module 9 Flashcards
(16 cards)
DSM criteria OCD
- Presence of obsessions, compulsions or both
- Theyre time consuming, cause distress
- No substance abuse
common OCD themes
- cleaning / contamination
- sexual / violated related thought
- responsibility for causing harm / checking
- ordering / counting
Comorbidities OCD
mood disorders, anxiety disorders, SUD and impulse control disorders
OCD vs OCPD
OCD is very situation specific, and ego dystonic
OCPD is always (in control etc), and ego syntonic
6 cognitive biases in OCD (dysfunctional beliefs)
Thought action fusion
inflated responsibility
catastrophising
intolerance for uncertainty
overestimation of danger
perfectionism
cognitive techniques for overcoming dysfunctional beleifs
estimation of catastrophe
estimation of responsibility (pie)
exposure and response prevention
CBT in OCD
- psychoeducation
- change / motivation
- Exposure response prevention
- focus on repairing dysfunctional beliefs
medication in OCD
SSRI’s, clomipramine, antipsychotics
neuromodulation
rTMS
DBS
cognitive theory of OCD
compulsions are aimed at preventing / reducing anxiety and distress. Therefore they are goal-directed, according to DSM. They are rational actions based on irrational beliefs and those beliefs stem from cognitive biases. Compulsivity develops as a consequence of cognitive biases.
Habit theory of OCD
compulsions cause relief, which is a negative reinforcer for compulsions, which leads to habit formation
impaired executive functions in OCD
cognitive flexibility: poor results on WSCT
Decision making: also poor choices on IGT. No diffference in DD, accept for when OCD is comorbid with MDD or GAD
inhibitory control: score low on stop/signal task. Other tasks nothing found.
Habit research OCD
Outcome revaluation paradigm (shock test)
slips of action task
still the big question
habit reversal therapy
1 awareness training
2 competing response training
outcome revaluation paradigm
- Blue square = shock on right hand. To prevent, press right foot padel, same for red/left
- One of the electrodes was removed from hand, so no shock. One of the shocks was revalued.
- After short training, OCD same results as control stop pressing
- After extensive training: OCD pressed more often to avoid devalued shock
Why rTMS in what brainpart
stimulates activity in DLPFC, because this is hypoactive, causing impairment in goal-directed behaviour
