Obsessive-Compulsive & Related Disorders (Intro Psych Tutorial #230)

Summary

In this video, Michael Corayer explores obsessive-compulsive and related disorders as outlined in the DSM-5. He discusses OCD's hallmark symptoms: obsessions and compulsions, affecting roughly 2% of the population equally across genders and often linked with depression. The video also covers hoarding disorder, characterized by an inability to discard possessions and leading to cluttered, potentially unsafe environments, with a prevalence of 2-6% and a strong association with mood disorders. Lastly, body dysmorphic disorder is introduced, featuring a preoccupation with imagined physical flaws, impacting approximately 2.4% of individuals, more commonly in females, and frequently comorbid with depression.

Takeaways

• 🧠 Obsessive-Compulsive Disorder (OCD) is characterized by obsessions and compulsions, with obsessions being recurrent, unwanted thoughts and compulsions being repetitive behaviors.
• 🌐 Common obsessions in OCD include fears of contamination, harm to others, and the need for symmetry and balance.
• 🧼 OCD's prevalence is estimated at about 2%, affecting males and females equally, and often co-occurs with depression.
• 🤔 Patients with OCD are aware that their compulsions are irrational but feel compelled to perform them to reduce anxiety.
• 🔁 The cycle of OCD involves intrusive thoughts leading to anxiety, which is temporarily relieved by performing compulsions, only for the anxiety to return.
• 🏚 Hoarding disorder, previously a subtype of OCD, is now recognized as a separate disorder in DSM-5, characterized by difficulty parting with possessions, even if they are worthless.
• 🐭 Animal hoarding is a specific type of hoarding disorder where individuals take in pets they cannot properly care for, leading to poor living conditions for the animals.
• 📈 The prevalence of hoarding disorder is about 2 to 6%, with a higher incidence in older populations and often co-occurring with mood or anxiety disorders.
• 🪞 Body Dysmorphic Disorder (BDD) involves a preoccupation with perceived flaws in one's appearance that are often minor or unnoticeable to others.
• 🪞 Individuals with BDD may exhibit behaviors such as constant mirror-checking, excessive grooming, or seeking reassurance about their perceived flaws.
• 🏥 Only a small percentage (7-8%) of those seeking cosmetic surgery meet the criteria for BDD, suggesting that most people undergoing such procedures do not have this disorder.

Q & A

What are the two main characteristic symptoms of obsessive-compulsive disorder (OCD)?

The two main characteristic symptoms of OCD are obsessions and compulsions. Obsessions refer to recurrent, unwanted, and intrusive thoughts, while compulsions refer to repetitive behaviors that the patient engages in.

What is the estimated prevalence of OCD according to the DSM-5?

The estimated prevalence of OCD in the DSM-5 is about 2%, and it is roughly equal for males and females.

How do individuals with OCD typically perceive their compulsions?

Individuals with OCD often know that their compulsions are irrational. They may rationally understand that their behaviors are not necessary, but they engage in them because it reduces their anxiety.

What is the relationship between OCD and depression?

OCD is often comorbid with depression, meaning that individuals with OCD may also experience symptoms of depression.

What is the difference between normal anxiety and the intrusive thoughts in OCD?

Normal anxiety, such as feeling the need to wash hands after touching something dirty, is a temporary response to a specific event. In OCD, the intrusive thoughts persist and recur even after the individual has taken action to alleviate the anxiety, leading to repetitive behaviors.

What is hoarding disorder, and how is it different from OCD?

Hoarding disorder is characterized by a difficulty in parting with personal possessions, even if they are worthless, and it can lead to clutter that impairs social and occupational functioning. It is different from OCD as it was given its own disorder label in the DSM-5 and is not considered a type of OCD.

What is excessive acquisition, and how is it related to hoarding disorder?

Excessive acquisition is a behavior where individuals with hoarding disorder acquire items that they do not have space for, leading to clutter and an inability to part with possessions. It is often seen in about 80 to 90% of people with hoarding disorder.

What is the estimated prevalence of hoarding disorder, and is it more common in any specific age group?

