Obsessive–compulsive disorder (OCD) is an anxiety disorder Anxiety disorders are blanket terms covering several different forms of abnormal and pathological fear and anxiety which only came under the aegis of psychiatry at the very end of the 19th century. Current psychiatric diagnostic criteria recognize a wide variety of anxiety disorders. Recent surveys have found that as many as 18% of Americans may characterized by intrusive thoughts Intrusive thoughts are unwelcome involuntary thoughts, images, or unpleasant ideas that may become obsessions, are upsetting or distressing, and can be difficult to manage or eliminate. Intrusive thoughts, urges, and images are of inappropriate things at inappropriate times, usually falling into three categories: "inappropriate aggressive that produce anxiety Anxiety is a psychological and physiological state characterized by cognitive, somatic, emotional, and behavioral components. These components combine to create an unpleasant feeling that is typically associated with uneasiness, apprehension, fear, or worry. Anxiety is a generalized mood condition that can often occur without an identifiable, by repetitive behaviors aimed at reducing anxiety, or by a combination of such thoughts (obsessions) and behaviors (compulsions). Symptoms may include repetitive hand-washing; extensive hoarding Compulsive hoarding is the excessive acquisition of possessions (and failure to use or discard them), even if the items are worthless, hazardous, or unsanitary. Compulsive hoarding impairs mobility and interferes with basic activities, including cooking, cleaning, showering, and sleeping. A person who engages in compulsive hoarding is commonly; preoccupation with sexual or aggressive impulses, or with particular religious beliefs; aversion to odd numbers; and nervous habits, such as opening a door and closing it a certain number of times before one enters or leaves a room. These symptoms can be alienating In sociology and critical social theory, alienation refers to an individual's estrangement from traditional community and others in general. It is considered by many that the atomism of modern society means that individuals have shallower relations with other people than they would normally. This, it is argued, leads to difficulties in and time-consuming, and often cause severe emotional and economic loss. The acts of those who have OCD may appear paranoid and come across to others as psychotic Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality". People suffering from psychosis are described as psychotic. However, OCD sufferers generally recognize their thoughts and subsequent actions as irrational, and they may become further distressed by this realization.
OCD is the fourth-most common mental disorder and is diagnosed nearly as often as asthma Asthma, from the Greek Άσθμα , meaning gasp, is a common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath and diabetes mellitus Diabetes mellitus —often simply referred to as diabetes—is a condition in which a person has a high blood sugar (glucose) level, either because the body doesn't produce enough insulin, or because body cells don't properly respond to the insulin that is produced. Insulin is a hormone produced in the pancreas which enables body cells to absorb.[1] In the United States ^ b. English is the de facto language of American government and the sole language spoken at home by 80% of Americans age five and older. Spanish is the second most commonly spoken language, one in 50 adults have OCD.[2] The phrase "obsessive–compulsive" has become part of the English lexicon, and is often used in an informal or caricatured manner to describe someone who is meticulous, perfectionistic Perfectionism, in psychology, is a belief that perfection can and should be attained. In its pathological form, perfectionism is a belief that work or output that is anything less than perfect is unacceptable. At such levels, this is considered an unhealthy belief, and psychologists typically refer to such individuals as maladaptive perfectionists, absorbed in a cause, or otherwise fixated on something or someone.[3] Although these signs may be present in OCD, a person who exhibits them does not necessarily have OCD, and may instead have obsessive–compulsive personality disorder (OCPD), an autism spectrum disorder The autism spectrum, also called autism spectrum disorders or autism spectrum conditions (ASC), with the word autistic sometimes replacing autism, is a spectrum of psychological conditions characterized by widespread abnormalities of social interactions and communication, as well as severely restricted interests and highly repetitive behavior, or no clinical condition. Multiple psychological Psychology is the study of human or animal mental functions and behaviors. In this field, a professional practitioner or researcher is a psychologist. Psychologists are classified as social or behavioral scientists. Psychological research can be considered either basic or applied. Psychologists attempt to understand the role of mental functions in and biological Biology is a natural science concerned with the study of life and living organisms, including their structure, function, growth, origin, evolution, distribution, and taxonomy factors may be involved in causing Etiology is the study of causation, or origination. The word is derived from the Greek αἰτιολογία, aitiologia, "giving a reason for" (αἰτία, aitia, "cause"; and -λογία, -logia) obsessive–compulsive syndromes In medicine and psychology, a syndrome is the association of several clinically recognizable features, signs , symptoms (reported by the patient), phenomena or characteristics that often occur together, so that the presence of one feature alerts the physician to the presence of the others. In recent decades, the term has been used outside medicine.
