OCD + PTSD Flashcards
Obsessive-Compulsive and Related Disorders include…
- OCD
- Hoarding
- Excoriation Disorder
- Body Dysmorphic Disorder
- Trichotillomania
Obsessions
Unwanted, repetitive, intrusive thoughts
- not excessive real-life concerns
- Causes distress and anxiety
Compulsions
Repetitive behaviours or mental acts that the person feels compelled to perform
- Meant to reduce anxiety or prevent dreaded event
- Disproportionate to obsessions they are trying to relive
- Can become ritualistic, and over time lose connection
- Some people are aware it is unreasonable
Obsessive-Compulsive Disorder
Involving obsessions, compulsions, or both
- Must be highly time consuming and interfere with everyday living
- Rituals can become rigid: develop obsessions and compulsions about not performing them properly
Magical Thinking
Believe that partaking in behaviour wards off danger in a way that would make sense to most people
Behaviour loop of OCD
Obsessive thought - Anxiety - Compulsive Behaviour - Temporary Relief
Compare and contrast Tic disorder and OCD
TIC DISORDER
- Sudden, short
- Fragmented movements
- Sensorimotor urges
- not related to anxiety
- involuntary
- waxing and waning
- also during sleep
OCD
- Ritualized
- Goal-directed
- Thoughts and imagninations
- Mostly related to anxitey
- Voluntary
- Waxing and waning
- Not during sleep
What is the heritability of OCD
27-65%
What is the lifetime prevalence of OCD
0.93% in CAN
- similar across cultures and countries
- more prominent in white ethnic groups
- No gender bias
- More common to start in childhood
Therapies for OCD
- SSRIs - 50-80% of patients experience reductions in obsessions and compulsions
- CBT: Exposure and Response Prevention
Exposure and Response Prevention
- exposure to objects or situations that produce anxiety, obsessive fears, compulsive behaviours
- patients must resist compulsions
- Learn that: compulsions do not cause obsessions to do away, anxiety surrounding obsessions is unfounded
Hoarding
- Emotional attachment to random things - must keep
- Causes comfort not distress
- Dysfunctional - can be unsafe or interfere with basic activities
- 5% prevalence in the US
- more common as you get older
- may give belongings human characteristics
- Causes stress to get rid of stuff
Trichotillomania
- Compelled to pull hair from body
- most likely scalp or eyebrows
- Automatic, hard-time inhibiting (similar to compulsions)
- May be because its not sitting right way rather than automatic
- Embarrassment or shame when people see aftermath or after engaging in behaviour
Excoriation Disorder
- Picking at skin
- Can include healthy skin or imperfections
- multiple sites
- damages skin
- Embarrassment after engaging in behavior or when others notice
Body Dysmorphic Disoder
- Preoccupation with the belief that one has a particular defect or flaw in their appearance
- Perceived imperfection is imagined or greatly exaggerated
- Can severely limit contact with others, or eye contact
- Can cause people to go through great lengths to conceal the flaw - homebound, plastic surgery
- Will check appearance, pick flaws, compare to others, seek reassurance form others
Trauma
- Experience of personally affected psychological state, which can sometimes lead to psychological dysfunction
Traumatic Event
When a person is exposed to actual or threatened death, serious injury, or sexual violation
- Can happen to you, someone you are physically close to or emotionally close to
- Affects everyone differently
- 70% experience event -> not all develop PTSD
What are the 4 types of symptoms required for PTSD diagnosis
- Reexperiencing Traumatic Event
- Avoidance
- Negative Changes in thought or mood
- hypervigilance
Reexperiencing Traumatic Event
- Intrusive images or thoughts, reoccurring nightmares
- Flashbacks
Flashbacks
Uncontrollable, intense, repeated episodes reliving the experience
- Can be difficult to distinguish between flashback and reality
- Usually only a few seconds, but can have long lasting emotional impacts
Persistent Avoidance of situations, thoughts or memories
- Including Social isolation and problems with interpersonal relationships
Negative changes in thought and mood
Could include survivor guilt, feeling permanently damaged, chronic distress, emotional numbness, feelings of detachment
Survivors Guilt
Can’t understand why you survived or weren’t injured when others were
Hypervigilance and chronic Arousal
- Feeling on guard, being vigilant to potential threat
- Irritability,, agitation, anger-outbursts
- changes in central nervous system leading to overarousal
Acute stress disorder vs Post-traumatic Stress Disorder
ONSET
- A: 0-28 days after the trauma occurs
- P: At least one month after the trauma occurs
DURATION
- A: Lasts between three days and four weeks
- P: lasts at least one month and can persist for several years
Prevalence of PTSD
- 9.2% lifetime prevalence
- More common in women, indigenous populations, members of the LGBTQ community, people with low SES, people of color
- Often comorbid with depression, anxiety, substance use disorder
What is the cause of PTSD
Traumatic event
Multifinality
- Start life under same circumstances
- Experience different levels of life stress
- Respond differently to traumatic event (PTSD vs no PTSD)
Equifinality
- Different in early life stages
- Both respond the same to traumatic event (PTSD)
The Traumatic Event theory of PTSD
Risk increases with
- Severity
- Duration
- Proximity
- Avoidant Coping strategies
- Memory problems
- Self- destructive coping strategies
- Dissociation immediatly after the event
Biological approach to theories of PTSD
- Some heritability
- Resting cortisol levels lower in those with PTSD
- Elevated heart rate
- More epinephrine and norepinephrine
Pre-frontal cortex in PTSD
May fail to prevent reactivation of memory traces associated with trauma
Amygdala in PTSD
Overactivation of amygdala may make memories feel more visceral
Hippocampus in PTSD
Dysfunction in hippocampus result in persistent emotional memories, dissociation, and arousal symptom
Dissociation
- Process in which different facets of sense of self, memories, or consciousness become disconnected from one another
- Disruption of normal integration in memory identity, consciousness, perception, behaviour and motor control
- More common for those with history of trauma
Ernest Hilgard Experiment
- Priming can be used to subconsciously encourage answers (HIDDEN OBSERVER PHENOMENON)
- Active Mode of Consciousness: Conscious plans and desires, voluntary actions
- Passive Receptive Mode of Consciousness: Can register and store information in memory without being aware
