Obsessive Compulsive Disorder Flashcards
What are 5 types of obsessive compulsive disorders listed in the DSM 5?
- Obsessive compulsive disorder
- Body dysmorphic disorder
- Hoarding disorder
- Hair pulling disorder
- Skin picking disorder
What are the behaviors of people with obsessive compulsive disorder supposed to reduce?
- It is supposed to reduce anxiety
- Ex: skin picking is supposed to reduce pleasure because when people are stressed they need a distraction for their issues
What are obsessions?
- Recurrent, persistent, intrusive, unwanted thoughts, urges or images
- The person wants to ignore, suppress, or neutralize the thoughts words or images
What are compulsions?
- Repetitive behaviors that the person feels compelled to perform to prevent distress or a dreaded event
- The person feels compelled to perform the repetitive behavior or thoughts in response to obsessions or according to rigid rules
What makes obsessions or compulsions a clinical concern for the individual?
- They take up at least an hour per day
- Or cause the person significant distress or impairment
- The person does not want them
What are the main features of obsessive compulsive disorder?
- unwanted thoughts
- create significant anxiety
- often drive repetitive behavior that is excessive
- not a part of the person’s control
- ego-dystonic
What are the five forms of obsessions?
- Doubts
- Images
- Thoughts
- Impulses
- Fears
What are five forms of compulsive rituals?
- Cleaning
- Checking
- Repeating
- Hoarding
- Orderliness
What are obsessions in terms of obsessive compulsive disorder?
- Intrusive, persistent, and uncontrollable thoughts or urges
- Experienced as irrational
- Most common: contamination, sexual and aggressive impulses, body problems
What are compulsions in terms of obsessive compulsive disorder?
- Impulse to repeat certain behaviors or mental acts to avoid distress (ex: cleaning, counting, touching, checking)
- Extremely difficult to resist the impulse
- May involve elaborate behavior rituals
- Compulsive gambling, eating etc. are NOT considered compulsions since they are pleasurable
Do males and females have the same rate of OCD?
Yes
What is the performance element in OCD?
- People perform to just perform! They would rather do it alone and lie about what their disorder actually is
- Does not always reduce anxiety
What percentage of OCD patients experience obsessions and compulsions?
69%
What percentage of OCD patients only experience obsessions?
25%
What percentage of patients only experience compulsions?
6%
When does OCD develop?
- Age 10 or during late adolescence/early adulthood
What population of people are more likely to seek treatment?
Women
What does the comorbidity rate for OCD?
75%
- Depression
- Hoarding
- Substance use disorder
What is the psychodynamic explanation for OCD?
- Fixation at the anal stage of development
- Reaction formation
What is the biological model for OCD?
- Genetic factors
- Dysfunction for in circuitry involving frontal cortex
What is the cognitive behavioral model for OCD?
- Extremist (black and white) thinking
- Magical thinking
How much more likely are monozygotic twins with OCD prone to developing OCD?
20 times
What two brain structures are most commonly associated with OCD?
Increased metabolic activity orbital frontal cortex, the basil ganglia, cingulate gyrus cortex
What brain structure is most common with OCD?
- Caudate nucleus
What are the behavioral components of OCD?
- Operant reinforcement
- Compulsions negatively reinforced
What are the cognitive components of OCD?
- Lack of satiety signal
- Individuals with OCD have a yadasentience (feeling of completion) deficit
- Attempts to suppress intrusive thoughts
What are psychological treatments for OCD?
- Exposure response prevention (ERP)
- Cognitive therapy
What are medications to treat OCD?
- SSRI’s
- Antidepressants
What are biological treatments of OCD?
Psychotherapy
What does cognitive therapy look like in OCD?
- Challenge beliefs about anticipated consequences of not engaging in compulsions
What is body dysmorphic disorder?
- Preoccupied with imagined or exaggerated defect or appearance
- Perceive themselves to be monstrous or ugly
- High levels of anxiety, shame, and depression
What do women focus on with body dysmorphic disorder?
Skin, hips, legs, breasts
What do men focus on with body dysmorphic disorder?
Height, penis size, body hair, muscularity
What compulsive behaviors do people with body dysmorphic disorder engage in?
- Check their appearance in mirrors often
- Camouflage their appearance
Do men or women more commonly have body dysmorphic disorder?
Women
What is the comorbidity rate for body dysmorphic disorder?
Almost all
What are the cognitive and behavioral factors of body dysmorphic disorder?
Focus on detail of appearance
- There is no actual distortion of appearance
- People attend to physical attractiveness features
- Miss the whole picture
- Become engrossed in small flaws
- Believe in an exaggerated importance of appearance
What brain structures commonly display hyperactivity in body dysmorphic disorder?
Orbitofrontal cortex and caudate nucleus
What are medications used to treat body dysmorphic disorder?
SSRIs
What does cognitive therapy look like for people who have body dysmorphic disorder?
- Challenge beliefs about bodily imperfections
- Challenge beliefs about standards of beauty
What is hoarding disorder?
Cannot part or form an attachment with acquired objects that are usually worthless
What percentage of people are unaware that they have hoarding disorder?
66%
What percentage of people with hoarding disorder hoard animals and how does this affect the animals?
33% - they receive poor care and often dirty living areas with poop (69% of cases have animal feces left around the living space
What does hoarding disorder usually result in for living conditions?
The accumulation of a large number of possessions that clutter active living spaces of the home or workplace of the extent that their intended use is compromised unless others intervene
What are vulnerability factors of hoarding disorder?
- Genetic influences
- Family history
- Traumatic life events
- Early experiences
What are the information processing problems people with hoarding disorder have?
- Attention
- Memory
- Executive functioning
What is the evolutionary perspective of hoarding disorder?
- The adaptive need to stockpile resources
What are the cognitive behavioral factors of hoarding disorder?
- Poor organizational ability
- Unusual beliefs about possessions
- Avoidance behaviors
What percentage of women have hoarding disorder?
76%
What percentage of people with hoarding disorder are 60 and older
46%
What is the goal of exposure with response prevention?
To gradually expose patients to their obsessions in a safe and controlled environment. Therapy will then become more intensive as patients demonstrate an ability to handle their obsessions.
What is trichotillomania?
Hair pulling disorder: A compulsive desire to pull out one’s hair
What is excoriation?
Skin picking disorder
