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Looming Vulnerability in Obsessive Compulsive Disorder

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Looming Vulnerability

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Abstract

Obsessive compulsive disorder (OCD) is characterized by the presence of recurrent obsessions and/or compulsions that are time consuming (i.e., occupy more than 1 h per day) and cause marked distress and/or functional impairment (i.e., interfere with daily routine or academic, occupational, or social functioning). Obsessions are persistent thoughts, ideas, and/or images that are regarded by the person as intrusive and/or inappropriate. Common obsessions include thoughts or images regarding germs and contamination, thoughts or impulses that are sexual or aggressive in nature, concerns regarding symmetry or exactness, worries about throwing things away, and concerns over somatic and religious matters (Abramowitz, Franklin, Schwartz, & Furr, 2003). Compulsions are ritualistic behaviors or covert mental acts that are performed to neutralize the anxiety caused by obsessions or to prevent a feared event (American Psychiatric Association, 2013). Common compulsions include cleaning, washing, checking, repeating, ordering, hoarding, counting, and praying (Abramowitz et al., 2003). Reassurance seeking is another compulsion that is observed clinically, but under-researched. Compulsions are either not connected in a rational way with the obsession they are designed to neutralize or they are clearly excessive. For instance, an individual who is consistently worried about germs might shower for 2 h and wash his or her hands 50 times each day to eliminate potential contaminants. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; APA, 2013), the content of the obsessions or compulsions cannot be confined to symptoms of another disorder (e.g., an anxiety disorder such as GAD, preoccupation with food as in eating disorders, preoccupation with drugs as in substance use disorders, preoccupation with serious illness as in hypochondriasis, preoccupation with sexual urges or fantasies as in paraphilias, concern with appearance as in body dysmorphic disorder, or ruminative thinking as in major depressive disorder). The DSM-5 no longer characterizes OCD as an anxiety disorder, despite its significant anxiety features. However, epidemiologic surveys suggest that the majority of individuals with OCD also meet full diagnostic criteria for an additional psychological disorder at the time of their assessment, most commonly a comorbid anxiety disorder (76%) or a depressive or bipolar disorder (63%) (APA, 2013).

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Authors and Affiliations

  1. Department of Psychology, Ryerson University, Toronto, ON, Canada

    Stephanie E. Cassin

  2. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Stephanie E. Cassin & Neil A. Rector

  3. Department of Psychology, George Mason University, Fairfax, VI, USA

    John H. Riskind

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  1. Stephanie E. Cassin
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  2. Neil A. Rector
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Correspondence to John H. Riskind .

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Cassin, S.E., Rector, N.A., Riskind, J.H. (2018). Looming Vulnerability in Obsessive Compulsive Disorder. In: Looming Vulnerability. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-8782-5_13

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