Obsessive-Compulsive Disorder: How to Spot the Signs

By SUZAN CLARKE

This morning on "Good Morning America" you saw a report about "Obsessed," the new A&E reality series that looks at the daily lives of people who suffer from obsessive-compulsive disorder.

The disorder, commonly known as OCD, is a debilitating illness that affects more than 2 million Americans.

According to the National Institute of Mental Health, OCD is characterized by recurrent, unwanted thoughts and repetitive behaviors.

Sufferers are mainly treated through cognitive behavioral therapy, comprising talk therapy plus exposure and response prevention..." More & video

"Hoarders" can't stack up to "OCD Project's" humanity

Joanne Ostrow

If you've seen one hoarder, you've got the idea.

As the A&E series makes clear, there's a deep-seated inability to let go that typifies those out-of-control collectors of junk and daily ephemera. It's a real pathology, but it's not ideally suited to television. "Hoarders," in its second season, tends to be repetitious.

The camera wallows in the accumulation and records the interpersonal angst the mess causes; an intervention by a therapist helps reveal the illness and remove some of the clutter. The letting go is considered a breakthrough, a professional organizer sometimes helps with logistics, and the crew moves on.

That's not how "The OCD Project" on VH1 works. This new series bears all the hallmarks of obscenely voyeuristic "reality TV" — including a house temporarily shared by eccentric characters caught at their worst — but then it takes a turn. You think it's going to mark a new low in titillating TV, and it ends up being surprisingly (perish the thought) educational.

"The OCD Project" airs in a three-hour prime-time block on Thursdays, with repeats including today at 3 p.m. and Sunday at 10 p.m. An array of symptoms is dealt with one by one, as six patients with obsessive-compulsive disorders endure what the host/therapist David Tolin promises will be "the toughest three weeks of their lives."

Tolin is a board-certified clinical psychologist, founder of the Anxiety Disorders Center at The Institute of Living at Hartford Hospital. He teaches psychiatry at Yale's School of Medicine and has a recurring gig on "Hoarders."

As a cable TV host, he's direct, forceful and telegenic in a tough-love way..." More

Treatment to solving obsessive-compulsive disorder as agonizing as condition on VH1's 'OCD Project'

DAVID HINCKLEY

"The OCD Project," Thursday night at 10 on VH1

The best part of this new VH1 show about treating obsessive-compulsive disorder (OCD) is that, in contrast to most reality programs, the featured subjects don't look even a little bit happy to be here.

When C-list celebs sign up for rehab shows, or civilian contestants risk humiliation on other reality shows, you often get the idea that they've calculated the pluses and minuses and decided that being on television outweighs any other consideration.

That may also be true here. But it doesn't feel that way. It feels like the six people who are undergoing tough-love OCD treatment on this show agreed to expose themselves in very unflattering ways because they're running low on both options and time.

Kristen, 28, who is phobic about "contamination," says she spends up to six hours a day washing her hands, sometimes until she rubs the skin off.

She works as a banker, but human contact, needless to say, doesn't come easily to someone who uses hand sanitizer every time she has to shake hands. So she lives in a bubble, literal and figurative. While it's a well-sanitized bubble, the 28-year-old also calls it "a lonely world."

Cody, 18, is home-schooled because his life revolves around various rituals. He estimates 60% of his day is rituals. It takes him an hour to turn a computer on or off.

Traci needs two hours to perform the rituals that get her out of bed. She's obsessed with the idea that if she doesn't perform these and dozens of others during the day, her 9-year-old son will die.

So even though her fears are more about herself than her son, he's imprisoned by them. She won't let him out of the house, for instance, because he might breathe "bad air."

While OCD is a casual punch line to much of the world, it's a life-changer to these six people, and not in a good way. The host, Dr. David Tolin, warns them that they won't enjoy his methods of taking their lives back...." More

More on Dr. Tolin, the show and watch the premiere: here

The OCD Project challenges six severe OCD sufferers to face fears in a bold move to better their lives

Obsessive-Compulsive Disorder (OCD) is a disorder of the brain where people experience obsessive thoughts, images, ideas or impulses – and they can't get past them. The day-to-day existence for severe OCD sufferers is dire. Untreated, they lead lives of self-punishment, fear and isolation that can result in job loss, broken families, bankruptcy and in some cases death.

