5.4 OCD

OCD = obsessive compulsive disorder

A condition characterised by obsessive/ compulsive behaviour. Obsession are cognitive whereas compulsions are behavioural

DSM-5 categories of OCD

— all of them have repetitive behaviour accompanied by obsessive thinking —

  • OCD = characterised by either obsessions (recurring thoughts) and/ or compulsions (repetitive behaviour)

  • Trichotillomania = compulsive hair pulling

  • Hoarding disorder = the compulsive gathering of possessions

  • Excoriation disorder = compulsive skin picking

The cycle of OCD

  1. Obsessive thought

  2. Anxiety

  3. Compulsive behaviour

  4. Temporary relief

Behavioural characteristics

— the behavioural component is compulsions —

  • Compulsions are repetitive. Feel the need to repeat a behaviour

  • Compulsions reduce anxiety. Compulsions are performed in an attempt to manage the anxiety produced by obsessions

  • Avoidance. Attempting to reduce anxiety by keeping away from situations that trigger it

Emotional characteristics

  • Anxiety and distress. Anxiety from the obsessive thoughts and the anxiety from the urge to repeat a behaviour/ compulsion

  • Accompanying depression. Low mood and lack of enjoyment in activities

  • Guilt and disguise. Feeling guilt over minor moral issues or disgust towards something external or at the self

Cognitive characteristics

— the cognitive component is obsessions —

  • Obsessive thoughts. Thoughts that recur over and over, its the major cognitive feature in 90% of people with OCD

  • Cognitive coping strategies. This may help to manage the anxiety but can make the person appear abnormal to others and can distract them from everyday tasks

  • Insight into excessive anxiety. They are aware that their obsessions and compulsions are not rational. They experience thoughts about the worst case scenario. They tend to be hypervigilant and focus on potential hazards