OCD and Trauma-Related Disorders (Psych Exam #2)

Repetitive, intrusive, uncontrollable thoughts or urges

Often irrational

Contamination, responsibility for harm, sex and mortality, violence, religion, and symmetry/order

Obsessions

Repetitive behaviors or mental acts that a person feels compelled to perform

Difficult to resist

In response to obsessions or rigid rules

May involve elaborate behavioral rituals

Done to reduce anxiety NOT on things that are pleasurable

Compulsions

Preoccupation with imagines flaw in one’s appearance

Body dysmorphic disorder (BDD)

Acquisition of an excessive number of objects and inability to part with them

Hoarding disorder

Diagnosis based on presence of obsession, compulsions, or both

Obsessive-Compulsive Disorder (OCD)

OCD often begins before what age?

14

About 1/3 of individuals with this disorder have little insight into overly harsh views and have suicidal ideations

BDD

1/5 of individuals with this disorder endure plastic surgery

BDD

Shape and weight as the foci of BDD can be explained by what other disorder?

Eating

75% of people with this disorder engage in excessive buying and 33% engage in animal hoarding

Beginning in childhood or early adolescence

Hoarding Disorder

Is OCD and BDD more common in men or women?

Women

*Hoarding disorder has no gender differences

Genetic vulnerability shared among these disorders

OCD, BDD, hoarding disorder

Frontal-striatal circuit involves these three components

Orbitofrontal cortex

Caudate nucleus

Anterior cingulate

Thought suppression in OCD is hard, what is this effect?

Paradoxical effect

Thinking about something is as morally wrong as engaging in the action

Thinking about an event makes it more likely to occur

Tendency to feel responsible for preventing harm

Thought-action fusion

What is the most common medication for BDD, OCD, and Hoarding Disorder?

Antidepressants

SSRIs (serotonin reuptake inhibitors) recommended as first line of treatment

Seeking situations that elicit obsessions to experience full force of anxiety

Exposure

Promotes the extinction of the conditioned response

Response prevention

Begins with tackling less threatening stimuli and progressing to more threatening stimuli

Exposure hierarchy

What percent of individuals show significant improvement with ERP?

69-75%

Some still experience mild symptoms after

Challenges beliefs about anticipated consequence of not engaging in compulsions (also involves exposure)

Cognitive Therapy (treatment outcomes comparable to ERP)

Implanting electrodes into the brain to help those with OCD attain relief

Deep brain stimulation

Extreme response to severe stressor with recurrent memories of trauma, avoidance of stimuli associated with trauma, negative emotions and thoughts, and increased arousal

Posttraumatic Stress Disorder

55% of people report at least one serious lifetime trauma

Men: military

Women: rape

What other effects come out of PTSD

Unemployment

Suicidality

Prolonged exposure to trauma may lead to a broader range of symptoms

Complex PTSD

Recurrent memories, dreams, flashbacks dealing with PTSD

Intrusion

Internal (dissociation, defense mechanisms, psychological numbing) and external reminders dealing with PTSD

Avoidance

Persistent negative beliefs and negative emotional states (anxiety, depression, anhedonia) associated with PTSD

Negative alterations in cognitions and mood

Aggressiveness, hypervigilance, exaggerated startle response associated with PTSD

Arousal and reactivity

PTSD 1.5 to 2 times more likely in men or women?

Women

Symptoms related to PTSD with shorter duration (3 days to 1 month after trauma)

Acute Stress Disorder

Not always predictive of PTSD

Central role in autobiographical memories and greater activation in PTSD

Hippocampus

A form of avoidance to keep away from confronting memories

Dissociation

Cognitive abilities and social support

Protective factors

This can lead to the extinction of OCD (something bad may happen if I do this)

Face fear and nothing bad happens=successful treatment

More effective than cognitive restructuring in preventing the development of PTSD

Exposure treatment