OCD

what are the Obsessive compulsive related disorders

body dysmorphia disorder, hoarding disorder, trichotillomania, excoriation

body dysmorphia disorder

only the person perceives flaws in their appearance. patients will attempt to fix what is wrong with their body

hoarding disorder

when the person collects maladaptive amounts of things. difficulty discarding possessions, even if its useless

trichotillomania

excessive hair pulling. severe = pulling on all areas of the hair. can happen in children and adults

excoriation

recurrent skin picking that results in lesions. it “reduces” the persons anxiety

what are the trauma related disorders

posttraumatic stress disorder and acute stress disorder

what is the difference between the two

Acute stress disorder can be applied immediately after someone experiences a trauma (specially 3 days - 1 month). if the symptoms persist, then the diagnosis can evolve to post traumatic stress disorder, which require symptoms for 1 month minimum

what is the criteria for OCD in the DSM 5

Obsessions

• persistent thoughts, urges, or images that are intrusive and unwanted, and thus cause anxiety for the patient

• the patient then attempts to ignore or suppress these thoughts with another thought or action

Convulsions

• repetitive behaviors or mental acts that the individual does in response to an obsession. like rules they most follow rigidly

the obsessions or compulsions are time consuming (more than 1 hour each day) or cause distress or impairment

what are the most most common “obsessions” (the intrusive thoughts). what is the most common out of all of them

• contamination — the most common

• aggressive behavior — 50%

• symmetry — 37%

• somatic concerns — 35%

• sexual content — 32%

what is the purpose of compulsions

preventing or reducing anxiety, distress, or a dreaded situation. however, these compulsions are not connected in a realistic way, as they are usually excessive

what are the most common convulsions

cleaning, checking, verbal rituals, hoarding, counting

what are the specifiers for OCD

with good or fair insight — the person knows that these delusions are probably not true

with poor insight — the person thinks that the delusions are probably true

with absent insight — the person thinks that the delusions are 100% true

how would this be written out in a diagnosis?

diagnosis: OCD, with poor insight.

Notations: struggling marriage

disability: WHO-DAS

is OCD a Chronic or Acute disorder

chronic — long lasting

what are the Biological causes to OCD

generalized vulnerability— 30-50% is genetic

low serotonin activity

what are the psychological causes of OCD (behavioral)

behavioral

• operant conditioning with reinforcement.

  • someone engages in a behavior to decrease their anxiety — anxiety is reduced — behavior is reinforced to reduce anxiety

what are the psychological causes of OCD (cognitive)

• yedasentience.

  • the subjective feeling of knowing when something is done. ex: you always “know” when to stop washing your hands. Impaired for OCD patients.

• enhanced thought action fusion

  • when the patient thinks that thinking about something is just as bad as actually doing it

what are the Biological treatments to OCD

SSRIs

what are the psychological treatments to OCD

exposure with response prevention

• allows people to experience their anxiety but prevents them from doing their conpulsion in order to train the patient that their anxiety will disappear on its own

• cognitive restructuring: training the patient that having the the thoughts are fine if you realize they’re meaningless