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History
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From the 14th to the 16th century in Europe, it was believed that people who experienced blasphemous, sexual, or other obsessive thoughts were possessed Spirit possession is the scientifically unfounded belief of paranormal, supernatural, psychological and/or superstitious spirits, gods, demons/daemons , animas, extraterrestrials, or other disincarnate or extraterrestrial entities taking control of a human body, resulting in noticeable changes in health and behavior. The concept of spiritual by the Devil Satan (Hebrew: הַשָׂטָן ha-Satan [citation needed] ; Arabic: الشيطان ash-Shayṭān ("the adversary") - both from the Semitic root: Ś-Ṭ-N) is an embodiment of antagonism that originates from the Abrahamic religions, being traditionally considered a "fallen" angel in Judeo-Christian belief, and a Jinn in.[4] Based on this reasoning, treatment involved banishing the "evil" from the "possessed" person through exorcism Exorcism is the practice of evicting demons or other spiritual entities from a person or place which they are believed to have possessed by causing the entity to swear an oath. The term became prominent in early Christianity from the early second century onward as the casting out of demons. Nevertheless, the practice is quite ancient and part of.[5] In the early 1910s, Sigmund Freud Sigmund Freud , born Sigismund Schlomo Freud (6 May 1856 – 23 September 1939), was an Austrian neurologist who founded the psychoanalytic method of psychiatry. Freud is best known for his theories of the unconscious mind and the defense mechanism of repression, and for creating the clinical practice of psychoanalysis for treating psychopathology attributed obsessive–compulsive behavior to unconscious conflicts that manifest as symptoms.[5] Freud describes the clinical history of a typical case of "touching phobia" as starting in early childhood, when the person has a strong desire to touch an item. In response, the person develops an "external prohibition" against this type of touching. However, this "prohibition does not succeed in abolishing" the desire to touch; all it can do is repress the desire and "force it into the unconscious".[6]
Signs and symptoms
Obsessions
Main article: Intrusive thoughts Intrusive thoughts are unwelcome involuntary thoughts, images, or unpleasant ideas that may become obsessions, are upsetting or distressing, and can be difficult to manage or eliminate. Intrusive thoughts, urges, and images are of inappropriate things at inappropriate times, usually falling into three categories: "inappropriate aggressiveA typical person with OCD performs tasks, or compulsions, to seek relief from obsession-related anxiety. Within and among individuals, the initial obsessions, or intrusive thoughts, can vary in their clarity and vividness. A relatively vague obsession could involve a general sense of disarray or tension, accompanied by a belief that life cannot proceed as normal while the imbalance remains. A more articulable obsession could be a preoccupation with the thought or image of someone close to them dying.[7][8] Other obsessions concern the possibility that someone or something other than oneself—such as God God is the English name given to the singular omnipotent being in theistic and deistic religions who is either the sole deity in monotheism, or a single deity in polytheism, the Devil The Devil is believed in certain religions and cultures to be a powerful, supernatural entity that is the personification of evil and the enemy of God and humankind. The Devil is commonly associated with heretics, infidels, and other unbelievers. The Abrahamic religions have variously regarded the Devil as a rebellious fallen angel or demon that, or disease A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal disfunctions, such as autoimmune diseases. Ecologically, disease is defined as—will harm either the person with OCD or the people or things that the person cares about.
