OCD Flashcards
What are the criteria for a diagnosis of OCD?
DSM-5 criteria
- A→ Presence of obsessions, compulsions, or both
- B→ Obsessions or compulsions are time-consuming (e.g., more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
- C→ Symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition
- D→ The disturbance is not better explained by the symptoms of another mental disorder
Specify→ Good or fair insight VS poor insight VS absent insight/delusional beliefs (4%)
Specify→ Tic-related disorder
What is the definition of an obsession in OCD?
Def→ Persistent ideas, thoughts, impulses, and images that are experienced as being intrusive and inappropriate, and cause marked anxiety or distress
- ego dystonic-> are not aligned with the ideal of self
What are the common content of obsessions?
- Contamination (most common)→ fear of getting germs but also spreading them
- Uncertainty→ fear of forgetting to check something, cannot tolerate even a little uncertainty (ex: need to check to stove multiple times just to be sure)
- Aggressive→ fear of hurting someone
- Symmetry/ Exactness→ ex: order pencils
- Sexual
- Somatic→ fear of corruption of body (ex: cancer, AIDS)
—>usually multiple obsessions
Give a definition of compulsions in OCD?
Def→ Repetitive Behaviors (or thoughts)
—>an attempt to neutralize or suppress obsessions
- negatively reinforced behaviours
- not designed to bring pleasure (not compulsive sexual behaviour, gambling…)
What are some common compulsions?
Common compulsions
- Washing/Cleaning compulsions
- Checking→ ex: calling someone multiple times, checking the stove
- Repeating→ look repetitively in certain direction
- Ordering
- Mental→ not overt BUT different to obsessions because not unwanted thoughts ex: prayers
What is the epidemiology of OCD?
Lifetime prevalence→ 1.5%
Gender->
- slightly more common in females
- more in males for children
Age of onset→ 19yo
- gradual onset
- chronic with a low rate of spontaneous remission
What are some cognitive models of OCD that have been proposed?
Deficits in short-term memory
- cannot remember if checked
Reality Monitoring
- hard to distinguish between real and imagined events
- difficulty with reality testing
Learning model
- obsessions develop with classical conditioning
- avoidance behaviours with operant conditioning→ negatively reinforced
What are neurobiological models of OCD?
Serotonin hypothesis→ hypersensitivity of postsynaptic serotonergic receptors
- lead to obsessions and compulsions
Structural models→ overactivity of direct circuit
What are some cognitive-behavourial model of OCD?
Characterized by dysfunctional beliefs
Inflated sense of personal responsibility
Exaggeration of importance of thoughts
- Thought/Action Fusion(TAF)
- Moral TAF→ unwanted thoughts about disturbing actions equivalent to the actions themselves
- Likelihood TAF→ thinking about a disturbing event makes the event more probable
Intolerance of uncertainty
- also think that lack sufficient coping skills to manage threatening situations
- compulsions to increase certainty
Disgust Proneness→ personality trait
- genetic and learning influences
- can be moral or physical
What is a functional assessment of OCD?
Assessment of obsessional stimuli
- finding external triggers
- finding internal obsessional stimuli
- finding feared consequences
Assessment of avoidance and compulsions
- cognitive motivation of rituals
- nature of rituals
- explore mental rituals as well
Self-monitoring
- collecting real-time data on OCD symptoms
What are some OC Related Disorders?
Body dysmorphic disorder
- intrusive, distressing thoughts concerning one’s appearance
Hoarding
- thoughts about acquiring and maintaining possessions
- not intrusive or unwanted thoughts→ not obsessions
Obsessive-Compulsive Personality Disorder (OCPD)
- personality traits→ excessive perfectionism, inflexibility, need for control
- ego-syntonic—> consider behaviours as rational and appropriate
