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OBSESSIVE-COMPULSIVE DISORDER (OCD)

OBSESSIVE-COMPULSIVE DISORDER (OCD). BAHAR IŞIK 1663970. OUTLINE. What is OCD? Symptoms and Diagnosis of OCD Prevalence The Aetiology of OCD The Treatment of OCD. WHAT IS OCD?.

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OBSESSIVE-COMPULSIVE DISORDER (OCD)

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  1. OBSESSIVE-COMPULSIVE DISORDER (OCD) BAHAR IŞIK 1663970

  2. OUTLINE • What is OCD? • Symptoms and Diagnosis of OCD • Prevalence • TheAetiology of OCD • TheTreatment of OCD

  3. WHAT IS OCD? • ObsesiveCompulsiveDisorder(OCD), is a type of anxietydisorderwhere a personfocuses on unreasonablethoughts (obsessions). • Theseobsessionscauseirrationalrepetitivebehaviors(compulsions). • People with OCD may start torealizethattheirbehaviorsareirrationalandmaytryto stop orignorethem. • So, thiscouldcausemoreanxietyandmorebehaviorstorelievestress of thesestressfulsituations. • OCD makes people feel: Depressed, Embarrassed, Hopeless, Frustrated, Ashamed,Bullied,Exhausted..http://www.ocduk.org/ocd

  4. SYMPTOMS OF OCD • Obsession • Intrusive, recurring thoughts that the individual finds distressing(e.g. causing harm to someone you love) • Commonobsessions: dirtandcontamination, needforsymmetry, hoarding, sexualcontent, agressivecontent, superstitiousfears • Compulsions • Repetitive or ritualized behaviour patterns that the individual feels driven to perform (tryingtoreduceorremovethefearandanxietyb.oobsessions) • Commoncompulsions: cleaning&washing, arranginguntilthingsare ‘justright’, hoarding, checking, mentalrituals (prayers, countingetc.)

  5. DSM-IV-TR Diagnostic CriteriaforObsessions • Obsessions are defined as: • Recurrent and persistent thoughts, impulses, or images that are experienced, at some time duringthe disturbance, as intrusive and inappropriate and that cause marked anxiety or distress. • The 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 (not imposed from without as in thought insertion).

  6. DSM-IV-TR Diagnostic Criteriafor Compulsions • Compulsions are defined as: • Repetitive behaviours (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 rules that must be applied rigidly. • The behaviours or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviours or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

  7. Types of Compulsions • Compulsive checking (e.g. of doors and windows) • Compulsive washing(to prevent contamination and infection) • Superstitious ritualized movementsor thoughts (e.g. counting backwards till a thought has gone) • Systematic arranging of objects • Compulsive hoarding (disposophobia)

  8. Prevalence of OCD • Onset is usually gradual • Frequently manifests in early adolescence following a stressful event or life period • Lifetime prevalence rate is around 2.5% • Females more frequently affected than men

  9. The Aetiology of OCD • Biological Factors • Psychological Factors • Memory Deficits • Inflated Responsibility • Thought Suppression

  10. 1) Biological Factors • Onset can be associated with traumatic head injury • Problems in thefrontal lobesand basal ganglia • No specific gene associatedwith OCD- but when a parent has OCD there is an increased risk thatthechildwillalsodeveloptheillness (Dawey, 2008).

  11. Biological Factors (continue..) • Brain Differences- individualswith OCD usedifferentbrain in performing a cognitivetaskthanpeoplewithoutthedisorder (Rauch et al., 1997).

  12. pet scan.. Ssri.. • PET scans made at the Children's Hospital of Michigan PET Center, Wayne State University show lower serotonin levels in OCD patients than control subjects. Another PET scan shows that with SSRIs, the PET scan of an OCD patient after treatment looks more like the scan of the control subject's brainhttp://serendip.brynmawr.edu/bb/neuro/neuro00/web1/Hollander.html

  13. 2) PsychologicalFactors 1) Memory Deficits • Doubting is a central feature of OCD, so may reflect underlying memory deficits • General memory deficit • Less confidence in the validity of their memories • A deficit in the ability to distinguish between the memory of real and imagined actions • However, ‘doubting’ seems to be a consequence of compulsive behaviour (e.g. checking) rather than a cause of it (van den Hout & Kindt, 2003; cited in Dawey, 2008).

