Obsessive-compulsive disorder (OCD)

Question 1

define OCD

Answer 1

a condition characterised by obsessions and/or compulsive behaviour
obsessions are cognitive whereas compulsions are behavioural

Question 2

what are the DSM-5 categories of OCD

Answer 2

trichotillomania - compulsive hair-pulling
hoarding disorder - compulsive gathering of possessions and the inability to part with anything, regardless of value
excoriation disorder - compulsive skin-picking

Question 3

describe the compulsions are repetitive characteristic (behavioural)

Answer 3

people with OCD feel compelled to repeat a behaviour, e.g., handwashing, counting, ordering objects

Question 4

describe the compulsions reduce anxiety characteristic (behavioural)

Answer 4

around 10% of people with OCD show compulsive behaviour alone, no obsessions, just a general sense of irrational anxiety
compulsions are performed in an attempt to manage the anxiety produced by obsessions, e.g., compulsive handwashing is carried out as a response to an obsessive fear of germs

Question 5

describe the avoidance characteristic (behavioural)

Answer 5

people with OCD try to manage it by avoiding situations that trigger anxiety, e.g., people who wash compulsively may avoid coming into contact with germs
this can lead people to avoid very ordinary situations, interfering with everyday life

Question 6

describe the anxiety and distress characteristic (emotional)

Answer 6

obsessive thoughts are unpleasant and frightening, and the anxiety that goes with these can be overwhelming
the urge to repeat a behaviour creates anxiety

Question 7

describe the accompanying depression characteristic (emotional)

Answer 7

anxiety can be accompanied by low mood and lack of enjoyment in activities
compulsive behaviour tends to bring some relief from anxiety but this is temporary

Question 8

describe guilt and disgust characteristics (emotional)

Answer 8

OCD sometimes involves other negative emotions such as irrational guilt, for example over minor moral issues, or disgusts, which may be directed at something external or at the self

Question 9

describe the obsessive thoughts characteristic (cognitive)

Answer 9

for around 90% of people with OCD the major cognitive feature is obsessive thoughts, thoughts that recur over and over again
these are always unpleasant
e.g., worries of being contaminated by germs, a door being left unlocked, impulses to hurt someone

Question 10

describe cognitive coping strategies characteristics (cognitive)

Answer 10

people respond to obsessions by adopting cognitive coping strategies, e.g., a religious person tormented by obsessive guilt may respond by praying
this helps manage anxiety, but can make the person seem abnormal and distract them from everyday tasks

Question 11

describe insight into excessive anxiety characteristics (cognitive)

Answer 11

people with OCD are aware that their obsessions and compulsions are not rational, this is necessary for a diagnosis
they experience catastrophic thoughts about the worst case scenarios that might result if their anxieties were justified
they tend to be hypervigilant