Obsessionality & Compulsivity

Question 1

What are obsessions?

Answer 1

persistent and recurrent intrusive thoughts, images, or impulses experienced as disturbing, inappropriate, or uncontrollable

Question 2

What are compulsions?

Answer 2

repetitive behaviors or rituals that a person feels driven to perform, often according to very specific or rigid rules

Question 3

Was OCD and BDD a new section as of DSM-5?

Answer 3

Yes! OCD was classified as anxiety and BDD was somatoform disorder

Question 4

How long does an obsession or compulsion have to take per day to be considered time consuming?

Answer 4

Has to take more than 1 hour per day

Question 5

On average how long do people with BDD spend thinking about their body-related concerns?

Answer 5

3-8 hours per day

Question 6

What is hoarding disorder?

Answer 6

a persistent difficulty discarding or parting with possessions, regardless of their actual value

Question 7

What is the lifetime prevalence of OCD and is there any differences between gender and ethnicity?

Answer 7

• 2-3%
• seems to be equal in gender and ethnicity

Question 8

What is the most common time of onset?

Answer 8

• childhood through young adulthood but can get it later in life as well

Question 9

Do people with OCD almost always have both obsessions and compulsions? And what does it often co-occur with?

Answer 9

-Yes
- anxiety disorders, depression and tic disorder

Question 10

Is BDD more common than we previously thought? Is there differences between gender? What is the typical age of onset?

Answer 10

• Yes it is, about 1-2%
• seems to be equally common in men and women
• adolescence through early adulthood

Question 11

Do people with BDD often seek medical intervention such as plastic surgeons and dermatologists?

Answer 11

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

Question 12

When do early signs of hoarding emerge?

Answer 12

In childhood or adolescence

Question 13

What does hoarding impair them with?

Answer 13

high rates of unemployment, financial difficulties, and social alienation

Question 14

Biological processes in OCD

Answer 14

• dysregulation of an “impulses and drives” circuit
• possible implication of fear circuitry
• heightened neurological response to making errors

Question 15

Behavioral processes in OCD

Answer 15

• Conditioned learning
• Habits

Question 16

Cognitive processes in OCD

Answer 16

• Obsession to compulsion
• attentional and perceptual biases
• Thoughts imbued with catastrophic meaning
• High standards of conduct and morality, responsibility -> heightened efforts to avert harms

Question 17

Why the incessant checking?

Answer 17

They are really concerned about being wrong

Question 18

Factors that are implicated in BDD

Answer 18

• environment that focus on appearance
• strong belief in the importance of appearance, valuing appearance
• biased attention to physical attractiveness
• attention to details

Question 19

Factors implicated in hoarding

Answer 19

• high rates of trauma, deprivation

Question 20

What are the cognitive factors implicated in hoarding?

Answer 20

• 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

Question 21

ERP as treatment (50-70% show improvement!) similar approaches can be used for BDD and hoarding

Answer 21

• exposure therapy to situations that elicit obsessions
• prevent the compulsions

Question 22

Cognitive components of treatment

Answer 22

• post exposure processing
• examine all their unhelpful beliefs, consequences, and discarding hoarded objects

Question 23

Biocentric treatments

Answer 23

• SSRIs/ SNRIs
• deep brain stimulation for OCD