Obsessive-Compulsive Disorder

Question 1

DSM5 criteria OCD

Answer 1

• presence of obsessions
• presence of compulsions
• obsessions and compulsions take up at least 1 hour per day
• causes significant impairment or distress
• can be either just obsessions, compulsions, or both

Question 2

obsessions

Answer 2

• recurrent and persistent thoughts, urges, images experienced as intrusive
• unwanted and cause anxiety or distress
• attempt to ignore or suppress and neutralize thoughts, urges, images

Question 3

compulsions

Answer 3

• repetitive B or mental cts individual feels driven to perform in response to obsession or according to rigid rules
• B or mental acts = aimed at preventing or reducing anxiety or distress or prevent the event
• not connected in a realistic way/too excessive

Question 4

prevalence

Answer 4

• lifetime prevalence = 1.6-2.3%
• 28.2% report experiencing obsessions and compulsions at some point in life
• onset = usually adolescence/early adulthood
• 90% meet criteria for another disorder (often anxiety or mood disorders)
• obsessions but not compulsions predict help-seeking B

Question 5

why do obsessions predict help-seeking better than compulsions?

Question 6

etiology - biological

Answer 6

• genetics
• brain regions implicated:
  1. orbitofrontal cortex
  2. cingulate gyrus
  3. caudate nucleus

Question 7

brain regions involved in determination of OCD: reasons

Answer 7

• overactivation and dysregualtion of orbitofrontal-caudate circuit
• involved with impulses, decision-making, etc.

Question 8

etiology - behavioural

Answer 8

• obsessive-compulsive B develops because they reduce anxiety
• classical conditioning - negative reinforcement
• cycle of:
  1. obsession
  2. anxiety
  3. compulsion
  4. relief

Question 9

etiology - cognitive

Answer 9

• exaggerated estimates of probability of harm
• need to control
• intolerance of uncertainty
• thought-action fusion
• disconfirmatory bias

Question 10

thought-action fusion

Answer 10

• distressing thoughts become fused with the action, event or object
• having these thoughts produces the same emotions as if the event occured

Question 11

disconfirmatory bias

Answer 11

search for evidence that they performed ritualistic B incorrectly

Question 12

etiology: social

Answer 12

• family variables
  1. controlling, overprotective with rigid rules
  2. low parental warmth, hostile, overly critical
  3. discouragement of autonomy

Question 13

etiology: sociocultural

Answer 13

• culture may influence how symptoms express
• African Americans show more concern about animals and contamination than European Americans

Question 14

treatments: biological

Answer 14

SSRI
- only 60% respond
- relapse if discontinued
- outcome improved when combined with behavioural interventions

Question 15

treatments: psychological

Answer 15

• exposure and response prevention (ERP)
• cognitive behavioural therapy

Question 16

exposure and response prevention (ERP)

Answer 16

• involves continued actual/imagined exposure to a fear-arousing situation
• response prevention

Question 17

response prevention

Answer 17

not allowing person with OCD to perform the compulsive B

Question 18

CBT

Answer 18

focuses on correcting dysfunctional beliefs