OCD

Question 1

Presence of obsessions and/or compulsions
👉 Obsessions = intrusive, unwanted thoughts/urges/images.
👉 Compulsions = repetitive behaviors/mental acts done to reduce anxiety or prevent feared events.

• Symptoms must take more than 1 hour per day or cause clinically significant distress/impairment in functioning.

Answer 1

OCPD

Question 2

Not better explained by another mental disorder
👉 Halimbawa, hindi dapat mas maipaliwanag ng GAD (excessive worry), Body Dysmorphic Disorder, Eating Disorders, o Psychotic Disorders.

Answer 2

OCPD

Question 3

Recurrent and persistent thoughts, urges, or images
👉 These are intrusive and unwanted, meaning hindi sila gusto ng individual pero paulit-ulit pumapasok sa isip.
👉 Result: nagdudulot ng marked anxiety or distress.

Attempts to ignore, suppress, or neutralize
👉 The person tries to push away or control these thoughts/urges/images.
👉 Often ginagawa ito sa pamamagitan ng compulsions (rituals, repetitive behaviors, or mental acts) para ma-neutralize ang anxiety.

Answer 3

OBSESSIONS

Question 4

Repetitive behaviors or mental acts
👉 Examples: handwashing, checking, counting, praying, repeating words silently.
👉 The person feels driven to perform these in response to an obsession, or according to rigid rules.

Aimed at preventing/reducing anxiety or dreaded events
👉 Ginagawa ang compulsion para ma-neutralize ang anxiety or maiwasan ang feared situation.
👉 Pero:

Hindi realistic ang connection (e.g., pagbilang ng 1–10 para maiwasan ang aksidente).

O sobra-sobra ang behavior (e.g., paghuhugas ng kamay ng 50 beses kahit malinis na).

Answer 4

COMPULSIONS

Question 5

Obsessions and compulsions are thematically related → e.g.:

Obsession: “Baka madumihan ako at magkasakit.”

Compulsion: “Maghuhugas ako ng kamay paulit-ulit para maiwasan ang sakit.”

Question 6

Obsessions and compulsions are shaped by culture
👉 Halimbawa: sa Saudi Arabia at Egypt, common ang cleanliness themes dahil naka-root sa Islamic emphasis on purity and ritual cleanliness.
👉 Sa ibang kultura, puwedeng iba ang themes (e.g., religious rituals, symmetry, contamination, or moral scrupulosity).

Question 7

Physical experiences na nauuna bago ang compulsion.

Examples: “just-right sensations” (parang hindi tama hangga’t hindi ulitin), feelings of incompleteness, o physical tension.

Common: Up to 60% of individuals with OCD report these sensory phenomena.

Answer 7

SENSORY PHENOMENA (OCPD)

Question 8

Involvement ng family or friends sa compulsive rituals.

Example: family members helping with checking, cleaning, or reassurance.

Important treatment target, lalo na sa children, kasi family involvement can reinforce the cycle.

Answer 8

ACCOMODATION

Question 9

_______– may be linked with ritualistic
behavior

● Hyperactivity in _______

Answer 9

Orbital frontal cortex
anterior cingulate cortex

Question 10

ETIOLOGY OF OCPD
Greater internalizing symptoms
Taglish: Mas madalas na iniipon sa loob yung problema, hindi agad sinasabi.
Example: Isang bata na laging tahimik at iniiyak lang sa kwarto kapag may problema, imbes na magsabi sa magulang.

Higher negative emotionality
Taglish: Mas madali silang makaramdam ng lungkot, galit, o takot.
Example: Kapag may maliit na pagkakamali, sobrang affected sila at naiiyak agad.

Behavioral inhibition in childhood
Taglish: Bata pa lang, sobrang mahiyain o takot makisalamuha.
Example: Yung bata na ayaw sumali sa laro kasi nahihiya o natatakot magkamali.

Physical and sexual abuse in childhood
Taglish: Nakaranas ng pananakit o pang-aabuso nung bata pa.
Example: Isang bata na palaging pinapalo nang sobra o inabuso, nagkakaroon ng trauma na dala hanggang paglaki.

Stressful or traumatic event
Taglish: May nangyaring sobrang stressful o traumatic na hindi nila makalimutan.
Example: Naaksidente, nawalan ng mahal sa buhay, o nakaranas ng sakuna.

