OCD and stress/ trauma related disorders Flashcards
Define obsession
obsessions are recurrent and persistent ideas, thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause marked anxiety or distress
What are compulsions?
. Compulsions are repetitive and intentional behaviors (or mental acts) performed in response to obsessions or according to certain rules that must be applied rigidly
clinical presentation of OCD
a person must have either obsessions or compulsions that cause marked anxiety or distress, are time-consuming (more than 1 hour daily), or significantly interfere with the person’s normal routine, occupational functioning, or usual social activities and relationships
what medications and therapies are considered for OCD treatement
Meds (SSRIs, Clomipramine (TCA), Venlafaxine)
Behavior therapy
Psychotherapy
Family Therapy
Disorders associated with OCD
• Obsessive-compulsive disorder
• Body dysmorphic disorder
• Hoarding disorder
• Trichotillomania (hair-pulling disorder)
Excoriation (skin-picking) disorder
characteristics of OCD vs:
- Obsessive-compulsive personality disorder
- generalized anxiety disorder
- hoarding disorder
- tic disorder
- body dysmorphic disorder
- Trichotillomania
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etiology of trauma/ stress-related disorders
• Traumatic event severe enough to be outside the range of normal human experience
highest cases of acute stress disorder come from…
interpersonal traumatic events (~50%)
MVAs (~13%)
Lifetime prevalence of PTSD and what are the top causes by gender
9% lifetime prevalence
women: assault
men: combat
who are adjustment disorders usually seen in and who tends to develop them?
seen most in women, unmarried people and young people (~5-20% undergoing outpatient mental care)
~1/3 cancer patients develop these disorders
Treatment of Acute stress disorder
Cognitive Behavior therapy
Benzos-reduce agitation and sleep disturbance
Treatment of PTSD
First-Line: Psychotherapy with or without medication- cognitive behavior therapy
SSRI and SSNRI (when CBT is not available), Prazosin (nightmares), atypical psychotics (psychotic symptoms), Benzos (hyperarousal and anxiety)
Conditions associated with trauma and stress-related disorders
• Reactive attachment disorder
• Disinhibited social engagement disorder
• Posttraumatic stress disorder
• Acute stress disorder
Adjustment disorders
presentation of Disruptive, Impulse-Control and Conduct Disorders
impaired self control
treatment of disruptive, impulsive-control and conduct disorders
• Cognitive Behavior Therapy
• Conduct Disorder: CBT and psychostimulants in comorbid ADHD, antipsychotic meds or mood stabilizers in severe aggression
• Oppositional Defiant Disorder: Psychotherapy
Disruptive Mood Dysregulation Disorder: psychotherapy, stimulants, antidepressants and atypical antipsychotics to address irritability and mood problems
compare and contrast
conduct disorder
oppositional defiant disorder
disruptive mood disorder
normal development
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compare and contrast differentials for trauma and stress-related disorders
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Disorders associated with Disruptive, Impulse-Control and Conduct Disorders
• Oppositional defiant disorder
• Intermittent explosive disorder
• Conduct disorder
• Antisocial personality disorder
• Pyromania
Kleptomania
Diagnostic criteria qualifying OCD
- recurrent and persistent thoughts, urges or images that are experienced, causing marked anxiety or distress
- individual attempts to ignore or suppress the urge with some other thought or action
- obsessions or compulsions are time-consuming or causing clinically significant distress or impairment
Diagnostic criteria for Body Dysmorphic Disorder
- preoccupation with one or more perceived defects or flaws in physical appearance that are not observable in the sight of others
- individual has performed repetitive behaviors or mental acts in response to the appearance concerns
3.
Diagnostic criteria for Excoriation Disorder
- recurrent skin picking resulting in skin lesions
- skin picking causes clinically significant distress or impairment
Diagnostic criteria for Reactive Attachment Disorder
- consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, causing the child to rarely or minimally seek/ respond to comfort when distressed
- a persistent social and emotional disturbance characterized by at least 2/3(minimal social/ emotional responsiveness to others, limited positive affect, episodes of unexplained irritability that is not evident even during nonthreatening interactions with adult caregivers.
- pattern of extremes of insufficient care
Diagnostic Criteria for Disinhibited Social Engagement Disorder
- pattern of behavior including 2 or more different occasions of a child actively approaching and interacting with unfamiliar adults, not limited to impulsivity
- pattern of extremes of insufficient care
- developental age of at least 9 months
Diagnostic Criteria for Acute Stress Disorder
- exposure to actual or threatened death, serious injury or sexual violation
- presence of 9 or more symptoms within categories of intrusion, negative mood, dissociation, avoidance, and or arousal, beginning after the traumatic event
Diagnostic criteria for Adjustment Disorders
- development of emotional or behavioral symptoms in response to an identifiable stressor, occurring within 3 months of the stress onset
- behaviors are clinically significant and do not represent normal bereavement
Diagnostic Criteria of PTSD in children above 6y/o
- direct/ indirect exposure to actual or threatened death, serious injury or sexual violence
- presence of at least one intrusion symptom begining after the traumatic event
- persistence of avoidance of stimuli associated with the event
Diagnostic Criteria of PTSD in children younger than 6 y/o
- direct exposure or witnessing of actual or threatened death, serious injury, or sexual violence
- presence of one or more intrusion symptoms
- one or more symptoms representing avoidance of stimuli or negative alterations in cognitions and mood associated with the traumatic event
- alterations in arousal and reactivity associated with traumatic events
- lasts longer than 1 month
- causes clinically significant distress or impairment