Lecture 10 - Preoccupation & Obsession Fall 2024 PDF

LECTURE 10 Preoccupation and Obsession Chapter 6 of Barlow textbook PSYC 257 – Dr. Pamela Seeds Newer 1 Administrative Items Oct. 14 – 18 – Reading Week – NO CLASS Oct. 21 – Guest lecturer on trauma and dissociative disorders...

LECTURE 10 Preoccupation and Obsession Chapter 6 of Barlow textbook PSYC 257 – Dr. Pamela Seeds Newer 1 Administrative Items Oct. 14 – 18 – Reading Week – NO CLASS Oct. 21 – Guest lecturer on trauma and dissociative disorders (Jackson Smith) Oct. 23 – Guest lecture on eating disorders (Dr. Allison Kelly) Oct. 28 & 30 – Mood disorders 2 2 RECAP: Last two lecture 1. Nature of anxiety and fear 2. When anxiety is disordered ◦ GAD, Panic Disorder, Agoraphobia, Specific Phobia, SAD 3. Nature of effective treatments PSYC 257 - P. Seeds 3 3 Outline 1. Somatic Disorders ◦ Illness anxiety disorder ◦ Functional Neurological Symptom Disorder (Conversion disorder)  Their nature, causes & treatment 2. Obsessive-Compulsive Disorder  Its nature, causes & treatment PSYC 257 - P. Seeds 4 4  1) Somatic Symptom Disorders  Pathological concern related to the appearance or functioning of physical body  Includes 5 related disorders a) Somatic symptom disorder b) Illness anxiety disorder (hypochondriasis) c) Psychological factors affecting a medical condition d) Functional neurological symptom disorder (Conversion disorder) e) Factitious disorder PSYC 257 - P. Seeds 5 Alll relate to the appearance or functioning of physical body 5 in DSM don’t have time to talk about all in class some will be in the text book Brackets means what it was formally referred to as Individuals that do have physical symptoms that are involved in body that usually don’t have a illness Rules out physical then answer must be in their head Tend to run in families and overrepresented in lower income population Focus on b and d in class Most interesting and probably have heard of 5  b) Illness Anxiety Disorder  Severe preoccupation and anxiety over having or acquiring a serious illness  Formerly known as hypochondriasis  Affects women and men equally  May emerge at any age  Evident in diverse cultures If are symptoms they are mild but the occupation on the symptoms are crazy high Lots of anxiety checking behaviours doctors appointments help seeking avoiding situations to not get sick or to not get worse If physical health was part of another anxiety disorder would rule out as not having this If ust focussed on physical health then would diagnose with this Lifetime prevelane 1-5% Present across cultures isn’t culturally bound When shifted from 4-5 DSM the former diangoese could be given more frequently but now the changes only 20-30% of those diagnosed can be diangoes with the changes 6  b) Illness Anxiety Disorder Some physical sensation anxiety and increased attention to it similar to panic disorder very aware of it And it spirals and snowballs the same Imporatnt to think about some feel symptoms more intensely than others (think pain threshold) Sometimes runs in families either very alert about symptoms and physical health or thos ewtih an actual health condition Stressful life events or something happened Ill as a child and very foccuessed about getting ill agin What does it mean being in that sick role 7 Trigger of some kind perceived threat and feel apprehension Gets nervsou focuses and then heightens anxiety and sympathetic nevours system kicks in Causes other symptoms About ones own self not about someone perceiving symptoms as this diagnose as something else 8  VIDEO – Illness Anxiety Illustration PSYC 257 - P. Seeds 9 - 9  b) Illness Anxiety Disorder  Treatment: ◦ Psychotherapy to challenge illness perceptions ◦ Counselling and/or support groups to provide reassurance Inst anything wrong with them so help them learn that their preoccupation Is the problem Challenge and redirect thinking Helpful for support group and those who have also struggled and can minimize calmness that professionals say that cant believe Minor smtopms maybe or those most of us experience and don’t make a big deal about it 10 QUESTIONS?? PSYC 257 - P. Seeds 11 11  d) Functional Neurological Symptom Disorder (Conversion disorder)  Severe physical dysfunction without corresponding physical pathology  Comorbidity ◦ Esp. somatization disorder  Low socioeconomic groups, women, men under extreme stress Much more severe form Very severe physical symptoms Paralysis having a stroke or seizure MAJOR MEDICAL ISSUE Tricky to diangoes will see al mdical professionals before see a mental health professional Will rule our everything Really really significant Cant get out of bed Wake up blind Very distressed friends and family seems major event and not real cause Copyright © 2015 by Nelson Education Ltd. 12  d) Functional Neurological Symptom Disorder (Conversion disorder) Bodies way of manifesting stress to those that are socially acceptable to those around them Stressors and lfei events and internal conflicts Mind converts the psychological distress into physical symptoms Therefore more platable Have sick role might have been needing but once they need care from others is now a viable option Once being cared for and being asked of less symptoms usually reduce due to love and care and lower expectations VIDEO FNSD (conversion disorder) Conversion disorder - (todaytonight) - Power of mind over body → not fabricated or made up the body does this to avoid stress