OT 501 Diagnostics (Obsessive Compulsive and Related Disorders)

what is obsessive compulsive disorder? (describe obsessions & compulsions)

obsessions:

-recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance as intrusive and inappropriate

-the individual attempts to ignore/suppress them

compulsions:

performed to prevent/reduce distress (not connected in realistic ways to the obsession- clearly excessive)

a compulsion happens in response to

an obsession

compulsion are _____ and cause ______

time consuming and cause significant distress or impairment

what are some typical obsessions?

contamination

religion

doubts (door unlocked, lights on, homework completed, is ___ at 4PM?, do you still like me?)

violent thoughts or images

need to have things in particular order (symmetry)

sexual thoughts or imagery

what are common compulsions?

repetitive behaviors (washing hands, ordering, checking)

mental acts (praying, counting, repeating words silently)

hoarding

what age does OCD onset?

19.5 years but 25% of cases start by age 14

OCD is a chronic condition unless...

treated

how many people does OCD impact?

1/100 children and adults

what are the two major treatment approaches for OCD?

psychopharmacology

-SSRIs

CBT

-exposure and response prevention

-provide evidence that the worst reality is not going to happen

-classical conditioning: make other associations other than anxiety

-redefines the impossible

(examples- railing, eating M&Ms off the floor, messy hair practice, pair laughter with feared obsession)

what disorders could OCD be easily misdiagnosed with?

ADHD, schizophrenia, body dysmorphic disorder, hoarding disorder, trichotillomania, excoriation (skin-picking disorder)

also someone could question gender identity

how can OCD be misdiagnosed for ADHD?

-difficulty in paying attention is also related to anxiety

-nervous fidgeting or compulsions

-OCD checking may impinge concentration

how can OCD be misdiagnosed for body dysmorphic disorder?

-preoccupation with flaws in physical appearance that are not observable

-person engages in repetitive behaviors in response to concern

-causes distress

-not an eating disorder

(example- nose, people will never be satisfied with that part of their body and keep going back to plastic surgeon)

how can OCD be misdiagnosed for hoarding disorder?

-persistent difficulty discarding or parting with possessions

-feels need to save items

-results in accumulations of possessions that clutter

-causes clinical distress or unsafe house

- NOT OCD

what age is hoarding disorder more common?

older population

trichotillomania

hair pulling disorder

-recurrent pulling out of one's hair

-repeated attempts to stop

-causes distress

-1-2% of population

-more common in females

excoriation

skin picking disorder- recurrent skin picking resulting in lesions, repeated attempts to stop, cause clinical distress, not due to substance (ex. meth or aderol)