anxiety Flashcards

Question

OCD obsession

Answer 1

``` Obsessions Intrusive (ego-dystonic), unwanted, foreign (ego-alien), and recurring: • Thoughts • Images • Impulses Themes: contamination, aggression, violence, religion, sexuality, order ```

Answer 2

Compulsions Repetitive behaviour or mental act that the person feels driven to perform to: • Neutralize the obsessive thoughts or images • Prevent some dreaded event or situation Provide relief Functionally (but not necessarily logically) related to obsessions

Answer 3

``` Mental Rituals • Fluctuating Insight • Family Involvement • Avoidance • Reassurance-Seeking ```

Answer 4

``` Lifetime prevalence: 3% (no gender/ethnic differences) Onset typically early adolescence or adulthood Course often chronic (only ~40% seek tx) Most have multiple obsessions ```

Answer 5

Common (anxiety and mood disorders) | Depression in 80%

Answer 6

``` Etiology: Bio Genes Moderately heritable NTs 5-HT implicated SSRIs > emotional force …but > in 5-HT function not found ```

Answer 7

Abnormalities in brain function • Slight structural abnormalities in basal ganglia (caudate nucleus) • ↑ metabolic levels in other parts of the brain (e.g., thalamus – cleaning and checking)

Answer 8

Attention to material related to obsessions Bad thoughts = bad deeds (capable of causing harm) Self-blame Attempts to suppress thoughts increase them

Answer 9

``` Behavioural Theory: Conditioning 1. Initial fear classically conditioned 2. Compulsions negatively reinforced (operant conditioning) 3. Stimulus generalization ```

Answer 10

Behavioural Theory: Conditioning | Social reinforcement

Answer 11

Hyperactivity in neural loop: orbital frontal cortex  cingulate gyrus  striatum (caudate nucleus and putamen)  globus pallidus  thalamus  back to the frontal cortex

Answer 12

``` Basal ganglia Typical: Control of motor behaviour OCD: Compulsions (severity of disorder correlates with brain activity?) Treatment (Bio and Psycho)  R caudate nucleus activity ```

Answer 13

Orbitofrontal cortex (OFC) Typical: Emotion in reward/punishment anticipation OCD: Increased activity (preoccupation?)

Answer 14

Over-importance of thoughts • Possible and necessary to control thoughts • Catastrophic thinking  thought neutralization • Thought-action fusion Overestimation of threat • Inflated sense of personal responsibility Perfectionism, intolerance of uncertainty

Answer 15

Antidepressants (e.g., SSRIs) …but stimulating 5-HT makes OCD worse Cingulotomy (extreme cases) Cingulum: limbic system communication

Answer 16

Cognitive | Challenge maladaptive thinking patterns

Answer 17

Behavioural | Exposure & response prevention (ERP)

Answer 18

Cognitive Strategies Constructive self-talk Realistically assess the difficulty of resisting OCD Replace maladaptive cognitions with realistic self-statements that emphasize ability to cope with OCD: “This task will be difficult, but I can handle this much anxiety this one time” Cognitive restructuring Analyze catastrophic estimation of danger Look at perceived responsibility for occurrence of catastrophe Cultivating detachment OCD is just a brain hiccup (an automatic thought habit) that comes and goes in its own time (a cloud in the sky) These hiccups are not in themselves important (no response is necessary because content is meaningless) I guess I’ll do something pleasant while OCD goes away

Answer 19

“Thinking Mistakes” Black-and-White Thinking A situation is either one way or another (no “gray area”) Catastrophizing The very worst is happening/going to happen Threat Overestimation Chances of something bad happening > really are Mind Reading You know what others are thinking

anxiety Flashcards

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