OCD and Related Disorders

obsessions

recurrent and persistent thoughts, impulses, or images

compulsions

repetitive behaviors or mental acts

DSM-5 Criteria for OCD

• either obsessions or compulsions

• obsessions or compulsions cause marked distress, are time-consuming, or significantly interfere with the person’s normal routine

• contents are not restricted to another Axis 1 disorder

___% lifetime prevalence of OCD

2-3

___ occurrence between men and women for OCD

equal

many wait an average of ___ years before seeking treatment for OCD

7

the neurological basis of OCD shows increased blood flow to …

oribifrontal cortex, right caudate, and left anterior cingulate cortex

exposure and response prevention

people are exposed to situations that elicit the compulsive act and then refrain from performing the compulsion

fear hierarchy

situations rated from 0-100

reasoning (cognitive restructuring)

not performing the critical ritual exposes the person to the full force of the anxiety provided by the stimulus

those who stick with treatment for OCD see ___% symptom reduction

50-70

___% maintain treatment gains 1 year follow up for OCD

76

superior to results obtained via …

meds

body dysmorphic disorder (BDD)

• a preoccupation with 1+ perceived defects or flaws in physical appearance

• at some point, the individual has performed repetitive behaviors or mental acts in response to appearance concerns

• causes clinically significant distress or impairment

• not better explained by weight concerns for an individual who meets criteria for an ED

prevalence of BDD is possibly up to ___% of the population

1-2

BDD seems to occur ___ in men and women

equally

BDD age of onset

adolescence

comorbidity for BDD

• 50% also have depression

• >25% have had a suicide attempt

• social anxiety

• OCD

___% go to physicians/surgeons/etc for treatment of BDD

75

biological causal factor of BDD

some evidence of genetic factors

psychological causal factors of BDD

self-schemas of attractiveness as worthiness, history of teasing about appearance

social causal factor of BDD

culture in which the importance of attractiveness is high

meds for BDD

SSRIs may have some effect

therapy for BDD

exposure and response prevention with CBT

hoarding disorder

• persistent difficulty discarding or parting with possessions, regardless of actual value

• difficulty is due to a perceived need to save the items and to the distress associated with discarding them

• results in accumulation of possessions that congest and clutter active living space and substantially compromise their intended use

• clinically significant distress and impairment

___% of the population has hoarding disorder

3-5

higher levels of ____ than those with OCD

disability

___ responsive to treatments used in OCD

less

trichotillomania (hair-pulling disorder)

• recurrent pulling out of one’s hair, resulting in hair loss

• repeated attempts to decrease or stop hair pulling

• causes clinically significant distress or impairment in social, occupational, or other areas of functioning

excoriation (skin-picking disorder)

• recurrent skin-picking resulting in skin lesions

• repeated attempts to decrease or stop skin picking

• causes clinically significant distress or impairment