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Psychopathology > Task 4 - OCD > Flashcards

Task 4 - OCD Flashcards

1
Q

DSM 5

A

A) presence of obsessions, compulsions or both
B) obsessions/compulsions are time consuming/cause clinically significant distress or impairment in social/occupational/other important areas of functioning
C) not attributable to physiological effects of a substance/other medical condition
D) not better explained by another medical disorder

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2
Q

specify if… insight..

A

1) with good/fair insight: individual recognizes that OCD beliefs are definitely/probably not true or that they may/may not be true
2) poor insight: thinks OCD beliefs are probably true
3) absent insight/delusional beliefs: completely convinced that beliefs are true

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3
Q

specify if..tic related

A

the individuals has a current/past history with a tic disorder

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4
Q

Prevalence

A
  • 1 to 3 p of people
  • often begins at young age
  • peak of age males: 6-15, females: 20-29
  • 66p are also significantly depressed
  • some studies found higher rates in women, others did not find this
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5
Q

symptoms

A
  • most common thoughts: dirt and contamination
  • other commons: aggressive impulses, sexual thoughts, impulses to do smth against one’s moral code, repeated doubts
  • sometimes compulsion is logically tied to obsession
  • magical thinking: believe that repeating behavior will ward off danger to themselves
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6
Q

Biological brain theories

A
  • circuit in brain executing primitive patterns of behavior (aggression, sexuality, bodily excretion)
  • > begins in orbital region of PFC
  • > impulses are carried to caudate in basal ganglia
  • strongest impulses flow to thalamus

in OCD: dysfunction
-PET scans show more

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7
Q

Biological brain theories

A
  • circuit in brain executing primitive patterns of behavior (aggression, sexuality, bodily excretion)
  • > begins in orbital region of PFC
  • > impulses are carried to caudate in basal ganglia
  • strongest impulses flow to thalamus

in OCD: dysfunction

  • PET scans show more activity in this primitive cricuit
  • drugs that regulate neurotransmitter seretonin can help (plays role in circuit)
  • runs in families
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8
Q

Cognitive behavioral theories

A

-inability to turn off negative, intrusive thoughts because:

1) may be depressed/generally anxious much of the time
2) tendency toward rigid, moralistic thinking -> judge negative, intrusive thoughts as more unacceptable -> feel more responsible
3) believe they should be able to control all thoughts and have trouble accepting that everyone has horific notions from time to time

-compulsions through operant conditioning (if engaging in certain behavior, anxiety is reduced)

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9
Q

Biological treatment OCD

A
  • antidepressants effecting levels of seretonin
  • Clomipramine was first
  • then SSRIs
  • 50 to 80p of OCD patients experience decreases
  • tend to relapse when discontinue
  • side effects
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10
Q

Behavioral Treatments - exposure and ritual prevention treatment (ERP)

A

-exposure and response prevention
-repeatedly expose client to focus of obsession (gradual exposure to triggers) and prevent compulsive responses to resulting anxiety
prevent compulsion -> allows extinction to take place
-client learns that NOT engaging in compulsive behavior does not lead to a terrible result
-improvement in 60 to 90p
-can be adapted to group, self-help, family, computer etc.
–in most clients improvement remains up to 6y

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11
Q

OCD subtypes (5)

A

1) early on-set
2) just-right
3) primary obsessional
4) scrupulosity
5) tic-related

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12
Q

Early on-set

A
  • symptom onset before puberty
  • higher frequency of tics and other pyschiatric comorbidities
  • compulsions often frequent and severe
  • strong familial risk
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13
Q

hoarding - related disorders

A
  • less insight than in other OCD subtypes
  • higher rates of psychiatric comorbidities, especially social phobia
  • may be less responsive to psychological treatment
  • thoughts about possessions
  • > less intrusive/unwanted/distressing than OCD
  • > part of natural stream of thought
  • anxious, sad or angry when pressured to get rid of possessions
  • emotional attachment to possessions
  • > equating them with their identity/ giving them human characteristics.
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14
Q

just right

A
  • patients wish to have things perfect, certain or under control
  • results in need to repeat certain actions until the uncomfortable feelings subside
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15
Q

primary obsessional

A
  • 25p lack overt compulsions
  • patients are not free from rituals, which may be mental (praying, counting, reciting ‘good words’)
  • common themes of obsessions: sex, violence, religion
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16
Q

scrupulosity

A
  • religious or moral obsessions
  • obsessions focus on whether one has committed a sin, or involves blasphemous (heiliges/göttliches verlästernd/verhöhnend)
  • compulsions include prayer, reassurance-seeking, excessive confession
17
Q

tic related

A
  • significant overlap with early onset OCD
  • many patients meet criteria for Tourette syndrome
  • high comorbid conditions (ADHD, body dysmorphic disorder, social anxiety, mood disorders)
18
Q

CBT

A
  • for patients that find ERP too difficult
  • targeting and modifying dysfunctional beliefs about their fears, thoughts and significance of rituals
  • beliefs that are challenged:
    1) responsibility appraisal = sufferer believes they are responsible for preventing harmful outcomes
    2) Over-importance of thoughts = believe that having thought about action is like performing it
    3) Exaggerated performance = having inflated estimates of likelihood of outcomes
19
Q

inflated responsibility

A
  • belief that one has power to bring about/prevent subjectively crucial negative outcomes
  • > negative outcomes may be actual: that is, having consequences in real world and/or at moral level
20
Q

thought-action fusion

A

dysfunctional assumption held by OCD sufferers

-> having a thought about an action is like performing it

21
Q

mental contamination

A

feelings of dirtiness can be provoked without any physical contact with a contaminant

