Obsessive-Compulsive and Related Disorders (Morrison, Ch. 5)

Question 1

The decreasing abilities or loss of normal functions
(affect, speech, avolition)

Answer 1

Negative Symptoms

Question 2

An excess or distortion of normal functions (e.g. delusions,
hallucinations, etc.)

Answer 2

Positive Symptoms

Question 3

The ability to distinguish between reality and fantasy

Answer 3

Reality Testing

Question 4

Patients who are preoccupied with obsessional ideas or certain repetitive behaviors

Answer 4

Obsessive Compulsive and Related Disorders

Question 5

Morrison’s comments on common features among Obsessive Compulsive and Related Disorders are:

Answer 5

• Onset when young
• Similar comorbidity (depression)
• Family history of OCD
• Similar treatment response
• Hints of dysfunction in the frontostriatal brain circuitry

Question 6

Persistent ideas, thoughts, impulses, or images that are experienced as intrusive and unwanted that cause marked anxiety or distressed

Answer 6

Obsessions

Question 7

Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) the goal of which is to prevent or reduce anxiety or distress, not to provide pleasure or gratification.

Answer 7

Compulsions

Question 8

Which disorder’s Diagnostic Criteria is the following:
A. Either obsessions OR compulsions OR both
Obsessions as defined by 1 and 2 below:
1. Persistent ideas, thoughts, impulses, or images that are experienced as intrusive and unwanted that cause marked anxiety or distressed
2. The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action

Compulsions as defined by 1 & 2 (below)
1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) the goal of which is to prevent or reduce anxiety or distress, not to provide pleasure or gratification.
2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive

B. The obsessions or compulsions caused marked distress, are time-consuming
(take ≥ 1 hour a day), or significantly interfere with the functioning
C. The disturbance is not due to substance use or a general medical condition

Answer 8

Obsessive Compulsive Disorder

Question 9

Prevalence for Obsessive Compulsive Disorder is:

Answer 9

1.2-2%

Question 10

The onset for Obsessive Compulsive Disorder is typically in:

Answer 10

Adolescence or early adulthood (between 19 and 24 years; mean age of onset 19 years old)

Question 11

Obsessive Compulsive Disorder is more common in higher _______ and high _______.

Answer 11

Socioeconomic status
intelligence

Question 12

Obsessive Compulsive Disorder appears to affect men and women about _____.

Answer 12

equally

Question 13

_____ of Obsessive Compulsive Disorder comorbid with depression.

Answer 13

2/3

Question 14

Up to ____% of Obsessive Compulsive Disorder attempt suicide.

Answer 14

25%

Question 15

______ plays an important role in OCD

Answer 15

Heredity

Question 16

Among family members of OCD patients, the prevalence of OCD and related symptoms is ______ than in the general population.

Answer 16

6 times higher

Question 17

For OCD: ___% concordance rate for monozygotic twins, ___% concordance rate for dizygotic twins.

Answer 17

.57%
.22%

Question 18

Without treatment for OCD, chronic course: Remission rate around __% among adults 40 years after diagnosis.

Answer 18

20%

Question 19

____ has a preoccupation with an imagined defect or flaw in physical appearance not observable or appear slight to others

Answer 19

Body Dysmorphic Disorder (BDD)

Question 20

____ has engaged in repetitive behaviors or mental acts in response to appearance concerns (mirror checking, excessive grooming, comparing appearance with that of others

Answer 20

Body Dysmorphic Disorder (BDD)

Question 21

_____ is dissatisfaction with overall body shape and anorexia nervosa are excluded. Note not delusional, more of an overvalued idea.

Answer 21

Body Dysmorphic Disorder (BDD)

Question 22

The prevalence of Body Dysmorphic Disorder (BDD) is __%

Answer 22

2.5%

Question 23

__% of patients diagnosed with Body Dysmorphic Disorder (BDD) in U.S. get cosmetic surgery?

Answer 23

7-8%
(Note: 1/3 of patients seeking rhinoplasty)

Question 24

The onset of Body Dysmorphic Disorder (BDD) is typically in ____. Subclinical signs most commonly in ___ years old.

Answer 24

adolescence
12-13 years old

Question 25

Body Dysmorphic Disorder (BDD) effects men and women _____.

Answer 25

Equally

Question 26

_____ comorbid with depression, social anxiety disorder, OCD, substance disorder

Answer 26

Body Dysmorphic Disorder (BDD)

Question 27

Which diagnosis includes, “high” SI, “high” suicide attempt?

Answer 27

Body Dysmorphic Disorder (BDD)

Question 28

Most frequently performed cosmetic surgery in the US since the early 2000s is _____.

Answer 28

Rhinoplasty

Question 29

______ Disorder: 1. Persistent difficulty discarding or parting with possessions, regardless of their actual value. 2. Difficulty due to a perceived need to save the items and to distress associated with discarding them.

Answer 29

Hoarding Disorder

Question 30

______ Disorder: 3. The difficulty of discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromise their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (e.g., family members, cleaners, or the authorities) * Incidence approx. 2-6%

Answer 30

Hoarding Disorder

Question 31

Onset of ______ begins in adolescence and gets worse every decade (clinical impairment by 30s)

Answer 31

Hoarding Disorder

Question 32

Hoarding Disorder is ___ more prevalent in older (55-94) than younger (34-44) ages

Answer 32

3X

Question 33

Hoarding Disorder is more common among ______, but _______ are more likely to be seen clinically.

Answer 33

Males Females

Question 34

Risk factors of Hoarding Disorder are:

Answer 34

Indecisive temperament Familial history

Question 35

Comorbidity of Hoarding Disorder: 75% either _______, 20% _____.

Answer 35

Mood or Anxiety Disorder OCD

Question 36

_______: A. Recurrent pulling out of one’s hair resulting in noticeable hair loss. B. Repeated attempts to decrease or stop hair pulling

Answer 36

Trichotillomania (hair pulling)

Question 37

Former criteria for ______: - An increasing sense of tension immediately before pulling out the hair or when attempting to resist the behavior - Pleasure, gratification, or relief when pulling out the hair

Answer 37

Trichotillomania (hair pulling)

Question 38

Trichotillomania prevalence: ____% in US population

Answer 38

1-2%

Question 39

Onset of Trichotillomania typically in ________. May wax and wane.

Answer 39

childhood or adolescence

Question 40

Risk factors of ______ are genetic vulnerability, OCD, or relative with OCD.

Answer 40

Trichotillomania

Question 41

Many more ______ than ______ are diagnosed with Trichotillomania. The ratio is 10:1.

Answer 41

women than men

Question 42

_____ is: 1. Repeated skin picking, resulting in skin lesions 2. Repeated unsuccessful attempts to decrease or stop picking skin

Answer 42

Excoriation

Question 43

The prevalence of Excoriation is __%

Answer 43

2%

Question 44

Excoriation onset is typically in ______.

Answer 44

Adolescence

Question 45

_____ risk factors: more common in individuals with OCD or having a relative with OCD.

Answer 45

Excoriation

Question 46

In Excoriation diagnosis, ___ are female.

Answer 46

75%

Question 47

Most individuals with Excoriation Disorder spend ______ per day picking or trying to resist picking.

Answer 47

an hour or more

Question 48

"Repeated hand washing in response to your fear that your hands are contaminated" is most like a _____ in Obsessive Compulsive Disorder

Answer 48

compulsion