4 - Obsessive-Compulsive Disorder (OCD)

What is OCD?

a condition characterised by obsessions and/or compulsive behaviour

(obsessions are behavioural, compulsions are cognitive)

What are the categories for OCD in the DSM-5?

• OCD

• Trichotillomania

• Hoarding Disorder

• Excoriation Disorder

Describe trichotillomania as a category of OCD

compulsive hair-pulling

Describe hoarding disorder as a category of OCD

compulsive gathering of possessions + inability to part w/ anything - regardless of its value

Describe excoriation disorder as a category of OCD

compulsive skin-pulling

What are the behavioural characteristics of OCD?

• repetitive compulsions

• compulsions reduce anxiety

• avoidance

What are the emotional characteristics of OCD?

• anxiety + distress

• accompanying depression

• guilt + disgust

What are the cognitive characteristics of OCD?

• obsessive thoughts

• cognitive coping strategies

• insight into excessive anxiety

What is meant by “compulsions are repetitive” as a behavioural characteristic of OCD?

• feel compelled to repeat a behaviour

  • e.g. handwashing,counting,praying,tidying

What percentage of people with OCD have compulsive behaviour alone?

10%

Why do majority of people with OCD have compulsive behaviours?

• compulsive behaviours performed to manage anxiety from obsessions

  • e.g. hand washing response to obsessive fear of germs

What is mean by “avoidance” as a behavioural characteristic of OCD

• keep away from situations that trigger their OCD

  • e.g. compulsive hand washing = avoid coming into contact w/ germs

  • can lead to avoiding ordinary things e.g. emptying bins

Why can OCD create anxiety & distress (emotional characteristic)?

• OCD = unpleasant emotional experience

• produces powerful anxiety (by obsessions + compulsions)

  • obsessive thoughts = unpleasant + frightening

  • urge to repeat behaviour creates anxiety

Why is OCD often accompanied by depression (emotional characteristic)

anxiety = low mood + lack of enjoyment in activities

Describe “guilt & disgust” as an emotional characteristic of OCD

• may feel irrational guilt/disgust

  • e.g. guilt over minor moral issues

  • disgust may be directed externally or at self

What percentage of people with OCD have obsessive thoughts? (cognitive characteristic)

90%

Why do people with OCD create cognitive coping strategies?

to deal w/ obsessions (e.g. religious person w/ guilt →praying/meditating)

Why are cognitive coping strategies good but also may be bad?

• help manage anxiety

• may make person look abnormal & can distract them from everyday tasks

What is meant by “insight into excessive anxiety” as a cognitive characteristic of OCD?

• people w/ OCD aware obsessions + compulsions are irrational

  • experience catastrophic thoughts about worst case scenarios that may result if their anxieties were justified

• tend to be hypervigilent- maintain constant alertness + keep attention focused on potential hazards