Perceived loss of control in the environment
Taglish: Feeling nila wala silang kontrol sa paligid o sa buhay nila.
Example: Isang estudyante na laging pinipilit ng magulang kung anong course ang kukunin, kaya feeling niya wala siyang choice.

Thought-action fusion
Taglish: Iniisip nila na kapag naisip mo ang isang bagay, parang ginawa mo na rin.
Example: Kung naisip mong “baka masaktan ang kaibigan ko,” iniisip mo na parang ikaw mismo ang nakasakit, kahit hindi mo naman ginawa.

Question 11

Chronic Pattern
Meaning: Kapag sinabi nating chronic pattern, ibig sabihin yung disorder (halimbawa OCD, depression, eating disorder, etc.) ay matagal na tumatagal—madalas years—at hindi basta-basta nawawala.

Key Point: Kung walang treatment, maliit ang chance na totally mag-remit o mawala. Parang naka-embed na siya sa daily life ng tao.

Example:

Isang tao na may OCD na halos 10 years nang paulit-ulit nagche-check ng locks at gas stove. Kahit minsan bumababa ang intensity, hindi talaga nawawala at tuloy-tuloy siya for years.

Parang “constant background noise” sa buhay ng tao.

🌊 Waxing and Waning
Meaning: Ito naman ay pattern kung saan ang intensity ng symptoms ay pabago-bago. Minsan lumalala (waxing), minsan humuhupa (waning), pero hindi tuluyang nawawala.

Key Point: Fluctuating ang severity—parang may “ups and downs.”

Example:

Isang tao na may OCD na minsan sobrang lala ng obsessions at compulsions (checking, cleaning), pero after a few weeks, medyo humuhupa at manageable.

Pero kahit humupa, bumabalik ulit sa ibang panahon. Parang “waves” na dumarating at umaalis.

Answer 11

OCPD

Question 13

Ang tao ay sobrang nakatuon sa isang perceived defect (hal. skin, nose, hair, body shape) na hindi nakikita ng iba o sobrang minor lang

Answer 13

BODY DYSMORPHIC

Question 14

Dahil sa appearance concerns, gumagawa sila ng rituals tulad ng:

Mirror checking

Excessive grooming

Skin picking

Comparing appearance with others
👉 Or mental acts (e.g., constant self-comparison, reassurance seeking).

Answer 14

BODY DYSMORPHIC

Question 15

Kung ang concern ay tungkol sa weight o body fat, dapat hindi mas maipaliwanag ng Eating Disorders (e.g., Anorexia, Bulimia).

Answer 15

BODY DYSMORPHIC

Question 16

Special subtype kung saan ang preoccupation ay sa body build — iniisip ng individual na sobrang maliit o hindi sapat ang muscles nila, kahit normal o muscular na sila.

👉 Common sa men, pero puwede rin sa women.

Answer 16

WITH MUSCLE DYSMORPHIA

Question 17

BDD was previously called dysmorphophobia or “imagined ugliness.”

Range of concerns → mula sa pakiramdam na “unattractive” or “not right” hanggang sa extreme na “hideous” or “like a monster.”

Ideas or delusions of reference → Madalas iniisip ng individual na pinagtatawanan o pinag-uusapan sila ng ibang tao dahil sa perceived defect.
👉 Example: “Naririnig ko silang tumatawa, siguradong ako ang pinagtatawanan nila dahil pangit ang ilong ko.”

Question 18

Dermatology patients → around 11–13%

General cosmetic surgery patients → about 13–15%

Rhinoplasty (nose surgery) patients → up to 20%

Adult jaw correction surgery patients → about 11%

Adult orthodontia/cosmetic dentistry patients → around 5–10%

Answer 18

BODY DYSMORPHIC

Question 19

Majority ng individuals with BDD ay nagre-request ng cosmetic or dermatological procedures para ma-improve ang perceived defect.

👉 Problem: kahit matapos ang procedure, hindi nawawala ang preoccupation kasi psychological ang root cause.

Question 20

Special subtype kung saan ang preoccupation ay hindi sa sarili, kundi sa appearance ng ibang tao (madalas significant other).

👉 Example: isang partner na convinced na “pangit” ang ilong ng asawa, kahit wala naman talagang defect.

