Obsessive Compulsive Disorder Flashcards
What are the stages in the vicious cycle of OCD?
- Obsessive thought
- Anxiety
- Compulsive Behaviour
- temporary relief
What is OCD?
OCD is a chronic disorder in which the mind is flooded
with persistent and uncontrollable thoughts
(obsessions) and the individual is compelled to repeat
certain acts again and again (compulsions)
What are the gender differences in OCD?
OCD affects men and women equally
What is the typical age of onset?
- Although it can occur in Children, the typical age of onset is around 20 years of age
- late onset OCD (beyond early 30s) is very rare
What is the diagnostic criteria of OCD?
A. presence of obsessions, compulsions, or both:
Obsessions are defined by 1 and 2:
1. recurrent and persistent thoughts, urges or images that are experienced at some time during the disturbance as intrusive and unwanted and that in most individuals cause marked anxiety or distress
2. the individual attempts to ignore or suppress thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion)
Compulsions are defined by 1 and 2
1. repetitive behaviours (e.g., hand washing, ordering, checking) that the individual feels driven to perform in response to an obsession or according to rules that must be rigidly applied
2. the behaviours or mental acts are aimed at preventing or reducing anxiety or preventing some dreaded event or situation; however these behaviours 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 are time consuming (i.e., take more than 1 hour per day) or cause significant distress or impairment in social, occupational or other important areas of functioning.
What are some OCD specifiers?
- Many individuals with OCD have dysfunctional beliefs.
- Individuals with OCD vary in the degree of insight they have about the accuracy of the beliefs that underlie their obsessive-compulsive symptoms.
- “OCD with good or fair insight” – the individual recognizes that beliefs are definitely or probably not true or that they may or may not be true.
- “OCD with poor insight” – the individual thinks beliefs are probably true.
- “OCD with absent insight/delusional beliefs” – the individual is completely convinced that beliefs are true.
What makes compulsions worse?
According to Rachman (2002), three “multipliers” that increase the intensity and frequency of compulsive
checking are:
- An inflated sense of personal responsibility
- The probability of harm if checking does not take place
- The predicted seriousness of harm.
What are the behavioural and cognitive theories of OCD?
- Learned behaviours reinforced by fear reduction
- Compulsive checking may result from a memory deficit:
- An inability to remember some action accurately (such as turning off the stove) or to distinguish between an actual behaviour and an imagined behaviour (“Maybe I just thought I turned off the stove”) could cause someone to check repeatedly.
- Possibly related to deficits in prospective memory (remembering to remember) and to non-verbal memory
What are the behavioural approaches to treatment of OCD?
- Exposure and Response Prevention (ERP) for OCD
- the person exposes himself or herself to situations that elicit the compulsive act—such as touching a dirty dish— and then refrains from performing the accustomed ritual—hand washing.
- The assumption is that the ritual is negatively reinforcing because it reduces the anxiety that is aroused by some environmental stimulus or event, such as dust on a chair.
- Preventing the person from performing the ritual (response prevention) will expose him or her to the anxiety provoking stimulus, thereby allowing the anxiety to be extinguished.
What are the Cognitive-Behavioural approaches to treatment for OCD?
- A combined CBT approach is clearly required when treating OCD rather than just a cognitive approach because an inherent part of any cognitive therapy is exposure and response prevention;
- To evaluate whether not performing a compulsive ritual will have catastrophic consequences, the client must stop performing that ritual.
- Cognitive procedures can eliminate the dysfunctional beliefs that contribute to the OCD clients’ faulty appraisals
- An “inference-based approach,” is geared toward identifying and ameliorating the obsessional inference
What is the genetic evidence for OCD?
- High rates of anxiety disorders occur among the first-degree relatives (10.3%) than control relatives (1.9%)
- Research into genetic markers: possible identification of candidate
genes for OCD but no genome-wide significant findings.
How can brain structure be related to OCD?
- Encephalitis, head injuries, and brain tumours associated with the development of OCD
- PET scan studies shown increased activation in the frontal lobes
- PET findings show a link to the basal ganglia
- a system linked to the control of motor behaviour
- ↑ activation in basal ganglia, unclear if cause or consequence of OCD
- Tourette’s syndrome is marked by both motor and vocal tics and has been linked to basal ganglia dysfunction.
- People with Tourette’s often have OCD as well
What does neuropsychological testing research show about OCD patients?
- Patients with long-term OCD show attention and memory deficits (Nakao et al., 2009).
- Meta-analysis findings by Snyder et al., (2015) that patients with OCD show impairment in executive functions
What are the hypotheses related to SSRI drug treatment?
- Suggests OCD is related to decreased serotonin
- However, 40-60% of OCD clients treated with SSRIs do not show improvement
What are the biological treatment approaches for OCD?
- Brain surgery: Cingulotomy - involves destroying two to three centimetres of white matter in the cingulum, an area near the corpus callosum
- Deep Brain stimulation: Bilateral (not unilateral) subthalamic nucleus deep brain stimulation is used for OCD treatment non-responders
