Lecture 4 OCD and related disorders

Question 1

DSM-5 OCD and related disorders

Answer 1

• OCD
• Body Dysmorphic Disorder
• Hoarding Disorder
• Excoriation (skin picking) Disorder
• Trichotillomania (hair pulling) Disorder

Question 2

What do they all have in common

Answer 2

• Repetitive behaviours, hard to decrease or stop them

- All comorbid with each other

Question 3

Criteria for OCD

Answer 3

• Presence of obsessions, compulsions (or both)
• Obsessions or compulsions= time consuming
• Not attributable to psychological effects of a substance or medical condition

Question 4

Obsession?

Answer 4

• Unwanted thoughts, urges that cause anxiety and stress

Question 5

Compulsion?

Answer 5

• Repetitive behaviour, mental acts

- Aimed at preventing or reducing anxiety or distress

Question 6

Symptoms of OCD (4 diff dimensions)

Answer 6

• Cleaning
• Harm
• Symmetry
• Taboo thoughts

Question 7

Prevalence, onset, course

Answer 7

• 2-3%
• 19.5 years old
• Often comorbid
• More common in women

Question 8

Causation and Maintenance of OCD

Answer 8

Operant Reinforcement

• compulsion= negatively reinforced by trying to reduce anxiety
• avoidance= maintains anxiety
  1. Obsession
• ex. constant thoughts about whether or not oven was turned off, even after checking once
  2. Anxiety
• obsessions become strong, feel uncomfortable, feel anxious= feel the need to act and reduce this uncomfortable feeling
  3. Compulsion
• repeatedly checking to confirm that oven is off= go home from work to check
  4. Relief
• you feel safe, no more anxiety
• but this behaviour is reinforced= more likely to do it in the future

Question 9

Cognitive factors associated with OCD

Answer 9

• Can’t stand uncertainty
• Inflated responsibility
• Thought-action fusion
• Magical Ideation

Question 10

How to treat OCD

Answer 10

• Medications
• CBT– cognitive restructuring, exposure therapy
• ERP (exposure and response prevention)

Question 11

Hoarding Disorder

Answer 11

• Can’t let go of things, keep in house

Question 12

Body Dysmorphic Disorder

Answer 12

• Flaw in physical appearance– not observable to others, or appear slight to others
• Avoid social situations, relationships– can become house bound
• Elevated suicide risk

Question 13

Common compulsions in OCD

Answer 13

• cleaning, washing
• repeating
• checking
• mental compulsions
• ordering, arranging objects

Question 14

Efficacious and specific

Answer 14

need 2 or more independent research groups

Question 15

Efficacious

Answer 15

needs to be better than when there is no treatment– cause might think: regression to the mean

Question 16

Possibly efficacious

Answer 16

supported by evidence from only 1 research group– awaiting replication

Question 17

obsessions are…

Answer 17

ego-dystonic

Question 18

Causation and Maintenance of OCD: cognitive model

Answer 18

• obsessions– not qualitatively diff from intrusive thoughts in general pop
• OCD results from misinterpretation
• you made up how to reduce anxiety= your compulsions that you do to reduce anxiety= cognitively distorted– and because you keep doing compulsions when exposed to obsessions, it is maintained– negatively reinforced
• attempts to suppress thoughts= may make matters worse

Question 19

Treatment

Answer 19

medications 
- tricyclic antidepressants 
- serotonin re-uptake inhibitors 
CBT 
- cognitive restructuring 
- challenge beliefs about intrusive thoughts 
- challenge beliefs about consequences of not doing compulsions 
behavioural experiments