Answer 20

Body dysmorphic disorder by proxy

Question 21

A subtype of Taijin Kyofusho (a Japanese culture-bound syndrome).
👉 Meaning: “phobia of deformed body.”
👉 Individuals fear that their body is ugly, deformed, or offensive to others, which overlaps with BDD themes

Answer 21

Shubo-Kyofu

Question 22

Varying cultural standards influence the specific body image concerns:

Japan → eyelids (double eyelid surgery is common).

Western countries → muscle dysmorphia (preoccupation with being “too small” or “not muscular enough”).

Question 23

Mean age of onset → 16–17 years old.

Two-thirds of individuals → nagsisimula before age 18.

👉 This shows na adolescence is a critical period for BDD development, kasi dito lumalakas ang self-consciousness at peer influence.

Question 24

Persistent difficulty discarding possessions
👉 Kahit wala silang actual value, nahihirapan ang tao na magtapon o maghiwalay ng gamit.

B. Perceived need to save + distress when discarding
👉 Iniisip ng individual na “baka kailanganin ko pa ito” o nakakaramdam ng matinding distress kapag tinatapon.

C. Accumulation leads to clutter
👉 Dahil sa difficulty discarding, naiipon ang gamit hanggang sa mag-congest at mag-clutter ang living areas.
👉 Result: hindi na nagagamit ang intended purpose ng space (e.g., kitchen na hindi na magamit sa pagluluto dahil puno ng gamit).

D. Clinically significant distress or impairment
👉 Ang hoarding ay nagdudulot ng functional impairment (social, occupational, safety risks).

Answer 24

HOARDING DISORDER

Question 25

Not better explained by another mental disorder 👉 Hindi dapat mas maipaliwanag ng ibang psychiatric condition, tulad ng: Obsessive-Compulsive Disorder (OCD) → kung hoarding is only due to obsessions/compulsions. Major Depressive Disorder → kung clutter is only due to lack of energy/motivation. Schizophrenia or psychotic disorders → kung accumulation is due to delusional beliefs. Neurocognitive disorders (e.g., dementia) → kung clutter is due to memory problems.

Answer 25

HOARDING DISORDER

Question 26

Majority ng individuals with hoarding disorder ay hindi lang nahihirapan magtapon, kundi patuloy ding kumukuha o bumibili ng bagong items, kahit hindi kailangan.

Answer 26

HOARDING

Question 27

Special subtype kung saan nag-aaccumulate ng maraming hayop (dogs, cats, etc.) pero hindi kayang alagaan nang maayos. 👉 Result: poor animal welfare + unsafe living conditions.

Answer 27

ANIMAL HOARDING

Question 28

Reasons for difficulty discarding 👉 Common explanations: Perceived utility (“baka magamit pa ito someday”) Aesthetic value (“maganda pa rin tingnan”) Sentimental attachment (“may memories ito, sayang itapon”) Responsibility for possessions (“ayokong maging wasteful, dapat may silbi pa ito”) Fear of losing important information (e.g., papers, notes, receipts).

Answer 28

HOARDING

Question 29

A. Recurrent pulling out of one’s hair → hair loss 👉 The person repeatedly pulls hair from scalp, eyebrows, eyelashes, or other areas, leading to noticeable hair loss. B. Repeated attempts to stop or reduce hair pulling 👉 May awareness ang individual na problematic ito, kaya sinusubukan nilang bawasan o ihinto, pero nahihirapan. C. Clinically significant distress or impairment 👉 Hair pulling causes emotional distress (shame, anxiety) or functional impairment (avoiding social situations, school/work problems). D. Not attributable to another medical condition 👉 Hair loss must not be due to dermatological or medical causes (e.g., alopecia, fungal infection). E. Not better explained by another mental disorder 👉 Hair pulling is not solely due to symptoms of another disorder (e.g., delusions in psychosis, body image concerns in BDD).

Answer 29

Trichotillomania (Hair-Pulling Disorder):

Question 30

Most common sites of hair pulling 👉 Scalp, eyebrows, and eyelashes/eyelids ang pinaka-target. 👉 Pero puwede rin sa ibang body hair (arms, legs, pubic hair). Pattern of hair pulling 👉 Puwede itong mangyari in brief episodes scattered throughout the day (parang automatic habit). 👉 O kaya sustained periods lasting for hours, lalo na kapag heightened ang stress or anxiety.

