Obsessive-compulsive disorder (OCD)

Question 1

What does OCD stand for?

Answer 1

OCD stands for obsessive-compulsive disorder.

Question 2

What is obsessive-compulsive disorder?

Answer 2

Obsessive-Compulsive disorder is a condition characterised by obsessions and/or compulsive behaviours. Most people with a diagnosis of OCD have both obsessions and compulsions.

Question 3

How does the DSM-5 categorise obsessive behaviour?

Answer 3

The DSM-5 recognises OCD and a range of related disorders. What these disorders all have in common is repetitive behaviour accompanied by obsessive thinking.

Question 4

The DSM-5 recognises OCD and a range of related disorders. List these disorders.

Answer 4

• OCD
• Trichotillomania
• Hoarding disorder
• Excoriation disorder

Question 5

OCD is characterised by obsessions and compulsions. Give an example of an obsession.

Answer 5

Recurring thoughts or images

Question 6

OCD is characterised by obsessions and compulsions. Give an example of a compulsion.

Answer 6

Repetitive behaviours such as hand washing

Question 7

What is trichotillomania?

Answer 7

Trichotillomania refers to compulsive hair pulling.

Question 8

What is a hoarding disorder?

Answer 8

A hoarding disorder refers to the compulsive gathering of possessions and the inability to part with anything, regardless of its value.

Question 9

What is excoriation disorder?

Answer 9

Excoriation disorder refers to compulsive skin picking.

Question 10

What are the two behavioural characteristics of OCD?

Answer 10

• Compulsions

- Avoidance

Question 11

Compulsions act as a behavioural characteristic of OCD. What is a compulsion?

Answer 11

The behavioural component of OCD is compulsive behaviour. There are two elements of compulsive behaviours:

• Compulsions are repetitive
• Compulsions reduce anxiety

Question 12

Compulsive behaviour is divided into two elements, the first being that compulsions are repetitive. How does this present itself?

Answer 12

Compulsions are repetitive:

Typically sufferers of OCD feel compelled to repeat a behaviour. A common example is hand washing. Other common compulsive repetitions include counting, praying and ordering group of objects.

Question 13

As well as being repetitive, compulsions can also reduce anxiety. Explain how.

Answer 13

Compulsions reduce anxiety:

Around 10% of sufferers of OCD show compulsive behaviour alone (they have no obsessions). However, for the vast majority compulsive behaviours are performed in an attempt to manage anxiety produced by obsessions. For example, compulsive hand washing is carried out as a response to an obsessive fear of germs. Compulsive checking, for example that a door is locked, is in response to the obsessive thought that it might have been left insecure.

Question 14

Avoidance is the second behavioural characteristic of OCD. How does this present itself in a sufferer of OCD?

Answer 14

The behaviour of OCD sufferers may also be characterised by their avoidance as they attempt to reduce anxiety by keeping away from situations that trigger it. Sufferers of OCD tend to try to manage their OCD by avoiding situations that trigger anxiety. For example, sufferers who wash compulsively may avoid coming into contact with germs. However, this avoidance can lead people to avoid very ordinary situations, such as emptying their rubbish bins. As a result, avoidance can interfere with leading a ‘normal’ life.

Question 15

What are the three emotional characteristics of OCD?

Answer 15

• Anxiety and distress
• Accompanying depression
• Guilt and disgust

Question 16

Anxiety and distress are examples of emotional characteristics of OCD. How does this negatively impact a sufferer of OCD?

Answer 16

OCD is regarded as a particularly unpleasant emotional experience because pf the powerful anxiety that accompanies both obsessions and compulsions. 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 17

Depression is an example of an emotional characteristic of OCD. How does this present itself in someone suffering with OCD?

Answer 17

OCD is accompanied by depression, so 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 18

Guilt and disgust are emotional characteristics of OCD. How do these negatively impact OCD sufferers?

Answer 18

As well as anxiety and depression, OCD sometimes involves other negative emotions such as irrational guilt.

Question 19

How are cognitive characteristics impacted by OCD?

Answer 19

The cognitive approach is concerned with the ways in which people process information. People suffering from OCD are usually plagued with obsessive thoughts but they also adopt cognitive strategies to deal with these.

Question 20

What are the three cognitive characteristics of OCD?

Answer 20

• Obsessive thoughts
• Cognitive strategies
• Awareness of excessive anxiety

Question 21

OCD sufferers usually experience obsessive thoughts. How does this present itself?

Answer 21

For around 90% of OCD sufferers the major cognitive feature of their condition is obsessive thoughts. These vary considerably from person to person but are always unpleasant. Examples of recurring thoughts are worries of being contaminated by germs or certainty that a door has been left unlocked and that intruders will enter through it.

Question 22

OCD sufferers develop cognitive strategies to deal with obsessions. How does this impact an individual?

Answer 22

Obsessions are the major cognitive aspect of OCD, but people also respond by adopting cognitive coping strategies. For example, a religious person tormented by obsessive guilt may respond by praying or meditating. This may help manage anxiety but can make the person appear abnormal to others and can distract them from everyday tasks.

Question 23

People with OCD present an awareness of excessive anxiety. How does this present itself?

Answer 23

People suffering from OCD are aware that their obsessions and compulsions are not rational. This is necessary for a diagnosis of OCD. If someone really believed their obsessive thoughts were based on reality that would be a symptom of a quite different form of mental disorder. However, in spite of this insight, OCD sufferers experience catastrophic thoughts about the worst case scenario that might result in their anxieties were justified. They also tend to be hyper vigilant (they maintain constant alertness and keep attention focussed on potential hazards.