OCD

Question 1

OCD

Answer 1

a mental health disorder characterised by obsessions and compulsions

Question 2

obsessions vs compulsions

Answer 2

Obsessions are intrusive, unwanted thoughts, urges or images that cause significant distress or anxiety

compulsions are repetitive behaviours or mental acts done to reduce anxiety or prevent a feared outcome, performed to reduce anxiety to prevent a feared event

Question 3

examples of obsessions and compulsions

Answer 3

ob: contamination, harm symmetry, taboo thoughts

Cmp: hand washing, checking, counting, repeating words

Question 4

feedback cycle of OCD

Answer 4

have an obsession e.g cleanliness and germs, creates anxiety about germs on and around them, creates a compulsion to wash hands thoroughly, leads to short term relief

however this just reinforces the OCD loop

Question 5

OCD cycle

Answer 5

Trigger (situation, thought, image).

Obsession (intrusive thought, “What if I’m contaminated?”).

Anxiety/Distress (intense fear or discomfort).

Compulsion (wash hands, check doors, count).

Temporary Relief (but reinforces obsession → cycle continues).

Question 6

DSM5 OCD

Answer 6

A) characterised by the presence of obsessions or compulsions or both
B) Time consuming - more than one hour a day or cause distress or impairment of functioning
(mild 1-3hrs per day), severe (constant intrusive thoughts or compulsions)
C & D) not attributed or explained by SUD or another medical/mental condition

Question 7

OCD themes

Answer 7

Cleaning
Symmetry
Taboo thoughts (aggressive, sexual or religious)
Harm (fear to harm self or others)

Question 8

Etiology

Answer 8

lifetime prevalence 4%, 12 month prevalence 3%

onset in late childhood or early adulthood

persistence in absence of treatment (chronic)

Comorbidity 50% - anxietty, depressiojn, tic disorder

more common in younger males, more common in older females

Question 9

Risk Factors

Answer 9

Biological
- genetics (heritiable from first realtvies, can be through twins too)
- brain structure (decision making impact)
- neurotransmitters (incr dopamine)
psychological
- cognitive biases (incr responsibility, overstimulation, thought action fusion - think that having the thought is just as bad as actually doing the action)
- personality traits (high levels of anxiety, perfectionism, harm avoidant)
environmental
- early life stress or trauma (neglect, abuse)
- family dynamics (family reinforcing behaviour unintentionally by feeding into OCD patterns e.g buying hand sani)

Question 10

misconceptions with COD

Answer 10

OCD is more than just being neat
Peoplw wiht OCD just enjoy routines and order
OCD is just a personalty quirk
Everyone has a little OCD

Question 11

Classical conditioning and OCD

Answer 11

early associations between stimulus and response bringing relief

NS: child touches dirty door knob
US: getting told that it will make them sick
CS: door knob becomes stimulus that trigger anxiety
over time gets reinforced in their head

Question 12

Operant conditioning and OCD

Answer 12

negative reinforcement

checking the stove repeatedly
obsession is thinking that you left it on, compulsion is checking the stove constantly, relief causes a decrease in anxiety, causing the cycle to continue

Question 13

Avoidance and OCD

Answer 13

Reinforces the threat of feared outcome

No exposure to change experience of outcome not occurring - causing no reduction in anxiety overtime

Question 14

Accomodation in OCD

Answer 14

other people in the persons life with OCD might accomodate to make things easier for the person e.g buying more soap so the person can wash their hands, or someone reassures that the door is locked for the other person to ease those worries

Question 15

Impact on families with child with OCD

Answer 15

icnr stress, frustration, guilt, burnout

accomodating or changing routines, lifestyle changes, conflict

siblings may feel neglected, parents may struggle to support differing neesds

howeve families often have greater empathy, patience an closeness

Question 16

Tx for OCD

Answer 16

CBT with Exposure response prevention (ERP) and family involvement

Question 17

Exposure response prevention (ERP)

Answer 17

gradually confronting feared htoughts images or situations and preventing the compulsive behaiour or ritual tht would normally induce anxiety

aim of this is to teach the patient that anxiety naturally decreases overtime without performing compulsions (exposure therapy)

Question 18

How does ERP work

Answer 18

Identify triggers and obsessions.

Rank triggers by anxiety level (hierarchy). FEAR LADDER

Gradually expose the patient to feared triggers (low → high).

Prevent compulsions during exposure.

Process experiences and reinforce adaptive coping.

Over repeated exposures, the OCD cycle weakens.

Question 19

Why involve family in CBT and ERP

Answer 19

Families often accommodate compulsions, unintentionally reinforcing OCD.

Psychoeducation helps families understand:

How OCD works.

Why accommodation is harmful.

How to support without enabling rituals.

Improves treatment adherence and outcomes.

Question 20

Examples of family involvement in ERP:

Answer 20

Reducing accommodation: Stop doing rituals for the patient (e.g., reassurance, helping with compulsions).

Support during exposure: Encourage the patient to confront fears without performing compulsions.

Monitoring progress: Track anxiety levels and successes.

Communication: Praise efforts and coping strategies, not the ritual.

Question 21

Benefits of CBT + ERP with family involvement:

Answer 21

Faster and more durable reduction in OCD symptoms.

Reduced family stress over time.

Improved patient self-efficacy and independence.

Stronger family problem-solving and coping skills.

Question 22

Psychoeducation

Answer 22

teaching family or patient about dx - how it develop, how to manage it

Question 23

cognitive strategies

Answer 23

techniques to identify and challenge maladaptive thoughts and beliefs
e.g challenging thoughts through tracking them and evaluating them

Question 24

relapse prevention

Answer 24

look for early signs of sx
develop sound coping strategies to cope with triggers without slipping
encourage ongoing exposure
family support