Glossary of OCD Terms 强迫症术语
作者: ocfoundation.org / 6625次阅读 时间: 2012年11月16日
标签: 强迫症
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Glossary of Terms

 

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A

Accommodation  - When others (family,  coworkers, friends, etc.) help a person with OCD to ritualize (for example,  by purchasing toilet paper and paper towels, by completing rituals, or by waiting while s/he ritualizes,  etc.).  Accommodation, although usually well-intended, actually  makes a person's OCD worse.  Family members can be helped by a  therapist to learn different ways of being supportive without helping  an individual to ritualize.

Automatic Thoughts  - Thoughts that "pop" into one's  mind during a certain situation.  These thoughts, although sometimes  very simple, can represent attitudes or beliefs that fuel feelings.   See also 'Hot Cognitions.'

Avoidance Behavior  - Any behavior that is done with  the intention of avoiding a trigger in order  to avoid anxiety.  Avoidance behaviors are treated as a ritual.

B

Behavior Therapist  - The therapist  (or social worker or psychologist) who is in charge of one's  treatment plan for OCD using behavior therapy, most often Exposure and Response Prevention.

Behavior Therapy  - A type of  therapy that applies learning theory principles to current problem behaviors  that one wishes to change.  As the name implies, the point of intervention  is at the behavioral level.

Body Dysmorphic Disorder (BDD)   - Obsessions about a body part being deformed  in some way, resulting in repeated rituals involving checking, mirror  checking, excessive grooming, inability to dress oneself, and avoidance behaviors.  Sometimes  individuals with BDD have plastic surgeries relating to their imagined  defects, but the relief (if there is any) is short-lived, and soon the  individual begins worrying again, or the focus of his/her BDD can change  to a different body part.

C

Checking Compulsions  - Repetitive  checking behaviors in order to reduce the probability that someone will  be harmed, or to reduce the probability that one might make a mistake.   The checking can be behavioral (i.e. physically returning to a room  to check if an appliance is turned off) or it can take the form of a  mental ritual (i.e. a mental review in which a person imagines in detail  each step he/she took to complete a task).

Competing Alternative Behaviors  - When one is trying  to stop a bad habit, one can engage in a competing alternative behavior,  which is an activity that inhibits the ability of the person with OCD  to engage in the habit that s/he is trying to break.  For example,  if one is knitting, one is unable to simultaneously pull one's hair.   See also 'Habit Reversal.'

Compulsions  - Compulsions, also known as rituals, are repetitive behaviors or thoughts  that conform to rigid rules as far as number, order, etc. that function  as an attempt to reduce anxiety brought on by intrusive thoughts.

Contamination Compulsions  - These  are washing and cleaning behaviors in a particular order or frequency  in an attempt to reduce chronic worry about being exposed to germs or  becoming ill.  This can also be done for emotional contamination, in which  a person washes and cleans in order to reduce the chances of taking  on the characteristics of another person.

Contamination Obsessions  - Excessive  worries about germs, bodily functions, and illness.  The risk is  overestimated, given the chances of actually getting sick.

D

Distraction  - A strategy used  primarily outside ERP to enhance one's ability to  resist rituals.  One does another activity  (for example, playing a board game, watching TV, taking a walk, etc.)  while triggered in order to cope with anxiety without ritualizing.

E

Emotional Contamination Obsessions  - Worry that one  will be contaminated by the characteristics of another person.   The worrier believes that the risk of "catching" the other person's  personality is much like when one is exposed to germs.  The spread  of the "emotional germs" can be through touching, or can even be airborne.   This usually includes magical thinking and superstitious behaviors.   For more on Emotional Contamination, click here.

Exposure and  Response Prevention (ERP)  - The behavioral treatment  of choice for OCD during which a person with OCD purposefully triggers an obsession  and blocks his/her rituals in order to create habituation.  ERP is initially done with a behavioral coach,  who assists the person with OCD to resist rituals.  Eventually  the coaching is faded, as the person with OCD becomes more able to resist  rituals without help.

Extinction  - The process by which reinforcement is withheld in order to decrease  or eliminate a target behavior.  It is common to have an extinction burst initially, which is  an increase of the target behavior when the extinction process is started.

Extinction Burst  - An initial increase in behavior  (can be obsessions or rituals)  when one first stops reinforcing a behavior.  When you start a  new and more difficult ERP, you should not be surprised  if initially you feel more ritualistic and the urge to ritualize feels  stronger.

F

Fading  the Prompt  - Once a positive behavior is successfully  initiated, the behavioral coach will stop giving the verbal or behavioral  cue out loud, so the individual with OCD can practice the new behavior  without help.  See also 'Verbal Prompt.'

Functional Analysis  - The therapist  and the individual with OCD study the behaviors and thoughts that occur  before and after a target behavior occurs.