The estimated prevalence of hoarding disorder is about 2 to 6%, and it is more common in older populations, being three times more common in people aged 55 to 94.

What is body dysmorphic disorder, and how does it manifest?

Body dysmorphic disorder is characterized by a preoccupation with perceived flaws or defects in one's physical appearance that are often slight or not noticeable to others. It can manifest as intrusive thoughts about the perceived flaw, repetitive behaviors such as constant mirror checking, and distorted thoughts that exaggerate the flaw.

How common is body dysmorphic disorder among individuals seeking cosmetic surgery?

Only about 7-8% of people who undergo cosmetic surgery actually meet the diagnostic criteria for body dysmorphic disorder, suggesting that the majority of those seeking cosmetic surgery do not have this disorder.

What is the estimated prevalence of body dysmorphic disorder in the United States, and is there a gender difference?

The estimated prevalence of body dysmorphic disorder in the United States is about 2.4%, and it is slightly more common in females than males.

Outlines

00:00

🤔 Understanding Obsessive-Compulsive Disorder (OCD)

Michael Corayer introduces the topic of obsessive-compulsive and related disorders in the DSM-5, focusing on OCD. He explains that OCD is characterized by obsessions, which are unwanted intrusive thoughts, and compulsions, which are repetitive behaviors. Common obsessions include fears of contamination, harm to loved ones, and the need for symmetry. The prevalence is about 2%, equally affecting males and females, and often co-occurs with depression. Patients with OCD recognize their compulsions as irrational but feel compelled to perform them due to anxiety reduction. The video uses relatable examples to illustrate the intrusive nature of OCD thoughts and the cycle of compulsive behaviors.

05:04

🏚️ Hoarding Disorder: From OCD to a Distinct Diagnosis

The script discusses hoarding disorder, which was reclassified in the DSM-5 as a separate disorder from OCD. It involves difficulty parting with possessions, leading to clutter that can impair social and occupational functioning and create unsafe living conditions. The disorder is characterized by excessive acquisition and, in some cases, animal hoarding. The prevalence ranges from 2 to 6%, with a higher incidence in older adults and a tendency to co-occur with mood or anxiety disorders. The video emphasizes that hoarding disorder is not simply a result of lack of energy or other external factors but is a distinct condition with specific diagnostic criteria.

🤦‍♂️ Body Dysmorphic Disorder: The Preoccupation with Imaginary Flaws

The final paragraph covers body dysmorphic disorder (BDD), previously known as dysmorphophobia. BDD is characterized by a preoccupation with perceived flaws in one's appearance that are often minor or unnoticeable to others. Symptoms include intrusive thoughts about the perceived flaw, repetitive behaviors such as constant mirror checking, and seeking reassurance. Patients may have distorted thoughts, exaggerating the flaw's impact. The prevalence of BDD is about 2.4% in the United States, slightly more common in females. Interestingly, only a small percentage of those seeking cosmetic surgery meet the criteria for BDD, suggesting that most people undergoing such procedures do not have this disorder, which often co-occurs with major depressive disorder.

Keywords

💡Obsessive-Compulsive Disorder (OCD)

OCD is a mental health disorder characterized by intrusive, unwanted thoughts (obsessions) and repetitive behaviors (compulsions). In the video, OCD is discussed as having a prevalence of about 2%, affecting males and females equally, and often comorbid with depression. The script uses examples such as excessive hand washing due to a fear of contamination or checking if the oven is off repeatedly, illustrating the irrational yet persistent nature of these behaviors.

💡Obsessions

Obsessions refer to the recurrent, unwanted thoughts that individuals with OCD experience. The video explains that these thoughts can be about contamination, harm to loved ones, or the need for symmetry and balance. An example given is the feeling that one's hands are contaminated, necessitating constant cleaning, which is a common obsession in OCD.

💡Compulsions

Compulsions are the repetitive behaviors that individuals with OCD engage in as a response to their obsessions. The video describes how compulsions, like washing hands excessively or checking if appliances are off, are performed in an attempt to alleviate anxiety caused by obsessions, despite the individual recognizing the irrationality of these behaviors.

