1. Obsessive-Compulsive Disorder
4.1.5 Psychopathology
The behavioural, emotional and cognitive characteristics of OCD
Pg in text book

2. Introduction to OCD

3. OCD: definition and symptoms
According to the NHS, OCD can be described as the following: Obsessive compulsive disorder (OCD) is a mental health condition where a person has obsessive thoughts and compulsive activity.
A compulsion is a behaviour, something you do
An obsession is a cognition, it takes place in your mind.

4. What is depression? What is OCD?
An obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters a person's mind, causing feelings of anxiety, disgust or unease.
A compulsion is a repetitive behaviour or mental act that someone feels they need to carry out to try to temporarily relieve the unpleasant feelings brought on by the obsessive thought.
Affective = a mental disorder characterised by extreme changes in mood
Continuum: varying degrees of severity.

5. What is OCD?
For example, someone with a fear of their house being burgled may feel they need to check all the windows and doors are locked several times before they can leave the house.
OCD symptoms can range from mild to severe. Some people with OCD may spend an hour or so a day engaged in obsessive-compulsive thinking and behaviour, but for others the condition can completely take over their life.

6. DSM-5 – characteristics of OCD
Common Symptoms:
DSM-5 – characteristics of OCD
Common symptoms
OCD: Characterised by either obsessions (recurring thoughts, images etc.) and/or compulsions (repetitive behaviours such as hand washing). Most people with a diagnosis of OCD have both obsessions and compulsions .
Trichotillomania: Compulsive hair pulling
Hoarding disorder: the compulsive gathering of possessions and the inability to part with anything regardless of its value.
Excoriation disorder: Compulsive skin picking.

7. Quote Signs and symptoms Common obsessions include the following:
Contamination
Safety
Doubting one's memory or perception
Scrupulosity (need to do the right thing, fear of committing a transgression, often religious)
Need for order or symmetry
Unwanted, intrusive sexual/aggressive thoughts

8. Quote Signs and symptoms Common compulsions include the following:
Cleaning/washing
Checking (eg, locks, stove, iron, safety of children)
Counting/repeating actions a certain number of times or until it "feels right"
Arranging objects
Touching/tapping objects
Hoarding
Confessing/seeking reassurance
List making

9. The OCD cycle
The diagram below shows how obsessions and compulsions are connected in an OCD cycle.

10. The characteristics of OCD
Make notes on each of these using pages
Emotional
Behavioural
Cognitive
What do you THINK about when you have OCD?
How do you FEEL when you are OCD?
How do you BEHAVE when you Have OCD?

12. Case studies

13. Answers
Johnny:
Obsessive thought is that if he gets up at any time other than when the digital clock reads the same forwards as backwards, a member of his family will be seriously hurt during the day.
Compulsive behaviour is only getting up at these
times
Lewis:
Obsessive thought is his belief that if the toilet roll is not in the correct position he will be contaminated by faeces.
Compulsive behaviour is spending hours adjusting the toilet roll in the lavatory until its position is exactly in parallel with the lines on the wall tiles.

14. Identify the behavioural, emotional and cognitive aspects of OCD ‘Apply it’

15. Case studies Identify the behavioural, emotional and cognitive aspects of OCD

16. Answers Mark Louise Behavioural: Behavioural:
▪▪ Compulsions: checking homework.
▪▪ Checking things obsessively, e.g. tracing the wiring.
Emotional:
▪▪ Anxiety and doubt.
▪▪ Low mood inferred.
Cognitive:
▪▪ Ruminations.
▪▪ Mistrust of perceptions.
Louise
Behavioural:
▪▪ Compulsive rituals:
–– Washing for hours
–– Scraping outer layer of soap
–– Eating 3 bites at a time
–– Chewing 300 times.
▪▪ Avoidance – she does not leave the house, do housework or talk on the phone.
Emotional:
▪▪ Anxiety – about touching wood, canned goods, etc.
Cognitive:
▪▪ Obsessive fear of contamination.
▪▪ Belief that actions can decontaminate food.

17. Rob remembers his mother being extremely tidy around the house when he was a young boy. His mother would become extremely anxious and shout at Rob if he ever made a mess. Since leaving home and moving into his own flat, Rob has become increasingly concerned about hygiene, cleaning his bathroom up to fifty times a day. Rob often lies awake at night worrying about the spread of germs.
2 0 In the context of obsessive-compulsive disorder, what is meant by an ‘obsession’ and what is meant by a ‘compulsion’? Refer to the example of Rob in your answer.
[3 marks]

18. AO1 Award one mark for a definition of `obsessions` - persistent/recurrent/unwanted/intrusive thoughts; and one mark for a definition of `compulsions` - repetitive/ritualistic behaviour.
AO2 One mark for an example of BOTH an obsession and a compulsion from the stem.
Examples of obsessions – lays awake worrying about germs; increased concern about hygiene around the home.
Examples of compulsions – cleaning his bathroom up to fifty times a day.

19. Homework
Research an individual with OCD and look at the main characteristics they display.

20. Exam Questions Outline the emotional characteristics of OCD. (3 marks)
Outline the behavioural characteristics of OCD. (3 marks)
Outline the cognitive characteristics of OCD. (3 marks)