OCD Flashcards
Obsessions
recurrent and persistent thoughts
- Most commonly thoughts, but there are also images or impulses
- Intrusive, uncontrollable
- Interpreted as strange, inappropriate, completely separate from who they are as a person
Types of Obsessions
Repugnant
- Dislike there feeling so they do something they don’t like
- Stand up and say something racist on the bus
Contamination
- Undercooked chicken
Doubting
- E.G scared that the stove may be on
Common Misconceptions of Obsessions
they are not:
- cravings
- preoccupation with a new thing
- recurrent sexual fantasies
- worries about real-life issues
Compulsions
behaviours to reduce anxiety related to the obsession
- “Undo” obsessions
- Recognises that you don’t have to do the compulsion and that it is irrational but still does it
- If it isn’t completed the right way it has to be repeated
OCD Example - Sandra
Obsessions - glass in the tea
Compulsions - checking and redoing to make sure there is no glass in the tea
Social Factors of OCD
Equal across genders, mean age of onset is 17 but significant portion have childhood onset
- May be important differences in childhood onset
Is OCD a Heterogeneous Disorder?
Everyones compulsions look a bit different
4 commonly replicable symptom dimensions
- Obsessions about contamination and washing compulsions
- Obsessions about responsibility for causing harm/making mistakes
- Obsessions about symmetry and ordering compulsions
- Repugnant obsessional thoughts concerning sex, religion, violence
Covert neutralising:
Biological Model of OCD
- Higher activity in the cortical-striatal-thalamic circuit (prefrontal cortex, thalamus, basal ganglia)
- Area related to filtering irrelevant information and preservation of behaviour, centre for repeat
Pharmacological Treatment of OCD
SSRI’s found to be useful
- Significant average symptom reduction of 40% in 50-60% of subjects
- Majority relapse after discontinuation
- Begin with talking therapy then SSRI’s if it isn’t working
Psychological Treatment of OCD
Exposure and Response Prevention (ERP)
- Through repeated exposure to feared situations and thoughts without performing compulsions the person learns:
- Emotional response subsides (happens more quickly over trials
- Shows that it is safe and moral to let the thought go without using a compulsion
Moderate symptom reduction between 55% and 66%
- Drop out rate of 19% though
The Effect of Combined OCD Treatment
Reduction of cortical-striatal-thalamic circuit with ERP and SSRI’s
OCD Example - Mary
- Contamination concerns with germs and HIV
- Religious obsessions, with compulsions in response
Cognitive Strategies for Treating OCD
- Idea that everyone experiences intrusive thoughts
- Idea to challenge what the thought means rather than taking it so seriously, just because you think it doesn’t mean I believe it
Relevant Beliefs from People with OCD
- Over importance of thoughts
- Over importance of thought control
- Overestimation of threat
- Perfectionism
- Intolerance of uncertainty
Thought Action Fusion
Likelihood - because I’ve had the thought it’s more likely to happen
Moral - the thought is as reprehensible as the action
- Confuses thought for action
