Lecture 6 - OC and related disorders

Question 1

Are males more likely to have OCD in childhood and women more likely to have OCD in adulthood?

Answer 1

Yes.

Question 2

What are the diagnostic criteria of OCD?

Answer 2

Individuals experience obsessions and/or compulsions that are time consuming and distressing.
Individuals can have good.fair insight, poor insight, or absent insight/delusional beliefs.

Question 3

Do most people with OCD have both obsessions and compulsions?

Answer 3

Yes.

Question 4

What is the 12 month prevalence of OCD?

Answer 4

1.2%

Question 5

What is the lifetime prevalence of OCD?

Answer 5

2.3%

Question 6

What is the average onset of OCD?

Answer 6

Around 19 years of age.

Question 7

Is checking/fear of harming others one of the main compulsions/obsessions?

Answer 7

Yes.

Question 8

Is there a gender difference in prevalence of OCD in adults?

Answer 8

No.

Question 9

What is the prevalence of OCD being a chronic illness for those who experience it?

Answer 9

50%.

Question 10

1/3 to 1/2 of those who experience OCD report that they first developed OCD symtoms in childhood.
T/F?

Answer 10

True.

Question 11

Are women more likely to have fears/obsessions about harming others?

Answer 11

Yes.

Question 12

What percentage of individuals with OCD have obsessions and compulsions?

What percentage have obsessions and mental rituals, but no behavioural compulsions?

Answer 12

90%

8-20%.

Question 13

Is OCD highly comorbid with other mental health disorders?

What are some of the disorders most commonly commorbid with OCD?

Answer 13

Yes.

MDD.
OCPD.
GAD.
Specific phobia.
Social phobia.
Suicidal ideation.

Question 14

What are some of the proposed causes of OCD?

Answer 14

Learned responses.
Genetic predispositions, such as mutations in the hSERT gene.
Environmental factors.
Brain structure and function.

Question 15

What mutations in the hSERT gene have been linked to OCD?

Answer 15

Mutations in hSERT that increase the activity of the serotonin transporter have been linked to OCD. The theory is that the transporter is too effective, reuptaking serotonin at a rate that is faster than the general population, resulting in decreased levels of serotonin in the synapses.

Question 16

Is OCD considered an anxiety disorder?

Answer 16

No.
Although, OCD is often comorbid with anxiety disorders.
I don’t know how I feel about this. From my experience anxiety was the major driver of my experiences with OCD.

Question 17

Is CBT an effective treatment for OCD?

Answer 17

Yes. For some CBT can be very effective at helping individuals out of their struggles with OCD.

Question 18

Is it true that 80% of the population may experience intrusive thoughts?

Answer 18

Yes. There are stats that suggest this.
The difference between individuals with OCD and the general population is that the former tend to resist these thoughts, identify with these thoughts, see these thoughts are a true reflection of who they are, are more intense in nature and more diametrically opposed to the individual’s values.

Question 19

Those who experience intrusive thoughts often want to have complete control over their thoughts, they also find their intrusive thoughts threatening, and have a low tolerance for (certain) uncertainty.
T/F?

Answer 19

Yes.

Question 20

Do people with OCD have a high level of perfection?

Answer 20

Sometimes. Not always though.

Question 21

Did COVID increase rates and severity of OCD?

Answer 21

For some, especially those concerned with contamination.
However, there was not a significant increase in new cases of OCD.

Question 22

What is Body Dysmorphic Disorder?

Answer 22

Individuals experiencing BDD have a preoccupation with one or more bodily flaws that are not observable by others, or are only slight.
This fear is associated with repetitive behaviours, such as body checking, seeking reassurance, mental processes.
This preoccupation and the associated behaviour leads to significant distress, including shame.
Some people have muscle dysmorphia as a specifier to BDD. This is much more common in men than in women.

Question 23

BDD has a very cultural element, as different cultures often have different beauty standard.
T/F?

Answer 23

True.

Question 24

What is the prevalence of BDD?

Answer 24

0.7 - 2.4%.

Question 25

There is not a disparity in prevalence of BDD between men and women.
T/F?

Answer 25

True.

This shocked me.

Question 26

What is the average age of onset of BDD?

Answer 26

16/17.

Question 27

What proportion of those experiencing BDD attempt suicide?

Answer 27

25%.

Question 28

Are those who develop BDD prior to 18 more likely to attempt suicide than those with adult onset BDD?

Answer 28

Yes.

Question 29

Apart of the shame and distress of how those with BDD experience, what are some other repercussions of this disorder?

Answer 29

Individuals can engage in avoidance behaviours that can lead to social isolation, occupational struggles etc.

Question 30

What are some of the treatments available for BDD?

Answer 30

Exposure to normally avoided situations.
Self-inquiry.
Considering why someone has developed a certain belief about their looks and value.

Question 31

What are the diagnostic criteria for HOARDING DISORDER?

Answer 31

A. Persistent difficulty letting go of possessions, despite their lack of value.
B. Difficulty is due to a perceived need to keep the items due, e.g., one day needing them - anxiety.
C. This difficulty to discard items results in the accumulation of objects to the point of congestion and decline in utility of their space.
D. The accumulation of items causes signigicant distress and impairment in social and occupational functioning.

Question 32

What is the prevalence of hoarding disorder in Europe and the US?

Answer 32

2-6%.

Question 33

Is it more likely that hoarding disorder will develop in older individuals than younger?

Answer 33

Yes.

Question 34

There appears to be no disparity in gender prevalence of HD, but it could be that men have it more often, but that women present for treatment than men.

Why is there so much uncertainty around the stats for HD?

Answer 34

HD was first included as a diagnosis in the DSM-5.

Question 35

What are some of the cognitive processes and patterns of thinking that underly hoarding disorder?

Answer 35

1. A need for control over possessions.
2. Concern about the loss of memory if possessions are let go of.
3. Can often attribute human-like characteristics to their possessions.

Question 36

Do some individuals develop a hoarding disorder where they feel the need to collect and retain many animals?

Answer 36

Yes.
Normally this is done out of good will and a desire to look after them and provide them with a “good life”.
This can lead to unintentional neglect.

Question 37

What is TRICHOTILLOMANIA?

Answer 37

A. Recurrent pulling of one’s hair that results in hair loss.
B. Repeated failed attempts to stop.
C. Hair pulling results in significant distress and functional impairment.
D. Hair pulling or hair loss is not attributable to another medical condition.

Question 38

Prevalence of trichotillomania seems to be around 1-2%.

Answer 38

Dearth of research.

Question 39

What are the most common sites of hair pulling?

Answer 39

Scalp and eyelashes/eyebrows.

Question 40

What is EXCORIATION disorder?

Answer 40

Skin picking disorder.
A. Recurrent skin picking that results in lesions.
B. Repeated attempts to stop.
C. Skin picking results in significant level of distress.
D. Not as a results of medical conditions or substances, such as cocaine.
E. Skin picking is not better attributable to another disorder, such as tactile hallucinations.

Question 41

What is the prevalence of excoriation disorder?

Answer 41

1-2%.

Question 42

What are some of the reasons people engage in excoriation or hair pulling?

Answer 42

1. Can make some people feel good.
2. Some people feel they go into a trance-like state. Can be mesmerizing.

Question 43

Is there are a large proportion of individuals with trichotillomania or excoriation disorder that are unaware of the act?

Answer 43

Yes.