Obsessive-Compulsive and Related Disorders (Morrison, Ch. 5) Flashcards
The decreasing abilities or loss of normal functions
(affect, speech, avolition)
Negative Symptoms
An excess or distortion of normal functions (e.g. delusions,
hallucinations, etc.)
Positive Symptoms
The ability to distinguish between reality and fantasy
Reality Testing
Patients who are preoccupied with obsessional ideas or certain repetitive behaviors
Obsessive Compulsive and Related Disorders
Morrison’s comments on common features among Obsessive Compulsive and Related Disorders are:
- Onset when young
- Similar comorbidity (depression)
- Family history of OCD
- Similar treatment response
- Hints of dysfunction in the frontostriatal brain circuitry
Persistent ideas, thoughts, impulses, or images that are experienced as intrusive and unwanted that cause marked anxiety or distressed
Obsessions
Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) the goal of which is to prevent or reduce anxiety or distress, not to provide pleasure or gratification.
Compulsions
Which disorder’s Diagnostic Criteria is the following:
A. Either obsessions OR compulsions OR both
Obsessions as defined by 1 and 2 below:
1. Persistent ideas, thoughts, impulses, or images that are experienced as intrusive and unwanted that cause marked anxiety or distressed
2. The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
Compulsions as defined by 1 & 2 (below)
1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) the goal of which is to prevent or reduce anxiety or distress, not to provide pleasure or gratification.
2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive
B. The obsessions or compulsions caused marked distress, are time-consuming
(take ≥ 1 hour a day), or significantly interfere with the functioning
C. The disturbance is not due to substance use or a general medical condition
Obsessive Compulsive Disorder
Prevalence for Obsessive Compulsive Disorder is:
1.2-2%
The onset for Obsessive Compulsive Disorder is typically in:
Adolescence or early adulthood (between 19 and 24 years; mean age of onset 19 years old)
Obsessive Compulsive Disorder is more common in higher _______ and high _______.
Socioeconomic status
intelligence
Obsessive Compulsive Disorder appears to affect men and women about _____.
equally
_____ of Obsessive Compulsive Disorder comorbid with depression.
2/3
Up to ____% of Obsessive Compulsive Disorder attempt suicide.
25%
______ plays an important role in OCD
Heredity
Among family members of OCD patients, the prevalence of OCD and related symptoms is ______ than in the general population.
6 times higher
For OCD: ___% concordance rate for monozygotic twins, ___% concordance rate for dizygotic twins.
.57%
.22%
Without treatment for OCD, chronic course: Remission rate around __% among adults 40 years after diagnosis.
20%
____ has a preoccupation with an imagined defect or flaw in physical appearance not observable or appear slight to others
Body Dysmorphic Disorder (BDD)
____ has engaged in repetitive behaviors or mental acts in response to appearance concerns (mirror checking, excessive grooming, comparing appearance with that of others
Body Dysmorphic Disorder (BDD)
_____ is dissatisfaction with overall body shape and anorexia nervosa are excluded. Note not delusional, more of an overvalued idea.
Body Dysmorphic Disorder (BDD)
The prevalence of Body Dysmorphic Disorder (BDD) is __%
2.5%
__% of patients diagnosed with Body Dysmorphic Disorder (BDD) in U.S. get cosmetic surgery?
7-8%
(Note: 1/3 of patients seeking rhinoplasty)
The onset of Body Dysmorphic Disorder (BDD) is typically in ____. Subclinical signs most commonly in ___ years old.
adolescence
12-13 years old
Body Dysmorphic Disorder (BDD) effects men and women _____.
Equally
_____ comorbid with depression, social anxiety disorder, OCD, substance disorder
Body Dysmorphic Disorder (BDD)
Which diagnosis includes, “high” SI, “high” suicide attempt?
Body Dysmorphic Disorder (BDD)
Most frequently performed cosmetic surgery in the US since the early 2000s is _____.
Rhinoplasty
______ Disorder:
1. Persistent difficulty discarding or parting with possessions, regardless of their actual value.
2. Difficulty due to a perceived need to save the items and to distress associated with discarding them.
Hoarding Disorder
______ Disorder:
3. The difficulty of discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromise their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (e.g., family members, cleaners, or the authorities)
* Incidence approx. 2-6%
Hoarding Disorder
Onset of ______ begins in adolescence and gets worse every decade (clinical impairment by 30s)
Hoarding Disorder
Hoarding Disorder is ___ more prevalent in older (55-94) than younger (34-44) ages
3X
Hoarding Disorder is more common among ______, but _______ are more likely to be seen clinically.
Males
Females
Risk factors of Hoarding Disorder are:
Indecisive temperament
Familial history
Comorbidity of Hoarding Disorder:
75% either _______, 20% _____.
Mood or Anxiety Disorder
OCD
_______:
A. Recurrent pulling out of one’s hair resulting in noticeable hair loss.
B. Repeated attempts to decrease or stop hair pulling
Trichotillomania (hair pulling)
Former criteria for ______:
- An increasing sense of tension
immediately before pulling out the hair or when attempting to resist the behavior
- Pleasure, gratification, or relief when pulling out the hair
Trichotillomania (hair pulling)
Trichotillomania prevalence: ____% in US population
1-2%
Onset of Trichotillomania typically in ________. May wax and wane.
childhood or adolescence
Risk factors of ______ are genetic vulnerability, OCD, or relative with OCD.
Trichotillomania
Many more ______ than ______ are diagnosed with Trichotillomania. The ratio is 10:1.
women than men
_____ is:
1. Repeated skin picking, resulting in skin lesions
2. Repeated unsuccessful attempts to decrease or stop picking skin
Excoriation
The prevalence of Excoriation is __%
2%
Excoriation onset is typically in ______.
Adolescence
_____ risk factors: more common in individuals with OCD or having a relative with OCD.
Excoriation
In Excoriation diagnosis, ___ are female.
75%
Most individuals with Excoriation Disorder spend ______ per day picking or trying to resist picking.
an hour or more
“Repeated hand washing in response to your fear that your hands are contaminated” is most like a _____ in Obsessive Compulsive Disorder
compulsion
