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Lecture 6

Lecture 6-OCD and Social Phobia Feb 26

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Neil Rector

Lecture 6: obsessive compulsive disorder and social phobia (February 26 2008) Obsessive compulsive disorder (OCD) Obsessions: recurrent and intrusive thoughts, images or urges causing marked anxiety o E.g. contamination fears, doubting, disturbing sexual thoughts. Compulsions: repetitive behaviors or mental acts to reduce anxiety o E.g. washing, checking, and ordering o Purpose is to turn off the anxiety caused by the obsessions Common obsessions o Contamination E.g. excessive concern with dirt or germs. Fear of dirty parts of towns, kisses, germs, blood, saliva o Doubting E.g. fear of responsibility for fire, burglar. Like fear of not locking the doors, appliances, interpersonal themes (did I say the right thing?) o Aggressive E.g. thoughts of strangling children. Violent or horrific images, fear of harming others. o Sexual E.g. sexual themes around children or incest o It has to be ego distonic it has to be inconsistent with who the person seems to be. L }LZ]ZL]ZZZ}L[Z]L] o ^}KLZ^l]ooZ}K}L7 L[KK_7o]2]}Z}LZ7Z}]L2}LZ: Common compulsions o Cleaningwashing E.g. excessive or ritualized handwashing Avoiding shaking hands o Checking E.g. checking locks, stoves appliances. Always checks to see if they actual locked the door. About 4-8 times o Avoidance Overt: avoidant behavior N E.g. avoiding contact with knives Covert neutralizing thoughts N E.g. undoing bad thoughts with good thoughts Majority of patients have more one type of OCD obsession. The most common ones in contamination and washing Repeating is rereading until understanding something perfectly. Subgroups of OCD o Contamination o Doubt o Order o Pure obsessions (sexual Epidemiological research: OCD o Life time prevalence: 2.6 % o Gender differences: 55-60% women o Age of onset: Early adolescene to mid-twenties
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