Some people dread entire concepts, fearing their materialization by causes that may seem implausible or indiscriminate to others. For example, a generalized fear of contamination Contamination is the presence of a minor and unwanted constituent in another material, metal, chemical or mixture, often at the trace level. In chemistry, the term usually describes a single chemical, but in specialized fields the term can also mean chemical mixtures, even up to the level of cellular materials might entail not only wariness of bodily secretions Secretion is the process of elaborating, releasing, and oozing chemicals, or a secreted chemical substance from a cell or gland. In contrast to excretion, the substance may have a certain function, rather than being a waste product or excretions Excretion is the process by which waste products of metabolism and other non-useful materials are eliminated from an organism. It is an essential process in all forms of life. It contrasts secretion, where the substance may have specific tasks after leaving the cell, but also apprehension toward household chemicals, radioactivity Radioactive decay is the process by which an unstable atomic nucleus loses energy by emitting ionizing particles or radiation. The emission is spontaneous in that the nucleus decays without collision with another particle. This decay, or loss of energy, results in an atom of one type, called the parent nuclide, transforming to an atom of a, newsprint, pets, or even soap In chemistry, soap is a salt of a fatty acid. Soap is mainly used for washing and cleaning, but soaps are also important components of lubricants.[9] Others may sense that the physical world is qualified by certain immaterial conditions. These people might intuit invisible protrusions from their bodies,[10] or could feel that inanimate objects are ensouled A soul is the supposed incorporeal essence of a person or living thing. Many philosophical and spiritual systems teach humans are souls; some attribute souls to all living things and even inanimate objects ; this belief is commonly called animism. The soul is often believed to exit the body and live on after a person’s death, and some religions.[10]
Some people with OCD experience sexual obsessions that may involve intrusive thoughts or images of "kissing, touching, fondling, oral sex, anal sex, intercourse, incest and rape" with "strangers, acquaintances, parents, children, family members, friends, coworkers, animals and religious figures", and can include "heterosexual Heterosexuality consists of sexual behavior, practices, and identity predicated on a primary preference or desire for the opposite sex. As a sexual orientation, heterosexuality refers to "an enduring pattern of or disposition to experience sexual, affectional, physical or romantic attractions primarily to persons of the opposite sex"; it or homosexual Homosexuality is romantic or sexual attraction or behavior among members of the same sex/gender. As a sexual orientation, homosexuality refers to "an enduring pattern of or disposition to experience sexual, affectional, or romantic attractions primarily to" people of the same sex; "it also refers to an individual’s sense of content" with persons of any age.[11] As with other intrusive, unpleasant thoughts or images, most people have some disquieting sexual thoughts at times, but people with OCD may attach extraordinary significance to the thoughts. For example, obsessive fears about sexual orientation can appear to the person with OCD, and even to those around them, as a crisis of sexual identity.[12][13] Furthermore, the doubt that accompanies OCD leads to uncertainty regarding whether one might act on the troubling thoughts, resulting in self-criticism or self-loathing.[11]
The person with OCD understands that their notions do not correspond The correspondence theory of truth states that the truth or falsity of a statement is determined only by how it relates to the world, and whether it accurately describes that world. The theory is opposed to the coherence theory of truth which holds that the truth or falsity of a statement is determined by its relations to other statements rather with the external world; however, they feel that they must act as though their notions were correct. For example, an individual who engages in compulsive hoarding Compulsive hoarding is the excessive acquisition of possessions (and failure to use or discard them), even if the items are worthless, hazardous, or unsanitary. Compulsive hoarding impairs mobility and interferes with basic activities, including cooking, cleaning, showering, and sleeping. A person who engages in compulsive hoarding is commonly might be inclined to treat inorganic matter Traditionally, inorganic compounds are considered to be of a mineral, not biological, origin. Complementarily, most organic compounds are traditionally viewed as being of biological origin. Over the past century, the precise classification of inorganic vs organic compounds has become less important to scientists, primarily because the majority of as