abpsych lecture 5-6: ocd & ptsd

• What are obsessions in Obsessive-Compulsive Disorder (OCD)?


  Intrusive and recurring thoughts, images, or impulses that are persistent and uncontrollable
• What are compulsions in OCD?

  Repetitive, clearly excessive behaviors or mental acts that the person feels driven to perform to reduce anxiety
• When do OCD symptoms typically begin?

  Before age 10 or in late adolescence/early adulthood
• At what age have OCD symptoms been described in children?

  As young as age 2
• Which gender is slightly more likely to develop OCD?

  Women
• Is OCD a chronic disorder?

  Yes, OCD is a chronic disorder
• What are some common comorbid conditions with OCD?

  Anxiety disorders, major depression, substance use, and hoarding
• What are some commonly reported compulsions in OCD?

  • Pursuing cleanliness and orderliness through elaborate rituals
  • Performing repetitive, magically protective acts (e.g., counting)
  • Repetitive checking to ensure certain acts are carried out
• What is Body Dysmorphic Disorder (BDD) characterized by?

  Preoccupation with an imagined or exaggerated defect in appearance
• What body parts do women with BDD typically focus on?

  Skin, hips, breasts, and legs
• What body parts do men with BDD typically focus on?


  Height, penis size, or body hair
• On average, how much time do people with BDD spend thinking about their appearance?

  3 to 8 hours per day
• What emotional states do people with BDD often experience?

  High levels of shame, anxiety, and depression about their appearance
• What percentage of people with BDD are unable to work?

  About 40 percent
• Is BDD more common in women or men?

  Slightly more often in women
• What is the prevalence of BDD?

  Less than 2 percent
• When does BDD typically begin?

  In late adolescence
• How do symptoms of BDD vary across cultures?

  Symptoms and outcomes are similar, but the body part of concern may differ by culture
• What are some comorbid disorders associated with BDD?

  Major depressive disorder (MDD), social anxiety disorder (SAD), OCD, substance use disorder (SUD), and personality disorder (PD)
• What is the main issue for people with Hoarding Disorder?


  They abhor parting with their objects
• What types of items do people with Hoarding Disorder collect?

  Clothes, tools, antiques, old containers, bottle caps, and sandwich wrappers
• What living conditions may result from hoarding?

  Extremely filthy homes with overpowering odors from rotten food or feces
• What percentage of people with Hoarding Disorder are unable to use their toilet?

  About 10 percent
• What is the relationship between excessive buying and Hoarding Disorder?

  Three-quarters of people with hoarding disorder engage in excessive buying
• Is hoarding more common in men or women?

  More common among men
• When does hoarding behavior usually begin?

  In childhood or early adolescence
• What are some comorbid conditions associated with Hoarding Disorder?

  OCD, major depressive disorder (MDD), generalized anxiety disorder (GAD), and social phobia
• What is Trichotillomania?


  Recurrent pulling out of one's hair, resulting in hair loss
• What may trigger Trichotillomania?

  Feelings of anxiety or boredom
• What is the emotional experience associated with Trichotillomania?

  May be preceded by an increasing sense of tension and lead to gratification, pleasure, or relief
• What is Excoriation?


  Recurrent skin picking resulting in skin lesions
• What may trigger Excoriation?

  Feelings of anxiety or boredom
• What is the emotional experience associated with Excoriation?

  May lead to gratification, pleasure, or relief when the skin or scab has been picked
• What are the genetic and neurobiological factors in the etiology of OCD and related disorders?

  • Moderate genetic contribution (heritability estimates: 30-50%)
  • Hyperactive brain regions in OCD and BDD:
  • Orbitofrontal Cortex
  • Caudate Nucleus
  • Anterior Cingulate
  • Loss of neuronal function and biochemical abnormalities
• What cognitive and behavioral factors contribute to OCD?

  Cognitive Factors:

  • Deficit in yedasentience
  • Thought suppression and its paradoxical effect

  
  

  Behavioral Factors:

  • Operant conditioning: compulsions negatively reinforced by anxiety reduction
• How do people with BDD perceive their appearance?

  • Focus on details more than the whole
  • Consider attractiveness vastly more important
  • Believe self-worth is exclusively dependent on appearance
• What cognitive-behavioral factors are associated with Hoarding Disorder?

  • Poor organizational abilities
  • Unusual beliefs about possessions
  • Avoidance behaviors
  • Extreme emotional attachment to possessions
  • Objects seen as core to self and identity
• What are the psychological treatments for OCD and related disorders?


  • Exposure and response prevention
  • OCD: Exposure to situations that elicit compulsive acts, refrain from rituals
  • BDD: Exposure to feared activities, avoid reassurance activities
  • Hoarding Disorder: Exposure to getting rid of objects
• What is Post-Traumatic Stress Disorder (PTSD)?

  An extreme response to a severe stressor involving anxiety, avoidance, and emotional numbing
• What type of event typically leads to PTSD?

  Exposure to a traumatic event that involves actual or threatened death or injury