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OCD
Psychopathology
of
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Compulsions
Compulsions are behaviors people perform inorder to try and reduce or remove the fear andanxiety caused by obsessions.
Common compulsions: Cleaning and washing
Arranging until things are just right
Hoarding
Checking
Mental rituals (prayers, counting etc.)
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OCPD
Preoccupation with details, orderliness, perfectionismrules and lists, so that the point of the activity is lost
Perfectionism that interferes with task completion
Excessively devoted to work so that leisure activities andfriendships suffer
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OCD vs. OCPD
OCD is ego dystonic ((symptoms distress
patient ))
OCPD are ego syntonic ((symptomsdistress others))
OCPD lacks true obsessions orcompulsions
OCPD go to med school
OCD patients are found in clinics
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Biological theorySerotonin Hypothesis
key chemical involved in OCD is called serotonin. key gene for this process is hSERT (hSERT works too fast ) improvement with SSRI (fluoxetin )
Genetics 1st degree relatives 35%, Monozygotes 80-87%
NEUROIMMUNOLOGY Paediatric Autoimmune Neuropsychiatric Disorders Associated with
Streptococcal Infection (PANDAS)
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Biological theoryNeuroimaging
circuit>>regulates primitive aspects of our behavior such as aggression,sexuality, and bodily excretions.
circuit>>>> relays information from orbitofrontal cortex to the thalamusand the caudate nucleus of the basal ganglia.
if circuit is activated,
impulses brought to your attention
perform a particular behavior that appropriately addresses the impulses
IN OCD abnormal activity in this brain circuit >>difficulty turning off or ignoring impulses
from this circuit Increased activity of the orbitofrontal cortex
Increased activity of the cingulate cortex
Increased activity in the caudate nucleus
Increased activity in the thalamus Dysfunction of cortical/basal ganglia loop
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Increased activity in the thalamus
Overactivity of prefrontal-basal
ganglia loops
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Psychodynamic Theories
Stress and parenting styles are environmental factors
that have been blamed for causing OCD
Psychodynamic therapy making the person aware of these conflicts can reduce
symptoms of OCD Usually patient refractory to this therapy:
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Cognitive Behavioral theory Learning Theory>>
OCD symptoms are a result of a person developing learnednegative thoughts and behaviour patterns, towards previouslyneutral situations which can result from life experiences.
cognitive model>> everyone experiences intrusive thoughts from time-to-time
misinterpret these thoughts as being very important andsignificant which could lead to catastrophic consequences
repeated misinterpretation of intrusive thoughts >> obsessionsand because the thoughts are so distressing>>compulsivebehaviour to >> resist, block, or neutralisethe obsessivethoughts.
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Why patient resist treatment.
Secondary gain ( symptoms had special meaning to thepatient )
Power and control over family members (interpersonal
meaning )
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