OCD

Question 1

DSM-5 categories of OCD

Answer 1

• it is an anxiety disorder, prevalence about 4% in UK

OCD - obsessions (recurring thoughts) or compulsions (recurring behaviours), most people with OCD have both

trichotillimania - compulsive hair-pulling

hoarding disorder - compulsive gathering of possessions, inability to part with something regardless of value

excoriation disorder - compulsive skin-picking

Question 2

behavioural characteristics of OCD - compulsions are repetitive

Answer 2

• people typically feel compelled to repeat a behaviour in order to help anxiety, for example hand washing
• other common compulsions include counting, praying, or ordering groups of objects

Question 3

behavioural characteristics of OCD - compulsions reduce anxiety

Answer 3

• around 10% of people with OCD show compulsions alone, they have no obsessions but an irrational sense of anxiety
• compulsive behaviours are often performed in an attempt to manage the anxiety produced by obsessions
• for example, compulsive hand washing is carried out as a response to an obsessive fear of germs

Question 4

behavioural characteristics of OCD - avoidance

Answer 4

• behaviour also characterised by avoidance, people try to reduce anxiety by keeping away from situations that trigger it
• for example, people who hand-wash compulsively may avoid coming into contact with germs
• this avoidance can lead to people avoiding ordinary situations, which can interfere with regular life

Question 5

emotional characteristics of OCD - anxiety and distress

Answer 5

• unpleasant emotional experience due to the powerful anxiety that accompanies compulsions and obsessions
• obsessive thoughts are unpleasant and frightening, anxiety can be overwhelming
• urge to repeat a behaviour causes anxiety

Question 6

emotional characteristics of OCD - accompanying depression

Answer 6

• OCD often accompanied by depression, anxiety accompanied by low mood and lack of enjoyment in activities
• compulsive behaviour tends to bring relief from anxiety but this is temporary

Question 7

emotional characteristics of OCD - guilt and disgust

Answer 7

• OCD often involves other negative emotions such as irrational guilt over minor moral issues
• or disgust, may be directed against dirt or the self

Question 8

cognitive characteristics of OCD - obsessive thoughts

Answer 8

• for around 90% of people with OCD, obsessive thoughts is the major cognitive feature
• these can vary but are always unpleasant
• for example, worries about dirt or germs, or impulses to hurt someone

Question 9

cognitive characteristics of OCD - cognitive coping strategies

Answer 9

• people respond by adopting cognitive coping strategies to deal with obsessions
• for example, a religious person with extreme guilt may respond by praying or meditating
• this may help anxiety but may make the person seem abnormal, and can disrupt daily tasks

Question 10

cognitive characteristics of OCD - insight into excessive anxiety

Answer 10

• people with OCD are aware that their obsessions and compulsions are not rational, this is necessary for a diagnosis of OCD
• however people experience catastrophic thoughts about worst case scenarios that might result if their anxieties were justified
• also tend to be hypervigilant, they maintain constant awareness and keep attention focused on potential hazards

Question 11

cycle of OCD

Answer 11

->obsessive thought->anxiety->compulsive behaviour->temporary relief->obsessive thought