Lecture 6 - Obsessive-Compulsive Disorder (Anxiety Disorders)

Question 1

(lecture):

What is the criteria for Obsessive-Compulsive Disorder (OCD) according to the DSM-5?

Answer 1

(lecture):

Criteria for OCD:
(DSM-5)
Presence of obsessions, compulsions, or both:

Obsessions are defined by:

1. 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 – (egodystonic - they recognise these thoughts are not the typical way they thought of life until a specific point of time, they see them as the product of their own minds)
2. The individual attempts to ignore or suppress such thoughts, urges or images, or to neutralise them with some other thought or action

Compulsions are defined by:

1. Repetitive behaviours (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly. (There’s a ritual element to this as these ritual behaviours follow a strict routine)
2. The behaviours or mental acts are aimed at preventing or reducing anxiety, or preventing some dreaded event or situation; however, these behaviours or mental acts are not connected in a realistic way with what they are designed to neutralise or prevent, or are clearly excessive (e.g., you may have a thought that your family will get in a car crash and die, so to prevent this you feel you have to walk in and out of a door 3 times. Usually the patient will understand there is no relation to these 2 things).

Question 2

(lecture):

List some facts about OCD.

Answer 2

(lecture):

Features of OCD:

• Life-time prevalence is lower than other anxiety disorders: 2.3%
• 90% experience obsessions & compulsions (overt behaviour)
• 98% when mental acts are considered (2% only have obsessions and can cope with these without performing compulsions)
• Similar prevalence in women & men
• Higher prevalence in divorced & unemployed people - may reflect the impairing characteristics disorder. Where the negative impacts of the condition (affecting others around you) makes it hard to hold onto relationships and jobs.
• Begins in late adolescence | young adulthood
• 25-50% experience MDD (major depressive disorder) at some time as a consequence.

Question 3

(lecture):

Describe the behavioural perspective of the causal factors of OCD

Answer 3

(lecture):

See purple writing on page 3 on G doc notes.

Question 4

(lecture):

Describe the cognitive perspective of the causal factors of OCD

Answer 4

(lecture):

See pink writing on page 3-5 on G doc notes.

Question 5

(lecture):

Do individuals with OCD have a overestimation of threat?

Answer 5

(lecture):

Yes, see orange writing on page 5 on G doc notes.

Question 6

(lecture):

Does thought control increase OCD symptoms?

Answer 6

(lecture):

See purple writing on page 6 on G doc notes.

Question 7

(lecture):

Describe Cognitive-Behavioural Therapy (CBT) for OCD patients.

Answer 7

(lecture):

See green writing on page 6-7 on G doc notes.

Question 8

(lecture):

Describe Mindfulness-based Cognitive Therapy (CT) for OCD patients.

Answer 8

(lecture):

See turquoise writing on page 7-8 on G doc notes.

Question 9

(lecture):

At the end of this lecture you should be able to:

1. Describe the main features of OCD
2. Explain how behavioural and cognitive perspectives account for their origin & maintenance of OCD
3. Describe the associated treatments
4. Discuss the role of processing bias, compulsions and thought control in the development and maintenance of OCD

Lecture Summary:
- OCD is characterised by
> presence of distressful and intrusive thoughts (obsessions)
> performance of rituals (compulsions) to alleviate distress caused by those thoughts
- Conditioning based explanations of OCD resulted in the development of exposure response prevention
- Cognitive theories argue it is the interpretations patients make of obsessions as being dangerous that are problematic
- Cognitive therapy focuses on changing the responsibility beliefs people have about their own thoughts (obsessions)
- Mindfulness based therapy focuses on changing the way patients relate with their obsessions and the anxiety they create

Answer 9

(lecture):