Obsessive-Compulsive and Related Disorders Overview

Obsessive-Compulsive Disorder (OCD)

Anxiety disorder with obsessions and compulsions.

Obsessions

Intrusive thoughts, urges, or images causing distress.

Compulsions

Repetitive behaviors performed to reduce anxiety.

Hoarding Disorder

Persistent difficulty discarding possessions, leading to clutter.

Trichotillomania

Hair pulling disorder, often linked to stress.

Excoriation Disorder

Skin picking disorder, resulting in skin damage.

Lifetime Prevalence

2.5% of the population affected by OCD.

Chronic Course

Only 20% of individuals recover completely.

Early Onset

OCD often begins before age 14.

Gender Ratio

2:1 female to male prevalence in OCD.

Common Obsessions

Contamination and aggression are frequently reported.

Common Compulsions

Checking and washing are typical compulsive behaviors.

Comorbidity

75% have comorbid anxiety disorders with OCD.

Biological Etiology

Dysregulation in brain regions affecting impulses.

Orbitofrontal Cortex (OFC)

Brain region involved in impulse regulation.

Cingulate Gyrus

Connects OFC to the caudate nucleus.

Caudate Nucleus

Part of basal ganglia, involved in behavior.

Hyperactive Circuit

OFC to caudate loop remains active in OCD.

Serotonin Levels

May be low in areas related to OCD.

Cognitive-Behavioral Etiology

Negative thoughts persist due to rigid thinking.

Yedasentience

Subjective feeling of completion in thoughts/actions.

Thought-Action Fusion

Belief that thoughts can cause actions.

OCD

Anxiety disorder characterized by intrusive thoughts.

Suppression

Attempting to stop unwanted thoughts or actions.

SSRIs

Medications improving OCD symptoms by 25-75%.

Cingulatomy

Psychosurgery targeting OFC-Caudate circuit for OCD.

Deep Brain Stimulation

Treatment involving stimulation in basal ganglia.

Exposure & Response Prevention

Therapy combining exposure to fears and preventing compulsions.

Exposure

Gradual exposure to feared thoughts or situations.

Response Prevention

Actively preventing compulsive behaviors in therapy.

Magical Thinking

Belief that thoughts can influence reality.

Family Accommodations

Family members easing OCD fears, hindering treatment.

Relapse Rates

High likelihood of OCD symptoms returning post-treatment.

Body Dysmorphic Disorder

Preoccupation with perceived defects in appearance.

Repetitive Behaviors

Actions like mirror checking in BDD response.

Ideas of Reference

Belief others are focused on one's perceived defect.

Suicidal Ideation

Thoughts of suicide common in BDD (33%).

Epidemiology of BDD

2% prevalence, more common in women.

Onset of BDD

Usually begins in adolescence, chronic course.

Comorbidity

High overlap of BDD with OCD (33%).

Cognitive-Behavioral Factors

Decision-making deficits contribute to Hoarding Disorder.

Hoarding Disorder

Difficulty discarding possessions, regardless of value.

Accumulation of Items

Leads to cluttered living spaces in hoarding.

Prevalence of Hoarding

Affects 1.5-2.6% of the population.

Childhood Onset

Hoarding begins in childhood or early adolescence.

Squalid Living Conditions

Poor hygiene and safety issues from hoarding.

Indecisiveness

Difficulty making decisions due to perfectionism.

Poor organizational abilities

Struggles with arranging tasks or items effectively.

Categorization difficulties

Challenges in classifying objects into categories.

Memory confidence

Lack of trust in one's memory capabilities.

Hoarding Disorder

Compulsive accumulation of possessions and inability to discard.

Emotional attachment to possessions

Strong feelings tied to inanimate objects.

Identity and possessions

Objects perceived as integral to self-identity.

'Just in case' items

Keeping items for potential future needs.

Avoidance behaviors

Actions taken to evade anxiety-inducing situations.

Motivational strategies

Techniques to encourage clients to acknowledge symptoms.

SSRIs

Selective serotonin reuptake inhibitors for treating anxiety.

Exposure & Response Prevention (ERP)

Therapy focusing on facing fears and stopping rituals.

Comorbidity

Co-occurrence of multiple disorders in individuals.

OCD

Obsessive-Compulsive Disorder characterized by intrusive thoughts.

BDD

Body Dysmorphic Disorder focused on perceived flaws.

PTSD

Posttraumatic Stress Disorder from traumatic experiences.

Acute Stress Disorder

Symptoms following trauma lasting 3 days to 1 month.

Intrusion symptoms

Recurrent memories or flashbacks of traumatic events.

Avoidance symptoms

Efforts to evade distressing thoughts or reminders.

Negative alterations in cognition

Changes in thoughts or mood after trauma.

Alterations in arousal

Increased reactivity or heightened alertness post-trauma.

Clinically significant distress

Symptoms causing notable impairment in daily functioning.

Avoidance

Efforts to evade distressing reminders of trauma.

Inability to remember

Failure to recall significant aspects of trauma.

Negative beliefs

Persistent distrust in self or others.

Excessive blame

Overly attributing fault for trauma consequences.

Negative emotional state

Chronic feelings of fear, guilt, or shame.

Diminished interest

Loss of enthusiasm for previously enjoyed activities.

Detachment

Feeling disconnected from others emotionally.

Inability to experience positive emotions

Persistent lack of joy or happiness.

Hypervigilance

Heightened state of alertness and anxiety.

Sleep difficulties

Problems with falling or staying asleep.

Irritability

Frequent anger outbursts or frustration.

Self-destructive behavior

Engaging in reckless or harmful actions.

Difficulty concentrating

Struggling to maintain focus on tasks.

Exaggerated startle response

Overreacting to unexpected stimuli.

Lifetime prevalence

7% of population experiences PTSD.

Acute PTSD

Symptoms lasting less than 3 months.

Chronic PTSD

Symptoms persisting for over 3 months.

Delayed onset PTSD

Symptoms appearing more than 6 months post-trauma.

Risk factors

Elements increasing likelihood of developing PTSD.

Personality traits

Characteristics like neuroticism impacting PTSD risk.

Coping styles

Methods of dealing with stress and trauma.

Biological mechanisms

Neurological factors contributing to PTSD symptoms.

Hippocampus function

Involved in organizing autobiographical memories.

Pharmacological treatments

Medications like SSRIs used for PTSD management.

Cognitive restructuring

Changing negative thoughts to more positive ones.

Exposure therapy

Systematic desensitization to trauma-related memories.

Eye Movement Desensitization

Therapy combining eye movements with trauma processing.