Obsessive-Compulsive & related disorders-
Characteristics (Pt 1)
• All are due to obsessive thinking- unwanted intrusive recurrent thoughts
• Involves compulsive behaviour- repetitive rituals impairing daily functioning
OCD
DSM- V: diagnosis criteria
OCD- the presence of obsessions, compulsions, or both
Obsessions defined by: Compulsions defined by:
1. Recurrent & persistent 1. Repetitive behaviours/ mental acts
thoughts, urges or impulses • Driven to perform acts due to an obsession, or
(worries) according to rules that must be applied rigidly
• Intrusive and unwanted • Examples:
• Causes anxiety or o Behaviours- Hand washing, ordering, checking
distress o Mental acts- Praying, counting, repeating words
silently
2. Attempts made to:
• Ignore/ supress such 2. Attempts made to:
thoughts/ urges/ images • Preventing/ reducing anxiety or distress
• Neutralise them with • Preventing a dreaded anticipated event/ situation
some other thought or from happening
action- by submitting to
(But these acts are not always realistically connected to what
a compulsion
they are aimed at preventing/ neutralising)
Examples
Obsessions (worrying) Compulsions (acting on the fear)
Constant, irrational worry about dirt, germs/ Cleaning- Repeatedly washing hands, bathing or
contamination cleaning (often for hours)
Excessive concern about accidentally hurting Checking- Checking and rechecking up to hundreds
or injuring someone of times a day if doors are locked/ something is
misplaced
1
Notes compiled by: Chew Wen Min
, Doubting that is irrational or excessive Mental rituals- Counting repetitively, excessive
praying, repeating ‘safe words’ to neutralize ‘bad
thoughts’
Excessive concern with order, arrangement, Ordering/ arranging- So that there are only certain
or symmetry items showing
Sexual- Worrying about distasteful sexual Sexual- Fears about typically taboo things, and so
thoughts or images compulsively act on them
1. Worry that they could be a pedophile 1. Fear that they might be a pedo- they repetitively
2. Worrying about being homosexual look at pics of kids to see if it produces arousal
3. Worrying that their genitals are 2. Fear that they might be gay- ‘come out’ to
contaminated people just to see if they receive negative reactions
3. Fear of contaminated genitals- excessively
washing genitals
Case study- (‘Charles’ by Rappaport, 1989)
Obsessions Charles had: Feeling of stickiness on his skin
Compulsions Charles had: To keep showering/ washing to rid of the stickiness
• Started washing compulsively at age 12, went to seek help with Rapport at 14
• Unable to rid himself of the feeling of ‘stickiness’
• Followed the same ritual each day to get ready:
o Take up to 3 hours in the shower
o 2 hours to get dressed
• Psychotherapy & drugs didn’t help him
• Didn’t know why he had to wash, just that he had to get rid of the stickiness
o Knew he wasn’t crazy, no voices telling him to do it, he just HAD to
• Couldn’t properly justify what would happen to him if he didn’t wash
• Was eager to find a cure for himself- even if that meant applying a sticky paste on his scalp
for an EEG scan, he endured it
Body Dysmorphic Disorder (BDD)
BDD- Preoccupation with one or more perceived defects in appearance
• AKA: Dysmorphia- The fear of having a deformity
• The individual performs repetitive behaviours/ mental acts in response to concerns about
appearance
o Ex: Mirror checking, seeking reassurance, excessive grooming
• Preoccupation is not restricted to concerns about weights or body fat- could be about
anything, (ex: Constant worry that eyebrows are not okay)
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Notes compiled by: Chew Wen Min