OCD & Trauma

Question 1

Obsessive-Compulsive Related Disorders

Answer 1

• OCD
• Body Dysmorphic Disorder
• Hoarding Disorder
• Trichotillomania
• Excoriation Disorder

Question 2

Most Prevalent obsessive-compulsive/related disorder

Answer 2

Hoarding disorder

Question 3

Common Types of Obsessions

Answer 3

• Thoughts/images associated with aggression, sexuality, or religion
• symmetry and ordering
• contamination & cleaning
• Checking (ex: locks)

Question 4

“Magical Thinking”

Answer 4

Feeling that there is a cause-effect relationship
ex: Scrub the entire house to get rid of germs

Varying levels of insight

Question 5

Trichotillomania & Dermatillomania cause

Answer 5

Tension & anxiety relieved when engaging in behavior

Behavior is often automatic & leads to more anxiety in the long run

Question 6

Body-Dysmorphic Disorder

Answer 6

Preoccupied with a certain body part that they see as defective or flawed

Repetitive behaviors or mental acts in reaction to perceived flaw

• comparison
• checking
• picking etc.

Question 7

OCD Etiology

Answer 7

Strong genetic component!!!

Tendency towards rigid/moralistic thinking

Feel they should be able to control their thoughts

Operant conditioning

Question 8

OCD Treatment

Answer 8

Pharmacotherapy & CBT

Exposure with Response Prevention

Drugs:

• Anafranil
• Luvox**
• Prozac
• Paxil
• Zoloft

Question 9

Stress vs. Trauma

Answer 9

Stress = event that exceeds ability to cope

Trauma = exposure to actual or threatened death, serious injury, or sexual violence

Question 10

4 types of Trauma

Answer 10

• Direct Experience
• Witness trauma occurring to others
• Learn of trauma to family/friend
• Repeated exposure to aversive details of trauma (ex: first-responders)

Question 11

PTSD Diagnostic Criteria

Answer 11

A- exposure to trauma
B- +1 intrusive symptom
C- +1 avoidance symptoms
D- 2+ Negative alterations in cognition/mood
E- 2+ symptoms of hyperarousal & reactivity

Duration at least 1 month

Question 12

TRAUMA acronym for PTSD diagnosis

Answer 12

Traumatic event 
Re-experience
Avoidance
Unable to function
Month +
Arousal

Question 13

PTSD Prevalence

Answer 13

More common in females

1/3 of ppl exposed to trauma will develop PTSD

Social support is a protective factor

Symptoms wax & wane

Acute stress disorder can become PTSD

Question 14

Acute Stress Disorder Diagnosis

Answer 14

A. Exposure to trauma
B. > 9 of the following symptoms
-intrusion symptoms (flashbacks, nightmares…)
-negative mood
-Dissociative sxs (altered sense of reality, amnesia)
-Avoidance sx (thoughts & external reminders)
-Arousal sx (sleep disturbance, anger, concentration, exaggerated startle response)

C. ≥ 3 days, up to 1 month after trauma

Question 15

Acute Stress Disorder Prevalence

Answer 15

<20% will develop ASD after trauma w/o interpersonal violence, but 50% will develop with interpersonal violence

Females > males

Question 16

Adjustment Disorder Diagnosis

Answer 16

A. Emotional or behavioral symptoms in response to stressor within 3 months of stressor onset

B. Symptoms cause distress out of proportion to stressor and/or impair functioning

• Symptoms stop within 6 months of stressor offset*
  ex: Losing your job

Question 17

Adjustment Disorder Specifiers

Answer 17

• w/ depressed mood
• w/ anxiety
• with mixed anxiety & depressed mood
• w/ disturbance of conduct
• w/ mixed disturbance of emotions & conduct

Question 18

Trauma Assessment

Answer 18

-inquire about trauma history
(sexual abuse, assault, survivor of accident, witness death/attack of someone)

Dont need to get all details of trauma…pts often disclose bits and pieces over time

Can use a PCL-5 screening form

Question 19

Trauma Treatment Options

Answer 19

Psychotherapy

• Prolonged Exposure Therapy
• Cognitive Processing Therapy
• Seeking Safety (PTSD & substance use disorder)
• Eye movement desensitization & reprocessing

Meds:

• Paxil
• Zoloft
• Prazosin –> good for nightmares