OCD and related disorders

Question 1

OCD facts and prevalence

Answer 1

less common than anxiety

lifetime prev 2%
- 10% attempt suicide

1. equally affects women and men
2. typical onset 20ys
3. late onset past 30s is VERY RARE

Question 2

obsessions vs compulsions

Answer 2

obsessions: intrusive and recurring thoughts, impulses, images
- common: contamination, sexual, aggressive, fear of health
- can be checking, procrastination, indecision, doubting

compulsions: repetitive behavs to dec distress caused by obsessions

compulsions worsened by:
1. sense of personal responsibility
2. predicted seriousness of harm
3. beliefs abt probability of harm

Question 3

cog theories OCD

Answer 3

inability to remember action i.e. lock door, or distinguishing actual vs imagined behaviour

deficits in prospective memory: look forward and remember to perform a task

Question 4

rachman’s theory of obsessions

Answer 4

misinterpret importance and significance of -ve thoughts

range of cognitive factors .e. inflated self responsibility

thought-action fusion: act of thinking abt event inc likelihood of it happening…thinking is morally as wrong as doing

Question 5

metacognition

Answer 5

overthink about self, inc self consciousness

Question 6

genetics in OCD

Answer 6

inc anxiety in relatives…possible genes for OCD

head injury and tumours assoc w OCD

Question 7

PET finindgs of OCD

Answer 7

inc activation frontal lobe, inc activation basal ganglia

basal ganglia related to tourette’s, which commonly assoc w OCD

Question 8

neuropsychological testing research

Answer 8

ppl w OCD have attention and memory deficits

impaired executive function

Question 9

SSRI

Answer 9

suggests OCD is related to dec serotonin

however, SSRI doesn’t work in treatment

Question 10

psychoanalytic theories of OCD

Answer 10

O and C result from instinctual forces

alref adler: saw OCD occur due to inferiority complex
- to maintain dominance, have compulsive rituals to feel in control

Question 11

PANDAS

Answer 11

pediatric autoimmune neuropsychiatric disorders associated w strepococcol infections

disorder impacting brain w SUDDENLY onset of symptoms of anx, moody, OCD

may dev ADHD, anxiety disorders, joint pain, temper

Question 12

negative reinforcement and OCD

Answer 12

reinforced when aversive situation is avoided

action that brings escape is reinforced

Question 13

ERP

Answer 13

exposure and repsonse prevention: expose self to compulsive act i.e. dirt dish

don’t perform ritual

unpleasant, needs practice time

19% refuse, and has high drop out

Question 14

assumptions of ERP

Answer 14

ritual is -vely reinforcing, decreases anxiety

exposure allows anxiety to be processed and decrease

Question 15

cog treatment OCD

Answer 15

combines CBT rather than only cog treatment
client stops ritual to see consequences

dec dysfunctional beliefs

effectiveness: equalyl effective as ERP

Question 16

issues in OCD treatment

Answer 16

high dropout

CBT sffects abnormal brain region volumes
- thalamus dec, orbito-frontal cortex inc

Question 17

cingulotomy

Answer 17

surgically destroy 2-3cm white matter in cingulum near corpus callosum

high risk, last resort

Question 18

bio treatments of ocd

Answer 18

cingulotomy
deep brain stim

Question 19

psychoanalytic treatment of ocd

Answer 19

uncover repressed conflicts, since O and C protect ego from conflict

Question 20

hoarding disorder

Answer 20

acquisition and failure to discard, worldwide disorder
strong genetic component

2-5% prevalence, 2x as much as OCD

ppl w hoarding are excited abt new items, while ppl w object obsessions are distresed

features:
1. onset before 20yrs
2. worsens w age
3. 15% have OCD
4. assoc w depression, up to 50%
5. depression may be response to hoarding

Question 21

cognitive factors of hoarding

Answer 21

faulty info processing: i.e. distractibility, difficulty thinking abt categories
- dysfunctional cognitions abt importance and meanings of items
- emotional deficits lead to misguided attachments

Question 22

treatments of hoarding

Answer 22

SSNRI: over half ppl respond well

CBT: exposure to not acquiring while discarding
- home visit by therapist
- cog restructure beliefs focused on problem solving, decision aking
- more diff for older adults

Question 23

body dysmorphic disorder

Answer 23

BDD: preoccupied w imagined defect in appearance, especially face, body, gentials, height

have poor insight and delusional thoughts

characteristics: mirror checks linked to OCD, loose clothes, cover w makeup

mainly women in adolescence

comorbid w : depression, ED, subs abuse

1/5 full remission, high relapse

Question 24

etiology of BDD

Answer 24

bio factors:
- genetics
- brain volume: dec in orbitofrontal cortex vomume and left anterior cingulate cortex

cog factors:
- focus on unwanted thoughts
- catastrophic interpretation of appearance
- maladaptive efforts to regulate emotions i.e. avoid ppl, wear makeup

Question 25

treating BDD

Answer 25

behavioural interventions: exposure and response like in OCD
- be in room w mirror w/o looking

cog strats i.e. identify dys thoughts

efficiency: CBT good, SSRI good

Question 26

trichotillomania

Answer 26

onset: adolesence
- equal for boys and girls, but greater in adult women than men

over day or in long sitting

Question 27

excoriation

Answer 27

chronic, leads to skin lesions

comofrbid w BDD, depressionm tricho

inc mood, anx, eating disorder

Question 28

etiology of body focused repetitive disorders

Answer 28

genetics: trich and excor influenced by same gene, which is different from the gene assoc w OCD, hoarding, BDD

emotion regulation model: dec -ve emotions that lead to pulling

frustrated action model: behavs triggered by frustration and boredom
- engaging in behav dec these, so engage more

Question 29

habit reversal training

Answer 29

for body focused disorders

1. awareness training: ID triggers and high risk situations
2. response training
3. estbalish motivation and support: stim control to reduce things in environ that trigger habit