Conversion disorder follow up 13  d) Functional Neurological Symptom Disorder (Conversion disorder)  Treatment: ◦ Cognitive-behavioural therapy (CBT) ◦ Reduce stress ◦ Minimize help-seeking behaviours - Neurology depratments work with them - Best offer CBT and understand what the stressor is and how to cope better and minimize and stop seek help seeking behaviours - If start working on the stress usually imporove Copyright © 2015 by Nelson Education Ltd. 14  QUESTIONS?? PSYC 257 - P. Seeds 15 Always need to rule out medical reason before treating for a psychological disorder 15  2) Obsessive Compulsive Disorder (OCD) PSYC 257 - P. Seeds 16 Use to be with anxiety buy was its own disorder in the new version 16  DSM-5-TR: Obsessive-Compulsive and Related Disorders  OCD  Body dysmorphic disorder  Hoarding disorder  Trichotillomania  Excoriation disorder PSYC 257 - P. Seeds 17 Reptitive beahiviours outside of and beyond person controls Want to stop but feel impoassible to do so 17  Obsessive-Compulsive Disorder (OCD) Recurrent obsessions and/or compulsions ◦ Obsessions – intrusive and nonsensical thoughts, images, or urges that one tries to resist or eliminate ◦ Compulsions – repetitive thoughts or actions to suppress thoughts & provide relief Howie Mendel One or both parts present Obeseeion half - Perceived undesirable wish could resist Comulsions - Want to get rid of intrusive thoughts and or images - Just right trying to satisfy feeling - Being done the right way 18  OCD Cont’d. DSM-5-TR Specifiers:  With good or fair insight  With poor insight  With absent insight/delusional beliefs PSYC 257 - P. Seeds 19 Don’t necessarily nee to recognize it is problematic Some people do some people don’t Some people think it is functional normal and makes sense May look dilusional Some seem completely ludicrous cuz we are not on inside of indivdaul 19  Common Obsessions in OCD Antony, Downie, & Swinson (1998) 20 Hoarding is now a different because different treatment Everyone will have an intrusice thought we have it think its weird and move on - Intrusive thoughts very common concern about the thoughts and what they mean is the starting point and downward spiral to OCd 20  Common Compulsions in OCD Antony, Downie, & Swinson (1998) 21 - Sometimes go with an intrusive thought - Other times no idea why they have this - Can be almost anything - Get curoious about whether they feel doing something or certain amount of times - Sometimes not realized is a compulsion 21  OCD – Facts and Statistics Lifetime prevalence Sex differences Age of onset Course Time consuming impairment comes in so much time late or missing or cant work at all cuz so much of day in these behaviours - Tends to emerge earlier in boys in childhood then in girls older it is about equal in both - About 2.5% of population - Following covid watching for increased contamination and cleanliness behvaiours and compulasions - Some people wouldn’t have developed but this produced perfect environment to develop - Sometimes get rid of them and then they come back the same or different - When come in really gotten in the way - Handwashing raw cracked hands - Tick or tourettes involvuntary motor or verbal movement disorder are kissing cousings sometimes comnorbid 22 - Mechanism underlying both is same in both cases 22  Causes of OCD Heritability Brain function Early learning PSYC 257 - P. Seeds 23 - Is heritable - Very specific brain regions - Brain changes altered when trying to resist compulasions - Brain motivates and drive but not happy when you try to appease it - Very anxiety provoking and upsetting - Serotonin is NT → biochem treatments SSRIs - Try to understand where ti comes from is hypervigilance and interpretations that are congruent with their belief systems - Maybe have parent who modeled and they think this is normally - Once have or trying to understand - If have thought it Is as bad as if you did the action - Not true have thought to themselves - Fusion between thoughts and reality - When have bad thoughts as shame and guilt provoking as if they did the bad action - Just part of stream of consciousness - Thought suppression is not good belief that the thoughts can be suppressed and should be able to and do a better job cant suppress move on is most common not with OCD 23 - Guilt and responsiblityies for compulsions 23 Maintenance Factors in OCD  Thought-action fusions  Attempts at suppression  Marked sense of responsibility and guilt 24 Maintenance of OCD? © AnxietyBC 25 25  OCD Treatment  Medical Treatment Clomipramine and other SSRIs Psychosurgery (cingulotomy) Deep brain stimulation  Psychological Treatment CBT + Exposure & Response Prevention (ERP) Outcomes New interest in mindfulness Best treatment option for cure is exposure and response prevention Face fears or don’t do compulsions 26  PSYC 257 - P. Seeds © AnxietyBC 27 Therapy done very gradually rather than big at the beginning 27 QUESTIONS?? PSYC 257 - P. Seeds 28 28 Somatic Symptom and Dissociative Disorders Overall Summary 1. Nature of somatic symptom disorders  Illness anxiety disorder  Functional Neurological Symptom Disorder (Conversion disorder) 2. Nature of OCD  Statistics  Causes  Treatment PSYC 257 - P. Seeds 29 29 Coming Up Oct. 14 – 18 – Reading Week – NO CLASS Oct. 21 – Guest lecturer on trauma and dissociative disorders (Jackson Smith) Oct. 23 – Guest lecture on eating disorders (Dr. Allison Kelly) Oct. 28 & 30 – Mood disorders 30 30