OCD Flashcards
Diagnostic criteria for OCD from DSM-5
Criteria A:
Presence of obsessions, compulsions, or both
Obsessions are in the DSM-5 defined by (1) and (2):
- 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.
- The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).
Compulsions are in the DSM-5 defined by (1) and (2):
- Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.
- The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive.
What do you need to be aware of when it comes to children and compulsions?
Young children may not be able to articulate the aims of these behaviors or mental acts.
Diagnostic criteria for OCD from DSM-5
Criteria B:
The obsessions or compulsions are time- consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
How much time must the obsessions and compulsions take up per day for a diagnosis of OCD according to the DSM-5?
More than 1 hour per day
Diagnostic criteria for OCD from DSM-5
Criteria C:
The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
Diagnostic criteria for OCD from DSM-5
Criteria D:
The disturbance is not better explained by the symptoms of another mental disorder
The disturbance is not better explained by the symptoms of another mental disorder. What could these other mental disorders be?
excessive worries, as in generalized anxiety disorder;
preoccupation with appearance, as in body dysmorphic disorder;
difficulty discarding or parting with possessions, as in hoarding disorder;
hair pulling, as in trichotillomania [hair- pulling disorder];
skin picking, as in excoriation [skin-picking] disorder;
stereotypies, as in stereotypic movement disorder;
ritualized eating behavior, as in eating disorders;
preoccupation with substances or gambling, as in substance- related and addictive disorders;
preoccupation with having an illness, as in illness anxiety disorder;
sexual urges or fantasies, as in paraphilic disorders;
impulses, as in disruptive, impulse-control, and conduct disorders;
guilty ruminations, as in major depressive disorder;
thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders;
or repetitive patterns of behavior, as in autism spectrum disorder
Diagnostic criteria for OCD from ICD-10
Criteria A:
Either obsessions or compulsions (or both), present on most days for a period of at least two successive weeks and be a source of distress or interference with activities.
Diagnostic criteria for OCD from ICD-10
Criteria B:
Obsessions (thoughts, ideas or images) and compulsions (acts) share the following features, all of which must be present:
- They are acknowledged as originating in the mind of the patient, and are not imposed by outside persons or influences.
- They are repetitive and unpleasant, and at least one obsession or compulsion must be present that is acknowledged as excessive or unreasonable.
- The subject tries to resist them (but if very long-standing, resistance to some obsessions or compulsions may be minimal). At least one obsession or compulsion must be present which is unsuccessfully resisted.
- Experiencing the obsessive thought or carrying out the compulsive act is not in itself pleasurable. (This should be distinguished from the temporary relief of tension or anxiety.)
Diagnostic criteria for OCD from ICD-10
Criteria C:
The obsessions or compulsions cause distress or interfere with the subject’s social or individual functioning, usually by wasting time.
Diagnostic criteria for OCD from ICD-10
Criteria D:
Not due to other mental disorders, such as schizophrenia and related disorders, or mood disorders.
Insight varies from
good (person knows for sure the feared outcome will not come true) to delusional (person is convinced the feared outcome will come true)
What are “pure” obsessionals?
In the past it was thought this was a subtype of people who did not experience compulsions
How come we no longer have the subtype of people who do not experience compulsions (so called “pure obssesionals)?
Once covert rituals (e.g. thinking a “good” thought) and reassurance-seeking were recognized as compulsions, studies found that 100% of people with obsessions have compulsions
What are examples of sensory phenomena?
Musculoskeletal sensations, internally or externally evoked “just right” perceptions, or urges that some people experience in connection with/preceding their compulsions
Ferrao et al. (2012) found that in their sample of over 1,000 people with OCD, __% reported that their compulsion was preceded by sensory phenomena
65%
With which symptom dimensions does sensory phenomena most often co-occur?
These phenomena more often co-occur with symmetry/ordering/
arranging and contamination/washing symptom dimensions, comorbid Tourette syndrome and a family history of tic disorders
How much insight is sensory phenomena associated with?
The presence of sensory phenomena has also been associated with less insight into the excessive or unrealistic quality of obsessions and compulsions
A number of studies have used factor-analytic strategies to identify symptom clusters based on the content of obsessions and the compulsive action. The most commonly identified clusters are:
(three subtypes of OCD)
- Contamination obsessions with cleaning compulsions,
- Symmetry-based obsessions with ordering/arranging rituals
- Repugnant/harm/
aggressive/religious obsessions with checking rituals
Do obsessions and compulsions change across time?
There is some evidence that although the content of obsessions and compulsions may change across time, the general themes of the primary obsessions and compulsions do not, particularly contamination obsessions and washing compulsions
Can people easily be subtyped according to the content of their obsessions and compulsive actions?
It is difficult to subtype people according to the content of their obsessions and compulsive actions because people often exhibit a variety of obsessions and compulsions that cut across subtypes
Leckman et al. (2010) concluded that subtypes of OCD should be based on __________ rather than subgroups of symptoms
severity or symptom endorsement rates
Early onset OCD (mean age of 11) is over-represented in which gender (according to Taylor, 2011)?
early onset OCD is over- represented in males
What is early onset OCD (mean age of 11) associated with?
Greater severity and symptoms.
It is also more likely to be associated with tic disorders, OC spectrum disorders and personality disorders
It is also associated with greater prevalence in first-degree relatives
What diagnostic criteria for OCD is the epidemiological data based on (in Carr, adults)?
Epidemiological data based on DSM-5 criteria for OCD are not yet available, so reported statistics reflect OCD as diagnosed with DSM-IV-TR criteria.
OCD has a 1-year prevalence of ___ - ___%
0.7–1.8%
OCD has a lifetime prevalence of ___ – ___%
2–3%
What gender differences exists in the 1-year and life-time prevalence for OCD?
no gender differences
___ – ___% of the population experience subclinical OCD in their lifetime
13.5–28.2%
Overall mean age of onset is ___ years
19.5 years
