reflection Obsessive-Compulsive Spectrum Disorders

There are many other disorders that have qualities involving repetitive thoughts and behaviors, akin to Obsessive- Compulsive Disorder (OCD). These disorders are sometimes called as Obsessive-Compulsive Spectrum Disorders (OC Spectrum Disorders) because of the similarities. Not only that, but some experts believe that these disorders may all have similar underlying neurobiological causes as OCD. Neuroimaging studies taken of the brain show similar activity between OCD and certain OC spectrum disorders. As well as having similarities to OCD, OC Spectrum Disorders are also very comorbid with OCD and vice versa. Many spectrum disorders are classified as impulse control disorders — where impulsivity can be thought of as seeking a small, short term gain at the expense of a large, long term loss.

OC Spectrum Disorders

Tourette's Disorder (also known as Tourette's Syndrome): A tic disorder that appears before the age of 18. Symptoms consist of multiple motor tic (such as twitching for no reason) and vocal tics (such as swearing for no reason) that occur, although not necessarily at the same time. Tics are recurrent physical movements or vocalizations with no apparent cause. Many studies have reported OCD symptoms in 50 percent of Tourette's disorder sufferers, with some studies showing rates as high as 74 percent. Studies have shown that 6 percent of OCD sufferers have Tourette's Disorder, with as many as 35 percent having some symptoms. Learn more about Tourette's...

Body Dysmorphic Disorder: Is currently classified by the DSM-IV-TR as a somatoform disorder. The main feature of this disorder is the obsession over an imagined physical defect or anomaly in a person of normal appearance. Any part of the body can be obsessed about, such as a big nose or simply being unattractive, but the most common symptom is usually over a perceived facial flaw. Body dysmorphic disorder can be very debilitating — with one study showing that as many of one third of its sufferers become housebound. The sufferer becomes obsessed with worry and rituals much like a person suffering from OCD. In the same way an OCD sufferer will check the stove numerous times to see if its turned off, a sufferer of body dysmorphic disorder will repeatedly look at their appearance in the mirror. Some studies have shown a lifetime 12 percent comorbidity rate with body dysmorphic disorder for people suffering from OCD. Studies have also shown that between 37-56 percent of people with body dysmorphic disorder have some history of OCD. More about body dysmorphic disorder...

Trichotillimania: Classified as an Impulse Control Disorder. People with Trichotillimania cannot stop themselves from pulling hair from their body, which results in noticeable hair loss. People with trichotillimaia will pull hair from any part of their body, but the most common pulling takes place with scalp hair, with eyebrow and eyelash pulling also being very common. Some people will pull hair from numerous parts of their body and some people from only one part. The hair pulling is often described as a compulsion that is disturbing to the person, much in the same way as someone suffering from OCD being distressed by a compulsion. More about trichotillimania...

Eating Disorders: Made up of two categories with two specific diagnoses: the first being Anorexia Nervosa and the second Bulimia Nervosa. A third eating disorder, Binge Eating, is mentioned in the DSM-IV-TR as a diagnosis that requires further study. Anorexia nervosa is defined as a failure to maintain a healthy, normal body weight through restriction of eating, or eating then purging. Bulimia nervosa is characterized by binge eating with a feeling of no control during binge eating episodes. The person must then compensate by fasting, purging or extreme exercise to prevent weight gain. Those suffering from bulimia and anorexia have obsessions about food, body image and the preparation of food. They also have rituals about diet, exercise, eating and food preparation. Sometimes a person suffering from an eating disorder will initially have obsessions about body image or food eaten, which then change into traditional OCD symptoms such as contamination, allowing them to meet OCD criteria. The overlap of symptoms between body dysmorphic disorder and anorexia nervosa is so high that the DSM-IV-TR lists anorexia with a specific exclusion criteria if the obsession is solely regarding weight. Studies showing eating disorder patients to have OCD symptoms have been as low as 11 percent and as high as 88 percent. Studies have also shown that 7 percent of those suffering from anorexia also have OCD, and 10 percent for Bulimia. Learn more about eating disorders...

