OCD-Related Disorders: Understanding Obsessions and Compulsions

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Questions and Answers

Which of the following is a cognitive feature of Somatic Symptom Disorder?

Attribution of normal bodily sensations to physical illness (correct)

Distress and disruption of daily life

Multiple physical complaints

Chronic pain without a medical cause

What factors influence the chronic nature of Somatic Symptom Disorder?

Severity of initial illness, access to healthcare, and comorbidity

Number of symptoms, psychological resilience, and social support

Age, level of education, and duration of symptoms

Number of symptoms, age, and comorbidity (correct)

Which symptom is specifically mentioned as causing distress and disruption in Somatic Symptom Disorder?

Persistent headaches

Multiple somatic symptoms (correct)

Episodes of unconsciousness

Emotional instability

Somatic Symptom Disorder includes worry about which of the following?

Physical illness Signup and view all the answers

Which aspect is NOT directly mentioned as influencing the Somatic Symptom Disorder's chronic nature?

Gender Signup and view all the answers

What is required for a diagnosis of Disruptive Mood Dysregulation Disorder?

Recurrent temper outburst, occurring 3 times or more per week, lasting at least 12 months Signup and view all the answers

Which symptom is NOT a criterion for Major Depressive Disorder?

Persistent irritable mood Signup and view all the answers

Which disorder is characterized by a depressed mood lasting at least 2 years?

Persistent Depressive Disorder Signup and view all the answers

Which disorder includes the presence of delusions and hallucinations during the late luteal phase of the menstrual cycle?

Premenstrual Dysphoric Disorder Signup and view all the answers

Which disorder is characterized by recurrent severe seasonal depressive episodes?

Seasonal Affective Disorder Signup and view all the answers

Which condition is considered an extreme subtype of PTSD and involves a switch between different personalities?

Dissociative Identity Disorder Signup and view all the answers

What best describes 'double depression'?

Experiencing both Major Depressive Episodes and Persistent Depressive Disorder with more severe symptoms Signup and view all the answers

Which region is NOT implicated in the pathophysiology of Dissociative Identity Disorder?

Thalamus Signup and view all the answers

Which symptom would exclude a diagnosis of Disruptive Mood Dysregulation Disorder?

Manic episodes lasting more than 1 day Signup and view all the answers

Which of the following is NOT a known risk factor for developing Obsessive-Compulsive Disorder?

Delusions of reference Signup and view all the answers

Which term describes grief where the individual adjusts to the loss while acknowledging the finality of death and its consequences?

Integrated Grief Signup and view all the answers

Which is a common characteristic of Body Dysmorphic Disorder but NOT of Obsessive-Compulsive Disorder?

Imagined defect in physical appearance Signup and view all the answers

What distinguishes Hoarding Disorder from OCD?

Extreme difficulty discarding items Signup and view all the answers

Which of the following symptoms is specifically linked with Trichotillomania?

Hair pulling not performed for cosmetic reasons Signup and view all the answers

Which feature is NOT typically associated with Body Dysmorphic Disorder?

Obsessions about symmetry Signup and view all the answers

Which historical figure first combined symptoms of depression and mania into what is now known as bipolar disorder?

Aretaeus of Cappadocia Signup and view all the answers

What is a shared feature of Hoarding Disorder and Prader-Willi Syndrome?

Difficulty planning and organizing tasks Signup and view all the answers

Which aspect distinguishes Trichotillomania from stereotypic movement disorder in individuals with ASD?

Preceded by feelings of anxiety or boredom Signup and view all the answers

A diagnosis of 'Bipolar I disorder, with psychotic features' is made when:

Psychotic symptoms occur exclusively during manic and major depressive episodes. Signup and view all the answers

Which of the following are often comorbid with Bipolar I Disorder?

Generalized anxiety disorder, ADHD, alcohol use disorder Signup and view all the answers

What symptom is characteristic of Excoriation disorder and must be absent for its diagnosis?

Delusions or tactile hallucinations Signup and view all the answers

People with Somatic Symptom Disorder typically exhibit which cognitive feature?

Attention focused on somatic symptoms Signup and view all the answers

Which term did Theophile Bonet begin using in 1679?

