5.5 OCD - Characteristics

5.5 OCD - Characteristics

1. DSM-5 recognises OCD as characterised either by obsessions and/or compulsion.

2. Behavioural

   • Compulsions are repetitive
     • People with OCD feel compelled to repeat a behaviour, common ones include hand washing, praying or ordering groups of objects.
   • Compulsions reduce anxiety
     • Around 10% of people with OCD show compulsive behaviour alone, without obsessions but only a sense of irrational anxiety. These compulsive behaviours are performed in order to manage the anxiety.
   • Avoidance
     • Tend to try to manage their OCD by avoiding situations which may trigger anxiety. This avoidance could lead to people avoiding everyday ordinary activities.

3. Emotional

   • Anxiety and distress
     • Regarded as an unpleasant emotional experience because of the overpowering anxiety that accompanies obsessions and compulsions. The urge to repeat a behaviour creates anxiety.
   • Accompanying depression
     • Accompanied by depression, so anxiety can be joined by low mood and lack of enjoyment. Compulsions tend to bring some relief.
   • Guilt and disgust
     • May be accompanied by irrational guilt over for example minor moral issues, or disgust.

4. Cognitive

   • Obsessive thoughts
     • For around 90% of people with OCD, the main cognitive feature is obsessive thoughts.
   • Cognitive coping strategies
     • People respond to obsessive thoughts by adopting cognitive coping strategies, for example a person tormented by religious guilt may respond by praying.
   • Insight into excessive anxiety
     • They are aware that these obsessions and compulsions are irrational, in fact being self aware is KEY in diagnosis.