Taak 5 OCD
Leerdoelen:
1. Kenmerken
2. Prevalentie
3. Co-morbiditeit
4. Etiologie
5. Prognose
6. Behandeling
Bron: Becker et al
Several characteristics of worries
● Worries are a cognitive phenomenon experienced as aversive, people worry about
future events and potential catastrophes, and worries are very hard to control.
○ Worries differ from similar cognitive phenomena, such as obsessions
● Worries are more frequently triggered and generally occur in the form of thoughts,
whereas obsessions often occur as images and impulses
● Although both are experienced as uncontrollable, worries are not as strongly resisted as
obsessions
● Most important: uncontrollability
Wegner’s conception of mental control
● 2 processes
○ Concentration on thoughts that one wants to think of
○ Suppression of unwanted thoughts
■ Impaired in GAD
The white bear paradigm
● Suppression of thoughts
● “Participants, spend 5 minutes thinking, about anything but not about white bears”
● Image of white bear comes to mind? → pressing button
● Attempt to suppress thoughts of target objects, caused a considerable number of
intrusions (unwanted thoughts)
→ used in this study with GAD patients
Discussion
● Intrusions signaled by button presses indicate that ptients with GAD do indeed suffer
from a lack of mental control regarding their worries
○ More intrusions of their worry than of white bears
→ opposite for nonanxious patients & patients with different anxiety
disorder
○ Seems to be caused by specific information processing characteristics of GAD
rather than differences in general psychopathology
● Results do not imply complete lack of mental control in GAD patients
, ● Both groups (GAD and control) exhibited similar patterns of intrusions
○ Speech phobics → more intrusions overall, think aloud task more
stressfull for them (logically because they are SPEECH phobics)
● Confirmation of Wegner’s hypothesis that mental control will be impaired under stress
Intrusions: ongewilde gedachten
● Obsessie: kunnen we allemaal hebben → niet meteen OCD
○ Hierbij is het alleen een gedachte van JOU
● OCD is niet alleen obsessie maar ook intrusion
○ Dus een gedachte die voor jou gevoel daar niet hoort maar toch
binnengedrongen is als het ware
○ Dus bij OCD is het zowel een gedachte van jou maar ook een binnengedrongen
gedachte
Hoe meer iemand met OCD de gedachten wil onderdrukken → meer flashbacks =
rebound effect
Bron: Clark & González
Obsessive-Compulsive Disorder
● Definition and symptom features
○ Obsessions: persistent, unwanted, and intrusive thoughts, images, or impulses
that are normally distressing and difficult to control despite the individual’s
attempt to prevent their occurrence or to neutralize their adverse effects
■ Most common: themes of dirt/contamination, pathological doubt over
one’s actions, repugnant thoughts of sex, immorality, religion, harm or
agression to self or others
■ Usually cause considerable anxiety although the severity of the anxiety or
distress can vary significantly from case to case
■ Guilt is often associated with obsessions
○ Obsessions and compulsions are usually functionally related
■ Fear of dirt related with compulsion of washing hands
○ Compulsions: repetitive, stereotypic, intentional behaviors or mental acts that
the person feels driven to perform in order to neutralize anxiety associated with
an obsession or prevent some imagined dreaded outcome
■ Most common “ritual” among OCD patients
● Also other cognitive strategies used
○ Reassurance sseking
○ Rationalization
○ Distraction
○ Thought stopping
○ Thought suppression
● Obsessions, worry, intrusive thoughts, and depressive rumination
○ Unconstructive repetitive thought
Leerdoelen:
1. Kenmerken
2. Prevalentie
3. Co-morbiditeit
4. Etiologie
5. Prognose
6. Behandeling
Bron: Becker et al
Several characteristics of worries
● Worries are a cognitive phenomenon experienced as aversive, people worry about
future events and potential catastrophes, and worries are very hard to control.
○ Worries differ from similar cognitive phenomena, such as obsessions
● Worries are more frequently triggered and generally occur in the form of thoughts,
whereas obsessions often occur as images and impulses
● Although both are experienced as uncontrollable, worries are not as strongly resisted as
obsessions
● Most important: uncontrollability
Wegner’s conception of mental control
● 2 processes
○ Concentration on thoughts that one wants to think of
○ Suppression of unwanted thoughts
■ Impaired in GAD
The white bear paradigm
● Suppression of thoughts
● “Participants, spend 5 minutes thinking, about anything but not about white bears”
● Image of white bear comes to mind? → pressing button
● Attempt to suppress thoughts of target objects, caused a considerable number of
intrusions (unwanted thoughts)
→ used in this study with GAD patients
Discussion
● Intrusions signaled by button presses indicate that ptients with GAD do indeed suffer
from a lack of mental control regarding their worries
○ More intrusions of their worry than of white bears
→ opposite for nonanxious patients & patients with different anxiety
disorder
○ Seems to be caused by specific information processing characteristics of GAD
rather than differences in general psychopathology
● Results do not imply complete lack of mental control in GAD patients
, ● Both groups (GAD and control) exhibited similar patterns of intrusions
○ Speech phobics → more intrusions overall, think aloud task more
stressfull for them (logically because they are SPEECH phobics)
● Confirmation of Wegner’s hypothesis that mental control will be impaired under stress
Intrusions: ongewilde gedachten
● Obsessie: kunnen we allemaal hebben → niet meteen OCD
○ Hierbij is het alleen een gedachte van JOU
● OCD is niet alleen obsessie maar ook intrusion
○ Dus een gedachte die voor jou gevoel daar niet hoort maar toch
binnengedrongen is als het ware
○ Dus bij OCD is het zowel een gedachte van jou maar ook een binnengedrongen
gedachte
Hoe meer iemand met OCD de gedachten wil onderdrukken → meer flashbacks =
rebound effect
Bron: Clark & González
Obsessive-Compulsive Disorder
● Definition and symptom features
○ Obsessions: persistent, unwanted, and intrusive thoughts, images, or impulses
that are normally distressing and difficult to control despite the individual’s
attempt to prevent their occurrence or to neutralize their adverse effects
■ Most common: themes of dirt/contamination, pathological doubt over
one’s actions, repugnant thoughts of sex, immorality, religion, harm or
agression to self or others
■ Usually cause considerable anxiety although the severity of the anxiety or
distress can vary significantly from case to case
■ Guilt is often associated with obsessions
○ Obsessions and compulsions are usually functionally related
■ Fear of dirt related with compulsion of washing hands
○ Compulsions: repetitive, stereotypic, intentional behaviors or mental acts that
the person feels driven to perform in order to neutralize anxiety associated with
an obsession or prevent some imagined dreaded outcome
■ Most common “ritual” among OCD patients
● Also other cognitive strategies used
○ Reassurance sseking
○ Rationalization
○ Distraction
○ Thought stopping
○ Thought suppression
● Obsessions, worry, intrusive thoughts, and depressive rumination
○ Unconstructive repetitive thought
