PSYCH 333 1nd Edition Lecture 11 Outline of Last Lecture I Biological Treatments II Behavioral Theories III Cognitive Theories IV Cognitive Treatments Outline of Current Lecture II Sociocultural Factors III Diathesis Stress Model IV Obsession V Compulsion VI Obsessive Compulsive Disorder VII Trichotillomania VIII Hoarding Disorder IX Body Dysmorphic Disorder X Biological Theories XI Biological Treatments XII Behavioral Theories XIII Cognitive Theories XIV Cognitive Behavioral Treatment XV Other Theories Current Lecture Sociocultural Factors o Gender Difference in reporting of symptoms Externalizing vs internalizing Men externalize go get a beer Women internalize cry it out Power control More prevalent in women o Culture Culture bound disorders Difference in prevalence rates Some differences in symptoms reported These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute Diathesis Stress Model o Diathesis Biological Genetics Psychological Self esteem Social Culture gender family of origin o New stressors trauma Ending a relationship getting fired getting a new job or getting into a new relationships o Onset of an anxiety disorder Obsessive Compulsive and Related Disorders Obsessions o Intrusive recurring thoughts o Different from worry phobia o Common obsessions Contamination cleanliness Sexual aggressive impulses Religion Symmetry order Compulsions o Behaviors or mental acts to reduce anxiety o Magical thinking o Common compulsion Hand washing Counting touching Checking Obsessive Compulsive Disorder o Onset usually in early childhood or late adolescence early adulthood Onset tends to be earlier for males o Chronic course low remission rates without treatment It won t go away on its own o Content of obsession compulsions may vary across culture but key features to be the same o Highly comorbid with other anxiety disorders depression other related disorders and tic disorders Trichotillomania and Excoriation o Trichotillomania Recurrent pulling of one s hair resulting in hair loss Repeated attempts to decrease or stop hair pulling without success o Excoriation Recurrent picking of one s skins resulting in lesions Repeated attempts to decrease or stop skin picking o Onset usually in adolescence o More of a compulsion than an obsession Hoarding Disorder o Acquisition of items and extreme difficulty discarding of items regardless of value o Onset usually in childhood o Chronic course with increasing severity over time o Typically do not seek treatment until later adulthood Body Dysmorphic Disorder o Preoccupation with imagined defects in appearance o Intrusive thoughts about appearance excessive efforts to correct defects o Muscle dysmophia subtype o Onset late adolescence 2 3 of cases have onset prior to age 18 o Course chronic with remission later in life o Comorbid with depression social anxiety disorder OCD substance use disorder and personality disorder Biological Theories o Genetics 30 50 heritable o Macroanatomy Orbitofrontal cortex primitive urges Thoughts about sex aggression and food Caudate nucleus executing of voluntary goal directed activity Basil ganglia coordinates muscle movement Anterior cingulate cortex gut feeling disgust Perception of pain highly activated with disgust and discomfort o Microanatomy Serotonin dopamine GABA and glutamate Biological Treatments o Medication Antidepressants SSRIs and tricyclic Need higher doses than for depression or anxiety disorders Sensitivity to side effects Efficacy is lower for OCD and trichotillomania Better efficacy for BDD Unknown for hoarding disorder and excoriation Behavioral Theories o Compulsive behavior is negatively reinforced Checking behavior o Vicious cycle o Anxiety Compulsion Relief Shame Anxiety Cognitive Theories o OCD Deficits in Yedasentience Low confidences in memories effects of checking on vividness of memories Illusions of control Effects of thought suppression o BDD Salience of physical feature facial procession o Hoarding disorder Attentional and organizational deficits Distorted beliefs about importance of possessions Salience of objects Cognitive Behavioral Treatment o Exposure and response prevention Prevent engagement in ritual compulsion Eliminates negative reinforcement of compulsive behaviors Extinction of anxious response o Cognitive treatments Addressing cognitive distortions o Mindfulness based interventions Letting your thoughts go Fairly effective for OCD Other Theories o Trichotillomania and excoriation Reaction to social isolation emotional pain Extreme loneliness Similar to grooming disorder in animals o Hoarding Evolutionary benefit of having stockpiles of supplies