Compulsive acts mirror checking camouflaging

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compulsive acts (mirror checking, camouflaging, excessive grooming, and skin picking) Half of BDD individuals are delusional (w/ delusions of reference) Pattern of anxious avoidance of others Body Integrity Identity Disorder (BIID): An OCD Spectrum Disorder? A belief, usually from early childhood,  that one or more limbs (usually the legs) do  not “belong” to  one’s  body, and that amputation of the limb(s) will achieve  "wholeness." Certainly regarding the limb(s) involved and the level of amputation desired.  Rehearsal activity (pretending) during which they imitate the amputated state in  private and in public.  Pursuit of elective amputation or attempts at self-amputation. BIID can include non-amputation bodily changes, such as beliefs that one “should”  be deaf, blind, paralyzed, or disfigured. Amputation or other surgery is the only known treatment. Body Integrity Identity Disorder (from  Whole , 2003) Streptococcus and OCD: PANDAS P ediatric  A utoimmune  N europsychiatric  D isorders  A ssociated with  S treptococcal infections Seen in school-age children who develop strep throat or strep rash, usually with fever  and urinary incontinence. Sudden onset of tic disorder, or OCD signs/symptoms, most commonly hand-washing  and preoccupation with germs. Rapid remission of symptoms usually occurs with antibiotic therapy.
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PANDAS accounts for only a small % of childhood OCD, but may point to possible  mechanisms involved in OCD (auto-immunity, neurotoxicity?). 1st Line OCD Treatments Antidepressant therapy with serotonin-boosting medications SSRIs:  e.g., Prozac, Luvox, Celexa, Lexapro Tricyclics: esp.,  clomipramine (Anafranil) Behavior Therapy Thought stopping Response prevention Psychosurgery (cingulotomy) for otherwise intractable cases Reactions to Extreme Trauma Intrusive recollections (daytime flashbacks,  nightmares, illusions),  and acute distress  upon cues suggestive of the trauma Dissociative symptoms (“psychic numbing”) emotional detachment being in a “daze” dropping out of usual activities avoidance of  topics related to trauma forgetting or “fogginess” re: key aspects of trauma feeling that the current setting is not real ( derealization )   feeling detached from one’s body ( depersonalization ) Chronic hyperarousal:  exaggerated startle,   insomnia,  hypervigilance,  motor  restlessness Irritability and aggressiveness (esp., males) Survival guilt 
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Traumas That Can Precipitate Stress Disorders Most Common traumas: Rape, attempted rape and assault (>300,000 rapes and attempted rapes per year in  U.S., 15:1 women:men)
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