Lecture 4 OCD and related disorders Flashcards
DSM-5 OCD and related disorders
- OCD
- Body Dysmorphic Disorder
- Hoarding Disorder
- Excoriation (skin picking) Disorder
- Trichotillomania (hair pulling) Disorder
What do they all have in common
- Repetitive behaviours, hard to decrease or stop them
- All comorbid with each other
Criteria for OCD
- Presence of obsessions, compulsions (or both)
- Obsessions or compulsions= time consuming
- Not attributable to psychological effects of a substance or medical condition
Obsession?
- Unwanted thoughts, urges that cause anxiety and stress
Compulsion?
- Repetitive behaviour, mental acts
- Aimed at preventing or reducing anxiety or distress
Symptoms of OCD (4 diff dimensions)
- Cleaning
- Harm
- Symmetry
- Taboo thoughts
Prevalence, onset, course
- 2-3%
- 19.5 years old
- Often comorbid
- More common in women
Causation and Maintenance of OCD
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
Cognitive factors associated with OCD
- Can’t stand uncertainty
- Inflated responsibility
- Thought-action fusion
- Magical Ideation
How to treat OCD
- Medications
- CBT– cognitive restructuring, exposure therapy
- ERP (exposure and response prevention)
Hoarding Disorder
- Can’t let go of things, keep in house
Body Dysmorphic Disorder
- Flaw in physical appearance– not observable to others, or appear slight to others
- Avoid social situations, relationships– can become house bound
- Elevated suicide risk
Common compulsions in OCD
- cleaning, washing
- repeating
- checking
- mental compulsions
- ordering, arranging objects
Efficacious and specific
need 2 or more independent research groups
Efficacious
needs to be better than when there is no treatment– cause might think: regression to the mean
Possibly efficacious
supported by evidence from only 1 research group– awaiting replication
obsessions are…
ego-dystonic
Causation and Maintenance of OCD: cognitive model
- 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
Treatment
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
