Obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD)

- A condition characterised by obsessions and/or compulsive behaviour. Obsessions are cognitive whereas compulsions are behavioural

What are the behavioural characteristics of OCD?

• Compulsions are repetitive

• Compulsions reduce anxiety

• Avoidance

Compulsions are repetitive

- This is a behavioural characteristic. Typically people with OCD feel compelled to repeat a behaviour. A common example is handwashing. Other common compulsive repetitions include counting, praying, and tidying/ordering groups of objects

Compulsions reduce anxiety

- This is a behavioural characteristic. Around 10% of people with OCD show compulsive behaviour alone- they have no obsessions, just a general sense of irrational versions of this. However, for the vast majority, compulsive behaviours are performed in an attempt to reduce this which is produced by obsessions. For example, compulsive handwashing is carried out as a response to an obsessive fear of germs

Avoidance

- This is a behavioural characteristic. People with OCD may attempt to reduce anxiety by keeping away from the situations that trigger it. For example, people who wash compulsively may avoid coming into contact with germs. However, this can lead people to avoid very ordinary situations, such as emptying their rubbish bins, and this can in itself interfere with leading a regular life

What are the emotional characteristics of OCD?

• Anxiety and distress

• Accompanying depression

• Guilt and disgust

Anxiety and distress

- This is an emotional characteristic. OCD is regarded as a particularly unpleasant emotional experience because of this that accompanies both obsessions and compulsions. Obsessive thoughts are unpleasant and frightening; it can be overwhelming. The urge to repeat a behaviour (a compulsion) creates this

Accompanying depression

- This is an emotional characteristic. Anxiety can be accompanied by low mood and lack of enjoyment in activities. Compulsive behaviour tends to bring some relief from anxiety but this is only temporary

Guilt and disgust

- This is an emotional characteristic. OCD sometimes involves irrational versions of this, for example over minor moral issues. And this, which may be directed against something external like dirt or at the self

What are the cognitive characteristics of OCD?

• Obsessive thoughts

• Cognitive coping strategies

• Insight into excessive anxiety

Obsessive thoughts

- This is a cognitive characteristic. 90% of people with OCD have this feature; they are thoughts that recur over and over again. These vary considerably from person to person but are always unpleasant. An example may be worries of being contaminated by dirt and germs

Cognitive coping strategies

- This is a cognitive characteristic. People use these to deal with their obsessions. For example, a religious person tormented by obsessive guilt may respond by praying or meditating. This may help manage anxiety but can make the person appear abnormal to others and can distract them from everyday tasks

Insight into excessive anxiety

- This is a cognitive characteristic. People with OCD are aware their obsessions and compulsions are not rational. In spite of this insight, people with OCD experience catastrophic thoughts about the worst case scenarios that might result if their anxieties are justified. They also tend to be hypervigilant, i.e. they maintain constant alertness and keep attention focused on potential hazards