💡Hoarding Disorder

Hoarding Disorder is characterized by a difficulty in parting with personal possessions, even when they are worthless or cluttered. The video script explains that this disorder is distinct from OCD and is associated with excessive acquisition and anxiety when attempting to discard items. It can lead to social and occupational impairments and unsafe living conditions.

💡Excessive Acquisition

Excessive acquisition is a term used in the context of hoarding disorder to describe the tendency of individuals to accumulate items beyond their capacity to store or use them. The video mentions that about 80 to 90% of people with hoarding disorder exhibit this behavior, leading to cluttered living spaces and significant distress.

💡Animal Hoarding

Animal hoarding is a specific type of hoarding disorder where individuals take in pets they cannot adequately care for, leading to neglect and overcrowding. The video script highlights this as a form of hoarding disorder that is particularly concerning due to the welfare of the animals involved.

💡Body Dysmorphic Disorder (BDD)

BDD is a mental health condition where individuals become excessively preoccupied with perceived flaws in their physical appearance that are often minor or unnoticeable to others. The video script explains that individuals with BDD may have intrusive thoughts and repetitive behaviors related to these perceived flaws, such as constantly checking the mirror or seeking reassurance.

💡Perceived Flaws

Perceived flaws are the minor or imagined defects in one's appearance that individuals with BDD focus on. The video script clarifies that these flaws are often not noticeable to others, but for the person with BDD, they become a significant source of distress and preoccupation, leading to behaviors that attempt to hide or fix the flaw.

💡Cosmetic Surgery

Cosmetic surgery is mentioned in the video in relation to BDD, as individuals with this disorder might seek cosmetic procedures to 'fix' their perceived flaws. However, the script notes that only a small percentage of those who undergo cosmetic surgery actually meet the criteria for BDD, indicating that not all who seek such procedures are driven by the disorder.

💡Comorbidity

Comorbidity refers to the co-occurrence of two or more disorders in an individual. The video script mentions that OCD is often comorbid with depression, and similarly, hoarding disorder is frequently comorbid with mood or anxiety disorders. This concept is important for understanding the complexity of mental health conditions and their interconnectedness.

💡Anxiety

Anxiety is a common emotional response to perceived threats or stressors and is closely related to the compulsions in OCD and the distress in hoarding disorder. The video script describes how individuals with OCD engage in compulsions to reduce anxiety caused by obsessions, and how those with hoarding disorder experience anxiety when faced with the prospect of discarding possessions.

Highlights

Obsessive-compulsive disorder (OCD) is characterized by obsessions and compulsions.

Obsessions are unwanted, intrusive thoughts; compulsions are repetitive behaviors.

Common OCD obsessions include contamination fears, harm to loved ones, and the need for symmetry.

OCD prevalence is about 2%, with equal rates among males and females.

OCD is often comorbid with depression.

Patients with OCD recognize their compulsions as irrational.

Compulsive behaviors in OCD temporarily reduce anxiety.

Hoarding disorder involves difficulty parting with possessions, even if worthless.

Hoarding disorder was reclassified from a type of OCD to its own disorder in DSM-5.

Hoarding disorder can create unsafe living environments and impair social and occupational functioning.

Excessive acquisition is common in hoarding disorder, with 80-90% of cases showing this behavior.

Animal hoarding is a type of hoarding disorder where individuals take in pets they cannot care for.

Hoarding disorder prevalence is 2-6%, more common in older populations.

Body dysmorphic disorder (BDD) is preoccupation with perceived physical flaws.

BDD flaws are often minor and not noticeable to others.

BDD symptoms include intrusive thoughts, repetitive behaviors, and distorted thoughts about perceived flaws.

BDD prevalence is about 2.4% in the United States, slightly more common in females.

Only 7-8% of cosmetic surgery patients meet BDD diagnostic criteria.

BDD is often comorbid with major depressive disorder.