"The OCD Project" challenges six severe OCD sufferers to face their fears in a bold move to better their lives by participating in twenty-one days of all-immersive therapy called Exposure and Response Prevention. World-renowned anxiety specialist Dr. David Tolin facilitates this proven treatment that encourages patients to face their worst fears in an attempt to stop the vicious cycle of the disease in eight, hour-long episodes. "The OCD Project" is set to premiere Thursday, May 27th at 10PM. To get a preview of the upcoming season, watch "The OCD Project" trailer on VH1.com. ..." More

Mammal Model Suggests Single Gene Linked to OCD

By Rick Nauert PhD

Researchers have discovered that mice missing a single gene developed repetitive obsessive-compulsive-like behaviors.

The genetically altered mice, which behaved much like people with a certain type of obsessive-compulsive disorder (OCD), could help scientists design new therapies for this debilitating condition.

The researchers made the accidental discovery while looking at the role of a gene, called Slitrk5, which they had earlier linked to blood stem cells and vascular cells.." More

When does your child really need medication?

By Candy Lashkari

A frightening number of parents are over-medicating their young children today. Many parents are considering medication for Obsessive-Compulsive Disorder (OCD) and for those children showing signs of Attention Deficit Hyperactivity Disorder (ADHD). Journalist Louis Theroux is taking a television viewers on an investigative journey through children who are under medication to modify their behavior.

Considering that all children tend to be somewhat competitive and self obsessed, where does one draw the line? Is medication that is going to curb and alter a child’s normal and natural reaction to situations just so that he can fit in better in to societal norms really worth giving the child? Or would it be better to allow the child to grow up showing his natural attitude and learning to deal with it when he gets social criticism...." More

The Genetics of Compulsive Hoarding

By Jane Collingwood
People who compulsively acquire and hoard clutter to the extent that it impairs their daily activities are labeled “compulsive hoarders.” The condition is classed as a subtype of obsessive-compulsive disorder (OCD), present in 30 to 40 percent of individuals affected with OCD. It may damage relationships, cut the individual off from society, and even endanger lives.

Compulsive hoarding is distinct from bad planning and disorganization because it is believed to be a pathological brain disorder. It is often a symptom of other disorders, such as impulse control disorder or attention-deficit hyperactivity disorder. Bereavement or another significant life event can trigger excessive hoarding behavior.

Hoarding often runs in families, but it is uncertain whether DNA is involved. “People with this problem tend to have a first-degree relative who also does,” says Randy O. Frost, Ph.D., a psychologist at Smith College, Northampton, Massachusetts. “So it might be genetic, or it might be a modeling effect.”

Gene research suggests that a region on chromosome 14 may be linked with compulsive hoarding in families with OCD. The study, carried out by a team from Johns Hopkins University School of Medicine in March 2007, analyzed samples from 999 OCD patients in 219 families. Families with two or more hoarding relatives showed a unique pattern on chromosome 14, whereas the other families’ OCD was linked to chromosome 3.

This was the third study to find genetic markers specifically associated with compulsive hoarding, according to Sanjaya Saxena, M.D., director of the University of California, San Diego, Obsessive-Compulsive Disorders Program.

In a letter to the editor of the American Journal of Psychiatry, she writes, “Other studies have confirmed that compulsive hoarding is strongly familial.” This research “adds to the mounting evidence indicating that compulsive hoarding is an etiologically discrete phenotype,” she believes.

What’s more, brain imaging studies suggest that compulsive hoarding involves a specific type of brain activity. Patients have a different pattern of glucose metabolism in the brain than either healthy people or non-hoarding OCD patients..." More

BURIED ALIVE: Recognizing the Warning Signs of Extreme Hoarding

By: Asher Kade

One of my two favorite books as a child was Shel Silverstein's "Where the Sidewalk Ends". It is now my older son's favorite book too. We both like "Sarah Cynthia Stout Would Not Take The Garbage Out." It seems fitting

or the article I decided to write after being inspired by ashow I watched the other day about extreme hoarders.