  • > can be caused by images, thoughts, memories
  • > may be associated with compulsive washing and even betrayal experiences
22
Q

thought suppression

A
  • defense mechanism to suppress obsessive thoughts
  • explains why intrusive thoughts are uncontrollable
  • actively suppressing unwanted thought -> cause it to occur more frequently (rebound effect)
  • suppressing unpleasant thought -> induces strong negative emotional state -> resulting in suppressed thought becoming associated with that negative mood state
23
Q

mood-as-input hypothesis

A
  • people use concurrent mood as info about whether they have successfully completed task or not
  • OCD sufferers persevere with compulsive activities until they are certain to have fully completed task
  • endemic negative mood is interpreted as providing info that they have not completed task -> so they preserve
24
Q

Article: checking and memory deficits - Radomsky method

A
  • 2 groups:
    1) relevant checking -> kitchen stove
    2) irrelevant checking -> kitchen faucet
  • pre test and posttest
  • assessed memory confidence, vividness, details and memory source (knowing vs remembering)
25
Q

Article: checking and memory deficits - Radomsky - expectations

A
  • repeated relevant checking -> reduce memory confidence, vividness and detail
  • irrelevant checking -> no effect
  • NOT expected that task repetition would lead to decreased memory accuracy
26
Q

Article: checking and memory deficits - Radomsky - findings

A
  • memory accuracy: high for both conditions for pre and posttest
  • memory confidence
  • > relevant checking: less confident, reported knowing knobs they checked (source and quality of memory were reduced)
  • > irrelevant checking: more confidence, remembering knobs they checked
27
Q

Likelihood Thought-act-fusion (TAF)

A
  • belief that having unwanted, intrusive thought increases likelihood that specific adverse events will occur
  • can involve the self (=Likelihood-Self) or someone else (Likelihood-Other)
28
Q

Moral Thought-act-fusion (TAF)

A
29
Q

relation TAF and OCD

A
  • not necessary nor sufficient for maintenance of obsessional thoughts
  • TAF increases likelihood to misinterpret thought in catastrophic way
  • believing one’s thoughts can have real-world consequences -> transforms normal thoughts in obsessions
  • TAf could maintain OCD by eliciting urge to neutralize
  • TAF decreased with successful treatment of OCD
30
Q

difference Normal and abnormal obsessions

A

-Similar in: form, content, expressed relation to mood and meaningfulness to respondent

different in:

  • frequency -> abnormal obsessions are more frequent and last longer
  • intensity -> more intense, strongly resisted, threshold of acceptability is higher for abnormal obsessions
  • consequences -> abnormal obsessions produce more discomfort and provoke more urges to neutralize, also easier to dismiss
31
Q

maximizing exposure therapy - inhibitory learning approach (Craske) - 8 strategies

A

1) maximize expectancy violation ( regarding frequency + intensity of aversive outcome)
2) Deepened extinction: multiple fear CSs are first extinguished separately before being combined during extinction
3) Occasional reinforced extinction
4) removal of safety signals/behaviors (presence of another person, therapist, cell phone, medications)
5) stimulus variability: vary stimuli and contexts
6) Retrieval cues: use a cue present during extinction or imaginally reinstate previous successful exposures (risk that cues become safety signals)

7) Multiple contexts:
- return of fear in context different than therapy

8) reconsolidation: retrieving already stored memories induces reconsolidation

32
Q

difference retrieval cue and safety signal

A
  • retrieval cues: retrieve CS-no US relationship

- safety signals: directly associated with non-occurrence of US

33
Q

inhibitory learning model - CS and US

A
  • original CS-US association is not erased during extinction -> left intact
  • secondary inhibitory learning: CS no longer predict US

After extinction, CS possesses 2 meanings:

1) original excitatory meaning CS-US
2) additional inhibitory meaning CS-no US

34
Q

Related disorders to OCD (4)

A

1) Hoarding
2) Body Dysmorphic
3) skin-picking
4I Hair pulling

35
Q

Hoarding (as related disorder)

A

..

36
Q

Body dysmorphic - related disorder

A

-excessive preoccupation with part of their body they believe is defective
-but believe other see it as normal/only slightly unusua
l
-results in a lot of time spent checking themselves in mirror, hide or change body part or seeking reassurance

  • women: more concerned with breasts, hips, legs, weight
  • men: body build, genitals, body hair and thinning hair
  • 30p attempt suicide
  • high comorbidity with anxiety, depression, PDs, substance use and OCD
  • onset: 16y
37
Q

Skin picking - related disorder

A
  • recurrently pick at scabs or places on skin
  • creating significant lesions that often become infected and cause scars
  • tend to feel tension before/while attempting to resist impulsive
  • pleasure/relief when giving in to it
  • 2-5p
  • onset: adolescence
38
Q

Hair-pulling - related disorder

A
  • history of recurrent pulling out their hair
  • resulting in noticeable hair loss
  • 1-3p
  • onset: 13y

Psychopathology (15 decks)

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