Obsessionality & Compulsivity Flashcards
What are obsessions?
persistent and recurrent intrusive thoughts, images, or impulses experienced as disturbing, inappropriate, or uncontrollable
What are compulsions?
repetitive behaviors or rituals that a person feels driven to perform, often according to very specific or rigid rules
Was OCD and BDD a new section as of DSM-5?
Yes! OCD was classified as anxiety and BDD was somatoform disorder
How long does an obsession or compulsion have to take per day to be considered time consuming?
Has to take more than 1 hour per day
On average how long do people with BDD spend thinking about their body-related concerns?
3-8 hours per day
What is hoarding disorder?
a persistent difficulty discarding or parting with possessions, regardless of their actual value
What is the lifetime prevalence of OCD and is there any differences between gender and ethnicity?
- 2-3%
- seems to be equal in gender and ethnicity
What is the most common time of onset?
- childhood through young adulthood but can get it later in life as well
Do people with OCD almost always have both obsessions and compulsions? And what does it often co-occur with?
-Yes
- anxiety disorders, depression and tic disorder
Is BDD more common than we previously thought? Is there differences between gender? What is the typical age of onset?
- Yes it is, about 1-2%
- seems to be equally common in men and women
- adolescence through early adulthood
Do people with BDD often seek medical intervention such as plastic surgeons and dermatologists?
Yes, they do but they may still think the problem is not fixed or they will move on to a different part of their body
When do early signs of hoarding emerge?
In childhood or adolescence
What does hoarding impair them with?
high rates of unemployment, financial difficulties, and social alienation
Biological processes in OCD
- dysregulation of an “impulses and drives” circuit
- possible implication of fear circuitry
- heightened neurological response to making errors
Behavioral processes in OCD
- Conditioned learning
- Habits
Cognitive processes in OCD
- Obsession to compulsion
- attentional and perceptual biases
- Thoughts imbued with catastrophic meaning
- High standards of conduct and morality, responsibility -> heightened efforts to avert harms
Why the incessant checking?
They are really concerned about being wrong
Factors that are implicated in BDD
- environment that focus on appearance
- strong belief in the importance of appearance, valuing appearance
- biased attention to physical attractiveness
- attention to details
Factors implicated in hoarding
- high rates of trauma, deprivation
What are the cognitive factors implicated in hoarding?
- difficulties with organization, planning, decision making
- common beliefs about self, others, possessions (all bad except when it comes to possessions)
- instead of being attached to others they are attached to possessions
ERP as treatment (50-70% show improvement!) similar approaches can be used for BDD and hoarding
- exposure therapy to situations that elicit obsessions
- prevent the compulsions
Cognitive components of treatment
- post exposure processing
- examine all their unhelpful beliefs, consequences, and discarding hoarded objects
Biocentric treatments
- SSRIs/ SNRIs
- deep brain stimulation for OCD
