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Year Two - Clinical Psych and Mental Health > OCD > Flashcards

OCD Flashcards

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1
Q

name symtom dimensions of OCD.

A
  • contamination obsessions and decontamination rituals
  • obsessions about being responsible for harm and checking rituals
  • obsessions and rituals related to symmetry and completeness
  • unacceptable obsessional thoughts and mental neutralising rituals.
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2
Q

define OCD.

A

anxiety evoking intrusive thoughts, images or urges and repetitive behaviours aimed at reducing the discomfort.

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3
Q

define the DSM-5 diagnosis of OCD.

A
  • person experiences obsessions or compulsions that:
  • cause distress
  • are time consuming
  • interfere with daily life
  • affects 1-2% of population
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4
Q

define intrusive thoughts

A
  • involuntary
  • unpleasant content
  • ego-dystonic
  • are everywhere (doesn’t mean you have OCD)
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5
Q

define obsessions.

A

recurrent and persistent thoughts, impulses or images that can be/ are intrusive and inappropriate and that cause anxiety or distress.

  • attempts to ignore or suppress thoughts, impulses or images to neutralise them
  • recognises the obsessions are a product of their own mind
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6
Q

intrusive thoughts are not…

A
  • worry thoughts
  • depressive rumination
  • preoccupation
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7
Q

state types of intrusive thoughts.

A
  • verbal
  • images
  • urges
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8
Q

give examples of common intrusive thoughts

A
  • hitting animals or people with car
  • insulting strangers
  • fatal disease from strangers
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9
Q

define compulsions.

A
  • repetitive overt behaviours or covert mental behaviour that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.
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10
Q

what is the point of compulsions?

A

aimed at preventing intrusive thoughts from happening or preventing/ reducing distress, however these behaviours are often not realistic at neutralising ‘distress’

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11
Q

give an example of obsession and compulsions.

A

obsession - intrusive thoughts hands are contaminated with germs
compulsion - frequent and prolonged hand washing that causes distress

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12
Q

state behavioural theories of OCD.

A
  • classical conditioning (little Albert)
    = if CS is repeatedly presented without US the CR will gradually disappear (extinction)
  • operant conditioning
    = person repeatedly checks front door is locked until they no longer feel fear (negative reinforcement).
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13
Q

describe the two-factor theory.

A
  1. object or event is classically conditioned to elicit fear
  2. person avoids object or event and/or develops behaviours to reduce fear
    3, avoidance and repeated behaviours are negatively reinforced, making re-occurence more likely and preventing extinction or behaviour.
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14
Q

describe exposure therapy of behavioural therapy.

A

associated with classical conditioning, exposure to feared stimulus should lead to habituation as anxiety gradually falls over repeated exposure session.

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15
Q

describe response prevention of behavioural therapy.

A

response prevention of all rituals and compulsions should weaken negative reinforcement of rituals and compulsions, making re-occurence less likely .

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16
Q

give evidence for ERP therapy.

A

applying both components of behavioural therapy (ERP) significantly reduces OC compared to just applying one component.

17
Q

state exposure-based therapies.

A

emotional processing theory

inhibitory learning theory

18
Q

what do EPT and ILT have in common?

A

a network linking obsessional thoughts, triggers, feared consequences , and the fear itself stored in memory along with compulsive behaviour urges.
network is activated when any part is triggered, activation strengthens pathways.

19
Q

outline EPT.

A
  • repeated activation means this network is strengthened by memory.
  • avoidance of triggers and compulsive behaviours leads to pathways being strengthened
  • prolonged exposure with response prevention to triggers and intrusive thoughts leads to habitation and new non-fear information about triggers and intrusive thoughts become integrated with old memory.
  • old fear network replaced with new fear network.
20
Q

give evidence for EPT.

A
  • degree of habituation is generally not correlated with exposure treatment outcomes
  • suggest habituation may not be primary mechanisms through which exposure theories have their effect
  • relapse is common
21
Q

outline ILT.

