Obsessive-Compulsive and Related Disorders

Question 1

What defines obsessions in Obsessive-Compulsive Disorder?

Answer 1

• Recurrent and persistent thoughts, urges, or images that are experienced as intrusive and unwanted causing marked anxiety and distress
• There are attempts to ignore or suppress such thoughts, urges, or images, or to neutralize with some other thought or action

Question 2

What defines compulsions in Obsessive-Compulsive Disorder?

Answer 2

• Repetitive behaviors (handwashing/ordering/checking) or mental acts (praying/counting/repeating words silently) the individual feels driven to perform in response to an obsession
• The behaviors and mental acts are aimed at preventing or reducing anxiety or distress; however, these behaviors/mental acts are not realistically connected with what they are designed to neutralize or prevent

Question 3

How long do obsession or compulsions need to take to meet criteria?

Answer 3

More than one hour or cause clinically significant distress

Question 4

What are criteria C and D for OCD?

Answer 4

C: the obsessive-compulsive symptoms are not attributable to the physiological effects of a substance/another medical condition

D: Disturbance not better explained by the symptoms of another mental disorder

Question 5

What are the insight specifiers for Obsessive-Compulsive Disorder?

Answer 5

• with good or fair insight: the recognition that the obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be true
• with poor insight: thinking that obsessive-compulsive disorder beliefs are probably true
• with absent insight/delusional beliefs: being completely convinced that obsessive-compulsive disorder beliefs are true

Question 6

When do you use the tic-related specifier in obsessive-compulsive disorder?

Answer 6

When the individual has a current or past history of a tic disorder

Question 7

What is a big difference between an OCD presentation and an anxiety disorder presentation?

Answer 7

Worries in anxiety are usually about real-life concerns whereas obsession of OCD usually do not involve real-life concerns and can include content that is odd, irrational, or a seemingly magical nature.

Question 8

What differentiates symptoms of OCD with those of Major Depressive Disorder?

Answer 8

The ruminations in MDD are usually mood-congruent and not necessary experienced as intrusive or distressing

Question 9

What is the main difference between eating disorders and OCD?

Answer 9

The obsessions in the eating disorders are limited to concerns about weight and food

Question 10

What is the difference between tic disorder/stereotyped movements and OCD

Answer 10

In a tic disorder, there is sudden, rapid, recurrent, nonrhythmic movement or vocalization. In a stereotyped movement is a repetitive, seemingly driven, nonfunctional motor behavior.

Tics and stereotyped movements are typically less complex than compulsions

Question 11

What are the differences in OCD and obsessive-compulsive personality disorder?

Answer 11

Obsessive-compulsive personality disorder does not have intrusive thoughts, images, or urges nor does it have repetitive behaviors performed in response to the intrusion. It more involves excessive perfectionism and rigid control.

Question 12

What are the criteria for a diagnosis of body dysmorphic disorder?

Answer 12

• Preoccupation with one or more perceived defects or flaws in physical appearance not observable/slight to others
• Repetitive behaviors (mirror checking, excessive grooming, skin picking, reassurance seeking) or mental acts (comparing appearance with other) in response to appearance concern
• The preoccupation is clinically significantly distressing
• Appearance preoccupation is not better explained by concerns with body fat/weight in someone with an eating disorder

Question 13

What makes up the muscle dysmorphia specifier in body dysmorphia?

Answer 13

The individual is preoccupied with the idea that their body is too small or insufficiently muscular

Question 14

What are the insight specifiers for body dysmorphia?

Answer 14

• Good or fair: recognition that the body dysmorphic beliefs are probably not true or that they may or may not be true
• Poor: individual thinks beliefs are probably true
• Absent insight/delusional beliefs: completely convinced that the beliefs are true

Question 15

What are the criteria for Hoarding Disorder?

Answer 15

• Difficulty discarding or parting with possessions regardless of value
• Difficulty is due to a perceived need to save them and distress associated with discarding them
• Difficulty discarding items results in accumulation of possessions that congest and clutter the living area
• Hoarding causes clinically significant distress
• Hoarding is not attributable to another medical condition
• Hoarding is not better explained by symptoms of another mental disorder

Question 16

What is the specifier for hoarding disorder regarding acquisition?

Answer 16

• with excessive acquisition: difficulty discarding possessions is accompanied by excessive acquisition of items for which there is no available space

Question 17

What is are the insight specifiers for hoarding disorder?

Answer 17

• Good or fair: recognition that hoarding-related beliefs/behaviors are problematic
• Poor: Individual is mostly convinced that hoarding-related beliefs and behaviors are not problematic despite evidence to the contrary
• Absent insight/delusional beliefs: individual is completely convinced that hoarding-related beliefs and behaviors are not problematic despite evidence to the contrary

Question 18

What are the criteria for trichotillomania?

Answer 18

• Recurrent pulling out of one’s hair, resulting in hair loss
• Repeated attempts to decrease or stop hair pulling
• Hair pulling causes clinically significant distress
• Hair pulling or hair loss is not attributable to another condition
• Hair pulling is not better explained by symptoms of another disorder

Question 19

What are the criteria for excoriation disorder?

Answer 19

• Recurrent skin picking resulting in skin lesions
• Repeated attempts to decrease or stop skin picking
• Skin picking causes clinically significant distress
• Skin picking not attributable to the physiological effects of a substance
• Skin picking not better explained by another mental disorder