GGZ 'Anxiety and related disorders' Task 5 OCD
Abnormal obsessions vs. normal obsessions
- Abnormal obsessions are: - answer>>>- Last longer
- Discomforting
- Intense
- Frequent (also: time consuming)
- Lower acceptability
- Ego-dystonic
- Urges to neutralize
- To be of known onset
- Are strongly resisted and harder to dismiss
- Diminished perceived control
Attentional bias and thought suppression - answer>>>Attentional bias found in anxiety
disorders may actually be caused by attempts at cognitive avoidance: as soon as
suppression efforts are activated, there is an immediate hypervigilance to threat cues.
Automatic target research - answer>>>The second process required in thought
suppression --> some sort of monitoring for the presence of the target thought in order
to alert the controlled distracter search to failures in the suppression attempt.
Catastrophic misinterpretation - answer>>>- OCD patietns have an inflated perception
that they are responsible for harm/negative outcomes to others and self, related to their
obsessions.
- Outcomes are perceived as way more negative than they are --> overestimation
--> Usually in patients with checking compulsions
Controlled distracter search - answer>>>The first process required in the suppression of
a thought is a deliberate and conscious search for thoughts that are not the to-be-
suppressed.
--> Each occurence of target thought will prompt the search for a new distracter.
Course OCD - answer>>>- Chronic (44%, often early onset) or intermittent (56%, more
often late onset)
- Without treatment OCD is persistent (only 6% full remission)
- OCD prevalence declines with age
Different types of OCD
, - Common classification (based on symptom presentation) - answer>>>- Forbidden or
taboo thoughts
- Symmetry
- Contamination obsessions and cleaning compulsions
- Harm, checking
Different types of OCD
- High vs. low belief subtype - answer>>>- Inflated responsibility / threat overestimation
beliefs --> contamination and harming obsessions
- Perfectionism / certainty beliefs --> order symmetry compulsion
- Importance / control of thoughts beliefs repugnant obsessions
Different types of OCD
- Older formulations - answer>>>- Repeated checking
- Hoarding (verzameldrang --> in DSM-5 een aparte stoornis)
- Focussing on specific symptom presentations of disorders
DSM-criteria OCD
- A. - answer>>>Presence of obsessions, compulsions or both
--> They make OCD self-reinforcing (striatum involved)
DSM-criteria OCD
- B. - answer>>>- The obsessions or compulsions are time-consuming (more than 1
hour a day)
- Or cause clinically significant distress or impairment
Ego syntonic - answer>>>Focus on everyday negative outcomes involving finances,
work, family, health (worry belongs to person)
--> Worry
Ego-dystonic - answer>>>Focus on fears and concerns that are unrealistic, even
irrational or imagery (e.g., obsessed with having cyanide on one's hand) --> intrusive
--> Obsessions
Epidemiology OCD
- Life time prevalence
- Age differences
- Gender - answer>>>- 1-3% --> one of the least common 'anxiety disorder' (obsessive
and compulsive are more common)
- More prevalent among 20-44, least common among 65+
- Childhood: equal, adulthood: women, older adults: men
First line treatment of OCD - answer>>>- Exposure and Response Prevention (ERP)
Abnormal obsessions vs. normal obsessions
- Abnormal obsessions are: - answer>>>- Last longer
- Discomforting
- Intense
- Frequent (also: time consuming)
- Lower acceptability
- Ego-dystonic
- Urges to neutralize
- To be of known onset
- Are strongly resisted and harder to dismiss
- Diminished perceived control
Attentional bias and thought suppression - answer>>>Attentional bias found in anxiety
disorders may actually be caused by attempts at cognitive avoidance: as soon as
suppression efforts are activated, there is an immediate hypervigilance to threat cues.
Automatic target research - answer>>>The second process required in thought
suppression --> some sort of monitoring for the presence of the target thought in order
to alert the controlled distracter search to failures in the suppression attempt.
Catastrophic misinterpretation - answer>>>- OCD patietns have an inflated perception
that they are responsible for harm/negative outcomes to others and self, related to their
obsessions.
- Outcomes are perceived as way more negative than they are --> overestimation
--> Usually in patients with checking compulsions
Controlled distracter search - answer>>>The first process required in the suppression of
a thought is a deliberate and conscious search for thoughts that are not the to-be-
suppressed.
--> Each occurence of target thought will prompt the search for a new distracter.
Course OCD - answer>>>- Chronic (44%, often early onset) or intermittent (56%, more
often late onset)
- Without treatment OCD is persistent (only 6% full remission)
- OCD prevalence declines with age
Different types of OCD
, - Common classification (based on symptom presentation) - answer>>>- Forbidden or
taboo thoughts
- Symmetry
- Contamination obsessions and cleaning compulsions
- Harm, checking
Different types of OCD
- High vs. low belief subtype - answer>>>- Inflated responsibility / threat overestimation
beliefs --> contamination and harming obsessions
- Perfectionism / certainty beliefs --> order symmetry compulsion
- Importance / control of thoughts beliefs repugnant obsessions
Different types of OCD
- Older formulations - answer>>>- Repeated checking
- Hoarding (verzameldrang --> in DSM-5 een aparte stoornis)
- Focussing on specific symptom presentations of disorders
DSM-criteria OCD
- A. - answer>>>Presence of obsessions, compulsions or both
--> They make OCD self-reinforcing (striatum involved)
DSM-criteria OCD
- B. - answer>>>- The obsessions or compulsions are time-consuming (more than 1
hour a day)
- Or cause clinically significant distress or impairment
Ego syntonic - answer>>>Focus on everyday negative outcomes involving finances,
work, family, health (worry belongs to person)
--> Worry
Ego-dystonic - answer>>>Focus on fears and concerns that are unrealistic, even
irrational or imagery (e.g., obsessed with having cyanide on one's hand) --> intrusive
--> Obsessions
Epidemiology OCD
- Life time prevalence
- Age differences
- Gender - answer>>>- 1-3% --> one of the least common 'anxiety disorder' (obsessive
and compulsive are more common)
- More prevalent among 20-44, least common among 65+
- Childhood: equal, adulthood: women, older adults: men
First line treatment of OCD - answer>>>- Exposure and Response Prevention (ERP)
