Obsessive Compulsive Disorder

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Obsessive Compulsive Disorder. Sally Lee and Angela Lu. Classification of OCD. Classified as anxiety disorder ICD-10 classifies it separately “neurotic, stress-related, somatoform disorder” Obsessions: plagued by persistent recurring thoughts that reflect exaggerated anxieties or fear - PowerPoint PPT Presentation

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Obsessive Compulsive Disorder

Obsessive Compulsive DisorderSally Lee and Angela LuClassification of OCDClassified as anxiety disorderICD-10 classifies it separately neurotic, stress-related, somatoform disorderObsessions: plagued by persistent recurring thoughts that reflect exaggerated anxieties or fearCompulsions: rituals or routines that relieve anxietyPatient BehaviorExcessive double-checkingCounting, tapping, repeatingOrdering, arrangingAccumulating junk (newspaper, containers..)Keep on washing, cleaning

Psychological PerspectiveCompulsions seen as learned and reinforced responses that help an individual reduce or prevent anxietyMisinterpretation of intrusive thoughts, causes creation of obsessions and compulsionsDysfunctional beliefs: inflated responsibility, over-importance of thoughts, control of thoughts, overestimate of threat, perfectionism, intolerance for uncertainty Biological PerspectiveIncreased grey matter volumes in bilateral lenticular nucleiAbnormalities with neurotransmitter serotonin (relatively under-stimulated) and dopamineDifferent functioning of circuitry in the striatum region of brainHyperactive anterior cingulate cortex (monitors actions, checks for errors)Genetic PerspectiveMutation in human serotonin gene hSERTHeritable factor (45-65% of OCD symptoms in children)Helped ancestors to be extra cautious, just taken to the extremeMay have helped ancestors to be wary of bad things and to be cleanEnvironmental/Social PerspectiveChildhood OCD can be triggered by a specific, often traumatic event (death, divorce, move)Stress can increase intrusive thoughtMore negative life events one or two years priorOnset is not related to family, but maintenance of OCD symptoms are associated with family members (can make things worse if they help)Seen as crazy socially and so many people try to hide it even though it causes them distress and the condition can worsenCultural PerspectiveCultural variation has minimal influence on lifetime prevalence ratesSymptoms take on characteristics of patients cultureMuslim culture uses religious connotation of weswas (devil and obsession)Religion can provide a huge part of obsessionsUS FrequencyFourth most common psychiatric disorderLifetime prevalence of 2.5%Similar rates reported across diverse culturesTenth most disabling medical disorder1 in 100 adults1 in 200 children and teens

Treatment & TherapyAs a chronic illness, OCD patients tend to have periods of severe symptoms followed by times of improvementA completely symptom-free period is uncommonPsychotherapynot an effective treatmentBetter combined with cognitive-behavioralProvide effective ways of reducing stressReduce anxietyResolve inner conflicts

11Insight TherapyKnowing oneselfAlso called psychodynamic psychotherapyExplore inner workings of mindUnderstand stuckness -> help move forward

Humanistic TherapyWork more broadly to examineWhole approach to lifePrevious experiencesOwn expectations/relationship with selfbecome confidentApproach fearful situations in diff. ways anxiety removed/more manageableCognitive-Behavioral TherapyAlso called exposure & ritual preventionSuccessful 80% of the timeMost effective + well-researched treatmentFocus on how thought triggers anxietyExpose directly prevent from performingCBT is part of an integrated approach to these moods, and helps one learn to catch these thoughts as they happen, challenge them, and replace them with more accurate, and more positive assessments.Negative thoughts breed negative moodsIn using CBT we focus in on how thoughts are actually helping to trigger upwellings of depression and anxiety. Your mood is very responsive to thoughts; if you are constantly thinking negative thoughts, then it's impossible that your mood will not reflect it.CBT has been heavily researched, and has been shown to be very effective in alleviating the worst of depression and anxiety. It can be surprising to see how impactful thoughts are, but it's absolutely true. When you learn to consciously shift your thinking, you both stop triggering the depression/anxiety, but you also start feeling in control of your inner life.CBT is a way of taking apart old habits of thought, and putting in their place healthier patterns of thought that, because of the way the brain is wired, inevitably lead to more buoyant moods that sustain over time. This is the absolutely essential skills-building part of therapy.14Group TherapyInteraction with other OCD sufferersProvide support + encouragementDecrease feelings of isolationImprove social skillsFace fear role play activities15Somatic TherapyAlso called experiencing therapyTalk body sense + mental imagesGuide through experience tasksHelp release stored emotionsShut down within nervous systemAfter, feel released / freeFinally, a feeling-orientated counsellor would perhaps work more broadly with the client to examine their fears in the context of who they are as a whole, perhaps exploring how their whole approach to life, their previous experiences, their own expectations or their relationship with their Self (including expectations 'internalised' from others) was leading them to become fearful. They may also help the client to become more confident by helping them become aware of the full range of their personal resources. Sometimes, fear is experienced when a client is trying to be someone they are not. By being true to themselves and their feelings, clients often learn to approach fearful situations in a completely different way and the anxiety is either removed or made more manageable.16PsychosurgeryUsed in extremely refractory cases of OCDOver 80% of patients respond favorably

Psychopharmacological Drug TreatmentsNo ongoing effects once medication stoppedAntidepressantsSRI TCA, SSRISSRI more widely usedAntipsychotic medicationsAnxioloyticsBenzodiazepinesUnreliably effective

Works CitedAanstoos, C. Serlin, I., & Greening, T. (2000). History of Division 32 (Humanistic Psychology) of the American Psychological Association. In D. Dewsbury (Ed.), Unification through Division: Histories of the divisions of the American Psychological Association, Vol. V. Washington, DC: American Psychological Association.Bugental, J.F.T (1964). The Third Force in Psychology. Journal of Humanistic Psychology, Vol. 4, No. 1, pp. 19-25Kring, A. M., Johnson, S. L., Davison, G. C., & Neale, J. M. (2010). Chapter 5: Anxiety Disorders. In Abnormal Psychology (pp. 119-153). Hoboken, NJ: John Wiley & Sons, Inc.Myers, D. G. (2010). Psychological Disorders. In Psychology (Ninth ed., pp. 593-669). New York, NY: Worth Publishers.Rowan, John (2001). Ordinary ecstasy : the dialectics of humanistic psychology. Hove: Brunner-Routledge