+

Obsessive-Compulsive Disorder(OCD) Adriana Lawrence April 20, 2012 per. 5

+Question of the Day

What comes to mind when you hear the phrase (OCD)?

+Vocabulary Terms of OCD

Obsession- an idea or thought that continually preoccupies or intrudes on a person’s mind.

Compulsion- a repetitive and seemingly purposeful behavior performed in response to uncontrollable urges or according to a ritualistic or stereotyped set of rules.

+Obsessive Compulsive Disorder OCD

Obsessive-Compulsive Disorder (OCD)- an anxiety disorder in which people have unwanted and repeated thoughts, feelings, ideas, sensations(obsessions) or behaviors that make them feel driven to so something (compulsions).

Obsessive thoughts usually cross a fine line between normality and disorder when they constantly interfere with everyday living and causes the person distress and anxiety.

- ex. Checking to see that you locked the door is normal; checking 10 times is not.

+Associated Features -involves the repetition of a specific behavior

Washing and cleaning, counting, putting items in order.

Checking or requesting assurance.

Hoarding

- storing useless items such as outdated newspapers, mail, shopping bags and food containers.

+Associated Features (cont.)

Obsessions (repetitive thoughts)

Compulsions (repetitive behaviors)

1.Concern with dirt, germs, or toxins

1. Excessive hand washing, bathing, tooth brushing, or grooming

2. Something terrible happens (fire, death, illness)

Repeating rituals (checking doors locks, stoves)

3.Fear of causing harm to another

Refusing to shake hands or touch something

4. Fear of thinking evil or sinful thoughts.

Repeating specific words, phrases, or phrases.-being stuck on words, images, thoughts, usually disturbing that will not go away. (can interfere with sleep)

+Associated Features (cont.) Obsessions (repetitive thoughts)

Compulsions (repetitive behaviors)

5.Fear of making a mistake 5.Repeatedly checking something

6. Need for symmetry, or exactness (perfection)

6. Needing to perform a task a certain number of times.-homework, appliances, car breaks, eating food in a certain order, arranging thing is a precise way.

7. Fear of being embarrassed or behaving in a social unacceptable manner

Constant counting, mentally or aloud during the tasks.

8. Excess doubt and the need for constant reassurance (constant checking)

Collecting or hoarding items with no important value.(newspaper, mail, junk)

+Associated Features

A. Either obsessions or compulsions

Obsessions as defined by (1), (2), (3), and (4)

1. Recurrent and persistent thoughts, impulses or images that are experienced, at some point during the disturbance, as intrusive and inappropriate and that cause some marked anxiety/stress.

2. The thought impulses or images are not simply excessive worries about real life problems.

3. The person attempts to ignore, or suppress such thoughts, impulses or images or to neutralize them with some other thought or action.

4. The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind. (not imposed from with out as in thought insertion).

DSM-IV-TR Criteria for Obsessive Compulsive Disorder(OCD)

+Associated Features

Compulsions as defined by (1) and (2)

(1) Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response or an obsession, or according to rules that mush be applied rigidly.

(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. At some point during the course of the disorder, the person has recognized that obsession or compulsions are excessive or unreasonable. (NOTE: This does not apply to children).

+Associated Features DSM-IV-TR continued

C. The obsessions or compulsions cause marked distress are time consuming (take more than one hour a day), or significantly interfere with the person’s normal routine, occupational (or academic functioning or usual social activities or relationships.)

D. If another Axis I disorder is present, the content of obsessions is not restricted to it (e.g., preoccupation with food in the presence of an Eating disorder; hair pulling in the presence of Trichotillomania; concern with appearance in the presence of Body Dysmorphic Disorder; preoccupation with drugs in the presence of a substance Use Disorder; preoccupation with having a serious illness in the presence of Hypochondriasis; preoccupation with sexual urges or fantasies in the presence of a Paraphilia; or guilty ruminations in the presence of Major Depressive Disorder).

+Associated Features DSM-IV-TR

E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a medical condition.

