Anadolu Psikiyatri Derg. Online First
Misinterpretations of intrusions, obsessive
beliefs and thought control strategies in
patients with obsessive-compulsive
disorder [Turkish]
Orçun Yorulmaz, Gülbahar Baştuğ, Verda
Tüzer, Erol Göka
Published Online : Apr 15, 2013
Common OCD rituals include:
• repeatedly checking door locks, windows, electronic
controls, and ovens.
• performing tasks in set ways, like putting on one’s shoes in a
fixed pattern.
• repeatedly arranging and rearranging objects.
• washing and cleaning repeatedly and unnecessarily.
• counting the number of dots on a wall or touching objects.
• hoarding newspapers, books, letters, soda cans, or other
objects
“11’e 10 kala” compulsive hoarding
“Benden bu kadar”
Explanations for Anxiety Disorders
• Learning models focus on acquiring fears via
classical conditioning, then maintaining them
through operant conditioning by reinforcements
and punishments.
• We can also learn fears by observing others or by
hearing misinformation from others.
Explanations for Anxiety Disorders
• Anxious people tend to think about the world
in different ways from non-anxious people.
• Catastrophic thinking - predicting terrible
events despite low probability.
• Anxiety leads us to interpret ambiguous
stimuli negatively. Anxiety sensitivity – a fear
of anxiety-related symptoms.
• http://www.youtube.com/watch_popup?v=pr
qBLPMjcVw&vq=medium
Explanations for Anxiety Disorders
• Many Anxiety disorders, including panic disorder,
phobias, and OCD, are genetically influenced
through level of neuroticism- a tendency to be
irritable.
• A malfunction of the caudate nucleus in people
with OCD.
• Genetic relationship between OCD and Tourette’s
Disorder.
Mood Disorders
• Over 20% of Americans experience a mood
disorder.
• Major Depressive Disorder (MDD) is the most
common, at 16%.
• More prevalent in females, twice. Women are tend
to ruminate more than men.
• It can begin at any age, most likely to develop in
30s.
• less common in elderly adults than in younger
people.
Table 15.8 Mood Disorders and Conditions.
Manic Episode
Postpartum Depression
Mood Disorders
• Depression symptoms can develop gradually or
suddenly, but are often recurrent.
• Average episode lasts 6 months to 1 year, most
people experience 5-6 episodes.
• But in as many as a fifth of cases, depression is
chronic, present for decades with no relief.
• Can cause extreme functional impairment across all
areas. LOW SELF-CARE.
Sample MDD Symptoms
• Feeling blue or irritable, pessimism, hopelessness
• Sleep difficulties, insomnia,
• Fatigue and loss of energy,
• Weight changes, loss of apetite
• Thoughts of death or suicide
Explanations for MDD
• Complex interplay of biological, psychological, and
social influences.
• Life events such as loss of something that is valued
(beloved people, financial support, or self-esteem,
imigration) can set stage for depression.
• Depression can create interpersonal problems,
which cause lack of social support.
According to Coyne’s interpersonal model of depression,
depression can trigger rejection from others, in turn
contributing to further depression. a vicious cycle
Explanations for MDD
• Lewinsohn’s behavioral model sees depression
resulting from a low rate of positive reinforcement
in the environment.
• Beck’s cognitive model holds that depression is
caused by negative beliefs and expectations.
– Cognitive triad, negative schemas, cognitive distortions
The Shuttle Box. Using an apparatus like this, Seligman found
that dogs who were first prevented from escaping the shock gave
up trying to escape electric shocks even when they were free to
do so. He called this phenomenon “learned helplessness.”
Explanations for MDD
• Learned helplessness - tendency to feel helpless
in the face of events we can’t control.
• People with depression attribute failure internally
and have global, stable attributions. They tend to
see their failures as general and fixed aspects of
their personalities.
• We develop depression depends on the difference
between how we feel—our actual affect—and
how we want to feel—our ideal affect.
THE ROLE OF BIOLOGY ON DEPRESSION
• Genes exert a moderate influence on MDD;
role of serotonin (5-HT), norepinephrine
(NE,NA), and dopamine (DA).
Bipolar Disorder=Manic-depressive
disorder
• Have both depressive and manic episodes.
• Elevated mood, lowered need for sleep, high energy,
talkativeness, inflated self-esteem.
– Also show highly irresponsible behavior, “pressured speech”,
heightened rate of creative accomplishments.
first manic episode after their early twenties.
• Equally common in men and women.
• people who’ve had one manic episode experience at least
one more.
• More than half the time, a major depressive episode
precedes or follows a manic episode.
People in the manic episodes go on uncontrolled
spending money.
Bipolar Disorder
• Produces serious problems in social and
occupational realms. The negative effects include
loss of employment, family conflicts, and divorce.
• Very heavily (85%) genetically influenced, but
stressful life events can cause episode onset.
– These can be negative or positive events.