OBSESSIVE-COMPULSIVE DISORDER

OBSESSIVE-COMPULSIVE DISORDER - OBSESSIVE-COMPULSIVE...

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OBSESSIVE-COMPULSIVE DISORDER DSM-IV 300.3 Obsessive-compulsive disorder An obsession is an intrusive/inappropriate repetitive thought, impulse, or image that the individual  recognizes as a product of his or her own mind but is unable to control. A compulsion is a repetitive urge  that the individual feels driven to perform and cannot resist without great difficulty (severe anxiety). Most  common obsessions are repetitive thoughts about contamination, repeated doubts, a need to have things in a  specific order, aggressive or horrific impulses, or sexual imagery. The individual usually attempts to ignore  or suppress such thoughts or to neutralize them with some other thought or action (compulsion). ETIOLOGICAL THEORIES Psychodynamics Freud placed origin for obsessive-compulsive characteristics in the anal stage of development. The  child is mastering bowel and bladder control at this developmental stage and derives pleasure from  controlling his or her own body and indirectly the actions of others. Erikson’s comparable stage for this disorder is autonomy versus shame and doubt. The child learns  that to be neat and tidy and to handle bodily wastes properly gains parental approval and to be messy brings  criticism and rejection. The obsessional character develops the art of the need to obtain approval by being excessively tidy  and  controlled. Frequently  the parents’  standards  are  too high for the child to meet,  and the child  continually is frustrated in attempts to please parents. The defensive mechanisms used in obsessive-compulsive behaviors are unconscious attempts by the  client to protect the self from internal anxiety. The greater the anxiety, the more time and energy will be  tied up in the completion of the client’s rituals. First, the client uses regression, a return to earlier methods  of handling anxiety. Second, the obsessive thoughts are either devoid of feeling or are attached to anxiety.  Thus, isolation is used. Third, the client’s overt attitude toward others is usually the opposite of the  unconscious feelings. Thus, reaction formation is being used. Last, compulsive rituals are a symbolic way  of undoing or resolving the underlying conflict. Biological Although biological and neurophysiological influences in the etiology of anxiety disorders have been  investigated, no relationship has yet been established. The mind-body connection is well accepted, but it is  difficult   to   establish   whether   the   biological   changes   cause   anxiety   or   the   emotional   state   causes  physiological manifestations. However, recent findings suggest that neurobiological disturbances may play 
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.

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OBSESSIVE-COMPULSIVE DISORDER - OBSESSIVE-COMPULSIVE...

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