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PSYC 337 > Last Lecture > Flashcards

Last Lecture Flashcards

1
Q

What is the DSM-V diagnostic criteria for OCD?

A
  1. Presence of obsessions, compulsions, or both
  2. The obsessions or compulsions are time-consuming; cause clinically sig. distress/impairment in social, occupational, or other areas of functioning
  3. OC symptoms not attributable to physiological effects of a substance or another medical condition
  4. Disturbance not better explained by symptoms of another mental disorder
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2
Q

What is the DSM-V definition of an obsession?

A
  1. Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted  cause anxiety or distress
  2. Attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action
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3
Q

What is the DSM-V definition of a compulsion?

A
  1. Repetitive behaviours or mental acts that the indiv. feels driven to perform in response to an obsession
  2. Behaviours or mental acts aimed at preventing /reducing anxiety or distress, preventing some dreaded event/situation (excessive)
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4
Q

Give some Examples of OCD:

A

Harm & Checking
Contamination and washing
Hoarding

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5
Q

What os the prevalence of OCD?

A

Lifetime: 2.5%

1 year: 1.5-2.1%

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6
Q

What is the usual age of onset?

A

late teens, early 20’s

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7
Q

Are there any gender differences in the prevalence of OCD?

A

no

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8
Q

What has OCD been linked with under the obsessive compulsive spectrum disorders?

A
  1. Preoccupations/bodily sensations disorders: Body dysmorphic disorder, anorexia, hypochondriasis
  2. Neurological disorders: Tourette’s syndrome, Autism
  3. Impulsive Disorders: Kleptomania, Pathologic Gambling
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9
Q

What is OCD most comorbid with?

A

Major Depressive Disorder

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10
Q

What is the evidence for a Biological Basis of OCD?

A
  1. Runs in families
  2. Often linked to Epilepsy & brain trauma (related to strep infections: autoimmune systems produce antibodies that are hostile toward Caudate nuclei)
  3. Associated with movement disorders
  4. Variations in Glutamate, serotonin, white matter genes
  5. Treatment: drug = first choice, surgery
  6. Imaging studies: Caudate nuclei
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11
Q

How is strep related to OCD?

A

autoimmune systems produce antibodies that are hostile toward Caudate nucleus

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12
Q

What is the Neurobiological model of OCD?

A
  1. Dysregulation of the caudate nucleus
  2. Dysfunction in the orbitofrontal-subcortical circuits
  3. Brain volume changes
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13
Q

where is the caudate nucleus located?

A

Basal Ganglia

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14
Q

What are the functions of the caudate nucleus?

A
  1. involved in memory, procedural learning
  2. triggers the urge to ‘do something’
  3. Equivalent of ancient grooming, hoarding and nesting instincts
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15
Q

What brain volume changes take place in patients with OCD?

A
  1. Reduced volume of the left anterior cingulate cortecx
  2. Reduced volume in the left and right orbitofrontal cortex
  3. Increased volumes of left and right thalamus
    4/ Increased grey matter density of frontal subcortical circuits
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16
Q

What is the Behavioral Model of OCD?

A

Learning aspects:

Ways people attempt to control arousal through avoidance which is difficult to change because it’s negatively reinforced

17
Q

Give an example of avoidance learning response substitution:

A

Symbolic undoing

18
Q

What is symbolic undoing?

A
  1. Person has an experience which produces guilt
  2. They engage in an act that tried to symbolically undo what they feel guilty about
  3. Act becomes a compulsion
19
Q

Give an example of symbolic undoing

A

Washing hands after a “dirty deed”

20
Q

What are some family factors associated with OCD?

A
  1. Highly verbal but not very communicative
  2. positive evaluation of etiquette
  3. Social isolation & withdrawal
  4. Emphasis on cleanliness
  5. instrumental morality
21
Q

Give an example of how superstition can result in OCD

A

example with pigeons being given food randomly, ended up reinforcing whatever behavior they happened to be doing

Trobriand islanders: developed a religion around fishing in the open sea and not around fishing in the lagoon

22
Q

What is the Cognitive Model of OCD? what model is it complimentary to?

A
  1. Over importance of thoughts & need to control thoughts
  2. Overestimation of threat & lack of tolerance for uncertainty
  3. Excessive responsibility
  4. Perfectionism
  5. Lack of tolerance for emotional discomfort

Complimentary to the Behavioral Model

23
Q

What are the Treatments for OCD?

A

SSRIs: problem 40% don’t respond and the remainder attain moderate improvement at best. Frequent relapse when drug is discontinued

Surgery

Exposure and response prevention

24
Q

What kind of surgery is performed on severe cases of OCD? What is their success rate?

A

Cingulotomy or Capsuotomy

25-30% experience improvement

25
Q

What are the 4 steps in exposure response prevention?

A
  1. Expose to threatening stimuli
  2. Prevent response
  3. Wait for anxiety to reduce
  4. Notice the anxiety reduction
26
Q

What are the success rates of Exposure and Response Prevention?

A

75-80% can expect benefits
70-80% maintain at 1 year follow-up
Benefits persist at 6 year follow-up

27
Q

What are “Masked Behaviors”

A

men who engage in other behaviors that mask their depression

28
Q

What are the theories that try to explain the gender difference in depression?

A
  1. There is no difference: masked depression
  2. Cultural role effects
  3. Biological (Estrogen etc…)
29
Q

What is a Biochemical explanation for depression?

A

Problem with Catecholamines:

Dopamine, Norepinephrine, Serotonin

30
Q

What does Serotonin have an important role in?

A

Mood
Sleep
Appetite

31
Q

How does Serotonin Turnover differ in depressed individuals?

A

it is much more rapid than in individuals who aren’t depressed

32
Q

What is the Psychoanalytic Model of Depression?

A

Spiral: begins with:

  1. Early Infantile lack of love
  2. Dependency
  3. Lack of Self-Esteem
  4. Ambivalence
  5. Loss
  6. Guilt turned inward
  7. Depression
33
Q

What is a theme throughout the depression literature?

A

Loss

34
Q

What stages does a monkey go through when it’s separated with it’s mother?

A

Protest

Despair

35
Q

What is the Learned Helplessness paradigm?

A

learn that no matter what you do it won’t work

36
Q

What is Lewinsohn’s loss of reinforcement theory of depression?

A

Low rate of positive reinforcement -> leads to a vicious circle

37
Q

What is Beck’s Cognitive Theory of Depression?

A

Cognitive Triad:
Negative view of Self
Negative view of World
Negative view of Future

PSYC 337 (19 decks)

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