Obsessive-Compulsive and Related Disorders (Lec. 4) Flashcards
Obsessive-Compulsive and Related Disorders as listed in DSM - V
- Obsessive-Compulsive Disorder
- body dysmorphic disorder
- hoarding disorder
- trichotillomania disorder (hair pulling)
- excoriation disorder (skin-picking)
obsessions
persistent and recurrent intrusive thoughts, images, or impulses that are experienced as disturbing, inappropriate, or uncontrollable; they are unwanted and nonsensical
compulsions
repetitive behaviors (rituals) or thoughts that person feels compelled to perform to prevent distress or a dreaded event; person feels driven to do it even though they know it is sensless
OCD
occurrence of both obsessive thoughts that cause significant anxiety, and compulsive behaviors performed in an attempt to neutralize such thoughts
Obsession types
doubts images thoughts impulses fears
Compulsion types
cleaning checking repeating hoarding orderliness
Obsessions most commonly associated with:
1 - dirt/germs 2 - aggression 3 - sexual behavior 4 - religious matters 5 - orderliness
OCD according to DSM - V
- presence of obsession, compulsions, or both
- obsessions or compulsions are time consuming
- symptoms NOT attributable to other physiological effects or conditions
- person recognizes that obsession is in their own mind and is irrational
Prevalence of obsessions vs. compulsions
69% - both
25% - obsessions only
6% - compulsions only
brain areas implicated in OCD
- orbital frontal cortex
- cingulate gyrus (anterior cingulate)
- caudate nucleus (basal ganglia)
- orbital frontal cortex –> caudate nucleus –> thalamus
ERP (Exposure and Response Prevention)
behavior therapy technique in which compulsive behavior is prevented so that patient is exposed to anxiety-eliciting stimuli
operant reinforfcement
cognitive explaination of OCD; compulsions are negatively reinforced by the reduction of anxiety; keep doing the compulsion because it “reduces” their anxiety
Yadasentience
subjective feeling of completion; many individuals with OCD have a deficit
Serotonin (in OCD disorders)
deficit of serotonin is implicated in OCD
*SSRI’s are successful at helping OCD symptoms
Tricyclics
type of antidepressant that helps OCD patients (clomipramines such as Anafranil)
psychosurgery
last resort OCD treatment; usually a cingulotomy (frontal lobe to basal ganglia cut); only 25 - 40% of cases successful
Goals of Exposure Therapy with Response Prevention
- break negative reinforcing value of compulsion
- extinguish anxiety caused by obsession
- enhance patient’s self-efficacy
Body Dysmorphic Disorder
obsession with some exaggerated or imagined flaw or flaws in appearance to the point where they firmly believe they are disfigured or ugly; most have compulsive checking behaviors
brain areas implicated in Body Dysmorphic Disorder
hyperactivity of orbital frontal cortex and caudate nucleus
Hoarding disorder
persistent difficulty discarding or parting with obsessions regardless of their actual value; involves a perceived need to save items and distress associated with discarding
trichotillomania
compulsive hair pulling - primary symptom is the urge to pull out one’s hair from anywhere on the body resulting in noticeable hair loss
Reaction formation
Psychodynamic explanation of OCD; transfer unacceptable thoughts/feelings of unconscious to a “safer” arena
