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Study Plan: Obsessive-Compulsive and Stressor-Related Disorders
Terms in this set (39)
Whenever Tania eats at a restaurant, she thinks about the number of people who may have touched her silverware. When no one is looking, she puts the silverware into her pocket, goes to the ladies room, and washes the silverware in hot water several times, without ever feeling like they are clean. Tania might be suffering from
Doris is a shy, eccentric 60-year-old woman living alone following the death of her mother, with whom she had lived for her whole life. At her mother's funeral, her brother Todd and his wife Cynthia try to persuade her to sell the house, especially the possessions that Doris has collected and saved over the years. Most of the items are of no value, except for sentimental reasons they cannot understand. The clutter has become hazardous, as Doris herself can hardly move through the house. There isn't anywhere to sit anymore, but Doris can manage to get to her bed, where she spends most of her time. One day, fed up, Todd and Cynthia arrive with Doris's therapist, planning on decluttering her house, but when Cynthia tries to throw out a pencil, Doris angrily throws them out of her house. Which of the following disorders is Doris likely to have?
Madison is a nine-year-old girl who often pulls out her own hair one hair at a time, and these hair-pulling episodes can last for hours at a time. She is unable to stop pulling out her hair, despite the development of several bald patches on her head. Which of the following impulse-control disorders is Madison most likely to have?
Which example below best demonstrates how someone might exhibit symptoms of body dysmorphic disorder?
Kit is 53 years old and works as a nurse in a retirement home. She never married and has always felt that men were turned off because of the shape of her nose, which she considers to be unusually large and crooked. Despite being reassured by friends and family members that her nose looks normal and that she is fairly attractive, she is overly conscious of the shape of her nose and thinks it negatively affects her overall appearance.
Excoriation disorder has a high rate of comorbidity with other psychiatric conditions, especially with
mood and anxiety disorders
Tianna was a sixteen-year-old Hispanic female who was living in a shelter after being removed from her aunt's house by the child welfare agency. She was living in the shelter for three months. During her interview with a counselor, she reported feelings of worry and anxiety and stated she was very sad. She felt sad every day almost all day long, and her sadness got worse after going to the shelter. She also complained of poor concentration and feelings of hopelessness and she said; "I feel like I will be sad for the rest of my life." Tianna may be experiencing
Isabella is a 5-year-old child who was placed with a foster family after years of abuse and neglect. She has adjusted to her foster family, but her foster parents notice that she tends to engage in overly familiar behavior with people she has never even met—like running toward a neighbor that she has never met and jumping into his/he
disinhibited social engagement disorder.
Rasheem is a 31-year-old man who was discharged from the army in 2015 after serving two tours of duty in Iraq. He has been experiencing significant difficulty sleeping and has nightmares. During his second tour, he experienced trauma he has never spoken with anyone about, but he talks about having intrusive memories of the traumatic events. He avoids anything that makes him think of his time in combat and he spends much of his time alone because seeing friends makes him feel irritable, and he doesn't want to snap at anyone. He is easily startled by noise and motion and is unnecessarily hypervigilant. His wife urges him to see a psychologist because he is "not the man that she married." The psychologist most likely diagnosed Rasheem with
Sam is a 54-year-old man whose wife died recently. Within the same year, he was diagnosed with chronic obstructive pulmonary disease. Six months following, he was dismissed from work as a construction worker because he could keep up with demands of the job. He had to sell his house and move to a different city. Sam became socially isolated and lost his appetite. If Sam were to take the Social Readjustment Rating Scale, the score might indicate that he is at risk for developing
mental health problems
Which type of attachment is seen most often in kids who have been abused or severely neglected?
Audrey was a victim of molestation when she was 18 years old. Her medical evaluation revealed that she possesses two short versions of a gene that regulates the neurotransmitter serotonin. Audrey is at a significantly higher risk of developing
Lashon was violently attacked in a dark parking lot after work a week ago. Her assaulter took her purse and her car and left her for dead. She is constantly re-experiencing the event through images, dreams, thoughts, and flashbacks. She finds herself avoiding situations that might make her think about the trauma, but she is still so anxious that she cannot concentrate or sleep. Lashon is likely suffering from
acute stress disorder
Which form of therapy has the highest rate of success in treating trichotillomania, and other body-focused repetitive behaviors, and involves learning a new response to compete with troublesome behaviors?
habit reversal training
Which psychological perspective best matches with the following statement?
The meanings linked to PTSD show cultural variations: in individualistic cultures, appraisals about a vulnerable or inadequate self are common; in collectivistic cultures, appraisals about social functioning or evaluation by others are common.
In a therapy session, Gail, who has a phobia of dogs, is asked to stand near a dog. This action reactivates her fear response. The therapist exposes her to dogs repeatedly while giving her support. Gail was never bit or harmed during these sessions. Eventually the fear response was reduced and she was less afraid of dogs. What specific technique is the therapist using?
extinction of the fear response" in the application of reconsolidation therapy
Josyel is asked by his therapist to talk about his traumatic experience and as he does, he tries to keep up with her finger as it moves back and forth rapidly. The therapist explained to him that this process will help him reprocess his memories to lessen the fear he has surrounding the traumatic event. What type of therapy is being used here?
eye movement desensitization and reprocessing
The cognitive model of OCD, as proposed by Paul Salkovskis, proposes that everyone will experience intrusive thoughts from time to time, but those with OCD falsely assume that
thinking about an action is the same as doing it
Maurice is a 15-year-old high-school student referred for treatment by his health teacher, who became worried by Mark's irrational concern about getting ill and vomiting. The teacher had discussed vomiting as an involuntary response to illness. From that class forward, Maurice would shun anyone who appeared to be sick at school. His friends wondered why he wasn't talking to them. He became so obsessed with getting ill that he also started carrying hand sanitizer everywhere he went and avoided the school restrooms. He would no longer touch food that he thought might be contaminated by germs. What is the probable diagnosis for Maurice?
