OCD

• DSM-5 categories of OCD

  • OCD
  • Trichotillomania
  • Hoarding disorder
  • Excoriation disorder
• OCD


  Characterised by either obsessions (recurring thoughts, images, etc.) and/or compulsions (repetitive behaviours such as hand-washing). Most people with a diagnosis of OCD have both obsessions and compulsions.
• Trichotillomania


  Compulsive hair-pulling
• Hoarding disorder


  The compulsive gathering of possessions and the inability to part with anything, regardless of its value
• Excoriation disorder


  Compulsive skin-picking
• Behavioural characteristics of OCD


  • Compulsions are repetitive

  • Compulsions reduce anxiety.

  • Avoidance
• Compulsions are repetitive


  • people with OCD feel compelled to repeat a behaviour.

  • e.g. hand-washing, counting, praying and tidying/ordering groups of objects such as CD collections or containers in a food cupboard
• Compulsions reduce anxiety


  • Around 10% of people with OCD show compulsive behaviour alone - they have no obsessions, just a general sense of irrational anxiety.

  • for the vast majority, compulsive behaviours help manage the anxiety produced by obsessions.

  • e.g. compulsive hand-washing is carried out as a response to an obsessive fear of germs.
• Avoidance


  • People with OCD tend to try to manage/reduce their OCD by avoiding situations that trigger anxiety.

  • this avoidance can lead people to avoid very ordinary situations, such as emptying their rubbish bins, and this can in itself interfere with leading a normal life.
• Emotional characteristics of OCD


  • Anxiety and depression

  • Accompanying depression

  • Guilt and disgust
• Anxiety and distress


  • OCD is a particularly unpleasant emotional experience because of powerful anxiety that accompanies obsessions and compulsions. • anxiety that goes with obsessive thoughts can be overwhelming. • The urge to repeat a behaviour (compulsion) creates anxiety.
• Accompanying depression


  • anxiety can be accompanied by low mood and lack of enjoyment in activities. • Compulsive behaviour tends to bring some temporary relief from anxiety.
• Guilt and disgust


  • OCD sometimes involves other negative emotions such as irrational guilt. • e.g. over minor moral issues, or disgust, which may be directed against something external like dirt or at the self.
• cognitive characteristics of OCD

  • Obsessive thoughts

  • Cognitive coping strategies

  • Insight into excessive anxiety
• Obsessive thoughts


  • thoughts that recur over and over again always unpleasant.

  • e.g. worries of being contaminated by dirt and germs,
• Cognitive coping strategies


  response adopted by people to deal with their obsessions.

  • praying

  • meditating

  can make the person appear abnormal to others and distract them from everyday tasks.
• Insight into excessive anxiety


  • People with OCD experience catastrophic thoughts about the worst case scenarios that might result if their anxieties were justified.

  • also tend to be hypervigilant, ie. maintain constant alertness and keep attention focused on potential hazards.