Task 4 - Obsessive-Compulsive Disorder Flashcards
DSM-5 Criteria OCD
A Presence of obsessions, compulsions, or both:
Obsessions are defined by (1) and (2):
1. Recurrent and persistent thoughts, urges, or images, that are experienced at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress
2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action
Compulsions are defined by (1) and (2):
1. Repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly
2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive
B The obsessions or compulsions are time-consuming or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
Facts about OCD
- people with OCD experience anxiety as a result of their obsessional thoughts, as well as when they are unable to carry out their compulsive behaviors
- they usually know that their thoughts and behaviors are irrational –> they cannot control them
- begins at a young age; 6-15 in males; 20-29 in females
- it is rare for new cases to develop after the early 30s
- average time it takes to receive treatment is 11 years
- feelings of shame and guilt lead to patients hiding their symptoms
- prevalence: 1-3%
Comorbidity
- 66% depression
- panic attacks
- anxiety disorder (75.8%)
- phobias
- substance abuse (38.6%)
- mood disorders (63.3%)
- suicide (50%)
Common obsessions
- aggression, sexuality, and/or religion
- symmetry and ordering
- contamination –> cleaning compulsion
Magical thinking:
- believe that repeating a behavior a certain number of times will ward off danger for themselves or others
- rituals become stereotyped and rigid
- develop obsessions and compulsions about not performing them correctly
Hoarding
= people who hoard cannot throw away their possessions - even things that most of us consider trash
difference to OCD: thoughts about their possessions are perceived as their natural stream of thought
similarity to OCD: repetitive behaviors and impaired behavioral inhibition
Hair-Pulling Disorder (Trichotillomania)
= recurrent pulling out of the hair, resulting in noticeable hair loss
similarity to OCD: repetitive behaviors and impaired behavioral inhibition
Skin-Picking Disorder
= people recurrently pick at their scabs or places on their skin, creating significant lesions that often become infected and cause scars
similarity to OCD: repetitive behaviors and impaired behavioral inhibition
Body Dysmorphic Disorder
= people are excessively preoccupied with a part of their body that they believe is defective but that others see as normal or only slightly unusual
similarity to OCD: repetitive behaviors and impaired behavioral inhibition
Thought-Action-Fusion (TAF): Likelihood TAF
= the belief that having an unwanted, unacceptable intrusive thought increases the likelihood that a specific adverse event will occur
–> not specific to OCD, also occurs in depression and anxiety disorders
Likelihood Self: the event can be related to oneself
Likelihood Other: the adverse event involves someone else
–> association with checking compulsion
Thought-Action-Fusion (TAF): Moral TAF
= the belief that having an unacceptable intrusive thought is almost the moral equivalent of carrying out that particular act
–> the occurrence of Moral TAF in combination with depression may be pathological and this may particularly be the case in people who are religious
Influence of TAF on OCD
- the heart of obsessional complaints is the tendency to interpret intrusive thoughts in a catastrophic way
–> TAF is seen as a belief that increases the likelihood that a catastrophic misinterpretation will occur - believing one’s thoughts can have real-world detrimental consequences transform normal intrusions into obsessions
- TAF is easily provoked, is aversive, and elicits an urge to neutralize
Normal and Abnormal Obsessions
- normal and abnormal obsessions are similar in form and content, but differ in frequency, intensity, and in their consequences
Repeated checking and memory distrust
- repeated checking does lead to memory distrust
- repeated checking under conditions that are designed to promote high perceived responsibility and threat perceptions result in memory distrust and decrements in memory accuracy
- repeated checking reduces memory vividness, detail, and memory confidence
- the primary emotion during checking is anxiety
Causes: Biological
- a circuit in the brain that is involved in behavior, cognition, and emotion
–> it projects from specific areas of the frontal cortex, to the striatum, then through the basal ganglia to the thalamus, and then loops back to the frontal cortex
–> dysfunction in this circuit may result in the system’s inability to turn off the primitive urges or the execution of the stereotyped behaviors - dysfunction in the serotonin system
- strep infection
- genes
Causes: Cognitive-Behavioral
Inability to ignore/dismiss negative, intrusive thoughts, including thoughts about harming others, or doing something against their moral code
- they are depressed or generally anxious
- rigid, moralistic thinking
- have trouble accepting that they cannot control their thoughts
