OCD Flashcards
What disorders are listed in the Obsessive- Compulsive and Related Disorders chapter of the DSM-5?
Obsessive- Compulsive Disorder (OCD); Body Dysmorphic Disorder; Hoarding Disorder; Excoriation Disorder (Skin-Picking); Trichotillomania (Hair-Pulling Disorder).
What are some commonalities between the disorders listed in the OC and Related Disorders chapter? (3 things).
- Repetitive behaviours or mental acts (that are difficult to stop).
- They are highly comorbid with one another.
- All are likely to be in first degree relatives (immediate family) of the proband.
If someone has an OC and Related Disorder, how likely is it that their identical twin will have the same disorder? What about a sibling?
Identical twins: 50%;
Non-identical: 20%.
What are the two most general symptoms of OCD and for a person to be diagnosed, do they need to present with both?
Obsessions and compulsions. No, only need one or both.
What is the DSM-5’s description of an Obsession? (2 things).
- Recurrent, persistent thoughts/urges/images that cause distress.
- Attempts to ignore, suppress or neutralise the thoughts/urges/images.
What is the DSM-5’s description of a Compulsion? (2 things).
- Repetitive behaviours or mental acts that is performed to suppress an obsession.
- They are not connected in a realistic way with the obsession, or are clearly excessive.
What two elements indicate that an obsession and/or a compulsion have become a mental illness?
- They are time-consuming.
- They cause clinically significant distress or impairment in normal functioning.
To be considered clinically significant, how must time (per day) must a person spend on their compulsion and/or obsession?
More than 1 hour per day.
Why is OCD considered different to Anxiety Disorders?
Because of the compulsion to act in a specific way.
Sometimes, people only have obsessive thoughts, what do they do instead of a compulsion? (3 steps).
- Suppress the thought;
- check to see if the thought is there;
- recreate the thought.
What does POOR INSIGHT of the illness indicate?
It indicates that the illness will be hard to treat (poor prognosis).
What does tic-related OCD indicate? (2 things).
That the person probably had a childhood onset of OCD and they may have neurological deficits.
What are 4 common dimensions in OCD that have been identified as the focus of the obsession?
- Cleaning;
- Harm;
- Symmetry;
- Forbidden or taboo thoughts.
In the CLEANING dimension, what is the focus of the obsession and the compulsion?
Obsession: contamination focus.
Compulsion: cleaning, washing, showering excessively.
In the HARM dimension, what is the focus of the obsession and the compulsion?
Obsession: focuses on a fear of harm to oneself or others.
Compulsion: Checking.
In the SYMMETRY dimension, what is the focus of the obsession and the compulsion?
Obsession: Evenness, symmetry, alignment.
Compulsion: Repeating, ordering & counting.
In the FORBIDDEN OR TABOO THOUGHTS dimension, what is the focus of the obsession?
Obsession: Aggressive, sexual, religious obsessions (that cause distress).
What are two other compulsions?
Repeating routine activities (in and out of a door), specific body movements (e.g. tapping).
What is an example of a ‘mental compulsion’?
Counting.
Philosophical arguments claim there is one underlying theme of obsessions and compulsions, what is it?
Death.
What is the lifetime prevalence of OCD?
2-3%
What is the point prevalence of OCD?
1%
25% of cases start by what age?
14.
What differences does OCD have in men vs. women?
More common in women but men have an earlier onset (before the age of 10).
What happens if someone with OCD does not get treatment?
It is chronic, will not leave on its own.
At what percentage is OCD comorbid with an anxiety disorder? Depression/Bipolar?
Anxiety: 76%.
Depression/bipolar: 63%.
What are indications of childhood temperament that can indicate OCD?
Highly negative and internal emotions.
What childhood event can potentially cause OCD?
A traumatic event, often sexual.
What is the Learning Theory model (Operant Conditioning) for the maintenance of OCD? (4 steps).
- Obsession causes anxiety.
- Compulsion relieves anxiety.
- Compulsion is negatively reinforced by the reduction of anxiety.
- But the anxiety comes back, due to attempts at avoidance.
What is the Cognitive Model for the maintenence of OCD?
Everyone has strange thoughts, but most know they are irrational. People with OCD misinterpret the intrusive thoughts.
(Response to intrusive thoughts differ from the general population).
OCD is also maintained by intolerance of ___, and inflated ___.
Intolerance of uncertainty; inflated responsibility.
What is thought-action fusion?
Believing that a ‘thought’ is the same as an ‘action’. Feeling remorse after the thought.
What is magical ideation?
Believing that something can magically happen.
What medications are normally prescribed for OCD and what is their efficacy?
Antidepressants (40-60% benefit). In particular SSRIs and tricyclic antidepressants.
In CBT, what does Cognitive Restructuring do for people with OCD?
Challenge beliefs about intrusive thoughts (obsessions).
Challenge beliefs about consequences of not engaging in the compulsion.
In CBT, what do Behavioural Experiments do for people with OCD?
They can prove to the patient they won’t carry out the obsession, because they don’t actually want to.
In CBT, what is Exposure and Response Prevention (ERP)?
Expose the person to their obsession, and prevent them from carrying out their compulsion.
What percentage of people with OCD benefit from CBT?
75%.
