CMN 552 ANXIETY EXAM STUDY GUIDE 2026
PRACTICE QUESTIONS AND SOLUTIONS
◉ 2. Differentiate between an obsession and a compulsion. (Sadock, p.
418) . Answer: Obsession: A recurrent and intrusive thought, feeling,
idea, or sensation.
Compulsion: A conscious, standardized, recurrent behavior, such as
counting, checking, or avoiding
◉ 3. What is the prevalence of OCD? . Answer: Lifetime prevalence in
the general population estimated at 2 to 3 percent.
Fourth most common psychiatric diagnosis.
Among adults, men and women are equally likely to be affected.
Among adolescents, boys are more commonly affected than girls.
Mean age of onset is about 20 years.
The onset of the disorder can occur in adolescence or childhood, in some
cases as early as 2 years of age.
,Single persons are more frequently affected with OCD than are married
persons, although this finding probably reflects the difficulty that
persons with the disorder have maintaining a relationship.
Occurs less often among blacks than among whites,
although access to health care rather than differences in prevalence may
explain the variation.
◉ 4. What are the common comorbid psychiatric conditions in patients
with OCD? Sadock p. 418 . Answer: The lifetime prevalence for major
depressive disorder with OCD is 67 percent and social
phobia 25 percent.
Also, alcohol use disorder, generalized anxiety disorder, specific phobia,
panic disorder, eating disorders, and personality disorders. Tourette's
disorder 5-7 percent.
Tics 20-30 percent.
◉ What are the risk factors for the development of OCD? Sadock p. 419
. Answer: There is a significant genetic component.
◉ 6. What etiological factors have been attributed to the development of
OCD? Sadock p. 419-420 . Answer: There is a positive link between
streptococcal infections and OCD.
,Altered function in neurocircuitry between orbitofrontal cortex, caudate,
and thalamus. Increased activity in the
frontal lobes, basal ganglia and cingulum. Bilaterally smaller caudates.
◉ 7. Review the psychosocial factors for the development of OCD.
(Sadock, p. 420) . Answer: OCD differs from obsessive-compulsive
personality disorder, which is associated with an obsessive concern for
details, perfectionism, and other similar personality traits.
Most persons with OCD do not have premorbid compulsive symptoms,
and such personality traits are neither necessary nor sufficient for the
development of OCD. Only about 15 to 35 percent of patients with OCD
have had premorbid obsessional traits.
Many patients with OCD may refuse to cooperate with effective
treatments such as selective serotonin reuptake inhibitors (SSRis) and
behavior therapy.
Patients may become invested in maintaining the symptomatology
because of secondary gains. For example, a male patient, whose mother
stays home to take care of him, may unconsciously wish to hang on to
his OCD symptoms because they keep the attention of his mother.
Research suggests that OCD may be precipitated by a number of
environmental stressors, especially those involving pregnancy,
childbirth, or parental care of children. An understanding of the stressors
, may assist the clinician in an overall treatment plan that reduces the
stressful events themselves or their meaning to the patient.
◉ 8. In OCD patients, what is "magical thinking"? (Sadock, p. 421) .
Answer: Persons believe that merely by thinking about an event in the
external world they can cause the event to occur without intermediate
physical actions.
◉ In what ways can the psychiatric nurse practitioner characterize
(specify) insight in the OCD patient? (Sadock, p. 421) . Answer:
Patients with good or fair insight recognize that their OCD beliefs are
definitely or probably not true or may or may not be true.
Patients with poor insight believe their OCD beliefs are probably true.
Patients with absent insight are convinced that their beliefs are true.
◉ What are the diagnostic/clinical features of OCD? Sadock p.421 .
Answer: Patients with OCD often take their complaints to physicians
other than psychiatrist.
Most patients with OCD have both obsessions & compulsions - up to
75%. Obsessions and compulsions are the essential feature of OCD.
Sometimes, patients overvalue obsessions and compulsions, for example
they may insist that compulsive cleanliness is morally correct, even
though they have lost their jobs because of time spent cleaning.
