Ch. 6 - Obsessive-Compulsive & Somatic Symptom Disorders

Trichotillomania // OC

→ hair-pulling disorder, which may have severe social consequences

→ at least 1-5% of college students, common in females


Excoriation // OC

→ skin-picking disorder (such as scabs, scars and open wounds)

→ affects 1-5% of general population

  • treatments:

    • habit reversal training

    • self monitoring

    • response interruption & redirection (RIRD)


Obsessive-Compulsive Disorder (OCD) // OC

→ intrusive nonsensical thoughts (obsessions) paired with repeated ritualistic actions/thoughts (compulsions) designed to suppress unwanted thoughts

*two-process theory - obsession classically conditions anxiety, while compulsions reduces it (which makes it negatively reinforced)

→ individuals may experience: generalized anxiety (severe), panic attacks, avoidance & major depression

  • statistics:

    • onset in early adolescence (8yrs to mid-20s)

    • female-to-male ratio increases in adulthood

  • causes:

    • two-process theory

    • genetic, biological & environmental factors

  • treatments:

    • SSRIs

    • exposure & response prevention (ERP) → specialized type of CBT


Body Dysmorphic Disorder (BDD) // OC

→ preoccupation with imagined defects in appearance (but may look typical), often leading to excessive checking/grooming/mirror checking

*co-occurs with OCD (brain imaging study showed similar brain functioning)

  • statistics:

    • 2.2% of adolescents

    • highest in white, asian & latin adolescents

  • causes:

    • insufficient information :(

  • treatments:

    • clomipramine & fluvoxamine

    • CBT (ERP)

    • plastic surgery (?) → often what is sought after

      • 8-25% of patients requesting plastic surgery have BDD (screening is important & highly needed)


Hoarding Disorder // OC

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

  • statistics:

    • often starts early in life, possibly increasing in a hazardous way

    • treated patients are often at the age of 50

  • treatment:

    • cognitive-behavior therapy (CBT)


Somatic Symptom Disorder (SSD) // SS

→ significant focus on physical symptoms (e.g. pain, weakness, short of breath etc.) to a level that results in major distress/problem functioning; person believes they are sick

*may or may not be associated with diagnosed medical condition

  • treatment:

    • better relationship between patient & physician

    • cognitive-behavior therapy (CBT)

    • antidepressants (SSRIs & SNRIs)


Illness Anxiety Disorder (Hypochondriasis) // SS

→ intense, ongoing fear of development of an illness despite absent/mild symptoms (physician reassurance = unhelpful)

  • statistics (w/ SSD):

    • prevalence is unclear (lifetime = 1-5%)

    • develops in adolescence

    • more common in unmarried women, lower socioeconomic groups & can be culture specific

  • causes:

    • tendency to have perceptual sensitivity

    • genetics, stressful life events, learned behavior (attention seeking?)


***RELATED DISORDERS:

  • malingering - fabrication/gross exaggeration of physical/psychological symptoms to obtain an external incentive/personal benefit

  • factitious disorder - falsifying physical/psychological symptoms episodically

    • imposed on another - malingering but presenting someone else instead of yourself