The Nature and Treatment of Obsessions and Compulsions: Abramowitz (2017) Flashcards
obsessions =
Intrusive, persistent thoughts, images, doubts, and ideas that people experience as unwanted.
Further, their content is incongruent with the person’s belief system, and they are resisted in that they are accompanied by the sense that they must be dealt with, neutralized, or avoided (by compulsions).
compulsions=
(urges to engage in) behaviors that serve to reduce or remove obsessional distress. Thus, they have a specific function (in contrast to many impulsive behaviors which are carried out because they produce pleasure, distraction, or gratification).
symptom dimensions of OCD =
- contamination
- responsibility for harm & mistakes
- incompleteness (order/symmetry/exactness/arranging rituals)
- taboo thoughts (violent/sexual/blasphemous)
blasphemous=
insulting a God
what is another strategy to deal with obsessions, aside from compulsions
Avoidance: this is usually done to prevent unwanted thoughts, negative outcomes, uncertainty, and compulsive urges.
cognitive-behavioural model of OCD
the idea that obsessions develop when a person mistakenly appraises intrusions (which are generally normal experiences) as threatening, personally significant, or provoking uncertainty that the person perceives as unmanageable. These appraisals evoke distress and motivate the person to engage in compulsions.
compulsions are viewed as counterproductive:
- Preventing learning by providing an immediate escape from anxiety and doubt, preventing the person from learning that upsetting thoughts, anxiety, and uncertainty are manageable and that obsessional distress eventually subsides naturally over time.
- Increasing obsessions by serving as reminders of obsessional intrusions, triggering their recurrence.
- Preserving misinterpretations: they maintain dysfunctional beliefs and misinterpretations of obsessional thoughts, because when feared consequences do not occur, this will be attributed to the performance of the compulsion.
core dysfunctional belief domains that are thought to underlie obsessions
- inflated responsibiltiy
- thought-action fusion
- need to control thoughts
- overestimation of threat
- perfectionism
- uncertainty intolerance
thought action fusion
The mere presence of a thought indicates that it is significant or that it increases the probability of the corresponding behavior or event
overestimation of threat=
Negative events are especially likely and would be especially awful
uncertainty intolerance=
It is necessary and possible to be completely certain that negative outcomes will not occur
treatment targets van CBT bij OCD
a) correct maladaptive beliefs and appraisals
b) decrease avoidance and compulsive behaviours that serve as barriers to the correction of the maladaptive beliefs
conditioning approach=
the idea that obsessions and compulsions (and other pathological fears) are acquired by classical conditioning and maintained by operant conditioning.
Research provides support for some aspects of this approach, but traumatic conditioning experiences do not appear to be necessary for the development of obsessions.
Obsessions arise from experiences during which they become associated with negative experiences (classical conditioning). Subsequently, obsessions are maintained by anxiety-reduction behaviors (negative reinforcement) that prevent its natural extinction (operant conditioning).
voorbeeld conditioning approach
Obsessional fears that the number 13 will cause bad luck can arise from experiences during which anxiety becomes associated with this number (classical conditioning). Subsequently avoiding the number 13 and performing compulsive praying rituals to prevent bad luck provides temporarily relieve of anxiety (operant conditioning).
exposure therapy and response prevention=
direct confrontation with feared stimuli to foster extinction learning.