Specify If

-With Poor Insight: If for the most of the time during the current episode, the person does not recognize that the obsessions and compulsions are excessive or unreasonable.

+Howie Mandel- Deal or No Deal game show host , OCD advocate, suffered from a germ phobia. *shaved his head to feel cleaner.

Before After

+Etiology- Researchers/Scientist Perspective

Researchers/ Scientist Perspective

-Undiscovered a striking correlation between certain kinds or bodily infections in young people and the development or aggravation of OCD Symptoms

-Although the relationship between the infection and OCD symptoms are unclear, scientist speculate that the infection affect areas in the brain.

- Can be hereditary; genes can be partly responsible for causing the disorder.

- However, no one really knows the actual cause. (theories).

+Etiology-Behaviorist Theory of OCD

Symptoms of OCD become established through a process of conditioning, in which their behaviors become associated with the momentary relief of anxiety.

-Negative reinforcement

+Etiology- Cognitive Behaviorist Perspective Individuals with OCD are primed to be over reactive to anxiety

producing events in their environment

Assumed that the patients are disturbed by the thought of the need to be perfect, the belief that they are responsible for harm of others and concerns over the possibility of danger.

People with Obsessive Compulsive Disorder have memory deficits. This causes them to have

a. Difficulty remembering behaviors

ex. Turning off the stove, locking the door

b. Constant doubting is related to a true inability to remember whether they have completed these acts.

+Prevalence Affects about 3.3 million adults and approximately 1

million children and adolescents in the U.S.

Many children who do develop OCD show a unique pattern of characteristics

ex. Perform their rituals in the right way or else their day will not go well.

More common in males:

- Between the ages of 6-15

- females tend to develop OCD around the age of 20-29

More common among teens and young adults than older people.

+Treatment- Many clinicians recommend psychological interventions along with medications to treat OCD.

Cognitive Behavioral Therapy (CBT)

- the goal of is to teach people witch OCD to confront their fears and reduce anxiety without performing the ritual behaviors (reducing the exaggerated thinking that occurs)

Ex. Exposing them to situations that provoke compulsive rituals or obsessions

+Treatment cont.

Medical therapy- antidepressants including Fluoxetine(Prozac) and Sertraline (Zoloft) has proven to be the most effective biological treatment for obsessive compulsive disorder.

If a patient doesn’t respond to Prozac or Zoloft, then they can be prescribed with Fluvoxamine (Luvox).

If they don’t respond to these medications they may benefit from Risperidone(Risperdal)

+Prognosis

Some people choose to hide their symptoms of OCD due to embarrassment.

seek help after so many years after the systems have been considered normal for them.

On average

-70 percent of OCD patients benefit from medicine or cognitive behavioral therapy

-40-60% reduction of OCD is from medicine

- 60- 80% reduction of OCD symptoms due to (CBT)

Medicine has to be taken on a daily basis and must actively participate in CBT for the treatments to function properly.

+References Halgin, R.P., & Whitbourne, S.K. (2005). Abnormal psychology: Clinical perspectives

on psychological disorders. New York, New York: McGraw Hill.

March, J. & Benton, C. (2007). Talking Back to OCD. (pp.10-11). The Guilford Press.

McDonagh, M. (2007, May 8). Mental illness needs range of treatments, says expert. Irish Times. http://search.ebscohost.com/login.aspx?direct=true&db=nfh&AN=9FY2781861207&site=src-live

Myer’s, D.G. (2011). Myer’s psychology for ap. New York, New York: Worth Publishers

Mice provide new clues about obsessive-compulsive disorder. (2007). Harvard Mental Health Letter, 24(6), 7. http://search.ebscohost.com/login.aspx?direct=true&db=hxh&AN=27653975&site=src-live

Obsessions and compulsions in youths. (2012). Harvard Mental Health Letter, 28(7), 1-2

http://search.ebscohost.com/login.aspx?direct=true&db=hxh&AN=70122100&site=src-live.

What you need to know about: Obsessive compulsive disorder. International OCD Foundation. www.ocdfoundation.org.

+Discussion

Which treatment is most effective for people with OCD?