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Obsessive Control Disorders - Coggle Diagram
Obsessive Control Disorders
Characteristics
Obsessions - intrusive, recurrent thoughts and unwanted urges
Examples - fear of harming oneself or others, fear of illness of infection, etc.
Compulsions - repetitive actions that impair normal functioning
Examples - checking things repetitively (eg; oven 20 times to make sure it's off), frequent and excessive hand washing
People with OCD try to oppress their obsessions by carrying out their compulsive behaviour to reduce their anxiety
Examples
Hoarding
Extreme difficulty to get rid of possessions
Homes may be unsafe dye to hygiene or access issues
Can negatively affect social life
Body Dysmorphic Disorder
Obsessive thoughts regarding perceived faults in one's physical appearance
The faults are not obvious to others
The obsessions are often focused on imagined flaws on the face
They try to oppress their obsessions by mirror checking, excessive grooming, comparing oneself, etc. to reduce anxiety
Case study Charles (Rappaport)
14 year old boy who spent >3 hours to take a shower and 2 hours to get dressed
Rituals
holding soap in one hand under water, then switching hands
Thought that he had something sticky on his hands which made him leave school
Mother contacted Rappaport after behaviour lasted for more than 2 years
He received medication, behavioural and psychotherapy
He underwent drug trial for clomipramine (antidepressant) which was effective in reducing symptoms at first
He developed tolerance and relapsed
Measures of OCD
Maudsley Obsessive Compulsive Inventory (MOCI)
Quick assessment tool (5 mins) with true or false questions
30 items that are either based on washing, checking doubting or slowness
Washing - I am excessively concerned about germs and diseases
Checking - I frequently have to check things
Doubting - Despite doing something carefully, I often feel it is not quite right
Slowness - I don't take a long time to dress
Yale Brown Obsessive Compulsive Scale (Y-BOCS) (Goodman)
Consists of a 30 min semi-structured interview
Checklist had 10 item severity scale
From 0 to 4
Total scored range from 0 to 40 and >16 is in the range for OCD
Evaluation of measures
Strengths
High concurrent validity - individuals will score similarly on different test
High test-retest reliability - individuals are likely to get similar results with repetition
Weaknesses
Response bias - self-reports are subjective - patients may exaggerate the severity of their symptoms - reduces validity
Issues and Debates
Reductionist
symptoms are specific and unique to individuals (individual differences) so it is hard to make generic tests. Y-BPCS and MOCI tend to test specific OCD symptoms - reductionist
The tests are one-dimensional - rating from 'not distressing' to 'severely distressing' does not take into account, the severity of symptoms
'Distress can be used to indicate depression, anxiety, etc. and not just OCD
Application to everyday life
Can be used to see improvement or deterioration in symptoms
Can be used to diagnose OCD