Obsessive Compulsive and Related Disorders

Obsessive Compulsive Disorder  (OCD) is an anxiety disorder. Individuals with OCD suffer with recurrent thoughts (or images) that can be violent or disturbing and cause significant anxiety and distress. Most of these thoughts or images are intrusive. Doubt is a central theme. In an attempt to reduce distress and anxiety, individuals with OCD may perform compulsive rituals such as counting, checking, or repeating words in a very specific way. These behaviors are both time consuming and unproductive. This is in contrast to individuals with Obsessive Compulsive Personality, who are organized perfectionists who are not distressed by their thoughts and behaviors because they align with their values and beliefs (ego syntonic). One of the most debilitating aspects of OCD is the insatiable nature of the compulsive behavior that never quite reaches an acceptable level of reassurance. This leads to tortuous repetition of the compulsive acts that the individual recognizes as being irrational (ego dystonic). 

A persistent need for reassurance, significant doubt, and catastrophic thinking are often prominent. Individuals with OCD may exhibit irrational thinking, called “magical thinking,” whereby things need to be performed or thought about in a specific way for fear that something unrelated and bad will happen. Example: “If I step on the crack, something bad will happen to my dog.” All of the Obsessive Compulsive and related disorders likely involve similar neurological substrates supported by overlap in symptoms and behavior patterns, neuroimaging studies and the high comorbidity in individuals with OCD.

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