A
  • exposure-based learning doesn’t result in modification of the existing fear memory about stimulus and response, rather, the original fear information is retained in memory and easily activated.
  • new non-fear information is stored as a separate memory
  • new memory is thought to be context-dependant
  • old and new (non-fear) memories continue to be activated, new non-fear memory completes for retrieval.
22
Q

give evidence for ILT.

A
  • isn’t a string association between degree of habituation and exposure-based theory outcomes.
  • ERP appears to be more effective when tasks are performed in a variety of contexts.
  • relapse rates following exposure-based therapy are high.
23
Q

state limitations to behaviour therapy.

A
  • not well tolerated
  • at least 16% of people refuse ERP
  • around 16% drop-out ] don’t fully engage in ERP tasks
24
Q

what percentage of engagement in ERP is needed in order to have effective outcomes?

A

at least 75%

25
Q

what does the cognitive model say about causes of OCD?

A

caused and maintained by what people believe about their intrusive thoughts.

26
Q

outline the cognitive model of OCD.

A

intrusive thoughts - beliefs about intrusive thought - anxiety - compulsive behaviour

27
Q

obsessive compulsive cognitions working group (OCCWG) identified six OCD-related beliefs, these were…

A
  1. importance of thought control
  2. importance od thoughts
  3. intolerance of uncertainty
  4. overestimation of threat
  5. personal responsibility for causing/ preventing harm
  6. perfectionism
28
Q

which OCD-related beliefs did factor analysis reveal?

A

1+2 (importance) , 3+6 (intolerance and perfectionism) , 5+4 (responsibility, threat)
- people with OCD score significantly more highly on 1+2 and 5+4 than people with other anxiety disorders and controls

29
Q

give evidence for responsibility beliefs.

A
  • manipulating sense of responsibility led to decreased urge to check.
  • in non-clinical population, led to greater checking behaviours
30
Q

give evidence for importance of thoughts.

A
  • manipulating beliefs and importance of thought control led to more intrusions and distress.
31
Q

state limitations to the cognitive model.

A
  • limited research that beliefs of intrusive thoughts play a casual role
  • cognitive therapy no more effective than ERP
  • dev origins of OCD-related beliefs not well understood
  • not all people with OCD are concerned with intrusive thoughts, cog model cannot not explain this.
32
Q

outline ERP in practice.

A
  • working together to identify main areas of OCD difficultly
  • identify ERP tasks that will trigger the intrusive thoughts and prevent engagement in compulsive behaviours or ritual.
  • write down a list of ERP tasks graded in difficulty
  • collaboratively support person to engage in tasks
  • tasks prolonged and repeated daily in a variety of contexts.
33
Q

state problems with habituation.

A
  • degree of habituation doesn’t seem to predict treatment outcomes for exposure-based therapy
  • anxiety isn’t always the troubling emotion in OCD
34
Q

what are the aimed positive outcomes of ERP tasks?

A
  • anxiety (or other problematic emotion) isn’t dangerous
  • can cope with high levels of anxiety
  • feared outcome doesn’t occur.
35
Q

outline cognitive therapy in practice.

A
  1. identify beliefs about intrusive thoughts
  2. dev shared formulation
  3. dev behavioural experiments to test accuracy of beliefs
    - person makes prediction of outcome
    - actual outcome usually not what was predicted = thoughts were irrational and so re-evaulated.
36
Q

name the finding from RCT comparing ERP with CT.

A
  • participants completed obsessive compulsive scale pre and post therapy + 3 months and two years after end of therapy.
  • no significant difference between the two, but both more effective than control conditions.
37
Q

50% of people do not recover following ERP or CT, suggest what is needed to increase this percentage.

A
  • improve engagement

- dev more acceptable, alternative therapies.

38
Q

define mindfulness

A
  • state of consciousness
  • full, curious and interested awareness of present experiences
  • non-judgmental, accepting attitude towards experience
39
Q

describe MBIs.

A
  • incorporate mindfulness often with behavioural and cognitive approaches
  • help reduce relapse and depressive symptom severity
  • can help improve engagement by enabling people to tolerate anxiety, lessen beliefs about importance of intrusive thoughts, consciously choose to disengage from compulsions.
  • shown to improve OCD symptom severity.

Year Two - Clinical Psych and Mental Health (5 decks)

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