Answer 30

TRICHOTILLOMANIA

Question 31

Hair pulling may be accompanied by rituals tulad ng: Examining the hair root Twirling or biting the hair Specific routines bago o pagkatapos mag-pull.

Answer 31

TRICHOTILLOMANIA

Question 32

Some individuals swallow the hair they pull (hair ingestion). 👉 This can be occasional or habitual, and often done secretly.

Answer 32

TRICHOPHAGIA

Question 33

When swallowed hair accumulates in the stomach or intestines, it forms a hairball mass called a ___. 👉 This can lead to serious medical complications such as: Abdominal pain Gastrointestinal obstruction Malnutrition In rare cases, Rapunzel syndrome (large trichobezoar extending into intestines).

Answer 33

TRICHOBEZOARS

Question 34

Hair pulling can be triggered or accompanied by different emotional states: 👉 Anxiety, boredom, tension, or relief. 👉 Sometimes it’s a way to cope with stress, other times it’s automatic when bored.

Question 35

Varying degrees of conscious awareness 👉 Minsan automatic (hindi napapansin), minsan deliberate (alam nila pero hindi mapigilan). Social context 👉 Hair pulling usually happens alone, not in front of others. 👉 If in presence of others, kadalasan immediate family lang. Other Behaviors Urges to pull hair from others 👉 Some individuals may feel urges to pull hair from other people (e.g., family, friends). 👉 Often done secretly, looking for opportunities.

Question 36

Hair pulling from non-human sources 👉 Some individuals may pull hairs from pets, dolls, or fibrous materials (e.g., blankets, threads). 👉 This shows the behavior can generalize beyond their own body. Denial of hair pulling 👉 Many individuals deny the behavior when confronted, dahil sa shame, embarrassment, or fear of judgment. 👉 Concealment strategies (wigs, makeup) often accompany denial. Hair pulling in infants 👉 Hair pulling can be seen in infants, but usually this behavior is self-limiting and resolves naturally during early development. 👉 Pathological trichotillomania is more common in older children, adolescents, and adults.

Question 37

A. Recurrent skin picking → skin lesions 👉 Individuals repeatedly pick at their skin (face, arms, hands, etc.), leading to visible lesions, wounds, or scars. B. Repeated attempts to stop or reduce 👉 May awareness na problematic ang behavior, kaya sinusubukan nilang bawasan o ihinto, pero nahihirapan. C. Clinically significant distress or impairment 👉 Skin picking causes emotional distress (shame, anxiety) or functional impairment (avoiding social situations, problems at school/work). D. Not due to medical condition or substance 👉 Skin lesions must not be explained by dermatological conditions (e.g., eczema, scabies) or substance effects (e.g., cocaine use).

Answer 37

EXCORIATION (SKIN PICKING DISORDER)

Question 38

Most commonly picked sites 👉 Face, arms, and hands ang pinaka-target ng skin picking. 👉 Pero puwede ring ibang areas (legs, scalp, cuticles). Methods of picking 👉 Usually gamit ang fingernails, pero marami ring gumagamit ng: Tweezers, Pins, Other sharp objects Associated behaviors 👉 Skin picking can involve: Rubbing, Squeezing, Piercing, Biting 👉 These behaviors intensify the damage and lead to lesions/scarring.

Answer 38

EXCORIATION

Question 39

Individuals often spend significant amounts of time on picking, minsan several hours per day. 👉 This shows how compulsive and impairing the behavior can be

Answer 39

EXCORIATION

Question 40

Concealment strategies 👉 Individuals often try to camouflage lesions using: Makeup, Clothing (long sleeves, scarves, etc.) 👉 Dahil sa shame or embarrassment about visible wounds. Associated rituals/behaviors 👉 Skin picking may be accompanied by rituals such as: Examining scabs, Rubbing or squeezing skin Collecting or manipulating picked material 👉 These behaviors reinforce the cycle of picking.

Answer 40

EXCORIATION

Question 41

More prevalent among women → mas mataas ang rates ng excoriation sa females compared to males. - Usually begins at puberty → adolescence is the critical period. Often triggered by dermatological conditions → e.g., acne. Sites of skin picking may vary over time → nagsisimula sa isang area (like face), pero puwedeng lumipat sa ibang body sites habang tumatagal.

Answer 41

EXCORIATION