(uncontrollable, reoccurring thoughts
behaviors that create an urge to repeat an action over and over
These OCD-related disorders
body dysmorphic disorder, hearing disorder, trichotillomania, and excoriation.
Obsessive-compulsive and related disorders
are a group of overlapping disorders that generally involve intrusive, unpleasant thoughts, and repetitive behaviors.
*elevate unwanted thoughts and repetitive behaviors to a status so intense that these cognitions and activities disrupt daily life.
persistent ideas, thoughts, or impulses that are unwanted and inappropriate, causing marked distress
Violence and aggression
repetitive and ritualistic acts that are typically carried out primarily as a means to minimize the distress that obsessions trigger or to reduce the likelihood of a feared event
cleaning, checking, repeating, ordering/arranging, counting
** mental acts such as praying, reciting, counting
Causes of OCD
three neurotransmitters: serotonin, dopamine, and glutamate (regulated by genes)
brain region called orbitofrontal cortex (responsible for learning and decision making)
the orbitofrontal cortex becomes especially hyperactive when they are provoked with tasks in which, for example, they are asked to look at a photo of a toilet or of pictures hanging crookedly on a wall (Simon, Kaufmann, Müsch, Kischkel, & Kathmann, 2010). The orbitofrontal cortex is part of a series of brain regions that, collectively, is called the OCD circuit; this circuit consists of several interconnected regions that influence the perceived emotional value of stimuli and the selection of both behavioral and cognitive responses (Graybiel & Rauch, 2000).
basal ganglia, anterior cingulate cortex, prefrontal/ orbitofrontal cortex
area of the frontal lobe involved in learning and decision-making
** people with OCD have higher connectivity in this region during symptom provocation
**Additionally, researchers have discovered that people diagnosed with OCD actually show under-activation of brain areas responsible for stopping habitual behavior.
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections
** another cause for OCD
Though symptoms often fade over time, low-level anxiety and OCD/TIC issues may remain permanently, and there are times where the exacerbation can take four to six months to remit.
Treatment for this diagnosis includes antibiotics, IVIG (an intravenous pooled blood product comprising immunoglobulins that is used in treating immune deficiencies), plasmapheresis or plasma exchange (PEX) (a process during which the harmful auto-antibodies are removed from the blood system), and others such as cognitive-behavioral therapy (CBT), tonsillectomy, and probiotics. Generally, the best treatment for acute symptoms is antibiotics, and CBT to help manage neuropsychiatric symptoms.
treatment for PANDAS
epidemiology for OCD
The average onset occurs between ages 8-12 and late to early adulthood. Approximately 1 in 100 adults in the United States have obsessive-compulsive disorder.
Obsessive-compulsive disorder affects about 2.3% of people at some point in their lives while rates during any given year are about 1.2%. It is unusual for symptoms to begin after the age of 35, and half of people develop problems before 20. Males and females are affected about equally and it occurs worldwide.
DSM-5 criteria for OCD
For a diagnosis of obsessive-compulsive disorder, the following must be present: , , or both, and the following must be true:
The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) and/or cause significant impairment in social, occupational, or other important areas of functioning; symptoms are not caused by the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition; symptoms are not better explained by those of another mental disorder (e.g., generalized anxiety disorder, hoarding disorder, or autism spectrum, etc).
It should also be specified whether or not the individual has good or fair insight (meaning they recognize their OCD beliefs are probably not true—such as someone who understands that washing their hands seven times in the morning and the evening will not prevent cancer, even though they continue with the compulsion anyway), or if they have poor insight (meaning, they think their OCD beliefs are probably true), or if they have delusional beliefs (indicating that they are convinced their OCD beliefs are absolutely true). It should also be noted whether or not they have been diagnosed with a tic disorder in the past or present.
etiology of OCD
Research shows that obsessive-compulsive disorder is influenced by factors. However, in the case of PANDAS, children can also be affected by OCD due to a complication with strep throat. More research is needed to understand the root cause of OCD and how/why it manifests itself in the way it does. Risk factors include a history of child abuse or other stress-inducing event.
treatment for OCD
Various treatments exist for obsessive-compulsive disorders and they range from self-help tools to in-patient care depending on the severity of symptoms. SSRIs are often prescribed.
Cognitive-behavioral therapy (CBT) is effective, particularly exposure and response prevention (EX/RP), which involves exposure to the situation that triggers compulsions and then not performing the ritual.
body dysmorphic disorder
involves an excessive preoccupation with an imagined defect in physical appearance
the probability that an identical twin will show symptoms or traits of a disorder if one twin has the disorder
obsessive-compulsive and related disorders:
characterized by the tendency to experience intrusive and unwanted thoughts and urges (obsession) and/or the need to engage in repetitive behaviors or mental acts (compulsions) in response to the unwanted thoughts and urges
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