Melancholicus mania Signup and view all the answers

Which disorder is most likely to include 'compulsions to suppress obsessions' as a symptom?

Obsessive-Compulsive Disorder Signup and view all the answers

What is a common feature of Bipolar II during hypomanic episodes?

Increased impulsivity Signup and view all the answers

According to the DSM-5, youth with Bipolar Disorder often exhibit:

Irritability and rage or silly, giddy behavior Signup and view all the answers

Which of the following differentiates Bipolar II from cyclothymic disorder?

Presence of at least one hypomanic episode and one or more major depressive episodes Signup and view all the answers

Who was known for employing a unifying approach to classifying mood disorders into manic-depressive insanity?

Emil Kraeplin Signup and view all the answers

What is a notable difference between Bipolar I and Bipolar II disorders?

Bipolar I has a higher prevalence of psychotic symptoms; Bipolar II has heightened creativity during hypomanic episodes. Signup and view all the answers

Which of the following must be considered when diagnosing a child with Bipolar I?

Family history of bipolar disorder, onset and medical history, and response to antidepressant treatment Signup and view all the answers

What is the primary difference between Bulimia Nervosa and Binge Eating Disorder?

The presence of purging behavior in Bulimia Nervosa Signup and view all the answers

What distinguishes Nocturnal Enuresis from Diurnal Enuresis?

Nocturnal Enuresis involves voiding urine during sleep. Signup and view all the answers

In which sleep stage do sleep spindles and K complexes primarily appear?

NREM Sleep Stage 2 Signup and view all the answers

Which of the following is NOT a symptom of Insomnia?

Frequent napping during the day Signup and view all the answers

What is Sleep Efficiency a measure of?

The actual time spent asleep relative to time spent in bed Signup and view all the answers

Which condition is most associated with recurrent episodes of excessive sleepiness despite having at least 7 hours of main sleep?

Hypersomnolence Disorder Signup and view all the answers

What is a common comorbid disorder with Binge Eating Disorder?

Major Depressive Disorder Signup and view all the answers

Which of the following is a potential consequence of chronic purging in Bulimia Nervosa?

Enlargement of salivary glands Signup and view all the answers

What behavioral characteristic is NOT typically observed in individuals with Enuresis?

Recurrent passage of feces Signup and view all the answers

Which sleep stage is characterized by the deepest level of sleep?

NREM Sleep Stage 3 Signup and view all the answers

Which sleep disorder is characterized by episodes of decreased respiration associated with elevated CO2 levels?

Sleep-Related Hypoventilation Signup and view all the answers

Which disorder involves efforts to avoid threats to survival, security, or physical integrity during REM sleep?

Nightmare Disorder Signup and view all the answers

What is characterized by recurrent episodes of arousal during sleep associated with vocalization and/or complex motor behaviors?

REM Sleep Behavior Disorder Signup and view all the answers

Which of the following is NOT a characteristic of Non-REM Sleep Arousal Disorders?

Remembering the event post-awakening Signup and view all the answers

Central Sleep Apnea can be identified by polysomnography if it shows:

5 or more central apneas per hour Signup and view all the answers

What characterizes Restless Legs Disorder, besides the urge to move the legs?

Sense of relief during movement Signup and view all the answers

What breathing pattern is associated with Central Sleep Apnea?

Cheyne-Stokes Breathing Signup and view all the answers

Which disorder is associated with a persistent or recurrent pattern of sleep disruption due to alterations in circadian rhythm?

Circadian Rhythm Sleep-Wake Disorders Signup and view all the answers

What condition is indicated by an absence of airflow for certain periods during sleep?

Obstructive Sleep Apnea Signup and view all the answers

Which disorder involves delayed ejaculation, higher levels of sexual dissatisfaction, and general health issues?

Delayed Ejaculation Signup and view all the answers

Which of the following is a common co-occurrence with Illness Anxiety Disorder?

Obsessive-Compulsive Disorder Signup and view all the answers

Which disorder is characterized by the presence of two or more distinct personality states?

Dissociative Identity Disorder Signup and view all the answers

What is a key characteristic of Somatic Symptom Disorder?

Distress centered around specific somatic symptoms Signup and view all the answers

In which disorder is there an incompatibility between symptoms and recognized neurological conditions?