Do you throw everything away and only live with the minimalism motto in mind-like my baby sister? Most of keep some things we simply don't need anymore but can't depart with the junked treasure. But, a few of us can't throw anything away. That's extreme hoarding.

SEE VIDEO

Their purses, their houses, their cars, they all have trash piled to the ceiling or bursting at the seams with old, unusable receipts, paper waste, human waste, and sometimes dead animals. These animals often keep these people company, as their social life begins to suffer understandably. Many are compulsive shoppers. Others fear throwing something away because they think something bad will happen. Most people that are hoarders suffer from Obsessive Compulsive Disorder. ..." More

Hoarding now Homeless

Mar 31, 2010: Report looks at causes of hoarding

By: Wendy Leung

The story of Guillermo Reyes, who was evicted this month after years of extreme pack-rat behavior, shines a light on a condition that medical experts have been researching since the 1990s.

As much as 5 percent of the population are believed to be hoarders, and researchers continue to learn more about this behavior.

Randy Frost, whose book "Stuff: Compulsive Hoarding and the Meaning of Things" will be published this month, defines hoarding as excessive buying or acquiring of free things. Hoarders also have difficulty throwing things away and are generally disorganized.

"People who hoard look at possessions differently than most," Frost said. "When we look at a bottle cap, for instance, we think it's useless, it's trash. But those who hoard may focus on the texture or think about putting it in a collage. That object then takes a different hue."
Frost, who teaches at Smith College in Massachusetts, started studying hoarding when a student asked whether the behavior was associated with obsessive- compulsive disorder.

"We put an ad in the newspaper looking for pack rats," Frost said. "We got 100 calls."
The research of Frost and Gail Steketee of Boston University can now be read on a Web site through the International OCD Foundation, a sort of clearinghouse on hoarding.

Jack Samuels, an assistant professor at John Hopkins University, said hoarding was considered uncommon before Frost's research..." More



Mar 31, 2010: Hoarder now homeless


By: Wendy Leung


Eight years ago, Guillermo Reyes was considered a nuisance - a pack rat whose junk and recyclable items spilled out of his three-bedroom home and into the driveway.
Today, he is homeless.

Reyes, 78, a soft-spoken man with a kind face and a slight frame, was evicted this month from a home he purchased with cash in 1976. The eviction came after years of involvement by the city, courts, a court-appointed receiver and lender - agencies that tried to get Reyes to clean up a property that had become a major public safety concern for him and the neighborhood.

But when Reyes' pat-rack behavior didn't change, a loan was taken out on his property for maintenance. Last year, that loan matured and the eviction process began..." More

Professor's exploration of hoarding garners attention

By: Clare Lynch

Almost two decades ago, psychology professor Randy Frost's involvement with hoarding began with an inauspicious question posed in a seminar on obsessive-compulsive disorder.

"One of the students asked about hoarding, and I said I didn't know anything about it, and nobody else did either, because you don't see it often," Frost said. "We decided to see if we could find someone who had this problem who would be willing to be interviewed for the project. So we put an ad in the newspaper looking for pack rats or chronic savers, and we got a hundred telephone calls."

Frost's research has advanced rapidly since 1991. He is now a nationally known expert on compulsive hoarding behavior. His book on hoarding, Stuff, co-written with Gail Steketee, will be published in April.

Hoarding itself has garnered a similar increase in attention, progressing from a little-known subset of obsessive-compulsive disorder to a field in its own right.

Compulsive hoarding behavior has three components, Frost explained. Hoarders first have problems with over-acquisition through compulsive buying or collecting of free objects. They then become so attached to those objects that they are unable to let them go. Finally, hoarders have a problem organizing their belongings..." More

Hoarding Intervention Interview

In this hoarding intervention interview, you will read expert advice about hoarding disorder, when it's time to step in to help a loved one and how to perform a successful intervention. Dr. Simon Rego is a licensed clinical psychologist, and board-certified in Cognitive Behavioral Psychology, which is evidence-based treatment of choice for hoarding. As Director of Clinical Training at the American Institute for Cognitive Therapy, he has treated many hoarders.

