OCD

• DSM-5 categories of anxiety

  OCD

  Trichotillomania

  hoarding disorder

  excoriation disorder
• what is OCD

  obsessions and/or compulsions
• what are obsessions

  unwanted, recurring, intrusive thoughts that cause significant distress and anxiety

  cognitive

  often themes of contamination, violent or sexual images
• what are compulsions

  behavioural

  repetitive behaviours that are an attempt to make obsessions go away

  e.g. handwashing
• trichotillomania

  compulsive hair-pulling
• hoarding disorder

  compulsive gathering of possessions

  inability to part with anything, regardless of value
• excoriation disorder

  compulsive skin-picking
• behavioural characteristics of OCD

  compulsions are repetitive

  compulsions reduce anxiety

  avoidance
• repetitive compulsions

  people with OCD feel compelled to repeat a behaviour

  e.g. handwashing , counting, praying
• compulsions reduce anxiety

  10% of people with OCD show compulsive behaviours alone- no obsessions

  but for most compulsive behaviours are performed to manage the anxiety produced by obsessions

  e.g. handwashing is carried out as a response to an obsessive fear of germs
• avoidance

  people with OCD attempt to reduce anxiety by keeping away from situations that trigger it

  can interfere with normal life

  e.g. fear of germs causes avoidance to raw chicken and cooking
• cycle of OCD

  obsessive thought --> anxiety --> compulsive behaviour--> temporary relief--> obsessive thought (etc)
• emotional characteristics of OCD

  anxiety and distress

  accompanying depression

  guilt and disgust
• anxiety and distress

  obsession and compulsions cause extreme anxiety

  obsessive thoughts are unpleasant and scary

  the urge of compulsions create anxiety
• accompanying depression

  OCD is often comorbid

  anxiety can be accompanied by low mood and lack of enjoyment

  compulsive behaviour brings slight relief from anxiety
• guilt and disgust

  OCD sometimes involves other negative emotions such as irrational guilt

  can be directed against something external e.g. dirt or at themselves
• cognitive characteristics of OCD

  obsessive thoughts

  cognitive coping strategies

  insight into excessive anxiety
• obsessive thoughts

  90% of people with OCD main cognitive feature is obsessive thoughts

  they vary between people but are always unpleasant
• cognitive coping strategies

  people adopt cognitive coping strategies to deal with obsessions

  helps to manage anxiety but can make the person appear abnormal to others

  can distract them from everyday tasks
• insight into excessive anxiety

  people with OCD are aware their thoughts aren't rational

  tend to be hyper vigilant

  people with OCD experience catastrophic thoughts about the worst case scenarios that might result if the anxieties were justified