Obsessive Compulsive Disorder Flashcards
obsessions
recurrent, persistent, intrusive, and unwanted thoughts, images, or impulses
compulsions
ritualistic or repetitive behaviors that a person carries out continuously in an attempt to decrease anxiety that interfere with personal, social, and or occupational functioning
common obsessive thought themes
contamination, religious preoccupation or blasphemy, aggressive urges, doubting, accidental harm to other, sexual
common compulsions
touching, rubbing, tapping, orderings, exhibiting rigid performance, checking rituals, counting rituals, washing/scrubbing, praying/chanting
biological etiology for compulsive disorder
increased activity in prefrontal cortex
cognitive etiology for compulsive disorder
childhood and environmental experiences of growing up, person believes their thoughts are overly important, perfectionism and intolerance of uncertainty, inflated personal responsibility
excoriation
skin picking
onychophagia
nail biting
trichotillomania
hair pulling
kleptomania
compulsive stealing; reward is thrill of stealing and not getting caught; more common in females; long term therapy for tx
oniomania
compulsive buying; spending beyond financial means; pleasure from acquiring purchased object and not the use of the object
hoarding
excessive acquisition; tx with medications, cbt, community resources
pyromania
fire setting; impulsive, not planned; more common in adolescents and males
body dysmorphic disorder
preoccupation with slight or even imagined physical imperfection; obsesses and worries about defect; repetitive, elective cosmetic surgery procedures, usually comorbidities
body identity integrity disorder
feeling alienated from a part of the body to the extent of seeking amputation of identified body part; usually will not amputate, so may resort to home amputation techniques
treatment for onychophagia
SSRIs
Asian Americans and African Americans report more of what OCD symptoms
contamination related
Asian Americans experience more of what types of beliefs
obsessive
Assessment of OCD patients
general appearance, motor behavior: tense, anxious, embarassement
mood, affect: overwhelming anxiety
thought process, content: obsessions out of nowhere, perseverate on obsessions
judgement, insight: obsessions as irrational but unable to stop them
self-concept: powerlessness
roles, relationships: impaired by compulsions
physiologic, self-care considerations: sleeping problems, trouble completing ADLs
10 Items on Yale Brown Obsessive Compulsive Scale
- time spent on obsession
- interference from obsession
- distress from obsession
- resistance to obsession
- control over obsession
- time spent on compulsion
- interference from compulsion
- distress from compulsion
- resistance to compulsion
- control over compulsion
OCD Treatment
combo of medications and therapy work best;
first line medications: SSRIs
second line: SNRI
children and adolescents more likely to respond to SSRIs, even if treatment resistant
tx for treatment resistant OCD
second-generation antipsychotics
second generation antipsychotics
risperidone, quetiapine, olanzapine
SSRIs
citalopram, fluoxetine, sertraline, escitalopram, paroxetine
SNRIs
desvenlafaxine, duloxetine, venlafaxine
how do SSRIs work?
block the reuptake of serotonin, symptoms gradually decrease when starting (10 days until start to see effect)
how to SNRIs work?
increase serotonin and norepinephrine levels
types of therapy used in OCD
cognitive behavioral therapy (CBT)
exposure therapy
response therapy
what is cbt?
treatment focuses on examining the relationships between thoughts, feelings, and behaviors
what is exposure therapy?
deliberately confronting situation and stimuli that one usually tries to avoid
what is response prevention?
delay or avoid performing the rituals. learn to tolerate the thoughts and anxiety; employ deep breathing and relaxation methods to tolerate anxiety
therapeutic communication techniques
validate feelings of anxiety, encourage sense of control
relaxation techniques
deep breathing and progressive relaxation
