Obsessive-Compulsive and Related Disorders: Exam 2 Flashcards
recurrent, persistent, intrusive, and unwanted thoughts, images, or impulses that cause marked anxiety and interfere with interpersonal, social, or occupational function
Obsessions
ritualistic or repetitive behaviors or mental acts that a person carries out continuously to neutralize anxiety
Compulsions
The person with these thoughts know they are excessive or unreasonable but believe they have no control over them.
Obsessive-Compulsive Disorder (OCD)
________ is diagnosed only when these _________, images, and impulses consume the person or ______ them to act out the behaviors to a point at which they interfere with ________, social, and occupational functions
OCD
Thoughts
Compels
Personal
What was OCD previously classified as?
an anxiety disorder due to the sometimes-extreme anxiety that people experience
How is OCD disorders characterized?
by repetitive thoughts and behaviors, such as OCD, are described in terms of an OCD spectrum.
What are the OCD spectrum’s?
Self-soothing behaviors
Reward-seeking behaviors
Disorders of body appearance or function
Trichotillomania
Dermatillomania or onychophagia
What OCD spectrum is this?
Self-soothing behaviors
Hoarding
Kleptomania
Pyromania or oniomania
What OCD spectrum is this?
Reward-seeking behaviors
Body dysmorphic disorder (BDD)
What OCD spectrum is this?
Disorders of body appearance or function
What are the common OCD compulsions?
85% Washing & Grooming
48% Checking
38% Rituals
17% Ordering
What are the three etiology models of OCD?
Cognitive
Genetic
Immune
What does the cognitive model of OCD consist of?
Believing one’s thoughts are overly important, that is, “if I think it, it will happen” this person has a need to control those thoughts
Perfectionism and the intolerance of uncertainty
Inflated personal responsibility (from a strict moral or religious upbringing) and overestimation of the threat posed by one’s thoughts
What does the genetic model of OCD consist of?
Genome-wide and candidate gene association studies found variations that may be involved in OCD pathology
They support the idea that a complex network of several genes may contribute to the genetic risk for OCD
What does the immune model of OCD consist of?
Antistreptococcal antibodies cross-react with basal ganglia neurons following streptococcus infection
This autoimmune reaction disrupts a basal ganglia-thalamocortical circuit and generates obsessive-compulsive symptoms
arises from Aaron Beck’s cognitive model approach to emotional disorders and describes a persons thinking as
Cognitive model of OCD
population-based studies confirmed substantial heritability in OCD
Genetic model of OCD
A postinfectious, autoimmune response may be associated with the development of OCD
Immune model of OCD
What does the onset of OCD consist of?
Can start in childhood, especially in males
Females – it more commonly begins in the 20s
Overall, the distribution between the sexes is equal
Early onset is more likely to affect males and has:
More severe symptoms
More comorbidity diagnoses
A greater likelihood of a family history
When does onset occur? What do the periods of this onset produce?
Onset is typically in late adolescence, with periods of waxing and waning symptoms over the course of a lifetime
___________ of symptoms may be related to stress.
Exacerbation’s
Internationally, OCD symptoms are similar, variation in symptom expression or beliefs about symptoms include:
Highly religious individuals
Belief in a supernatural cause
Pharmacologic treatment varies
What does highly religious individuals believe in regards to OCD symptoms?
Both Christian and Muslim may have a heightened sense of personal guilt about their symptoms
What do individuals who have a belief in a supernatural cause believe in regards to OCD symptoms?
Much more likely to contact a faith healer for help
What falls under the pharmacologic treatment for OCD?
In seven different countries, the use of selective serotonin reuptake inhibitors (SSRIs) was most prevalent but varied from 59% to 96% overall
What does the assessment of OCD consist of?
Yale-Brown Obsessive-Compulsive Scale
History
General appearance and motor behavior
Mood and affect
Thought processes and content
Judgment and insight
Self-concept
Roles and relationships
Physiological and self-care considerations
What does the nursing diagnoses of OCD consist of?
Anxiety
Ineffective coping
Situational low self-esteem
What are the outcomes of OCD treatment in clients?
The client will…
-Complete daily routine activities within a realistic time frame]
-Discuss feelings with another person
-Spend less time performing rituals
What are the interventions for OCD?
Therapeutic communication
Combination of medication and therapy:
Medications include…
-First line: Selective serotonin reuptake inhibitors
-Second line: Serotonin and norepinephrine reuptake inhibitors
-Treatment-resistant OCD: second-generation antipsychotics
Behavioral therapy
-Exposure
-Response prevention
What is the client education for OCD?
Teach about OCD
Review the importance of talking openly/tolerating anxiety
Medication compliance
Behavioral techniques
What is the family and community teaching for OCD?
Avoid giving advice
Don’t try to “fix” the problem
Patience
Take breaks (caregiver role-strain)
What are the self-awareness issues in regards to OCD?
Need to understand client cannot simply stop the behavior
Client already knows the thoughts and rituals interfere with life
Explore feelings about the condition requiring long-term medication and behavioral therapy
OCD patients are _______ _______ of their compulsions and hate the effect these compulsions have on their lives, but they feel _____________ to sustain from them.
Acutely Aware
Powerless
What about the studies of OCD?
Studies show promise, but they have yet to defiantly explain how people develop OCD.
What does the cognitive stage of OCD consist of overall?
Childhood and environmental experiences of growing up.
What stage of OCD has been accepted as an partial explanation for OCD?
The Cognitive Stage of OCD
OCD is a _________ condition!
Chronic
Most of the time OCD clients seem normal on the outside, but they suffer with what on the inside?
Fear and anxiety
What is the GOAL for OCD clients?
For OCD symptoms to no longer interfere with the clients ability to carry out their responsibilities. Additional outcomes from OCD therapy include: the client will demonstrate effective use of cognitive behavioral therapy techniques.
What is the MOST IMPORTANT variable in regards to outcomes for OCD?
For the patient to be willing to make changes in their behavior, because it will continuously improve their quality of life!
Where do most OCD treatments occur?
Outpatient facilities
When is the only time an OCD patient will be in the hospital?
When they are completely unable to carry out their daily routines.
What is an example of therapeutic communication in regards to OCD?
The nurse encouraging the client to discuss their obsession, in order to increase the clients sense of security. The nurse should allow the client to preform the ritual, but the nurse gradually decreases the time spent preforming the ritual.
__________ compliance is important, it may be necessary to try __________ medications to see which works best for the client!
Medication
Different
