Lecture 6 Flashcards

OCD

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1
Q

What is OCD?

A

classified as an anxiety disorder
the occurrence of unwanted and intrusive obsessive thought usually accompanied by compulsive behaviours used to neutralise the obsessive thoughts

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2
Q

prevalence onset

A

2% lifetime prevalence
1% one year prevalence
98% show obsession and compulsion
equal across gender
equal across culture
socio-economic drift noticeable

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3
Q

age onset

A

late adolescence, early adulthood
childhood onset more common in males

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4
Q

Features of OCD

A

obsession
- recurrent intrusive thoughts
- images
- experienced as disturbing or inappropriate

compulsion
- used to get rid of or deal with obsessions, prevent distress
- repetitive behaviours
- covert mental acts

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5
Q

DSM - 5 criteria for obsessions

A

recurrent and persistent thoughts, urges or images that are experienced at some post during the disturbance as intrusive and unwanted and cause marked anxiety and distress
the person attempts to suppress or ignore such thoughts, impulses or images or neutralise them with some other thoughts or actions

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6
Q

DSM - 5 criteria for compulsions

A

repetitive behaviours or mental acts in response to an obsession or according to rules that must be applied rigidly
the behaviours or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation. these behaviours either are not connected in a way that could neutralise or pre-empt what they are meant to address or are clearly obsessive

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7
Q

co - morbidity

A

80% experience depressive symptoms
30% experience major depression
co - occurs with other anxiety disorder such as panic, social phobia, PTSD
high co-occurence with body dysmorphic disorder

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8
Q

intrusive thoughts

A

when the occur regularly and impact our daily life
repetitive behaviour may join intrusive thoughts

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9
Q

types of compulsions

A

cleaning
checking
repeating
ordering
counting

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10
Q

pathological doubt

A

linked to a cognitive deficit in memory
failure to do a task, as a result an individual believes something terrible will happen as a result

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11
Q

unrealistic risk assessment

A

lack of understanding of how unlikely such an event is

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12
Q

behavioural explanation - Mowrer

A

touching door handle causes contamination which causes anxiety
waking hands reduces anxiety reinforcing behaviour
any thought of door handle leads to anxiety
excessive hand washing if anything causes anxiety

a cycle of OCD

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13
Q

evolutionary explanation

A

biological preparedness - some obsessions are more common
animals show displacement activities when stressed. rather than focusing on a stressful/threatening situation, they focus on something else

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14
Q

thought suppression increases intrusive thoughts

A

non-OCD can forget about intrusive thoughts
OCD patients asked to suppress them, report more intrusive thoughts - a rebound effect

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15
Q

cognitive explanation

A

increased sense of personal responsibility
- appraisal of intrusive thoughts
- negative automatic thoughts

inability to distinguish between thoughts and actions
- thinking about something becomes the same as doing it

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16
Q

biological explanation

A

brain abnormalities
an increased glucose metabolism in the frontal brain regions

17
Q

Baxter et al 2000

A

primitive urges arise in the ortitofrontal cortex
- sex, aggression, hygiene and danger

urges usually filtered by basal ganglia before reaching the thalamus and rest of the cortex

18
Q

chemical imbalances

A

drugs that increase levels of serotonin alleviate symptoms
50-70% show improvement but relapse rates are high if discontinued

19
Q

psychosurgery

A

bilateral cingulotomy

20
Q

drug treatment

A

SSRI
if treatment effective and 12 month continuous supply to prevent relapse and then review

21
Q

CBT

A

shown to be most effective
patients exposed many times to situations that cause obsessive thoughts and they learn to tolerate the anxiety and so reduce the need for compulsive behaviour

  • reduces stress
  • reduces anxiety
  • resolves inner conflict

low intensity treatments can be offered if symptoms are mild such as group CBT

22
Q

effectiveness of CBT

A

CBT vs medication - CBT more effective
combined CBT and drug therapy - interactionism
SSRIS and CBT combined are most effective