Grande's Obsessive Compulsive Disorder

Grande’s (2014) three videos in this activity were informative on obsessive compulsive, posttraumatic stress, and social anxiety disorders. Grande presented the fundamental facets of each disorder, all of which encompass the criteria in the DSM-5 manual. Of note on obsessive compulsive disorder was Grande’s reference to how compulsive behaviors lack any realistic connection to what obsessions they attempt to neutralize. For example, an individual anxious over losing a job may count the cheerios in his bowl each morning. Clearly, there is no relationship between the obsession and compulsion. A second aspect of the disorder is the behavior is usually excessive, and counting each bowl of cereal is a bit over the top and has nothing to do
with his employment status. Moreover, a third concern was that 50% of those with OCD presented with suicide ideation, and of that percentage, 25% attempted suicide, which is surprisingly large number. Fourth, in adulthood, there is slightly more females suffering from OCD compared to males, but more males are affected in childhood. Finally, I was surprised at how high the risk factors were for first degree relatives of adults with the disorder (double) and for first-degree relatives of those with early onset at 10-fold.
Moving on to posttraumatic stress disorder, Grande (2014) discussed the diagnostic criteria and one that caught my attention was the first line, which included exposure to actual or threatened death and sexual violence.
Grande’s example using the dog attack provided a clear illustration of how PTSD develops subsequent to a threat of death. I found the example helpful in understanding how facing a threat of death (dog attack) may engage in subtle avoidance behaviors because of the traumatic experience. More interesting is Dr. Grande’s suggestion that avoidance behaviors do not necessarily involve blatant measures of prevention but can come across as insignificant (subtle) actions to an outside observer. Therefore, therapists need to consider all symptoms not just the more obvious ones presented by the client. Another feature of PTSD that Dr. Grande touched on concerned remission and how one could suffer with the disorder for more than 50 years. This statement shows how important assessments are and how important it is to conduct a thorough one. Finally, Dr. Grande’s comment on developmental regression was intriguing; in that, if children can regress to an earlier developmental period, then why not adults. I will have to do more research on regression in the
future.
Moreover, with social anxiety disorder, Dr. Grande’s distinction between panic disorder and social anxiety disorder helped clarify the two. For example, social anxiety disorder can involve panic attacks but the panic attack is focused on a negative evaluation. Conversely with panic disorders, the focus is on the attack itself. A second point Dr. Grande made may come across as insignificant, but I felt his mention of being careful in using acronyms to abbreviate disorders such as social anxiety disorder. Essentially, therapists must be accurate with their diagnosis and careful with communicating the type of disorder.
As for questions, I might ask why the prevalence rates change from more males affected by OCD in childhood to more females in adulthood.
Does this have to do with the effects of early treatment or do female rates progressively increase as individuals move into adulthood. On PTSD, I am puzzled as to why physical violence was not included in the criteria since it specified sexual violence. Similar to sexual violent acts, physical violence can cause serious injury and expose one to actual or threatened death. Thus, why not just include physical violence. Another question on PTSD includes more information on developmental regression. Do adults regress to earlier phases of development and how regressive an adults behavior compared to children’s’ behaviors. On social anxiety disorder, I would as Dr. Grande if the disorder is content specific. For example, my daughter’s friend is comfortable in competitive sports but is extremely anxious when discussing class presentations. In addition, I dropped a graduate course when I found out it included a class presentation; however, I eventually finished it and have no problem with public speaking
engagements.
Last but not least, I cannot recall any experiences with individuals diagnosed with social anxiety disorder, OCD or PTSD, but I want to comment on my personal experiences with panic attacks. Without getting into details, I experienced panic attacks several years ago and was eventually diagnosed with general anxiety disorder. My first experience with panic attacks started during my undergraduate years. The panic attacks occurred in the evening and self-treated with a drive to the store for Sudafed, but they progressively became more intense, until I sought help from a psychiatrist, who then recommended me to the university’s psychologist. I found that exercise helped and it was years later that I experienced more panic attacks. This time however, they started out as uncomfortable experiences that occurred at night. Like the old days, I self-medicated with Sudafed. However, as time progressed, the attacks occurred during the day and night, and even at work. Eventually, I had to call in sick because they got so bad. At that time, I sought help from my doctor, who prescribed Lexapro and Xanax as well as counseling. Of the three, I still take Lexapro, which works for me since I rarely have panic attacks anymore.