Chapter 13: Obsessive-Compulsive and Related Disorders

Vocabulary flashcards summarizing key terms, criteria, etiology, impact, treatment, and prognosis for obsessive-compulsive and related disorders.

Obsessive-Compulsive Disorder (OCD)

Presence of obsessions, compulsions, or both that are time-consuming and cause significant distress or impairment.

Obsessions

Recurrent, persistent thoughts, urges, or images experienced as intrusive and unwanted.

Compulsions

Repetitive behaviors or mental acts performed in response to an obsession or according to rigid rules.

Body Dysmorphic Disorder (BDD)

Preoccupation with one or more perceived defects in appearance that are not observable or appear slight to others.

Hoarding Disorder

Persistent difficulty discarding possessions, regardless of value, due to a perceived need to save them.

Trichotillomania

Recurrent pulling out of one’s hair resulting in hair loss, with repeated attempts to decrease or stop the behavior.

Excoriation Disorder

Recurrent skin picking resulting in lesions, with repeated attempts to decrease or stop the behavior.

DSM-5 Criteria for OCD

Obsessions, compulsions, or both that are time-consuming (≥1 hour/day) or cause significant distress or impairment.

DSM-5 Criteria for BDD

Preoccupation with perceived physical defects unnoticeable to others plus repetitive behaviors such as mirror checking.

DSM-5 Criteria for Hoarding Disorder

Difficulty discarding items, perceived need to save them, and accumulation that congests living areas.

DSM-5 Criteria for Trichotillomania

Recurrent hair pulling causing hair loss, repeated attempts to stop, and significant distress or impairment.

DSM-5 Criteria for Excoriation Disorder

Recurrent skin picking with resultant lesions, repeated attempts to stop, and significant distress or impairment.

Etiology of OCD

Genetic factors, abnormal orbitofrontal–striatal circuitry, and environmental stressors.

Etiology of BDD

Possible serotonin dysfunction, distorted body image, and societal appearance pressures.

Etiology of Hoarding Disorder

Deficits in decision making, emotional attachment to possessions, and avoidance behavior.

Etiology of Trichotillomania and Excoriation

Linked to impulsivity, emotion-regulation deficits, and possible familial patterns.

Cognitive Factors in OCD

Thought-action fusion, overestimation of threat, and excessive need for control.

Functional Impact of OCD

Rituals and avoidance impair social, occupational, and academic functioning.

Functional Impact of BDD

Causes social avoidance, distress, and excessive grooming or cosmetic-procedure seeking.

Functional Impact of Hoarding

Leads to cluttered living spaces, safety hazards, and interpersonal conflict.

Functional Impact of Trichotillomania

Visible hair loss may cause embarrassment and social avoidance.

Functional Impact of Excoriation

Skin damage can lead to medical complications and social avoidance.

Course of OCD

Often begins in childhood or adolescence; chronic without treatment with fluctuating symptoms.

Course of BDD

Usually starts in adolescence; chronic with high distress and possible suicidal ideation.

Course of Hoarding

Onset in adolescence; progressive and chronic, often clinically significant in older adulthood.

Course of Trichotillomania/Excoriation

Typically begins in adolescence; symptoms wax and wane with stress.

Pharmacological Treatment for OCD

High-dose SSRIs (e.g., fluoxetine, fluvoxamine) are first-line.

Pharmacological Treatment for BDD

SSRIs commonly used; some individuals respond to antipsychotics.

CBT for OCD

Exposure and Response Prevention (ERP) targeting compulsions and distress.

CBT for BDD

Cognitive restructuring combined with exposure techniques.

CBT for Hoarding

Decision-making skills, organizational strategies, and gradual discarding.

CBT for Trichotillomania/Excoriation

Habit-reversal training and stimulus control.

Insight in OCD and Related Disorders

Ranges from good/fair to poor/absent; poorer insight predicts poorer treatment response.

Difference: OCD vs. OCPD

OCD involves distressing obsessions/compulsions; OCPD involves rigid perfectionism without true obsessions.

Difference: Hoarding vs. Collecting

Hoarding causes distress and impairs living areas; collecting is organized and not distressing.

Comorbidity of OCD

Common with anxiety disorders, depression, and tic disorders.

Comorbidity of BDD

Frequently co-occurs with depression, social anxiety disorder, and OCD.

Comorbidity of Hoarding

Often co-occurs with depression, anxiety disorders, and ADHD.

Comorbidity of Trichotillomania/Excoriation

May co-occur with anxiety, depression, and OCD.

Prognosis of OCD

Chronic without treatment; good response to CBT and medication.

Prognosis of BDD

Chronic course with high distress and increased risk of suicidal behavior.

Prognosis of Hoarding

Chronic and tends to worsen over time without intervention.