OCD Flashcards
What are Obsessions?
Recurrent, persistent and intrusive thought, image or impulse that causes anxiety
Not simply excessive worries
Person attempts to ignore, suppress or neutralize them with other thought/action
Recognized as product of person’s own mind
Consistent cross-culturally and across life-span
Tend to be ego-dystonic (are in conflict with the person’s ideal self-image)
Can take the form of extreme doubting, procrastination, and indecision. Unable to function.
Most people with OCD keep the content and frequency of their obsessions secret for many years
What are some common obsessions?
contamination fears repeated doubts fears of harming oneself or others lack of symmetry sexual or religious thoughts
What are compulsions?
Repetitive behavior or mental act performed in response to obsession or according to rigid rule
Aimed at reducing or preventing distress or preventing occurrence of feared event.
The activity is not realistically connected with its apparent purpose and is clearly excessive.
What are common compulsions?
cleaning and washing checking repeating ordering/arranging counting
Related - Hoarding
What are characteristics of OCD?
Obsessions OR Compulsions
Insight: at some point, person recognizes as excessive or unreasonable (not in children).
Distress/impairment: time consuming (i.e., they take more than 1 hour a day) or cause marked distress or significant impairment.
Specificity: If other disorder present, content of obsessions/compulsions not restricted to it.
What are the key features of OCD?
Anxiety
Compulsions reduce anxiety
Fear something terrible will happen to themselves or others around them.
What are the psychosocial theories of OCD?
Thought-action fusion – Inflated sense of responsibility
(1) the mere act of thinking about unpleasant events increases the perceived likelihood that they will actually happen;
(2) at a moral level, thinking something unpleasant (e.g., imagining hurting others) is the same as actually having carried it out.
Cognitive biases: attentional distortions,
Paradoxical effect of thought suppression
What are the biological theories of OCD?
Moderate genetic contribution
Dysfunctional orbitofrontal-caudate-thalamic pathway
Hypothesized to be related to increased serotonin
However, 40-60% of OCD clients treated with SSRIs do not show improvement
Encephalitis, head injuries, and brain tumors associated with the development of OCD
PET scan studies shown increased activation in the frontal lobes
There is a link to the basal ganglia; a system linked to the control of motor behaviour
Tourette ’s syndrome is marked by both motor and vocal tics and has been linked to basal ganglia dysfunction.
People with Tourette ’s often have OCD as well
What are the treatments for OCD?
Behavioral Therapy: Exposure - Response prevention Can be an effective treatment, but SSRIs: Slow effect (6-12 weeks) High relapse rates Neurosurgery for cases with intractable OCD
How does Exposure with Response Prevention work? (ERP)
person exposes themself to situations that elicit the compulsive act—such as touching a dirty dish—and then refrains from performing the accustomed ritual—hand washing.
The assumption is that the ritual is negatively reinforcing because it reduces the anxiety that is aroused by some environmental stimulus or event, such as dust on a chair.
Preventing the person from performing the ritual (response prevention) will expose them to the anxiety provoking stimulus, thereby allowing the anxiety to be extinguished.
the ERP treatment is arduous and unpleasant for clients.
Typically involves exposures lasting upwards of 90 minutes for 15 to 20 sessions within a three-week period, with instructions to practice between sessions.
17 to 19% of clients refuse treatment and refusal to enter treatment and dropping out are generally recognized problems for many interventions for OCD.