Conversion Disorder Signup and view all the answers

Which disorder is often developed in the context of a stressful life and involves a preoccupation with having or acquiring a serious illness?

Illness Anxiety Disorder Signup and view all the answers

Which disorder features the individual presenting another individual as ill without obvious rewards?

Factitious Disorder Imposed on Another Signup and view all the answers

What term describes the loss of memory associated with a traumatic event, often leading individuals to unexpectedly end up in a new place?

Dissociative Fugue Signup and view all the answers

Which disorder might involve both motor and sensory dysfunctions that do not align with any known medical condition?

Conversion Disorder Signup and view all the answers

What must Somatic Symptom Disorder be accompanied by in addition to the physical symptoms?

Excessive thoughts, feelings, or behaviors Signup and view all the answers

What distinguishes Depersonalization-Derealization Disorder from Illness Anxiety Disorder?

Loss of sense of reality and perception Signup and view all the answers

Which of the following disorders are commonly co-morbid with cyclothymic disorder?

Substance-related disorders Signup and view all the answers

What is a significant characteristic of irritability in children with Bipolar Disorder?

Persistent and highly disabling Signup and view all the answers

Emotion Reactivity refers to which of the following?

Threshold and intensity of emotional experience Signup and view all the answers

What is a characteristic behavior of infants with Rumination Disorder?

Straining and arching the back with head held back Signup and view all the answers

Which disorder involves eating non-nutritive, nonfood substances for at least one month?

Pica Signup and view all the answers

Which of the following conditions may increase the risk for Pica?

Neglect and lack of supervision Signup and view all the answers

What is a primary co-morbidity concern with Avoidant/Restrictive Food Intake Disorder (A/RFID) that has male predominance?

ASD (Autism Spectrum Disorder) Signup and view all the answers

Which subtypes are associated with Anorexia Nervosa?

Binge-eating/purging type and restricting type Signup and view all the answers

What is a notable feature of clients with dysregulation in emotion regulation?

Maladaptive operation of control structures Signup and view all the answers

Which of the following can be associated with trichotillomania in the context of Pica?

Ingesting skin or hair Signup and view all the answers

Which of the following systems is notably involved in why alcohol affects cognitive abilities?

Glutamate system Signup and view all the answers

Which condition is characterized by confusion, loss of muscle coordination, and unintelligible speech and is caused by a deficiency of thiamine?

Wernicke-Korsakoff Syndrome Signup and view all the answers

What side effects are typical of the natural chemicals found in the opium poppy?

Inducing sleep and relieving pain Signup and view all the answers

Which is the common psychoactive substance known as a 'gentle stimulant'?

Caffeine Signup and view all the answers

At which stage of the four-stage model for the progression of alcoholism does drinking heavily with few outward signs of a problem occur?

Prodromal Stage Signup and view all the answers

Which of the following substances can lead to tolerance, making it difficult for users to reach the euphoric state they initially experienced?

Cannabis Signup and view all the answers

What is the chronic memory disorder often caused by severe alcohol misuse and associated with a deficiency of thiamine called?

Korsakoff Syndrome Signup and view all the answers

What is the reaction called when alcohol reduces inhibitions and makes a person more outgoing?

Substance Intoxication Signup and view all the answers

Which hallucinogenic substance is produced synthetically in the laboratory and is widely known?

Lysergic acid diethylamide (LSD) Signup and view all the answers

What condition that may result from long-term alcohol use is marked by a combination of confusion, loss of muscle coordination, and unintelligible speech?

Wernicke-Korsakoff Syndrome Signup and view all the answers

Which sexual disorder can include symptoms such as thyroid problems, anxiety, and urinary incontinence?

Female Sexual Interest/Arousal Disorder Signup and view all the answers

Which disorder must a person be at least 18 years old to be diagnosed with?

Voyeuristic Disorder Signup and view all the answers

Anxiety about anticipated vulvovaginal or pelvic pain is a symptom of which disorder?

Genito-Pelvic Pain/Penetration Disorder Signup and view all the answers

Which disorder is characterized by intense arousal from the physical suffering of another person for at least 6 months?

