CMN 552: Module 3 Study Guide - Obsessive-Compulsive & Trauma-
and Stressor-Related Disorders
Introduction
This guide provides a focused, exam-aligned review of Module 3: Obsessive-Compulsive &
Trauma- and Stressor-Related Disorders. It is designed to support efficient studying and a
strong foundational understanding of the essential concepts related to the assessment,
diagnosis, and management of these complex conditions in psychiatric mental health
nursing. The guide summarizes key topics, lecture highlights, and module-relevant material
to help you identify key points, reinforce comprehension, and prepare confidently for
quizzes, exams, and coursework.
I. Core Concepts: DSM-5 Classification and Diagnostic Criteria
Module 3 focuses on two distinct categories in the DSM-5 that were previously grouped
under anxiety disorders: Obsessive-Compulsive and Related Disorders, and Trauma- and
Stressor-Related Disorders. Understanding their specific diagnostic criteria is paramount.
A. Obsessive-Compulsive and Related Disorders
This category includes conditions characterized by obsessions and/or compulsions, or
preoccupation with body-related concerns and repetitive behaviors.
• Obsessive-Compulsive Disorder (OCD):
– Obsessions: Recurrent and persistent thoughts, urges, or images that are
experienced, at some time during the disturbance, as intrusive and unwanted,
and that in most individuals cause marked anxiety or distress. The individual
attempts to ignore or suppress such thoughts, urges, or images, or to neutralize
them with some other thought or action (i.e., by performing a compulsion).
– Compulsions: Repetitive behaviors (e.g., hand washing, ordering, checking) or
mental acts (e.g., praying, counting, repeating words silently) that the
individual feels driven to perform in response to an obsession or according to
rules that must be applied rigidly. The behaviors or mental acts are aimed at
preventing or reducing anxiety or distress, or preventing some dreaded event
or situation; however, these behaviors or mental acts are not connected in a
realistic way with what they are designed to neutralize or prevent, or are
clearly excessive.
– Diagnostic Criteria: Presence of obsessions, compulsions, or both. They are
time-consuming (e.g., take more than 1 hour per day) or cause clinically
significant distress or impairment in social, occupational, or other important
areas of functioning.
, • Body Dysmorphic Disorder: Preoccupation with one or more perceived defects or
flaws in physical appearance that are not observable or appear slight to others. The
individual performs repetitive behaviors (e.g., mirror checking, excessive grooming,
skin picking, reassurance seeking) or mental acts (e.g., comparing one’s appearance
with that of others) in response to the appearance concerns.
• Hoarding Disorder: Persistent difficulty discarding or parting with possessions,
regardless of their actual value, due to a perceived need to save the items and distress
associated with discarding them. This difficulty results in the accumulation of
possessions that congest and clutter active living areas and compromise their intended
use.
Exam Tip: Be able to differentiate between obsessions and compulsions, and understand
how they manifest in OCD. Recognize the key features that distinguish OCD from other
related disorders like Body Dysmorphic Disorder and Hoarding Disorder.
B. Trauma- and Stressor-Related Disorders
These disorders are characterized by exposure to a traumatic or stressful event as a
diagnostic criterion.
• Posttraumatic Stress Disorder (PTSD):
– Exposure to Trauma: Direct exposure, witnessing in person, learning that the
traumatic event occurred to a close family member or friend, or repeated or
extreme indirect exposure to aversive details of traumatic events (e.g., first
responders).
– Intrusion Symptoms: Recurrent, involuntary, and intrusive distressing
memories of the traumatic event; recurrent distressing dreams; dissociative
reactions (e.g., flashbacks); intense or prolonged psychological distress at
exposure to internal or external cues; marked physiological reactions to
internal or external cues.
– Avoidance: Persistent avoidance of stimuli associated with the traumatic
event.
– Negative Alterations in Cognitions and Mood: Inability to remember
important aspects of the traumatic event; persistent negative beliefs about
oneself, others, or the world; distorted cognitions about the cause or
consequences of the event; persistent negative emotional state; diminished
interest or participation in significant activities; feelings of detachment;
persistent inability to experience positive emotions.
– Alterations in Arousal and Reactivity: Irritable behavior and angry
outbursts; reckless or self-destructive behavior; hypervigilance; exaggerated
startle response; problems with concentration; sleep disturbance.
– Duration: The disturbance (symptoms in Criteria B, C, D, and E) lasts for more
than 1 month.
