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Ocd Psychopathology

Jun 03, 2018

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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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