Sexual Sadism Signup and view all the answers

Which disorder involves ejaculation approximately one minute following vaginal penetration?

Premature (Early) Ejaculation Signup and view all the answers

Which disorder must persist for at least 6 months and include nonconsensual acts?

Exhibitionistic Disorder Signup and view all the answers

Which disorder is rarely the sole sexual diagnosis for men?

Male Hypoactive Sexual Disorder Signup and view all the answers

Which disorder can be linked to childhood sexual abuses and substance misuse?

Voyeuristic Disorder Signup and view all the answers

Which disorder includes difficulties in vaginal penetration and vaginal pain during intercourse?

Genito-Pelvic Pain/Penetration Disorder Signup and view all the answers

Which disorder involves engaging in nonconsensual touching or rubbing against a person for at least 6 months?

Frotteuristic Disorder Signup and view all the answers

Study Notes

Obsessive-Compulsive Disorder

Obsessions are intrusive and nonsensical thoughts, images, or urges that individuals try to resist or eliminate.
Compulsions are thoughts or actions used to suppress obsessions and provide relief.
Sensory phenomena are physical experiences that precede compulsions.
Individuals with OCD often avoid people, places, and things that trigger OC.
Accommodation involves the involvement of family and friends in compulsive rituals.
Risks for OCD include perinatal events, premature birth, tobacco use during pregnancy, sexual and physical abuse, and environmental factors like infectious agents.
Tic Disorders commonly co-occur with OCD.
Obsessions usually do not involve real-life concerns and can include irrational or magical content.

Important Distinctions

Obsessions and compulsions are not limited to concerns about weight and food.
Compulsions are usually preceded by obsessions, while tics are often preceded by premonitory sensory urges.

Body Dysmorphic Disorder

It is characterized by a preoccupation with an imagined defect in appearance.
Individuals with BDD may have ideas or delusions of reference.
BDD is associated with high levels of anxiety, social avoidance, depressed mood, negative affectivity, rejection sensitivity, and perfectionism.
It is also associated with low extroversion and low self-esteem.
Abnormalities in emotion regulation, attention, and executive function are common in BDD.
Excessive appearance-related preoccupations and repetitive behaviors are time-consuming.
BDD can be co-morbid with eating disorders, major depressive disorder, social anxiety, and substance-related disorders.

Hoarding Disorder

It is characterized by difficulty discarding or parting with possessions.
Prader-Willi Syndrome is a rare genetic disorder that can lead to hoarding.
Excessive acquisition of items that are not needed or for which there is not available space can occur with difficulty discarding possessions.
Common features of hoarding disorder include indecisiveness, perfectionism, avoidance, procrastination, difficulty planning, and organizing tasks.
Animal hoarding is a related but distinct issue.

Trichotillomania

It is characterized by the recurrent pulling out of one's hair, leading to noticeable hair loss.
It should not be diagnosed when hair removal is performed solely for cosmetic reasons.
Trichotillomania may be triggered by feelings of anxiety or boredom.### Trichotillomania
Is an impulse control disorder characterized by recurrent hair pulling
May be preceded by an increasing sense of tension or may lead to gratification, pleasure, or sense of relief when the hair is pulled out
Hair pulling does not usually occur in the presence of other individuals, except immediate family members

Excoriation Disorder

Characterized by skin picking
Note delusion or tactile hallucination
In the absence of deception, excoriation disorder can be diagnosed if there are repeated attempts to decrease or stop skin picking

Somatic Symptom Disorders

Somatic Symptom Disorder

One or more symptoms cause distress and disruption of daily life
Chronic, influenced by the number of symptoms, age, level of impairment, and any comorbidity
Cognitive features include attention focused on somatic symptoms, attribution of normal bodily sensations to physical illness, worry about illness, and anxiety about illness

Illness Anxiety Disorder

Preoccupation with having or acquiring serious illness (≥6 months)
Usually minimal to no symptoms, mild intensity
Interpret ambiguous stimuli as threatening
Develop in the context of a stressful life

Conversion Disorder

Altered voluntary motor or sensory function
Incompatibility between the symptom and recognized neurological or medical conditions
Unexpected neurological disease cause for the symptoms is rarely found at follow-up
Too much use of denial