Depersonalization disorder: Listed in the DSM-IV-TR as a dissociative disorder, it is defined by a feeling of being detached from ones mind or body (as if the person were floating outside of their body). People often feel as is they are not in control of their body or speech, and can feel a lack of affect. The actual experience of depersonalization is fairly common among normal functioning people, and also occurs during drug use. The depersonalization of someone suffering from depersonalization disorder is severe, frequent, unwanted and interferes with ones life. Depersonalization disorder frequently occurs during other disorders such as schizophrenia and depression, and therefore is not diagnosed when it appears only during these other disorders. OCD and depersonalization disorder have similar onset and a similarly chronic course. In much the way a person suffering from OCD suffers from unwanted, repetitive thoughts, so to does a person suffering from depersonalization disorder. More about depersonalization disorder...

Hypochondriasis: Involves an abnormal, excessive obsession regarding ones health. People who have hypochondriasis misinterpret bodily signals as being signs of apocalyptic events, e.g. a headache to be a sign of a brain tumor. The person will visit the doctor numerous times for reassurance, but continue to believe there's a problem despite being told they are perfectly fine. These obsessions contain similarities to OCD contamination fears and checking rituals. Read more about hypochondriasis....

Compulsive Skin Picking: Also called onychophagia, compulsive skin picking involves the picking of ones skin in a repetitive manner so that the skin is noticeably damaged. This disorder is an impulse control disorder similar to trichotillimania, and just like trichotillimania, usually centers around the face, but can involve any part of the body. People will pick at things on the skin such as freckles, pimples, sores, moles, etc., but will also pick at imagined defects. Read about compulsive skin picking and scratching and the related compulsive nail biting...

Possible OC Spectrum Disorders

Compulsive Sexual Behavior (CSB): CSB is a very broad category with many types of sexual behaviors. Generally though, CSB is divided into two categories: paraphilic and non-paraphilic. Paraphilic sexual behaviors are irregular sexual behaviors that are obsessive and compulsive (pedophilia, voyeurism, exhibitionism, frotteurism, etc.). Non-paraphilic behaviors are normal sexual behaviors taken to levels so extreme they cause extreme distress and impairment. There is great debate as to whether CSB is an addiction, an impulse control disorder, an obsessive-compulsive disorder, or even a mood disorder. But it is clear that certain types of CSB are driven by both obsessions in compulsions. Read about sexual compulsivity and medication treatments...

Olfactory Reference Syndrome: The obsessive, irrational fear that ones body is emitting a foul and unpleasant odor that may offend others. This fear can of course be obsessed about much like an OCD fear (e.g. contamination). More about olfactory reference syndrome...

Pathological Gambling: Doesn't appear in the DSM-IV-TR as its own disorder, but could be classified as an impulse control disorder. Pathological gambling is characterized by an obsessive need to gamble. More about pathological gambling...

Autism/Asperger's Disorder: Autism is a pervasive developmental disorder that begins in early childhood. It is characterized by severe deficits in the ability to communicate and interact with others. Also present in autism are repetitive behaviors and a limited range of interests, which of course is where its similarities to OCD lie. Asperger's is basically a milder form of autism   with sufferers usually having a higher level of functioning. More about autistic disorder...

Intermittent Explosive Disorder: An impulse control disorder characterized by episodes of uncontrollable rage and anger. Someone with this disorder will just blow up in a violent, uncontrollable rage   sometimes called a "rage attack." This behavior is out of proportion to the act that caused the response, and is not caused by any substance, such as medication or alcohol.

Pyromania: An impulse control disorder that involves intentionally setting a fire for gratification. Prior to setting a fire the person will obsess and be tense, and after compulsively committing the act, will feel relief and gratification. The fire setting is not done for any personal reasons, such as revenge, anger, monetary gain, etc., nor is it done in any sort of state of psychosis. Merely it is an obsession that must be acted upon.

Kleptomania: An impulse control disorder characterized by the impulsive need to steal. Like pyromania the act is not done for personal reasons, such as monetary gain or revenge (in fact, a person with kleptomania will sometimes replace the item they steal after the fact), nor is it done because of another disorder, such as anti-social personality disorder or bipolar disorder (a.k.a. manic depression). Similar to OCD or pyromania, the person will obsess about their thought, e.g., stealing   and feel tension and anxiety. Upon acting compulsively by stealing, a kleptomaniac feels momentary relief from their obsession. More about kleptomania...

Credits: Article written by M. Jahn & M. Williams, Ph.D. (more about author),

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