OCD Flashcards
(22 cards)
DSM-5: OCD + related disorders
- OCD: intrusive thoughts/ beh
- Hoarding disorder: persistent difficulty in discarding/parting with possessions
-Trichotillomania - Body dysmorphic disorder: excessive concern in perceived deficit in body part
- Excoriation (skin-picking)
OCD -criteria
-presence of obsessions, compulsions or both
- Obsessions = recurrent + persistent intrusive thoughts causing anxiety/ distress
-compulsion = repetitive beh to reduce anxiety
Pauls et al - model of OCD
- stimulus = obsession = distress = compulsions = temporary relief from distress = reinforces beh
Types of OCD
- cleanliness = handwashing, germs
- checking = checking something over + over again(e-g. locking door)
Frontal striatal activation + OCD
- over active in OCD
-Maltby et al study -> ppts respond ASAP to letter k , when mistakenly responded to x, OCD had slightly higher activity than controls
Anterior cingulate cortex + orbitofrontal activity +OCD
-Maltby et al -> ppts with OCD show excess activity during correct rejection of x in these areas
- suggests compulsive beh are accompanied by increased activity + feeling things aren’t right when completing a task = checking beh
serotonin, Obsession + love
-Marazitt et al
- ppts who had recently fallen in love scored high on OCD scale + showed comparably low levels of serotonin as OCD patients
OCD treatment
- respond well to certain edrugsg-clomipramine + SSRIs
- CBT good success rates:
-Beh -> receive exposure to obsession whilst using relaxation techniques + preventing compulsion = anxiety extinguished
-cog-> restructuring + breaking down irrational beliefs + using self-report to control antiety
-Simpson et al > CBT enhances impact of SSRI on OCD
Neurological changes with OCD treatment
- Nako et al > symptom provocation task
-All OCD treated with fluoxetine + CBT show reduced orbitofrontal + anterior cingulate activation after treatment - Nabeyama et al > CBT alone reduced frontal response to symptom provocation test
Hoarding Disorder + DSM- 5
- criteria A -> difficulty discarding/ parting with possessions
-criteria B -> distress with discarding them
-mentioned first in 1994 - got own category in 2013
OCD + Hoarding Disorder
- No entry up to 2010
- Not introduced as disorder till 2022
cog Beh Model + Hoarding disorder
- Grisham + Baldwin -3 components of stekettee + Frost CBM
- pos emotions associated with belongings
-reluctant to discard belongings due to resulting distress = avoidance beh
-cog issues (memory, attention)
Attentional issues + hoarding
- Grisham et al assessed ADHD like symptoms + attention to keep watching for a specific letter presentation
-ppts with hoarding scored high ADHD + performed less well on atention task
Hoarding vS OCD
- Tolin et al
-go/no-go object presentation task - OCDS big orbitofrontal cortex response to correct rejects
-Hoarders didn’t - large precentral gyrus response instead - shows difference between 2 disorders
Psychological Treatment for hoarders
- Muroff et al assessed CBT for hoarding with 12 month follow up
- most patients showed no/very little improvement
- exposure of getting rid objects
Pharmacological treatment for hoarders
- Grassi et al -> Treated ppts with anti ADHD drug atomoxetine for 12 weeks
- majority showed large improvement in severity
- Antidepressants are most common
- SSRIs most recommended
DSM-5 Body Dysmorphic Disorder
- criteria A -> perceived defects or flaws in physical appearance that aren’t observable by others
- criteria B-> perform repetitive (mirror checking, excessive grooming)or mental acts (comparing appearance)
BPD- The Wolf Man
- Freud treated wolf man for reoccuring nightmares about wolves
-he developed an obsession with his nose - neglected daily life
BDD: suicidal indeation
-Phillips 2007 - mean annual suicide attempt rate of 2.6% is 3 -12 higher than US
BDD + orbitofrontal cortex + occipital cortex activity
-feusner et al-> presented ppts own face to BDD patients + found increased activity in orbitofrontal cortex
- But decreased activity in occipital cortex indicating suppression of visual info
face matching + BDD
- feussner et al
- Target faces presented Then 2 faces to choose from same, distorted
- All ppts quickly match target face when upright
- controls slower when face is inverted but BDD less effected because see face details more than others
BDD + treatment
- crereand et al-> cosmetic surgery was no help + some made things worse
-Phillips et al -> ppts had mix of SSRI/ psychotherapy + found high release rates - Exposure therapy to feared activity (interact with people who could be critical of their looks)
