Obsessive Compulsive Related Disorders

What is the key difference between an obsession and a compulsion?

an obsession is an intrusive thought/impulse/image; a compulsion is a repetitive behavior or mental act performed in response

What makes obsessions clinically significant in OCD?

they persist despite attempts to ignore, stop, or neutralize them and impair functioning

Why does someone with OCD perform compulsions?

to neutralize an obsession or prevent a feared event, even though the behavior is excessive or ineffective

What are common types of obsessions in OCD?

symmetry/ordering, forbidden aggressive/intimate/religious thoughts, and contamination

What are common types of compulsions in OCD?

checking, counting/organizing, washing, and avoiding germs

Someone repeatedly checks the stove because of intrusive thoughts that they caused a fire. Which is the obsession and which is the compulsion?

fear of causing a fire = obsession; repeatedly checking the stove = compulsion

What is the defining feature of hoarding disorder?

persistent inability to discard useless items, resulting in severe clutter

What serious consequences can results from hoarding disorder?

unsanitary illness, social isolation, work disability, medical problems, and eviction

What is the typical course of hoarding disorder?

usually begins before age 20, is chronic, and becomes more severe with age

What items are commonly hoarded?

paper, books, clothing, containers, and sometimes animals

What characterizes body dysmorphic disorder (BDD)?

preoccupation with perceived defects in physical appearance

What behaviors can result from appearance concerns in BDD?

checking/hiding flaws, grooming rituals, clothing changes, and excessive beauty-product purchases

Someone repeatedly checks a perceived appearance flaw that others barely notice. What disorder fits best?

body dysmorphic disorder

When does BDD typically begin, and what is its usual course?

typically begins during adolescence and is chronic

What is muscle dysmorphia?

a form of BDD found almost exclusively among men

What is another name for hair-pulling disorder?

trichotillomania

What characterizes trichotillomania?

repeated hair pulling despite attempts to stop, causing hair loss and distress/impairment

What areas are commonly affected by trichotillomania?

scalp, eyelashes, and eyebrows

What is another name for skin-picking disorder?

excoriation disorder

What characterizes excoriation disorder?

repeated skin picking despite attempts to stop, causing lesions and distress/impairment

How are trichotillomania and excoriation disorder similar?

both involve repetitive behaviors that continue despite attempts to stop and cause physical damage and impairment

What do genetic studies suggest about OCD and related disorders?

they have a significant genetic contribution; estimated inherited diathesis is 40-60%

What neurotransmitter is especially relevant to biological theories and treatments of OCD?

serotonin

What social factors are associated with OCD and related disorders?

authoritarian parenting, childhood trauma, and adverse life events

What thinking patterns are associated with OCD according to cognitive theories?

rigid/moralistic thinking and believing one should control all thoughts

Why can ordinary disturbing thoughts become problematic for someone with OCD?

they may have trouble accepting that disturbing thoughts occasionally happen to everyone

How does operant conditioning help maintain compulsions?

compulsions reduce anxiety, so they are negatively reinforced and become more likely to recur

What biological treatment is used for OCD and related disorders?

antidepressants that enhance serotonin

What is exposure and response prevention (ERP)?

exposure to the obsession/fear while preventing the person from performing the compulsion

Why does exposure and response prevention help treat OCD?

it helps the person learn that the thoughts themselves are not harmful without using compulsions to reduce anxiety