PSY404 Notes Lectures 19-42

Lecture 19

Short Notes on Obsessive-Compulsive and Related Disorders

1. Obsessive-Compulsive Disorder (OCD)

Obsessions: Recurrent, intrusive thoughts, urges, or images causing anxiety (e.g., fear of contamination, symmetry, aggressive impulses).

Compulsions: Repetitive behaviors (e.g., washing, checking, ordering) or mental acts (e.g., praying, counting) performed to reduce anxiety.

DSM-5 Changes: Moved from Anxiety Disorders to its own category.

2. Body Dysmorphic Disorder (BDD)

Definition: Preoccupation with perceived physical flaws not noticeable to others.

Behaviors: Mirror checking, excessive grooming, comparing with others, and seeking reassurance.

Impact: Causes significant distress and impairs social and occupational functioning.

DSM-5 Insight Levels: Good, poor, or absent (delusional beliefs).

3. Hoarding Disorder

Definition: Persistent difficulty discarding possessions due to a perceived need to save them.

Features: Accumulation of clutter that compromises living spaces and creates safety hazards.

Impact: Causes distress and functional impairment in daily life.

Insight Levels: Good, poor, or absent.

4. General Features of OCD and Related Disorders

Anxiety plays a central role in driving compulsions and repetitive behaviors.

Repetitive behaviors temporarily reduce anxiety but are excessive and time-consuming. Disorders cause distress and impair functioning in social, occupational, and personal areas.

5. DSM-5 Diagnostic Criteria for OCD

Presence of obsessions, compulsions, or both.

Symptoms are time-consuming (e.g., >1 hour daily) or cause significant distress/impairment.

Not due to substances, medical conditions, or other mental disorders. Short Questions (3 Marks)

Q4. What are some examples of obsessions in OCD?

Examples include fears of contamination, intrusive thoughts about symmetry, aggressive impulses, or unwanted religious or sexual ideas.

Q5. What are common compulsions in OCD?

Compulsions include hand washing, ordering objects, checking repeatedly, counting, and praying to reduce anxiety caused by obsessions.

Q6. What changes were made in DSM-5 regarding OCD and related disorders?

In DSM-5, OCD was moved from the Anxiety Disorders category to its own category, and new disorders like hoarding, trichotillomania, and excoriation disorders were added.

Q7. What role does anxiety play in OCD?

Anxiety is a key factor in OCD; obsessions cause anxiety, and compulsions temporarily reduce it, creating a repetitive cycle.

Q8. What are the common preoccupations seen in Body Dysmorphic Disorder?

Common preoccupations include perceived flaws in skin, facial features, body size, or symmetry, often minor or unnoticeable to others. Long Questions (5 Marks)

3. Discuss the differences between OCD obsessions and compulsions.

Obsessions are intrusive, recurrent thoughts or urges that cause significant anxiety. These thoughts are perceived as irrational but uncontrollable. Compulsions, on the other hand, are repetitive behaviors or mental acts performed to alleviate anxiety caused by obsessions. While obsessions disrupt normal thought processes, compulsions involve physical or mental actions often done rigidly or ritualistically.

4. Outline the diagnostic criteria for Body Dysmorphic Disorder (BDD) as per DSM-5.

BDD diagnosis involves preoccupation with perceived physical defects, repetitive behaviors like mirror checking or grooming, significant distress in daily functioning, and exclusion of concerns tied to eating disorders. The degree of insight (good, poor, or absent) and presence of muscle dysmorphia are also specified.

5. Describe the concept of hoarding disorder and its implications.

Hoarding disorder involves difficulty discarding items regardless of value, leading to clutter that disrupts the intended use of living spaces. This behavior often results in distress, social withdrawal, and safety hazards like fire risks or unsanitary conditions. The disorder may involve excessive acquisition and varying levels of insight about the problem.

6. Explain the role of repetitive behaviors in OCD and their impact on daily life.

Repetitive behaviors, such as checking locks or washing hands, are performed to neutralize obsessive thoughts and reduce anxiety. However, these behaviors are time-consuming and often interfere with daily life, relationships, and work, creating a significant functional impairment for the individual.