Lecture 7: OCD and related disorders Flashcards
What is OCD?
A disorder with intrusive thoughts (obsessions) and repetitive behaviors (compulsions).
What are obsessions?
Unwanted, distressing thoughts, urges, or images that are hard to ignore or control.
What are compulsions?
Repetitive actions (e.g., washing, checking) done to reduce anxiety, but excessive.
How is OCD diagnosed?
- Time-consuming (>1 hour/day) or distressing
- Not caused by another disorder or substance
- Insight varies (good, poor, or delusional)
What are common OCD symptoms?
- Contamination fears
- Hoarding
- Checking
- Orderliness
- Intrusive thoughts
How do obsessions and compulsions relate?
- Contamination → Avoid, decontaminate
- Order → Rearrange, check
- Harm → Avoid, mentally review
- “It must be right” → Repeat until perfect
- Blasphemous thoughts → Pray, neutralize
How do clinical and non-clinical obsessions differ?
- General thoughts: Fear of harm to loved ones, aggression, intrusive sexual thoughts
- OCD thoughts: Extreme, irrational fears (e.g., harming pets, believing they committed crimes)
What is mental contamination?
- Feeling contaminated by thoughts, memories, or symbols, not physical contact
- Triggers: Hearing about illness, recalling disliked people, bad luck symbols
- Often linked to moral judgment (e.g., feeling “dirty” = bad or immoral)
How does OCD differ from GAD?
- GAD: Worries are ego-syntonic, triggered by daily stress, verbal-based.
- OCD: Thoughts are ego-dystonic, lack clear triggers, more imagery-based, bizarre/magical.
How is OCD a learned behavior?
Mowrer’s two-process theory:
1. Neutral stimuli become associated with fear via conditioning.
2. Compulsions reduce anxiety, reinforcing the behavior.
What cognitive biases contribute to OCD?
- Focus on disturbing material.
- Difficulty ignoring negative thoughts.
- Suppressing thoughts paradoxically increases them.
- Low confidence in memory leads to compulsions.
What are the biological causes of OCD?
- Genetic factors: Higher concordance in identical twins.
- Neurotransmitter issues: Serotonin system dysfunction worsens symptoms.
What are effective OCD treatments?
- Behavioral: Exposure and response prevention (ERP).
- Medications: Clomipramine (Anafranil), Fluoxetine (Prozac).
- Relapse risk: High if medication is stopped.
What is Body Dysmorphic Disorder (BDD)?
- Obsession with perceived physical flaws (not noticeable to others).
- Repetitive behaviors (mirror checking, grooming, skin picking).
- Avoidance of activities due to appearance concerns.
- Causes significant distress or impairment.
- Not explained by weight concerns (which would indicate an eating disorder).
How does BDD affect daily life?
- 99% experience social interference.
- 95% avoid social interactions.
- 94% feel depressed.
- 90% struggle with work or academics.
- 63% have suicidal thoughts due to BDD.
How common is BDD?
- Affects about 2% of people.
- Equally common in men and women.
- Typically begins in adolescence.
- Often coexists with depression.
How does culture influence BDD?
- Cultural standards shape concerns (e.g., double eyelids).
- Taijin Kyofusho (Japan): Fear of offending others with appearance.
- Asians: More focus on straight hair, fair skin, fewer body shape concerns.
How does gender affect BDD?
- Muscle dysmorphia in men: Obsession with muscularity.
- More likely to experience suicide attempts, lower quality of life, and substance abuse.
How is BDD related to OCD and eating disorders?
- OCD similarities: Obsessions and ritualistic behaviors.
- Eating disorder similarities: Body dissatisfaction, preoccupation with appearance, distorted body image.
Risk Factors for BDD
- Genetic: Family history of BDD, OCD, or depression.
- Social: Bullying, social media, high beauty standards.
- Personal: Perfectionism, skin issues.
Treatments for BDD
CBT: First-line treatment for mild cases, uses exposure therapy.
Medication: SSRIs (e.g., fluoxetine) may take 12 weeks to work.
OCD vs. BDD
OCD: Compulsions driven by intrusive thoughts.
BDD: Behaviors driven by fixing perceived physical flaws.
What is the Bergen 4-Day Treatment (B4DT) Method for OCD?
The Bergen 4-Day Treatment is a rapid treatment for OCD, offering a high response rate (90%) and a remission rate of 70% after 3 months. It involves four consecutive days of therapy with six patients per group.
Response Rate
The percentage of patients who show significant improvement in symptoms after treatment.
Remission Rate
The percentage of patients whose symptoms reduce to a minimal or non-clinical level after treatment.