Psychological Factors Affecting Other Medical Conditions

Medical symptom is present
Psychological or behavioral factors affect medical condition
Psychological or behavioral factors are judged to affect the course of medical condition

Factitious Disorder

Imposed on self: Individual presents himself or herself as ill
Imposed on another: Presents another individual as ill
Absence of obvious rewards
Malingering: False medical symptoms or exaggerating existing symptoms in hopes of being rewarded

Dissociative Disorders

Depersonalization-Derealization Disorder

Depersonalization: Your perception alters so that you temporarily lose the sense of your own reality, as if you are in a dream watching yourself
Derealization: Your sense of external world is lost; things may seem to change shape or size, people may seem dead or mechanical
Characterized by the presence of constellation of typical depersonalization/derealization symptoms and the absence of manifestations of illness anxiety disorder

Dissociative Amnesia

Inability to recall important autobiographical information, usually of traumatic or stressful nature, that is inconsistent with ordinary forgetting
Usually localized or selective amnesia for specific events, then generalized, if entire life history
Dissociative Fugue: Memory loss revolves around specific incident, an unexpected trip; individuals just take off and later find themselves in a new place, unable to remember why or how you got there

Dissociative Identity Disorder

Disruption of identity characterized by two or more distinct personality states
Host personality: The person who becomes the patient and asks for treatment; developed later

Sleep Disorders

Recurrent Episodes of Irrepressible Need to Sleep

Lapsing into sleep, or napping with cataplexy
Hypocretin deficiency, and evidence from polysomnography showing REM sleep latency less than or equal to 15 mins
3x/week, for at least 3 months

Obstructive Sleep Apnea Hypopnea

At least 4 obstructive apneas or hypopneas per hour of sleep or evidence from polysomnography of 15 or more obstructive apneas and/or hypopneas per hour of sleep
Apnea: absence of airflow
Hypopnea: reduction in airflow

Central Sleep Apnea

Evidence by polysomnography of 5 or more central apneas per hour of sleep
Cheyne-Stokes Breathing: an abnormal pattern of breathing characterized by progressively deeper, and sometimes faster, breathing followed by a gradual decrease that results in a temporary stop in breathing called an apnea

Polysomnography demonstrates episodes of decreased respiration associated with elevated CO2 levels

Circadian Rhythm Sleep-Wake Disorders

Persistent or recurrent pattern of sleep disruption due to alteration of the circadian system or misalignment between the endogenous circadian rhythm
Leads to excessive sleepiness or insomnia, or both

Non-REM Sleep Arousal Disorders

Incomplete awakening from sleep: sleepwalking or sleep terrors
Cannot remember anything when they woke up
Occur mostly in childhood and non-rem sleeps
Produce rapid and complete awakening without confusion, amnesia, or motor activity

Nightmare Disorder

Repeated occurrences of extended, extremely dysphoric, and well-remembered dreams that usually involve efforts to avoid threats to survival, security, or physical integrity
Upon awakening, they become oriented and alert
Appear in children exposed to acute or chronic psychosocial stressors
Occur during REM Sleep

REM Sleep Behavior Disorder

Repeated episodes of arousal during sleep associated with vocalization and/or complex motor behaviors
During REM sleep
Upon awakening, the individual is completely awake, alert, and not confused### Depressive Disorders
"Other specified depressive disorder" or "unspecified depressive disorder" diagnosis is given when symptoms do not meet the full criteria for a depressive disorder
A separate diagnosis of PDD is not made if symptoms occur only during the course of a psychotic disorder
Double Depression: suffering from both MDE and PDD with fewer symptoms

Premenstrual Dysphoric Disorder

At least 5 symptoms must be present in the majority of menstrual cycles
Delusions and hallucinations have been described in the late luteal phase of the menstrual cycle but are rare

Seasonal Affective Disorder

Episodes must have occurred for at least 2 years with no evidence of non-seasonal MDE during that period
Also known as "Cabin fever"

Grief

Integrated Grief: acute grief, acknowledging the finality of death and its consequences, and adjusting to the loss
Complicated Grief: a reaction that can develop without a pre-existing depressed state

Dissociative Identity Disorder (DID)