  14. Psychological Factors(contınue) 2) Inflated Responsibility: The belief that one has power to bring about or prevent subjectively crucial negative outcomes. • These outcomes are perceived as essential to prevent. • They may be actual, that is, having consequences in the real world, and/or at a moral level.

  15. Examples of Inflated Responsibility 1. I often feel responsible for things that go wrong. 2. If I don’t act when I can foresee danger, then I am to blame for any consequences if it happens. 3. If I think bad things, this is as bad as DOING bad things. 4. I worry a great deal about the effects of things that I do or don’t do. 5. To me, not acting to prevent disaster is as bad as making disasters happen. 6. I must always think through the consequences of even the smallest actions. 7. I often take responsibility for things that other people do not think are my fault.

  16. The Role of Inflated Responsibility • Inflated responsibility is a characteristic of individuals with OCD (Salkovskis et al., 1999 ; cited in Dawey, 2008). • Experimental studies that have manipulated inflated responsibility show that it causes increases in compulsions (Lopatka & Rachman, 1995; cited in Dawey, 2008).

  17. PSYCHOLOGICAL FACTORS(contınue) 3)Thought Suppression • Individuals experiencing obsessive thoughts often try to actively suppress them • Deliberately suppressing thoughts can actually increase their frequency (Wenzlaff & Wegner, 2000; cited in Dawey, 2008).

  18. Treatment of OCD • Exposure & Ritual Prevention (EPR) • Cognitive Behaviour Therapy (CBT) • Pharmacological & Neurosurgical Treatments

  19. Exposure & Ritual Prevention (EPR) • Exposure and ritual prevention treatments: • A means of treatment for obsessive-compulsive disorder (OCD) which involves graded exposure to the thoughts that trigger distress, followed by the development of behaviours designed to prevent the individual’s compulsive ritual.

  20. Example of ERP exposure hierarchy • Example: Fear of contamination (distress level/100) 1) Touch rim of own unwashed coffee cup. (30) 2) Touch rim of partner’s unwashed coffee cup. (40) 3) Eat snack from dish in cupboard after touchingpartner’s unwashed coffee cup. (45) 4) Drink water from partner’s glass. (55) 5)Eat snack straight from unwashed table top. (65) 6)Have coffee at a café. (70) 7)Have meal at a restaurant. (80) 8)Touch toilet seat at home without washing hands for 15 mins.(85) 9)Touch toilet seat at home without washing hands for 30 mins. (90) 10)Use public toilet. (100)

  21. Cognitive Behaviour Therapy (CBT) • Dysfunctional beliefs that are usually challenged using CBT include: • Responsibility appraisals – sufferers believe they are solely responsible for preventing any harmful outcomes • The over-importance of thoughts – sufferers believe that having a thought about an action is like performing the action • Exaggerated perception of threat – sufferers have highly inflated estimates of likelihood of harmful outcomes

  22. Pharmacological & Neurological Treatments • Selective Serotonin Reuptake Inhibitors (SSRIs) are the most regularly prescribed drug for OCD. • Cingulatomy is an intervention of last resort (destroying cells in the cingulum, close to the corpus callosum)(surgery)

  23. CONCLUSION • What is OCD? • Symptoms and Diagnosis of OCD Obsessions & Compulsions • Prevalence • The Aetiology of OCD • Biological & PsychologicalFactors • The Treatment of OCD • Exposure & Ritual Prevention (EPR) • Cognitive Behaviour Therapy (CBT) • Pharmacological & Neurosurgical Treatments

  24. THANK YOUFOR LISTENING…

  25. Reference list • Dawey, G. (2008). Psychopathology:Research,AssesmentandTreatment in Clinical Psychology. UK: The BritishPsychological Society and Blackwell Publishing. • RauchSL, Savage CR, Alpert NM, et al., 1997, Probingstriatalfunction in obsessive-compulsivedisorder: a PET study of implicitsequencelearning. Journalof NeuropsychiatryandClinicalNeuroscience, 9(4): 568- 573. • http://www.ocduk.org/ocd • http://serendip.brynmawr.edu/bb/neuro/neuro00/web1/Hollander.html

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