if it had the sentience Sentience is the ability to feel or perceive. The term is used in science and philosophy, and in the study of artificial intelligence. Sentience is used in the study of consciousness to describe the ability to have sensations or experiences, known to Western philosophers as "qualia". In eastern philosophy, sentience is a metaphysical or rights Rights are legal, social, or ethical principles of freedom or entitlement — i.e. rights are normative rules about what is allowed of people or owed to people, according to some legal system, social convention, or ethical theory. The concept of rights is often fundamental to civilized societies, and it is of vital importance in such disciplines of living organisms, but such an individual might find their consequent behavior irrational on a more intellectual level. In severe OCD, obsessions can shift into delusions when resistance to the obsession is abandoned and insight into its senselessness is lost. (Insel and Akiskal (1986))
Compulsions
Main article: Compulsive behaviorWhile some with OCD perform compulsive rituals because they inexplicably feel they must, others act compulsively so as to mitigate the anxiety that stems from particular obsessive thoughts. The person with OCD might feel that these actions somehow either will prevent a dreaded event from occurring, or will push the event from their thoughts Metacognition is defined as "cognition about cognition", or "knowing about knowing." It can take many forms; it includes knowledge about when and how to use particular strategies for learning or for problem solving. Metamemory, defined as knowing about memory and mnemonic strategies, is an especially important form of. In any case, the individual's reasoning is so idiosyncratic or distorted that it results in significant distress for the individual with OCD or for those around them. Excessive skin picking (i.e., dermatillomania) or hair plucking (i.e., trichotillomatia) and nail biting (i.e., onychophagia) are all on the Obsessive-Compulsive Spectrum. Individuals with OCD are aware that their thoughts and behavior are not rational,[14] but they feel bound to comply with them to fend off feelings of panic or dread.
Some common compulsions include counting specific things (such as footsteps) or in specific ways (for instance, by intervals of two) and doing other repetitive actions, often with atypical sensitivity to numbers or patterns. People might repeatedly wash their hands[15] or clear their throats, making sure certain items are in a straight line, repeatedly check that their parked cars have been locked before leaving them, constantly organizing in a certain way, turn lights on and off, keep doors shut or closed at all times, touch objects a certain number of times before exiting a room, walk in a certain routine way like only stepping on a certain color of tile, or have a routine for using stairs, such as always finishing a flight on the same foot.
People rely on compulsions as an escape from their obsessive thoughts; however, they are aware that the relief is only temporary, that the intrusive thoughts will soon come back. Some people use compulsions to avoid situations that may trigger their obsessions. Although some people do certain things over and over again, they don't necessarily perform these actions compulsively. For example, bedtime routines, learning a new skill, and religious practices are not compulsions. Whether or not behaviors are compulsions or mere habit depends on the context in which the behaviors are performed. For example, arranging and ordering DVDs or videos for eight hours a day would be expected of one who works in a video store, but would seem abnormal in other situations. Put another way, if the activity helps bring efficiency to one's life, it is probably a habit, if it interferes with one's normal enjoyment of life, it is probably a compulsion.[16]
In addition to the anxiety and fear that typically accompanies OCD, some people may spend hours performing such tasks (i.e., compulsions) every day. In such situations it can be hard for the person to fulfill their work, family, or social roles. In some cases, these behaviors can also cause adverse physical symptoms. For example, people who obsessively wash their hands with antibacterial soap Antibacterial soap is any cleaning product to which active antibacterial ingredients have been added. These chemicals kill bacteria and microbes. They are no more effective at deactivating viruses than any other kind of soap or detergent, and it also kills nonpathogenic bacteria and hot water to remove what they consider to be contamination can make their skin red and raw with dermatitis Dermatitis is a blanket term meaning "inflammation of the skin".[17]
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Thu, 26 Aug 2010 04:21:17 GMT+00:00
New York Times Researchers say hoarding, which is sometimes connected to obsessive-compulsive disorder , is surprisingly common: 2 percent to 5 percent of the United States ...
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