life-time prevalence fairly low
- 90% individuals experience obsessions and compulsions
- Similar prevalence in men and women
- 50% experience major depressive disorder at the same time
- Some overlap with autism
5
Q
What is the behavioural perspective? (And Treatment)
A
- Mowrer’s two factor theory: classical conditioning and operant conditioning
- Does not explain why some individuals do not go on to do compulsions
- Exposure with response prevention (ERP)= principles based on behavioural perspective
- Exposure to stimuli that provokes obsessions
- Prevention of compulsions - ppts asked not to perform their compulsions
- Fairly effective treatment - 50% of patients recover - but hard as obsessions are paired with compulsions and will drop out of treatment: create a hierarchy
6
Q
What is the cognitive perspective?
A
- Obsessions (not a problem but those with OCD have reoccurring and multiple) (egodystonic) = automatic thoughts (egosyntonic - aligns with view of the world) = dysfunctional schemas (responsibility) = compulsions (prevention correction)
- Cyclical
7
Q
What is the other cognitive perspective?
A
- Early experiences and critical incident activate responsibility schemas which activates obsessions
- This leads to misinterpretations responsibility, info processing bias (hypervigilance/overestimation of threat), mood changes (depression/distress), safety strategies (avoidance and thought control)and compulsions which all feed into the obsessions
8
Q
What are responsibility schemas?
A
Recurring experiences:
- Growing up with rigid rules of conduct
- Being shielded from responsibility
- Being raised with a sense of responsibility for avoiding harm
- Increased responsibility for family members protection
Isolated experiences
- Incidents in which one actually does cause harm or erroneously believes that he or she did
9
Q
What are misinterpretations of responsibilities?
A
- Thinking being the same as acting - thought-action fusion
- Failure to prevent self or other’s harm is the same as being responsible for that harm
- Responsibility is never attenuated by other factors, such as low probability of a given event occurring
- Not trying to prevent or neutralise an obsession is the same as wishing the event occurs
- People must and can control their own thoughts
10
Q
What is Overestimation of threat in CBT for OCD? (With Study)
A
- Lack of self-serving positivity attributional bias
- Overestimate the likelihood of harm befalling them
- Experience reduced relief compared to controls when presented with stats about low freq of harmful events
11
Q
What is Thought Control in CBT for OCD?
A
- OCD patients present higher thought control than typical individuals
- Correlational studies: thought suppression associated with negative appraisal of those thoughts and OCD symptoms
- Exp studies: Thought suppression alleviates neg appraisals and distress - adaptive coping strategy
12
Q
What does CBT do for OCD?
A
- Identification of key distorted beliefs
- Collaboration construction of a non-threatening alternative account of obsessional fears
- Challenge responsibility appraisals - pie-chart technique
- Question power of obsession
- ERP are used as an experimental test of the new alternative theory
13
Q
What is the Pie-Chart technique?
A
- Not down negative thoughts triggered by obsession e.g dread/fear
- Ask how much they believe this will happen and how many time has the dreaded event has happened - mostly it is 0 = challenging the thought with evidence
- Follow up with questions e.g why are these thoughts sustained if nothing bad has happened
- Infers an underlying belief
14
Q
What is mindfulness based therapy?
A
- Provides strategies to facilitate exposure to intrusive thoughts = noticing and sitting with diff thoughts as they arise with curiosity and acceptance
- Provides strategies to tolerate anxiety during ERP = observe/accept unpleasant physical sensations
- Cultivates ability to choose how best to respond to compulsive urges rather than reacting automatically = encourage people to be aware of behavioural choices
15
Q
What was a study looking at mindfulness based therapy?
A
- ERP vs MB-ERP
- Both groups improved in OCD severity, no advantage of MB-ERP
- MB-ERP did not have benefits in depression wellbeing and OCD-related beliefs
- Important to adhere to clinical guidelines recommending ERP
