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Chapter 7:

Chapter 7:. Obsessive-Compulsive Disorder and Social Anxiety Disorder. Obsessive-Compulsive Disorder (OCD). Characterized by obsessive thoughts and compulsive behaviors that arise as a consequence of those thoughts.

jesse-levine
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Chapter 7:

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  1. Chapter 7: Obsessive-Compulsive Disorder and Social Anxiety Disorder

  2. Obsessive-Compulsive Disorder (OCD) • Characterized by obsessive thoughts and compulsive behaviors that arise as a consequence of those thoughts. • Thoughts may appear “delusional” or have a “psychotic” quality; however, unlike individuals with a psychotic disorder, individuals with OCD are aware of how irrational their thoughts are.

  3. OCD • Begins at a young age (for men, 6 to 15, and for women, 20 to 29). • Usually a gradual onset. • 1 to 3% of people will develop OCD in their lifetime. • Chronic course and often very debilitating.

  4. OCD diagnostic criteria • Either obsessions or compulsions: • Obsessions as defined by all of the following: • Recurrent and persistent thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause distress and anxiety. • Thoughts, impulses, or images are not simply excessive worries about real life problems. • The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action. • The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind. • Contamination, aggression, sexual, blasphemy, doubts

  5. OCD diagnostic criteria • Compulsions as defined by all of the following: • 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 to an obsession or according to particular rules. • 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. • Obsessions and Compulsions are viewed as unreasonable.

  6. Theories of OCD • Most prominent psychological theory of OCD is cognitive-behavioral in nature. • Obsessions are caused by catastrophic misinterpretation of the significance of intrusive thoughts/images/impulses. • Through this catastrophic misinterpretation, neutral cues in the environment or internally are turned into threatening ones, leading to avoidance (compulsions).

  7. Theories of OCD • As a result of this avoidance, catastrophic misinterpretations are never challenged and thus persist. However, relief is achieved in the short term (compulsions negatively reinforced). • Attempts are made to avoid, neutralize, or suppress obsessions, leading to a vicious cycle. • Obsession  Neutralization  Relief  Confirmation of belief  Obsession

  8. Theories of OCD • Inflated responsibility for thoughts stemming from moralistic, rigid ways of thinking. • Thought-action fusion. • Underlying beliefs about one’s ability to control thoughts.

  9. Treatment • Cognitive Restructuring and Exposure • Response prevention  prevent the use of compulsions to manage obsessive thoughts. In doing so, individual may habituate to anxiety as a result of obsessions and obsessions can be disconfirmed.

  10. Social Anxiety Disorder • Persistent fears of situations involving social interaction or social performance or situations in which there is the potential for scrutiny by others. • More than 13% of the population meet criteria for SAD at some point in their lives. • More than just “shyness.” • Generalized (most social situations), Non-generalized (limited to specific situations)

  11. Model of SAD • Underlying beliefs that people are critical. • Poor mental representation of the self, especially in social situations. • Misinterpretation of internal and external cues that negatively influence the mental representation of the self.

  12. A Model of SAD • Attentional bias for negative cues (e.g., frowning, yawning) that confirm maladaptive beliefs about the self and performance. • All of this information is used to create a prediction of what the audience expects and how the individual is performing. With SAD, there is a huge discrepancy between these two evaluations.

  13. A Model of SAD Mental resources allocated to many different tasks (multiple-task paradigm). -Monitor external threat -Monitor self-presentation -Attention also given to task at hand All of this results in heightened anxiety (e.g., blushing, sweating, stammering) and avoidance behaviors (e.g., avoiding eye contact, reducing verbal output, etc.)

  14. Treatment • Again, cognitive-behavioral treatment has been found to be highly effective for SAD. • Cognitive restructuring for maladaptive beliefs about the self, performance expectations, and interpretations of audience’s behavior. • Exposure to social situations. • Attentional control training.

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