OCD Flashcards
With OCD, does the individual recognise that the habits are abnormal?
Yes!
With OCD, how many hours a day do you need to lose to obsessions/compulsions to meet diagnosis?
<1hr
What does it mean to have ‘egodystonic’ intrusive thoughts?
Counter to the self image of the person (ie harming a child)
In OCD, what is ‘safety behaviour’?
The things people do to manage their anxiety (ie the obsessions like washing hands)
Is it possible to have OCD without having compulsions?
Yep - 8-20% fall into this category
What’s the gender dimension to OCD at a population level?
1:1
- Childhood onset more common in males
- Some presentation differences… females more likely to do harm/checking and somatic obsessions
What’s the gender dimension to OCD at a clinical level)?
Difference in focus
Men are more likely to have a focus on sexual religious stuff
Women are more likely to focus on aggression or cleaning stuff
What is are the key co-morbidities with OCD?
There are five:
About a quarter
- major depressive disorder (MDD)
- obsessive–compulsive personality disorder (OCPD)
About one in five
- generalized anxiety disorder (GAD)
- specific phobia (SP)
- Social phobia (Social Phobia)
What’s the difference between OCD and OCPD?
The latter is trait based
What % of OCD attempt suicide?
Lifetime history is 9%
What % of OCD have had suicidal ideation in the last month?
~6%
Name one of the 5 main theories of OCD aetiology
- Early childhood trauma (inc modelling by parents)
- Personality (neuroticism)
- Genetics (hSERT)
- Maybe early childhood trauma, maybe living with someone finicky about cleanliness
- Personality - neuroticism
What are the key features of Salkovskis’ (1985) cognitive model of OCD?
- Premise that intrusive thoughts are normal
- Some individuals place special meaning those thoughts, respond to them in a special way
- These responses increase vigilance for intrusive thoughts and protests the meaning of the intrusion
What are the things that shape whether an intrusive throught might become an obsession (according to Clarke and O’Conner 2005)?
There are five:
- Overly important (‘if I’m thinking this way, it must be important’);
- Highly threatening (‘if I continue to think like this, something bad will happen’);
- Requiring complete control (‘I’ve got to stop thinking this way’);
- Necessitating a high degree of certainty (‘I need to be certain that nothing bad will happen’)
- Associated with a state of perfection (‘I can’t stop thinking about this until I do it perfectly’)
What works better for OCD, drugs or therapy?
THERAPY!
How soon after onset is BODY DISMORPHIC DISORDER (BDD) typically diagnosed?
10-15 years after onset
What is the suicide attempt rate for BODY DISMORPHIC DISORDER (BDD)?
25%
What is the typical course of BODY DISMORPHIC DISORDER (BDD)?
Chronic
Is BODY DISMORPHIC DISORDER (BDD) treatable?
Yup
What is the significance of developing BODY DISMORPHIC DISORDER (BDD) before the age of 18?
- more likely to attempt suicide,
- more likely to have comorbidity,
- more likely to have gradual (rather than acute) disorder onset
What are the cognitive factors associated with HOARDING DISORDER?
- Control over possessions
- Concern about memory (need to keep things so you don’t forget)
- Responsibility over possessions
What is Trichotillomania?
Hair pulling
To get a Trichotillomania diagnosis, do you need to have tried to stop?
Yes
What is blepharitis and what is it related to?
Swelling of the eyelid - associated with Trichotillomania (hair pulling)
What medical professional might first come upon hair pulling?
Dentist (wearing teeth down due to chewing the hair)
What is excoriation?
Skin picking
What is the aetiology of hairpulling and skin picking
Pleasure?
Emotional regulation? (dealing with either arousal or boredom)
What are the two subtypes of hair pulling and skin picking?
- automatic (dissociative)
- focused
Why does the DSM treat the OCD disorders together?
- Characterised by intrusive thoughts
- All highly distressing
- All amenable to treatment, IF the patient is motivated
What are the main brain regions involved in OCD?
Some key areas are those around organisation and memory.
Here is the list provided in the slide:
- Orbitofrontal context
- Cingulate gyrus
- Basal Ganglia
- Caudate Nucleus,
