Obsessive Compulsive Disorder (OCD)

What is OCD?

Obsessive-Compulsive Disorder (OCD)  is characterized by obsessions and compulsions.

Obsessions are persistent thoughts, urges, or images that are intrusive and unwanted. Obsessions often cause individuals marked anxiety and/or distress.

Compulsions are repetitive or ritualistic behaviors (or mental acts) that are performed in response to an obsession. Compulsive behaviors are often performed to reduce and/or prevent distress triggered by an obsession. Sometimes avoidance behaviors serve the same function as a compulsive behavior.

Common OCD Symptoms

  • Examples of Obsessions:

    • Excessive concern with dirt, germs, or contaminants
      (e.g. avoids touching dirt or items that may have germs, holds breath to avoid inhaling contaminated air)
    • Concerned with having an illness or getting sick
      (e.g. worries about being sick and frequently requests doctor visits)
    • Need for symmetry or exactness
      (e.g. items cannot be moved,  upset if toys or preferred items are not lined up)
    • Excessively bothered by things that are not “just right”
      (e.g. family members have to say things in “just the right” way,  repetition of words or phrases until “just right” feeling is experienced)
    • Harm-related obsessions
      (
      e.g. fears of being responsible for terrible events like a fire, or concerns that harm may come to self or loved ones)
  • Examples of Compulsions:
    • Excessive or ritualized hygiene behaviors
      (e.g. excessive or ritualized hand washing, showers, or cleansing routines)
    • Excessive checking behaviors
      (e.g., checking to make sure doors are locked, stove is off, iron unplugged, checking to make sure that no mistake was made)
    • Need to touch, tap, or rub
      (e.g. urge to touch items, run finger along surfaces or edges, lightly touch other people, tap a certain number of times)
    • Repeating routine activities
      (e.g. re-reading, re-writing, going in/out of doorways, taking off/on clothing)
    • Counting compulsions
      (e.g. counting things like ceiling or floor tiles, books in a bookcase, words in a sentence)
    • A need to tell, ask, or confess
      (e.g. describing every detail of a story, ask for reassurance, or saying “I’m sorry” multiple times, seeking forgiveness to an excessive degree)
    • Need to do something until it feels “just right”
      (e.g., engaging in a behavior until a specific internal feeling is alleviated)
    • Buying, saving, and/or collecting unneeded items
      (e.g. saves useless objects, holds on to school papers for long periods of time, has piles of clutter in room)

Treatment for OCD

Exposure-based cognitive behavioral therapy (CBT) is recommended as the first-line treatment for children and adolescents with OCD. While exposure-based CBT can include several therapeutic skills, there are often four core skills across manualized treatments.  These include: (1) education about the illness and approach to treatment, (2) development of a symptom hierarchy, (3) cognitive strategies to fight back against obsessive thoughts, and (4) exposure to obsessive triggers while refraining from engaging in compulsive behaviors.  While all aspects of treatment are important, the emphasis of treatment for children and adolescents is often placed on exposures.  In this treatment, clinicians work with children and families to overcome daily life challenges caused by OCD and achieve wellness.

Our Research on OCD

Please help us learn more about OCD and how best to help patients and families overcome these symptoms by participating in our research.  Contact us using this contact form, call our office at (443) 287-7157, or email us at email-coach to learn more about ongoing research studies.

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