OCD

Question 1

What are the symptoms of OCD? (APA, 2013)

Answer 1

Obsessions - recurrent persistent thoughts, urges or images; intrusive and unwanted; causes anxiety and distress
Compulsions - repetitive behaviors or mental acts done to alleviate the obsessions
Person knows/thinks they are unreasonable

Question 2

What are the differential DX for OCD?

Answer 2

Any other anxiety DX - these lack the obsessions and compulsions
Depressive D/O

Question 3

What is Freud’s etiological perspective of OCD? (1923)

Answer 3

Failure to progress through or resolve issues of the anal phase
Punishing superego results in the individual unable to experience pleasure in normal, healthy ways forcing the UCS mind to find creative ways to allow the ego to replace the sense of pleasure with other, pathological sources

Question 4

What are common defensive functions associated with OCD?

Answer 4

Undoing - UCS efforts to counterbalance some affect, usually guilt or shame with attitude or behavior that will magically erase it
Reaction formation - turning an affect or behavior into its opposite so it’s less threatening

Question 5

What is Salzmann’s (1980) etiological perspective of OCD? (Contemporary Psychoanalytic)

Answer 5

Obsessive pattern is a way for preventing any thought that could produce shame, loss of pride, or a feeling of deficiency or weakness
There is a need to control the internal and external life
Anger and dependency are consciously unacceptable
As a child they had difficulty expression aggression

Question 6

What is the CBT etiological perspective of OCD? (Ellis, 1993; Beck, 1987)

Answer 6

SXS are caused by false beliefs about the self and the world

Presence of activating events throughout life result in maladaptive and untrue beliefs

Question 7

What is a behavioral etiological perspective of OCD? (Mowrer, 1939)

Answer 7

Behaviors are in response to an actual threat but due to remaining anxiety, behaviors are retained far longer than necessary
Compulsive behaviors become reinforcing

Question 8

What are biological etiological considerations for OCD?

Answer 8

Strong biological component, runs in families (APA, 2013)
Deficits in orbitofrontal cortex (Behar et al., 1984)
Low serotonin levels (Riggs and Foa, 1993)

Question 9

What psychiatric medications might be helpful in treating OCD?

Answer 9

SSRI

Question 10

What is the citation for the behavioral etiological perspective of OCD?

Answer 10

Mowrer, 1939

Question 11

What are the citations for the biological etiological perspective of OCD?

Answer 11

APA, 2013 - biological component
Behar et al., 1984 - orbitofrontal cortex
Riggs and Foa, 1993 - serotonin

Question 12

What is the citation for the Contemporary Psychoanalytic etiological perspective of OCD?

Answer 12

Salzmann, 1980

Question 13

What is the citation for Classical Psychoanalytic etiological perspective of OCD?

Answer 13

Freud, 1923

Question 14

What is the citation for the CBT etiological perspective of OCD?

Answer 14

Ellis, 1993; Beck, 1987