• Acute Stress Disorder: Similar to PTSD but with a shorter duration of symptoms
(from 3 days to 1 month after trauma exposure).
and Stressor-Related Disorders
Introduction
This guide provides a focused, exam-aligned review of Module 3: Obsessive-Compulsive &
Trauma- and Stressor-Related Disorders. It is designed to support efficient studying and a
strong foundational understanding of the essential concepts related to the assessment,
diagnosis, and management of these complex conditions in psychiatric mental health
nursing. The guide summarizes key topics, lecture highlights, and module-relevant material
to help you identify key points, reinforce comprehension, and prepare confidently for
quizzes, exams, and coursework.
I. Core Concepts: DSM-5 Classification and Diagnostic Criteria
Module 3 focuses on two distinct categories in the DSM-5 that were previously grouped
under anxiety disorders: Obsessive-Compulsive and Related Disorders, and Trauma- and
Stressor-Related Disorders. Understanding their specific diagnostic criteria is paramount.
A. Obsessive-Compulsive and Related Disorders
This category includes conditions characterized by obsessions and/or compulsions, or
preoccupation with body-related concerns and repetitive behaviors.
• Obsessive-Compulsive Disorder (OCD):
– Obsessions: Recurrent and persistent thoughts, urges, or images that are
experienced, at some time during the disturbance, as intrusive and unwanted,
and that in most individuals cause marked anxiety or distress. The individual
attempts to ignore or suppress such thoughts, urges, or images, or to neutralize
them with some other thought or action (i.e., by performing a compulsion).
– Compulsions: Repetitive behaviors (e.g., hand washing, ordering, checking) or
mental acts (e.g., praying, counting, repeating words silently) that the
individual feels driven to perform in response to an obsession or according to
rules that must be applied rigidly. The behaviors or mental acts are aimed at
preventing or reducing anxiety or distress, or preventing some dreaded event
or situation; however, these behaviors or mental acts are not connected in a
realistic way with what they are designed to neutralize or prevent, or are
clearly excessive.
– Diagnostic Criteria: Presence of obsessions, compulsions, or both. They are
time-consuming (e.g., take more than 1 hour per day) or cause clinically
significant distress or impairment in social, occupational, or other important
areas of functioning.
, • Body Dysmorphic Disorder: Preoccupation with one or more perceived defects or
flaws in physical appearance that are not observable or appear slight to others. The
individual performs repetitive behaviors (e.g., mirror checking, excessive grooming,
skin picking, reassurance seeking) or mental acts (e.g., comparing one’s appearance
with that of others) in response to the appearance concerns.
• Hoarding Disorder: Persistent difficulty discarding or parting with possessions,
regardless of their actual value, due to a perceived need to save the items and distress
associated with discarding them. This difficulty results in the accumulation of
possessions that congest and clutter active living areas and compromise their intended
use.
Exam Tip: Be able to differentiate between obsessions and compulsions, and understand
how they manifest in OCD. Recognize the key features that distinguish OCD from other
related disorders like Body Dysmorphic Disorder and Hoarding Disorder.
B. Trauma- and Stressor-Related Disorders
These disorders are characterized by exposure to a traumatic or stressful event as a
diagnostic criterion.
• Posttraumatic Stress Disorder (PTSD):
– Exposure to Trauma: Direct exposure, witnessing in person, learning that the
traumatic event occurred to a close family member or friend, or repeated or
extreme indirect exposure to aversive details of traumatic events (e.g., first
responders).
– Intrusion Symptoms: Recurrent, involuntary, and intrusive distressing
memories of the traumatic event; recurrent distressing dreams; dissociative
reactions (e.g., flashbacks); intense or prolonged psychological distress at
exposure to internal or external cues; marked physiological reactions to
internal or external cues.
– Avoidance: Persistent avoidance of stimuli associated with the traumatic
event.
– Negative Alterations in Cognitions and Mood: Inability to remember
important aspects of the traumatic event; persistent negative beliefs about
oneself, others, or the world; distorted cognitions about the cause or
consequences of the event; persistent negative emotional state; diminished
interest or participation in significant activities; feelings of detachment;
persistent inability to experience positive emotions.
– Alterations in Arousal and Reactivity: Irritable behavior and angry
outbursts; reckless or self-destructive behavior; hypervigilance; exaggerated
startle response; problems with concentration; sleep disturbance.
– Duration: The disturbance (symptoms in Criteria B, C, D, and E) lasts for more
than 1 month.
• Acute Stress Disorder: Similar to PTSD but with a shorter duration of symptoms
(from 3 days to 1 month after trauma exposure).