Transcripts

Hi, I'm Michael Corayer and this is Psych Exam  Review. In this video we're going to look at  

the category of obsessive-compulsive and  related disorders in the DSM-5 and so  

we'll start with obsessive-compulsive disorder.  Obsessive-compulsive disorder or OCD has two main  

characteristic symptoms and these are obsessions  and compulsions. So obsessions refers to recurrent  

unwanted and intrusive thoughts that the patient  keeps having and compulsions refers to repetitive  

behaviors that the patient keeps engaging in. So  the obsessions that are common in OCD are thoughts  

related to contamination, like feeling that one's  hands are contaminated and need to be cleaned,  

or fears about harming others that if, if the  person doesn't do something then loved ones will  

be harmed or even killed, or thoughts related to  the need for symmetry and balance. The estimated  

prevalence in the DSM-5 for OCD is about 2% and  it's roughly equal for males and females and it's  

often comorbid with depression. Now another part  of OCD is that the patients who suffer from this  

often know that their compulsions are irrational.  So they know that they've just washed their hands  

recently and rationally they shouldn't need  to wash their hands again or they know that  

turning a light switch on you know a set number  of times, like maybe they always turn the switch  

four or five times, they may rationally know  that of course that shouldn't do anything,  

that shouldn't matter, that might not protect  their loved ones from harm or something,  

but they still engage in this behavior, right?  They feel that they don't have full control over  

this. And so one way we could think about this  is to imagine a thought that you may have had  

before that your hands are contaminated. This  is something we've all experienced before;  

you touched something that you know is dirty or  that might have something on it that you don't  

want on your hands and so you have this little bit  of anxiety that comes along with that, that you  

need to wash your hands. You've touched something  disgusting or maybe you've been handling raw meat  

or something, you think "I really need to wash  my hands" and so there's a little bit of anxiety  

until you wash your hands. And that's normal, we  all experience that. But then could imagine that  

you wash your hands and very soon after you've  washed your hands that thought comes back;  

that your hands are still contaminated, that maybe  you didn't do a good job cleaning them or maybe,  

maybe they're actually contaminated again. And  you might rationally know that that's not the case  

but you might still feel some anxiety related to  that. Maybe, you know what, maybe if I if I wash  

my hands again, I'll feel better, right? It will  reduce the anxiety and this is sort of what it's  

like for somebody who's suffering from OCD. They  might rationally know that this behavior isn't  

needed but it reduces their anxiety when they  engage in the compulsive behavior and so they'll  

wash their hands again or they'll maybe wash their  hands with, with hotter water or use more soap or  

or maybe use a stronger sort of cleansing material  to wash their hands. And what happens is they keep  

having this anxiety come back. Similarly  we all have some experience of, you know,  

wondering whether we left the iron on or the  oven on when we're out, you know? We think "did  

I leave that on?" and this causes a little bit of  anxiety. And you know maybe we check, you know,  

you're on your way out the door and you think "I  should probably check the oven", maybe "I need to  

unplug the curling iron" or something that might  be dangerous and you check and then you could  

imagine just as you left if that thought came  back. You know, "well I know I just checked but  

did I turn it off or maybe I accidentally turned  it back on" right? And that might cause even more  

anxiety and so you could see how it's possible for  somebody to get stuck in these sort of loops where  

they're feeling anxiety related to this obsessive  thought and they're not really feeling in control  

of the thought, it's intrusive right? It keeps  coming back to them even though they actually  

know that they just did something that should take  care of it. And I hope that gives you a little bit  

more insight into what it's like to suffer from  this disorder. Okay, so let's look at another  

disorder in this category and this is hoarding  disorder. This is another disorder like OCD  

that did get some exposure in popular media you  may have heard of this or seen TV shows showing  

people with hoarding disorder. And this used to be  considered a type of obsessive compulsive disorder  

in the DSM-IV, but in the DSM-5 it was now given  its own disorder of label. So it's not considered  

to be a type of OCD anymore and this refers to a  difficulty parting with personal possessions, even  

