Obsessive Compulsive/Trauma and Stress-related Disorders Flashcards
How is PTSD diagnosed?
Exposure to a traumatic event
Re-experiencing of symptoms (e.g., flashbacks)
Avoidance symptoms (e.g., avoidance of thoughts and reminders)
Negative changes in cognitions and mood (e.g., emotional numbing)
Marked alterations in arousal (e.g., hypervigilance)
What is the lifetime prevalence of PTSD?
Lifetime prevalence in Australia is approx. 1.3 per cent
Prevalence is similar in children and adults exposed to trauma
What are key Risk factors for PTSD?
Relatively few people develop PTSD following a trauma
Factors have been identified that increase the risk of developing PTSD following a trauma: including female gender, history of psychological disturbance, more severe traumatic exposure and low social support
What are key aetiology findings of PTSD?
Cognitive models: Maladaptive appraisal of the traumatic event
Learning accounts: Emphasises classical conditioning
Biological accounts: Extreme arousal at time of trauma results in a strong conditioned fear response
Avoidance: Avoidance of trauma reminders maintains PTSD
How is PTSD treated?
Medication: Particularly selective serotonin reuptake inhibitors (SSRIs)
Cognitive behaviour therapy (typical duration 9–12 sessions): Involving psychoeducation, anxiety management, cognitive restructuring, imaginal exposure and in vivo exposure, and relapse prevention
How is PTSD prevented?
Difficult to determine whether early interventions are effective or whether the stress response remits naturally
Post traumatic stress reactions in the initial month after trauma classified as acute stress disorder (DSM-IV)
Early interventions use CBT approaches
What are current challenges in treatment and prevention?
High rates of drop out from treatment
Need to better prepare patients to tolerate the distress of exposure therapy Potentially augment CBT by enhancing extinction
Internet-based approaches are promising
Also need to develop community-based treatments
How is OCD diagnosed?
Presence of obsessions: Intrusive impulses or images of a distressing nature
Presence of compulsions: Repetitive behaviours that the person feels compelled to perform
Symptoms cause marked distress, are time consuming or significantly interfere with person’s functioning
How does OCD appear in individuals?
OCD varies considerably from case to case
Common obsessions include: –Fear of contamination/germs; fear of fire, robbery, rape or assault; of losing one’s mind or becoming insane; of insulting others; of harming others by acting on a sudden impulse; of engaging in a paedophilic act etc.
Almost any behaviour can become a compulsion:–Checking power points; blinking one’s eyes; counting objects; saying a mantra; tapping a surface; hopping; arranging objects on a desk etc.
What is the prevalence of OCD?
2–3 per cent range
What are key aetiology findings of OCD?
Neuropsychological model:
–Failure of inhibitory pathways in the brain to stop ‘behavioural macros’ in response to internal or external stimuli
Cognitive model:
–Obsessional thoughts are common in the general population
–OCD sufferers interpret these thoughts to indicate that danger may occur to themselves or others
How is OCD treated?
Cognitive behaviour therapy is the treatment of choice: Involves exposure and response prevention along with cognitive restructuring
Medication: Only 40–60 per cent of sufferers seem to benefit from medication
What is Hoarding Disorder?
Persistent difficulty in discarding possessions, and high level of distress associated with removing items
Risks to health and safety, e.g., death from house fires stemming from hoarded newspapers
What is Body Dysmorphic Disorder?
Preoccupation with an imagined defect of appearance
Level of concern is excessive
Can display compulsive mirror-checking, excessive grooming, or reassurance-seeking
What is Trichotillomania?
Recurrent pulling out of one’s own hair, resulting in hair loss
Urge to remove hair is often associated with anxiety or worry