G

Generalization  - The transfer  of learning from one environment to another, or from one stimulus to  a broader range of stimuli in the same category.

H

Habit Reversal Treatment  - This is the behavioral  treatment of choice for Trichotillomania.   In this treatment the patient becomes more aware of patterns of picking  or pulling, identifies the  behaviors that bring on the picking  or pulling, and then works on developing alternative behaviors to block  the destructive habit.  For instance, when feeling high levels  of anxiety a hair puller can knit, which keeps both hands occupied and  keeps the individual engaged in a relaxing activity when s/he is at  a high risk to pull.

Habituation  - The process during which a person stops  responding to a stimulus because it is no longer new.  For example,  after jumping into a cold swimming pool, one might initially feel that  the water is too cold; however, after splashing around for a few minutes,  the water begins to feel warmer  (even though the water temperature  has not changed at all) because the swimmer has gotten used to the water  temperature.  An example of this in OCD would be when someone who  worries about germs touches a doorknob without a barrier for at least  1.5 hours.  As time passes without the person ritualizing, the  person can no longer maintain an anxious response.

Harm Obsessions  - Excessive worries  that one will be harmed, or that others will be harmed, due to intentional  or accidental behavior on the part of the person with OCD.

Hierarchy  - A list of situations  or triggers that are ranked in order from easier tasks to more difficult  tasks according to the patient's estimated SUDS  ratings.  Consider the hierarchy as a map or outline of future ERPs.

Hoarding Compulsions  - Saving  unreasonable amounts of an item "in case someone else might need it,"  even though one no longer has space to keep belongings.  Objects  are saved even when they are a health hazard.

Hoarding Obsessions  - Worry that  one must save more than is necessary in order to feel secure.   The hoarder is not as disturbed by his/her saving and accumulation patterns  as those around him/her.

Hot Cognitions  - Automatic  thoughts that generate strong or intense affect.

I

Insight  - For someone with OCD,  this is the understanding (when not triggered by an obsession) that one's worry is not realistic,  nor does the logic applied to the person's ritual  make any sense.  Usually when one is triggered or experiencing  high anxiety about an obsession, the level of insight decreases dramatically.

M

Mental Ritual  - A mental act,  done in response to an unwanted obsession,  that is completed in order to reduce anxiety.  Often a mental ritual  must be repeated multiple times.  It can be a prayer, a repeated  phrase, a review of steps taken, a self-reassurance,  etc.  Often a mental ritual is repeated so often that the individual  barely has any awareness of the thought.

Mindfulness  - A focus on the  present.  This is a skill that takes a considerable amount of practice.

N

Negative Reinforcement  - When  a reinforcement is removed, the behavior  increases.  When a person's headache is eased after taking an aspirin,  that experience will increase the likelihood that the person will take  an aspirin the next time he has a headache.

Neutralization  -  Refers  to when an individual with OCD "undoes" a behavior or thought that is  believed to be "dangerous" by neutralizing it with another behavior  or thought.   This behavior is also considered a ritual.

O

Obsessions  - Obsessions are repetitive intrusive  thoughts or images that dramatically increase anxiety.  The obsessions  are so unpleasant that the person with OCD tries to control or suppress  the fear.  The more the person attempts to suppress the fear, the  more entrenched and ever-present it becomes.

Obsessive Compulsive Disorder (OCD)   - People diagnosed with OCD spend over one hour daily struggling with  repetitive intrusive thoughts, impulses and/or behavioral urges that  increase their anxiety.  They try to control their obsessions with compulsive behaviors (rituals)  that function as an attempt to reduce their anxiety.  Over time,  the rituals become less and less effective in controlling the obsessions.

Overvalued Ideation  - When the  person with OCD has great difficulty understanding that his/her worry  is senseless.

P

Perfectionism  - Unrealistically  high expectations about one's performance on any task.  Failure  is catastrophic and unbearable.  Anything less than 100% perfection  is considered a failure.  Consequently, perfectionists are paralyzed  and sometimes unable to begin a task until the last minute, or are sometimes  unable to complete a task.  For more on perfectionism, click here.

Positive Reinforcement  - An action  or behavior is applied and the consequence is that the frequency of  the behavior will increase.  For example, when a teacher praises  a student for raising his/her hand in class before speaking, the likelihood  of the student's behavior of raising his/her hand before speaking will  increase.

Praying Compulsions  - This can  include repetitive praying for forgiveness or asking God to protect  a person perceived to be at risk, reading the Bible or watching religious  TV programming for hours daily, and repeated confessing for possible  sins.

Psychiatric Nurse  - This mental  health professional has a Bachelor's degree in nursing with a special  emphasis on psychiatry and working with mentally ill populations.

Psychiatrist  - This mental health  professional has completed medical school and has specialized in psychiatry  and mental illness.  S/he can do therapy and prescribe medicine.

