Obsessive - Compulsive & Related Disorder
Obsessive - Compulsive Disorder (OCD) focuses on avoiding frightening or repulsive intrusive thought (obsessions) or neutralizing these thoughts through the use of ritualistic behavior ( compulsion). OCD is the devastating culmination of the anxiety disorder. It is not uncommon for someone with OCD to experience severe generalized anxiety, recurrent panic attacks, debilitating avoidance and major depression, all occurring simultaneously with obsessive compulsive symptoms. With OCD, establishing even a foothold of control and predictability over the dangerous events in life seems so utterly hopeless that victims resort to magic and rituals.
1. Pursuing cleanliness and orderliness.
2. Avoiding particular objects.
3. Performing repetitive.
4. Being magical.
5. Protective practice.
6. Hand washing.
7. Craving for long.
9. Repeating words silently.
10. Checking lights turned off.
11. Checking gas jets.
12. Checking faucets were turned off.
13. Windows fastened.
14. Checking doors locked.
15. Performing a particular act, such as eating slowly.
OCD is viewed as a result of feelings of incompetence. It is observed that when children are kept from developing a sense of competence by doting or excessively dominating parents, they develop an inferiority complex and may unconsciously adopt compulsive rituals in order to carve out a domain in which they exert control and can feel proficient. Compulsive checking is that it results from a memory deficit. Behavioral accounts of compulsion consider them learned behaviors reinforced by fear reduction. Encephalitis, head injuries and brain tumors have all been associated with the development of obsessive- compulsive disorder. As with all anxiety disorders, biological and Psychological vulnerabilities seem to be involved in the development of OCD.
The effects of drugs on OCD have been evaluated extensively. The most effective seem to be those that specifically inhibit the reuptake of serotonin, such as clomipramine or the SSRIs, with no particular advantage to one drug over another. Relapse often occurs when the drug is discontinued.
Highly structured Psychological treatment work somewhat better than drugs, but they are not readily available. The most effective approach is called Exposure and Rituals Prevention (GRP), a process whereby the rituals are actively prevented and the patient is systematically and gradually exposed to the feared thoughts or situations.
David H. Barlow, BOSTON UNIVERSITY
V. Mark Durand, UNIVERSITY OF SOUTH FLORIDA- ST. PETERSBERG
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