PSYCH 333 1nd Edition Lecture 11 Outline of Last Lecture I. Biological TreatmentsII. Behavioral TheoriesIII. Cognitive TheoriesIV. Cognitive Treatments Outline of Current Lecture II. Sociocultural FactorsIII. Diathesis-Stress ModelIV. ObsessionV. CompulsionVI. Obsessive-Compulsive DisorderVII. TrichotillomaniaVIII. Hoarding DisorderIX. Body Dysmorphic DisorderX. Biological TheoriesXI. Biological TreatmentsXII. Behavioral TheoriesXIII. Cognitive TheoriesXIV. Cognitive-Behavioral TreatmentXV. Other TheoriesCurrent 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