Abnormal Psychology Chapter 7 Obsessive Compulsive Related and Trauma Related Disorders Obsessive Compulsive Disorder Repetitive intrusive uncontrollable thoughts Repetitive behaviors or mental acts that the person feels compelled to perform Anxiety disorder chapter of DSM Chronic disorder More than 3 quarters meet for comorbid anxiety disorder in their lifetime 2 3 meet for major depression Most frequent foci for obsessions include Fears of contamination sexual or aggressive impulses body problems religion symmetry of order People with obsessions may also be prone to extreme doubts procrastination and indecision Common reported compulsions Pursuing cleanliness orderliness sometimes through elaborate rituals Performing repetitive magically protective acts such as counting or touching a body part Repetitive checking to ensure certain acts are carried out ex returning 7 8 times to see that lights stove etc were turned off One study 78 with compulsions stated their rituals were silly absurd Occurs usually before 10 years old OR late adolescence early adulthood Adults 1 meet criteria in 1 year about 2 meet criteria in their lifetime Slightly more common in women than men 3 areas unusually active 1 Orbitofrontal cortex an area of medial prefrontal cortex above the eyes 2 Caudate Nucleus part of the basal ganglia 3 Anterior Cingulate Heritability ranges from 30 50 Characterized by deficit in yedasentience this subjective feeling of knowing Clomipramine let to 50 reduction of OCD symptoms Body Dysmorphic Disorder Preoccupation with an imagined flaw of ones appearance Excessive repetitive behaviors or acts regarding appearance Somatoform disorder chapter of DSM 3 8 hours a day are spent thinking about it More common in women than in men prevalence rate less than 2 About 1 3 of people with BDD will meet diagnostic criteria for OCD Hoarding Disorder Acquiring excessive amount of objects Inability to part with objects New diagnosis for DSM 1 3 of people with this will also engage in animal hoarding More common among men but few men seek treatment Associated with this depression generalized anxiety disorder social phobia People with BDD Hoarding disorder often have a family history of OCD Hoarding is related to poor organization skills unusual beliefs about possessions avoidance behaviors All 3 disorders respond to SRI s Post Traumatic Stress Disorder PTSD At least 1 3 of women meet criteria after a rape 4 categories 1 intrusively re experiencing the traumatic event 2 avoidance 3 mood cognitive change 4 increased arousal reactivity Beyond severity nature of the trauma matters Traumas caused by humans are more likely to cause ptsd than natural disasters Greater activation of amygdala diminished activation of prefrontal cortex Relate to the hippocampus People with ptsd have smaller volume of hippocampus than those without ptsd SSRI s common medication used Early cognitive behavioral intervention can reduce ones chances of developing ptsd Exposure treatment seems to be more effective than cognitive restructuring in preventing the development of ptsd Anorexia Nervosa Anorexia loss of appetite Nervosa loss is due to emotional reasons 3 features required for diagnosis 1 restriction of behaviors that promote healthy body weight 2 intense fear of gaining weight or being fat 3 distorted body image or sense of body shape 2 types of anorexia nervosa 1 restricting type weight loss achieved by severely limiting food intake 2 binge eating purging type person has regularly engaged in binge eating purging Binge eating purging type Exhibit more personality disorders impulsive behavior stealing alcohol drug abuse social withdrawal suicide attempts 2 3 of women with restricting type switched over to binge eating purging type 8 years later 10x more frequent in women than in men 5 complete suicide 20 attempt suicide 50 70 eventually recover recovery often takes 6 or 7 years death rate 10 higher than general population twice as high in those with additional disorders mortality rates among women range from 3 5 higher sociocultural on women to be thin Opioids released during starvation Excessive exercise increases opioids Low levels of metabolites serotonin feeling of full Compensate by cooking meals for others related to perfectionism personal inadequacy Bulimia Nervosa Bulimia comes from greek word meaning ox hunger More likely to binge alone in morning or afternoon Occur 1x a week or 3 months for DSM 5 accurate with description of their body also likely to be highly dissatisfied with their body Typically begins in late adolescence or early adulthood Comborbid with notably depression personality disorders anxiety disorders substance use disorders and conduct disorder Typically have normal BMI Calculated by dividing weight in kilograms by height in meters squared and is considered a more valid estimate of body fat than many others Binge 2 characteristics 1 eating excessive amount of food more than most people would in a short amount of time 2 involves a feeling of losing control over eating as if one cannot stop Women normal BMI 20 25 Mortality rate nearly 4 Close to 75 recover 10 20 remain fully symptomatic Key difference between bulimia and binge is weight loss Low level of opiods betaendorphines in builimia promote craving Low self esteem Low levels of metabolites serotonin feeling of full Binge Eating Disorder Includes reccurent binges 1x per week for at least 3 months lack of control during binge episode and distress about bingeing as well as other characteristics such as rapid eating and eating alone most people with this are obese prevalence 3 5 for women and 2 for men more common in women than men equally prevalent among European African Asian and Hispanic Americans Comorbid with depression anxiety disorders Increased risk of type 2 diabetes cardiovascular problems breathing problems insomnia and joint muscle problems 25 82 recover BMI greater than 30 is obese Does not have compensatory behaviors purging fasting low opioids reinforce binging Most common and lasts the longest of the 3 eating disorder avg 14 4 yrs Identical twins more likely then non identical twins Genetics of disorders first degree relatives of individuals with both disorders more likely to have disorder Obesity sleep problems Anxiety depression IBS early menstruation in women Eating Disorders Hypothalamus not directly involved Low levels of endogenous eating behaviors impact personality semi starvation leads to preoccupation with food