PRACTICE QUESTIONS AND SOLUTIONS
◉ 2. Differentiate between an obsession and a compulsion. (Sadock, p.
418) . Answer: Obsession: A recurrent and intrusive thought, feeling,
idea, or sensation.
Compulsion: A conscious, standardized, recurrent behavior, such as
counting, checking, or avoiding
◉ 3. What is the prevalence of OCD? . Answer: Lifetime prevalence in
the general population estimated at 2 to 3 percent.
Fourth most common psychiatric diagnosis.
Among adults, men and women are equally likely to be affected.
Among adolescents, boys are more commonly affected than girls.
Mean age of onset is about 20 years.
The onset of the disorder can occur in adolescence or childhood, in some
cases as early as 2 years of age.
,Single persons are more frequently affected with OCD than are married
persons, although this finding probably reflects the difficulty that
persons with the disorder have maintaining a relationship.
Occurs less often among blacks than among whites,
although access to health care rather than differences in prevalence may
explain the variation.
◉ 4. What are the common comorbid psychiatric conditions in patients
with OCD? Sadock p. 418 . Answer: The lifetime prevalence for major
depressive disorder with OCD is 67 percent and social
phobia 25 percent.
Also, alcohol use disorder, generalized anxiety disorder, specific phobia,
panic disorder, eating disorders, and personality disorders. Tourette's
disorder 5-7 percent.
Tics 20-30 percent.
◉ What are the risk factors for the development of OCD? Sadock p. 419
. Answer: There is a significant genetic component.
◉ 6. What etiological factors have been attributed to the development of
OCD? Sadock p. 419-420 . Answer: There is a positive link between
streptococcal infections and OCD.
,Altered function in neurocircuitry between orbitofrontal cortex, caudate,
and thalamus. Increased activity in the
frontal lobes, basal ganglia and cingulum. Bilaterally smaller caudates.
◉ 7. Review the psychosocial factors for the development of OCD.
(Sadock, p. 420) . Answer: OCD differs from obsessive-compulsive
personality disorder, which is associated with an obsessive concern for
details, perfectionism, and other similar personality traits.
Most persons with OCD do not have premorbid compulsive symptoms,
and such personality traits are neither necessary nor sufficient for the
development of OCD. Only about 15 to 35 percent of patients with OCD
have had premorbid obsessional traits.
Many patients with OCD may refuse to cooperate with effective
treatments such as selective serotonin reuptake inhibitors (SSRis) and
behavior therapy.
Patients may become invested in maintaining the symptomatology
because of secondary gains. For example, a male patient, whose mother
stays home to take care of him, may unconsciously wish to hang on to
his OCD symptoms because they keep the attention of his mother.
Research suggests that OCD may be precipitated by a number of
environmental stressors, especially those involving pregnancy,
childbirth, or parental care of children. An understanding of the stressors
, may assist the clinician in an overall treatment plan that reduces the
stressful events themselves or their meaning to the patient.
◉ 8. In OCD patients, what is "magical thinking"? (Sadock, p. 421) .
Answer: Persons believe that merely by thinking about an event in the
external world they can cause the event to occur without intermediate
physical actions.
◉ In what ways can the psychiatric nurse practitioner characterize
(specify) insight in the OCD patient? (Sadock, p. 421) . Answer:
Patients with good or fair insight recognize that their OCD beliefs are
definitely or probably not true or may or may not be true.
Patients with poor insight believe their OCD beliefs are probably true.
Patients with absent insight are convinced that their beliefs are true.
◉ What are the diagnostic/clinical features of OCD? Sadock p.421 .
Answer: Patients with OCD often take their complaints to physicians
other than psychiatrist.
Most patients with OCD have both obsessions & compulsions - up to
75%. Obsessions and compulsions are the essential feature of OCD.
Sometimes, patients overvalue obsessions and compulsions, for example
they may insist that compulsive cleanliness is morally correct, even
though they have lost their jobs because of time spent cleaning.
