Chapter 6 - Obsession & Preoccupation Flashcards
(15 cards)
what do all preoccupation and obsessive disorders relate to
Related to and involve an experience of anxiety.
what is Somatic Symptom Disorder and Related Disorder? what is the focus of the anxiety? are there any specifiers
- Focus of anxiety on preoccupation of symptoms.
- Symptoms can become aspect of identity: Life revolves around our symptoms. If I don’t have symptoms, I have a hard time understanding myself.
- Anxiety surrounding health and engage excessive time and energy devoted to those symptoms.
o More sensitivity surrounding symptoms.
SPecifier: pain, severe symptoms marked by impairements for 6 months
what is illness anxiety disorder? what is teh ansiwety orientated toward? are there any specifiers? how is it diffferent from somatic
Preoccupation of having or acquiring an illness.
- Formerly known as hypochondriasis
o Reworked the criteria in DSM 5 (stopped in DSM 4)
- Anxiety about an underlying illness, alarmed but health status
- Distinguishing between somatic symptom disorder: Usually there aren’t many somatic symptoms (mild if so).
- Specifier: care-seeking: Excessive health related behaviours.
- Maladaptive avoidance behaviours: shutting yourself out from the medical system
what are teh causes of somatic and illness anxiety disorder
Causes of Somatic Symptom and Illness Anxiety Disorder:
Super related to feelings of anxiety, hyper focus on bodily sensations.
1. Social Learning: Patterns and behaviors passed along parents or family members
2. Response to stressful life event: Somewhat adaptive from experiencing life events. We can go through something or vicariously that involves stressful events that can sensitize us.
3. Disproportionate incidence of disease within family: Many people in the family get certain disorder or illness that are genetically heritable can cue us in our bodies.
4. Interpersonal influences: Developing a sick role and when its primed it can encourage us to take on this role.
- Benefits of being sick: Having an out for something, attention, being catered to
what are treatments for somatic and illness anxiety disorder
- Exploring unconscious conflicts psychodynamically
- Existential perspective: We project ourselves into the future when we feel these distressing things and if we get an alert of being close to death can accompany anxiety.
o Fava et al., 2000 study – 20 individuals who met DSM of illness anxiety disorder (divided to two groups) and administered explanatory therapy (clinician would explain the disorder, causes, what we understand it as) and assessed symptoms right after. The other group didn’t get explanatory therapy until after the follow up. Group who had clinicians explanatory therapy had reduced symptoms and maintained reduction after 6 months follow up. - CBT focused on clients eliciting their own symptoms in order to increase sense of control
what is conversion disorder? WHat about freaud? what is the focus of anxiety?
Individual has one or more symptoms of some altered voluntary motor or sensory function (e.g. paralysis of the limbs, blindness) but there is no organic pathology
o If we experience a lot of anxiety and it feels too much to process and deal with, we will have unconscious defense mechanisms that protects our egos and gets expressed n other ways.
- Precipitated by stress: when we are stressed, the symptoms get worse.
- La belle indifference: There tends to be a particular indifference in the symptoms. The person who experiences the symptoms aren’t too bothered by them (i.e. gets minimized).
specifier: acute episode (less than 6 months) and persistent
what is facticious disorder. formerly known as? Specfier? what is malingering?
Faking psychological or physical signs or symptoms of injury or illness for some benefit without obvious external benefit.
- Malingering; lying with an overt motivation or gain. Factitious disorder is different because there is deception but there’s no overt motivation or gain (i.e. benefit of sick role).
- Formerly Munchausen syndrome by proxy: Factitious disorder imposed on another. Someone we rely on and do things to keep them sick.
- Internal gain: considered by psyche or emotional internal gain
- Factitious Disorder
singular or recurrent
what is OCD? WHat is the anxiety towards? specifier?
- Characterized by anxiety with a focus on unwanted and persistent and intrusive thoughts or images. (not what will happen in the world, it’s about a through arising in our minds)
- Obsessions: Thoughts
- Compulsions: Actions and rituals to repress the thoughts
- Comorbid with tic-disorder (10% OCD cases) and other anxiety disorders.
- Lots of self-judgement and criticism of our own thoughts and if we are hyper aware and critical, it makes sense that someone would have to work really hard to change their thinking repertoire
- Specifiers: recognize that this is a problematic behaviour
o If the compulsions are justified it make in more difficult
if left untreated, what happens to OCD symptoms
Obsessions left untreated can build on themselves and can get debilitating.
o Compulsion comes with relief
what are the types of obsessions
- Symmetry/exactness: Repeat actions until it feels just right. (27% of OCD cases)
- Forbidden thoughts or actions: checking or avoidance behaviours (21% OCD cases)
- Cleaning/contamination: (16% of OCD cases)
- Hoarding: (15% of OCD cases)
what are the causes of OCD
- Thought-action fusion: A pattern where we tend to equate a thought with an action/activity (if I look at this thing my brother will get cancer)
o Theres a higher likelihood of OCD if we come from a family that has more religious or fundamental households (black and white worldviews). - Thought Suppression and Obsessional Thinking: If we assess a thought as negative and unacceptable, it makes sense that we want to supress that thought.
o Theres a level of control where if they aren’t in control then anything could happen, so I need to do these things to make it stop.
what are OCD treatments
- SSRI’s: Regulating serotonin levels seems to be helpful in regulating thought patterns but relapse occurs when discontinuing medications (~60% effective)
- Behavioural Approaches:
o Exposure & Ritual Prevention (ERP): Prevent rituals from being actively carried out. Eliciting and being with clients when these compulsions come to develop a window of tolerance to client to learn to trust themselves.
o CBT - Psychosurgery: Lesion or ultrasound to the cingulum bundle (~30% effective)
o Function of Cingulum: Executive control, emotion, episodic memory
what is BDD? is it related to OCD? what is anxiety orientated towards?
- Preoccupation with one or more defects or flaws in physical flaws that are not observable or are perceived slight to others.
- Closely related to OCD
- Similar brain patterns and age of onset with OCD
- BDD tends to be under diagnosed and tends to be chronic
- Treatment: SSRI’s, CBT but people try to fix the imagined ugliness with plastic surgery
what is hoarding disorder? what are the 3 charactersitics
Three characteristics:
- Excessive acquisition
- Difficulty discarding anything
- Living in excessive clutter
what is trichotillomania and excoration? how do you treat and what is it comordbis with
Trichotillomania:
- Obsessional or repetitive urge to pull out their own hair on their body
Excoriation:
- Skin picking recurrent
- Causes significant distress
Co-morbid: OCD, BDD, both of the ones listed
Habit Reversal Training: Replace behavioural patterns with something else or also CBT.