if they're worthless. So somebody is hoarding lots  of items they experienced a great deal of anxiety  

or stress in trying to part with those items. Now  it's important to note that this difficulty in  

parting with possessions is not due to obsessive  thoughts, it's not due to brain injury, or autism,  

or a lack of energy. So if somebody feels  they just don't have the energy to, you know,  

clean out the attic or something or or clean out  their living space then that wouldn't necessarily  

be considered to be a hoarding disorder. Okay so  often this accumulation of things, this clutter,  

impairs the person's ability to function socially  or even occupationally and it also can create an  

unsafe living environment. And so it represents  a bit of danger to the patient in some cases.  

Now in most cases about 80 to 90% of people  who have hoarding disorder show what's called  

excessive acquisition, that means that they will  acquire things that they do not have space for  

that they cannot possibly fit into their home.  So often there will be a very little space where  

they're living and just, you know, packed to the  ceiling with with piles of things that they just  

can't bring themselves to give away. It causes  a great deal of anxiety to them try to part  

with these possessions. Another type of hoarding  disorder that is seen is animal hoarding and this  

is where people will take in pets that they cannot  possibly care for, that they can't provide minimal  

standards of nutrition and care and grooming for  these animals and yet they take them in. They try  

to take these animals as pets. Now the estimated  prevalence for hoarding disorder is about 2 to  

6% and it's also roughly equal between males and  females, although it's much more common in older  

populations. So it's 3 times more common and  people in the age range of 55 to 94 and in 75%  

of cases of hoarding disorder we see that it's  comorbid with a mood disorder like depression  

or an anxiety disorder. Ok so the last disorder  that we'll look at in the obsessive-compulsive  

and related disorders category is called body  dysmorphic disorder and this was formerly known  

as dysmorphophobia but now it has this new label  bought body dysmorphic disorder and this refers  

to a preoccupation with perceived flaws or defects  in one's physical appearance. And it's important  

that these flaws or defects are things that  are very slight; they're often not noticeable  

to others. So this is not the case where somebody  actually has some disfigurement or some terrible  

scarring or something but they have some minor  flaw. But they are preoccupied with this,  

they can't stop thinking about it and so  often this is in the form of skin issues  

like scars or wrinkles, but it can apply to  other aspects of physical appearance; hair,  

teeth, facial features, or areas of the body,  and some of these symptoms of body dysmorphic  

disorder include intrusive thoughts related to  this perceived flaw. The person keeps thinking  

about this right? They have these unwanted and  recurrent thoughts about this flaw and they also  

might have some repetitive behaviors and so these  could include things like constantly checking a  

mirror to look at this perceived flaw and see how  it looks, or repetitive grooming behaviors that  

are designed to maybe hide this flaw or conceal  it, or constant reassurance seeking where they  

might repeatedly be asking friends or family or  loved ones about this flaw and how it looks and,  

you know, is it noticeable in this condition or is  it noticeable in this lighting or something like  

that. And patients who receive this diagnosis  also often have distorted thoughts about this  

perceived flaw so they might have this tendency to  exaggerate or catastrophize this perceived flaw by  

saying that they feel that they're deformed or,  you know, in the extreme cases that you know "I'm  

a monster" right? "I'm hideous to look at" because  of this minor flaw. Now the estimated prevalence  

of body dysmorphic disorder is about 2.4% in the  United States and it's slightly more common in  

females than males. Now you might expect that this  body dysmorphic disorder would be very common in  

people who are seeking cosmetic surgery but the  estimate in the DSM-5 is that only about 7-8% of  

people who undergo cosmetic surgery actually meet  the diagnostic criteria for this body dysmorphic  

disorder. So that suggests that many people  who are seeking or have had cosmetic surgery  

are not going to meet the diagnosis for this body  dysmorphic disorder and it's often comorbid with  

major depressive disorder. Okay so those are  a few disorders in the obsessive-compulsive  

and related disorders category of the  DSM-5. I hope you found this helpful,  

if so, please like the video and subscribe  to the channel for more. Thanks for watching!

you