Switch: transitioning from one personality to another
Extreme subtype of PTSD
Hypnotic Trance: focused on one aspect of their world, becoming vulnerable to suggestions by the hypnotist
Often presents with comorbid depression, anxiety, substance abuse, self-injury, or other common symptoms
Early life trauma is a risk factor
Implicated brain regions: orbitofrontal cortex, hippocampus, parahippocampal gyrus, and amygdala
Does not have a classic bipolar sleep disturbance
Individuals with DID have the highest hypnotic capacity among all clinical groups

Sexual Disorders

Female Sexual Interest/Arousal Disorder: absent or reduced interest in sexual activity, associated with problems in experiencing orgasm, pain during sexual activity, infrequent sexual activity, and couple-level discrepancies in desire
Genito-Pelvic Pain/Penetration Disorder: difficulties in vaginal penetration, vaginal pain during intercourse or penetration attempts, and anxiety about anticipating vulvovaginal or pelvic pain
Male Hypoactive Sexual Disorder: persistently deficient or absent sexual/erotic thoughts or fantasies and desire for sexual activity
Premature (Early) Ejaculation: ejaculation approximately 1 minute following vaginal penetration or even before the individual wishes it, with a sense of lack of control over ejaculation and apprehension about anticipated inability to delay ejaculation
Voyeuristic Disorder: intense arousal from observing an unsuspecting naked person, nonconsensual, and often associated with childhood sexual abuse, substance misuse, and sexual preoccupation/hypersexuality
Exhibitionistic Disorder: intense arousal from exposing genitals to an unsuspecting person, nonconsensual
Frotteuristic Disorder: intense arousal from touching or rubbing genitals against a nonconsenting person
Sexual Masochism: intense sexual arousal from being humiliated, beaten, bound, or otherwise made to suffer
Sexual Sadism: intense sexual arousal from the physical suffering of another person

Substance: a chemical compound ingested to alter mood or behavior
Psychoactive substances: alter mood, behavior, or both
Substance Use: ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, educational, or occupational functioning
Substance Intoxication: physiological reaction to ingested substances
Substance Use Disorders: problematic use of substances
Physiological Dependence: tolerance and withdrawal

Alcohol

Produced through fermentation of yeast, sugar, and water
Depressant: reduces inhibitions, induces relaxation, and impairs brain function
Withdrawal Delirium (Delirium Tremens): a condition that can produce frightening hallucinations and body tremors
Breathalyzer: measures levels of intoxication
GABA: particularly sensitive to alcohol
Glutamate system: involved in alcohol's effects on cognitive abilities
Two types of organic brain syndromes can result from long-term alcohol use: Dementia and Wernicke-Korsakoff Syndrome
Fetal Alcohol Syndrome: a condition caused by maternal alcohol use during pregnancy
Alcohol Dehydrogenase: metabolizes alcohol
Korsakoff syndrome: a chronic memory disorder caused by a severe deficiency of thiamine (vitamin B-1)

Four-Stage Model for the progression of Alcoholism

Pre-Alcoholic Stage: drinking occasionally with few serious consequences
Prodromal Stage: drinking heavily but with few outward signs of a problem
Crucial Stage: loss of control, with occasional binges
Chronic Stage: primary daily activities involve getting and drinking alcohol

Other Substances

Caffeine: a gentle stimulant found in tea, coffee, soda, and cocoa products
Cannabis (Marijuana): reactions include mood swings or even dream-like experiences, with chronic and heavy users reporting tolerance
Hallucinogens: most commonly "LSD", produced synthetically in the laboratory
Phencyclidine (PCP): causes impulsivity and aggressiveness
Inhalant: solvents, aerosol sprays, gases, and nitrites, often found at home or workplace
Opioid: natural chemicals in the opium poppy that have a narcotic effect, including natural opiates, synthetic variations, and comparable substances that occur naturally in the brain
Sedative, Hypnotic, or Anxiolytic: calming, sleep-inducing, and anxiety-reducing substances, including barbiturates and benzodiazepines

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Description

Identify and differentiate OCD-related disorders by understanding the characteristics of obsessions, compulsions, sensory phenomena, and accommodation. Learn about the risks and common behaviors associated with OCD.