OCD

Question 1

What are some other disorder that are in the same category as OCD

Answer 1

Body dysmorphic disorder, hoarding, skin-picking and hair pulling

Question 2

When was the first mention of OCD

Answer 2

1691 sermon on religious melancholy by John Moore, Bishop of Norwich
The parishioners had intrusive thoughts during worship and the more they tried to suppress them, the more they came to mind

Question 3

Prior to the DSM how was OCD categorized

Answer 3

As an anxiety disorder

Question 4

How did the ICD-10 categorize OCD

Answer 4

OCD was a subcategory in the broader category of “neurotic, stress-related, and somatoform disorders”

Question 5

Although OCD is not in the anxiety disorders anymore in the DSM-5 what can we say about the sequencing of the anxiety disorders and OCD

Answer 5

They are very close together in the DSM reflecting their close relationship

Question 6

What is criterion A of OCD

Answer 6

Presence of obsessions, compulsions or both

Question 7

What is criterion B of OCD

Answer 7

Obsessions or compulsions are time-consuming (>1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

Question 8

What is criterion C of OCD

Answer 8

Symptoms are not attributable to the physiological effects of a substance or another medical condition

Question 9

What is criterion D of OCD

Answer 9

The disturbance is not better explained by the symptoms of another mental disorder

Question 10

What needs to be specified during an OCD diagnosis

Answer 10

Insight: good, fair, poor or absent insight
Tic-related: current or past history of a tic disorder to help determine course and onset

Question 11

True or false: Tic disorders are not comorbid with OCD

Answer 11

False, they are highly comorbid

Question 12

Define obsessions

Answer 12

Persistent ideas, thoughts, impulses, and images that are experienced as being intrusive and inappropriate and cause marked anxiety or distress
They are ego-dystonic - inconsistent with your sense of self or desired self

Question 13

True or false: the person experience a large sense of lack of control with their obsessions

Answer 13

True

Question 14

True or false: the obsessions are not a “natural” part of the person’s personality and they are not aware that these are his/her thoughts

Answer 14

False: the person recognizes that these are his/her thoughts

Question 15

True or false: OCD is distinguished from schizophrenia or psychosis, there is no delusional system of thought insertion

Answer 15

True

Question 16

What helps us characterize OCD from GAD

Answer 16

OCD is not just worries about real-life problems like is seen in GAD

Question 17

What are the contents of obsessions

Answer 17

Contamination (most common)
Uncertainty - doubts about whether you did something
Aggressiveness - afraid of hurting someone else
Symmetry/Exactness
Sexual
Somatic

Question 18

What can we say about the number and stability of an individual’s obsession

Answer 18

They are usually very stable and people can have multiple obsessions

Question 19

True or false: people with OCD almost never act on their impulses
Why?

Answer 19

True
They are unpleasant because they don’t actually want to act on their thought - ego dystonic

Question 20

What is an example of a developmental difference in obsessions

Answer 20

Children are less likely to have sexual obsessions and more likely to have aggressive obsessions

Question 21

Define compulsions

Answer 21

Repetitive behaviours, sometimes thoughts (negatively reinforced) with an attempt to neutralize or suppress obsessions
Designed to reduce anxiety from the obsession not to bring pleasure or gratification

Question 22

Why would people who engage in compulsive sexual, eating or gambling behaviour not be exhibiting OCD compulsions?

Answer 22

They are all designed for gratification- they are positively reinforced

Question 23

How can we characterize compulsions

Answer 23

The person must perform the behaviour
Sometimes these can be simple actions or very bizarre and complex
Frequently is a form of “undoing” the thought or fear

Question 24

What are some common compulsions

Answer 24

Washing/cleaning
Checking (reassurance)
Repeating
Mental (deliberate response to unwanted thoughts) - most difficult to intervene

Question 25

True or false: even though most people will present with both obsessions and compulsions, both are not needed for a diagnosis of OCD

Answer 25

True

Question 26

What proportion of people will only have obsessions

Answer 26

1/4

Question 27

What do people with only obsessions tend to do

Answer 27

Ritualize mentally

Question 28

In whom are we most likely to see compulsions without obsessions and how is it manifested

Answer 28

In children - usually counting, touching, ordering (the child would say that they just have to do it) Very rare in adults

Question 29

What is the lifetime prevalence of OCD? Is there a difference among adults and children?

Answer 29

1.5% No difference among adults and children

Question 30

What is the gender difference in OCD

Answer 30

Slightly more common in females than in males Specifically in children: more common in males

Question 31

What is the age and pattern of onset in OCD

Answer 31

Age: 19 Pattern: gradual

Question 32

What did the 40-year follow-up study of “natural” course; First hospitalization OCD patients by Skoog & Skoog (1999) find

Answer 32

At the end of 40 years, 20% had completely recovered - got effective treatment quickly 28% had recovery with subclinical symptoms 52% still experiencing clinically significant symptoms Of those who recovered, it was usually in the first 5 years of hospitalization

Question 33

What are the characteristics of the cognitive models of OCD

Answer 33

Obsessive thoughts are very common People with OCD experience their thoughts as intrusive and/or upsetting - they believe that it is indicative of them as a person Inflated sense of personal responsibility and self-blame If the thoughts come to pass, it’s their fault which makes them upset NA increases the area of thoughts which increases them getting upset - vicious cycle Must ritualize to reduce anxiety

Question 34

According to the cognitive models of OCD what can we say about OCD being due to deficits in STM

Answer 34

People can’t remember if they checked or if they thought about checking Difficult to distinguish between real and imagined events (reality testing) Often convinced thoughts are true

Question 35

Who is associated with the intolerance of uncertainty

Answer 35

Jonathan Grayson

Question 36

What is intolerance of uncertainty and how can we characterize individuals who have intolerance of uncertainty

Answer 36

The tendency to react negatively on an emotional, cognitive and behavioural level to uncertain situations and events Individuals with intolerance of uncertainty believe they lack sufficient coping or problem-solving skills to effectively manage threatening situations - they need to have a plan Compulsions usually act as a way of increasing certainty

Question 37

What is the IU demonstration intended for

Answer 37

Meant to I still a doubt and uncertainty - people with OCD experience this but x1000000 Compulsions only change how you feel temporarily

Question 38

Thought/Action Fusion (TAF) is also known as _________

Answer 38

Magical thinking

Question 39

What is moral TAF VS Likelihood TAF

Answer 39

Moral TAF: unwanted thoughts about disturbing actions equivalent to the actions themselves - having the thought is just as bad as the event itself Likelihood TAF: thinking about a disturbing event makes the event more probable - having the thought increases the likelihood

Question 40

True or false: TAF is unique to OCD

Answer 40

False: it is observed across many/most disorders but it’s more common in OCD

Question 41

Rachan, Shafran, Mitchell, Trant & Teachmen did a study on 63 undergraduates with some degree of self-reported TAF. What were the results?

Answer 41

Change in Anxiety results: anxiety decreased regardless if the person was in the “neutralize first” condition or the “20 minute delay condition” Change in desire to neutralize results: the change is seen with wanting to neutralize the anxiety - implication at large: anxiety will go down whether we engage in neutralizing or not

Question 42

Who is associated with the concept of disgust

Answer 42

Bunmi Olatunji

Question 43

What is disgust proneness and what can we say about it

Answer 43

It is a multidimensional construct Genetic and learning influences May also play a role in other disorders - spiders phobics seeing a spider on a cookie OCD may reflect a false contamination alarm - EX: becoming a child molester by touching the pencil of someone who molested a child Very hard to counter-condition Can help explain some of the challenges in treatment