Psychologist  - This mental health professional holds  a doctorate in either clinical or counseling psychology.  This  individual can have a Ph.D., which is a research degree, or a Psy.D.,  which has a clinical focus.

Psychopharmacologist  - This mental  health professional prescribes psychiatric medicines and is an expert  in how these medicines work together.

R

Reassurance Seeking  - When a  person with OCD asks others questions repetitively to reduce his/her  anxiety (for example, "Do you think this food is spoiled?" or "Do you  think I will get sick?").  Sometimes a person with OCD can get  reassurance merely from watching another's facial expression and/or  body posture.  All reassurance seeking is considered a ritual.

Redirection  - When a therapist  tells an individual with OCD to change or stop a behavior that is interfering  with treatment.

Reinforcement  - Any response from an individual that  will increase the frequency of a particular behavior from the recipient.

Relapse Prevention  - A set of  skills, both cognitive and behavioral, aimed at preventing an individual  with OCD from slipping back into old compulsive behaviors.

Retrigger  - A thought or behavior  completed by the individual with OCD in order to undo the negative effects  of the rituals.  The person may feel relieved  by a reassuring thought like, "I will be okay," but then he must say  to himself, "Well, maybe I won't be okay.  Anything is possible."

Ritual   - Another word for compulsive behavior, which can be a behavior that  others can see, or a hidden or unseen mental behavior.  Many mental  health professionals will identify anything that  reduces one's  anxiety as a ritual.  For example, although avoidance behavior is done to avoid  the trigger altogether, it still is the same  as an outright ritual, in that it is an attempt to reduce anxiety.

S

Scrupulosity (Religious) Obsessions   - Excessive worry about being moral, or worry about blasphemy.

Self-Directed Exposure and Response Prevention  (SDERP)  - Once you have learned to effectively block  rituals with the assistance of a behavioral coach, you will practice  your ERP on your own, with very little help.  This task is much  more difficult because you must resist your rituals when triggered and  there is no one to hold you accountable or help you motivate yourself  to resist.

Self-Reassurance  - A thought or phrase said out loud  or silently in order to lower one's anxiety (for example, "I'm not going  to get sick," or "I would never hurt a child).  This is considered  a ritualistic behavior.

Sexual Obsessions  - Unwanted,  inappropriate sexual thoughts that are repulsive to the person affected.   Often, thoughts are sexually aggressive towards a vulnerable population  (children, the elderly, family, or strangers).

Social Worker  - This individual has a Master's degree  in social work, which specializes in psychotherapy, social adjustment  and social justice issues.

Somatic Obsessions  - Unrealistic  worry about catching a particular illness (for example, HIV or Hepatitis).

Stimulus Control  - When a person  changes something in his/her environment that affects a particular behavior.   For example, if a person can't sleep, lights are turned off in the room.

Subjective  Units of Distress (SUDS)  - This is a scale from either  1 to 10 or 1 to 100, in which the person with OCD rates his/her anxiety,  1 being the least anxious to 10 or 100 being the most anxious.   The scale is each individual person's sense of his/her own anxiety.

Superstitious Behavior  - Behavior that is accidentally  reinforced by coincidence.  The behavior increases but it does  not have the influence that the person imagines it does.

Symmetry and Exactness Compulsions   (also known as Just Right Compulsions) - Involves fussing with the position  of an object for too much time.  The person can't stop the behavior  until it "feels right."

Symmetry and Exactness Obsessions   (also known as Just Right Obsessions) - One fears that something bad  might happen if the behavior is stopped before it "feels right."   Some people with these obsessions do not worry that something bad will  happen; rather, they report that something MUST feel right before ending  a particular behavior.

T

Tic Disorder  - A neurological  disorder in which the body involuntarily moves in a random pattern.   This is usually worsened by stress.

Tourettes Disorder  - A   neurological disorder in which a person engages in both involuntary  physical and verbal behaviors in a random fashion.  This is usually  worsened by stress.

Trichotillomania  - When a person is unable to stop  impulsively pulling his/her hair from his/her head, eyebrows, eye lashes,  arms, legs or pubic area.  The hair pulling is often pleasurable  and soothing.  People report doing this behavior when stressed  or bored.  Skin picking also falls into this category.  See  also 'Habit Reversal Treatment.'

Trigger  - This can be an external event or object or  an internal thought that sets off an obsession.

V

Verbal Prompt  - A verbal cue that directs the patient  as to what to do to resist a ritual, distract  from obsessing, or to manage the effect.  See also 'Fading  the Prompt.'

Y

Y-BOCS  - Yale-Brown Obsessive  Compulsive Scale.  Includes a symptom checklist of OCD obsessions and compulsions  and a rating scale to measure the severity of the OCD.  Usually,  people who score over 16 also meet the DSM-TR criteria for OCD.

By Carol Hevia, Psy.D.
Behavior Therapist
OCD Institute, McLean Hospital

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