chapter 6: BDD/HOARDING

body dysmorphic disorder

an OCD relation

• preoccupation with some imagined defect in appearance, thought looks reasonably normal

BDD symptoms

• imagined ugliness

• repeated looking in mirrors

• typically focuses on several body areas

how is BDD related to OCD

• can co-occur, family typically has OCD

• brain imaging shows similar abnormal functioning as OCD

• engage in checking and compensating rituals like skin picking and mirror checking

BDD causes

insufficient information on psychological or biological predisposing factors

• BUT OCD tends to co-occur

treatment of BDD

• SSRIs: clomipramine and fluvozamine

• CBT: exposure and response prevention

3 major characteristics of hoarding

• excessive acquisition of things

• difficulty discarding anything

• living with excessive clutter under conditions best characterized as gross disorganization

age onset of hoarding

starts early in life, gets worse

• patients usually seek treatment ~50 years old

  • mobility issues, family influence, time taken to accumulate stuff leads to a wake-up call

treatment of hoarding

CBT

causes of hoarding

• indecisiveness

• genetics

• culture

• comorbid mood or anxiety disorder is common

OCD vs hoarding

hoarding is not diagnosed if SX are direct consequence of OCD. hoarding is the enjoyment of collecting rather than a compulsion.

trichotillomania

where one pulls out one’s hair fro anywhere on the body, including scalp, eyebrows and arms

• more in females

excoriation

repetitive and compulsive picking of the skin, leading to tissue damage

• scabs, scars, open wound common

treatment for trichotillomania and excoriation

habit reversal training with exposure and response prevention

• help them understand the function of behaviour

  • triggers, ABC method, replacement behaviours