Hoarding Intervention Interview with Dr. Simon Rego

LTK: How does a loved one know when hoarding has become a problem and an intervention needs to take place?

Dr. Simon Rego (SR): While we all have the tendency to acquire and save things at times, hoarding is typically only considered to be a clinical problem after it becomes “compulsive”. By compulsive, we mean that the acquiring and then failing to discard possessions turns into a repetitive behavior that the person feels driven to perform, despite the fact that the items may be of limited value. The compulsive behavior also causes extremely negative consequences (e.g., rooms so cluttered that they cannot be used as intended), and/or significant distress or impairment in the person’s ability to function. A quick way to determine whether the hoarding has reached clinical levels is to check to see if rooms/objects cannot be used as intended. If the person can no longer function at home, work, school or socially due to his/her hoarding, or if any interference in their compulsion to hoard (e.g., family members throwing out items) causes him/her to get very upset.

LTK: What is the first step when trying to help someone with a hoarding disorder?

SR: If you are a concerned friend or family member and can find a treatment provider trained to treat compulsive hoarding, you may actually have some success in getting the person in the door to get some help. Compulsive hoarders may lose motivation quickly once they realize the treatment will focus on having them “debulk” or eliminate a large percentage of the items that they have acquired. They may also be initially hesitant if they previously have had unsuccessful treatment or if family members have tried to eliminate their items without consent in the past. They may also defend their behavior as not that much different as anyone else’s collecting of things or come up with reasons why they find it important to keep their materials.

LTK: How does an intervention for hoarding work?

SR: The treatment of choice for compulsive hoarding is something called Cognitive Behavioral Therapy (CBT). CBT is an evidence-based treatment that has patients examine and challenge their problematic beliefs and also identify and change any problematic behavioral patterns. In the case of compulsive hoarding, the treatment targets the thoughts that lead to the excessive acquisition of materials of limited value (e.g., “This soap is on sale! It is such a good deal that I should buy a crate!”), the saving of these materials (e.g., “I bet Aunt Joan will be able to use this!”), and the way the person tries to organize these materials (e.g., “I’m not sure where it should go.”). The treatment then targets the avoidance behaviors that compulsive hoarders usually engage in, usually in response to the distress caused by their dysfunctional beliefs. For example, compulsive hoarders may avoid storing an object out of sight because they believe they will lose the memory the item generates.

Treatment has patients gradually and intentionally confront these beliefs using something called exposure and response prevention. For example, this may involve sorting items into categories and ranking them in terms of how anxiety provoking it would be to discard them, and then selecting an item that provokes less anxiety (at first) and then discarding it. In the process, negative thoughts become challenged and corrected, and a tolerance to anxiety can be built. Over time, if this is done in a structured, prolonged, and repetitive manner, it gets increasingly easier for compulsive hoarders to debulk materials from their home (i.e., momentum builds).

LTK: Do you always need a professional, such as a counselor, involved in an intervention?

SR: Some people on the less severe end of the spectrum may be quite successful doing the work on their own. Other people may do well using a good self-help book. Still others correct the issue with the help of family members or friends, or by hiring a de-cluttering service. It is when the hoarding has reached clinical levels (e.g., rooms cannot be used as intended or the person cannot function in other areas of his or her life or becomes very distressed when unable to/prevented from hoarding) that professional assistance becomes essential. One other thing to consider, however, is how long the issue has been a problem, and if it seems to be growing worse (i.e., rooms can still be used, but are getting very cluttered). In this case, it may be wise to act in advance of the problem getting bigger and reach out for professional assistance from someone with expertise in treating this problem.

LTK: What are some common mistakes loved ones make when trying to help a loved one with hoarding disorder?

SR: The first mistake that loved ones make with compulsive hoarders is to assume that it is not a psychological disorder. It can be easy to fall into the trap of thinking that the person with the problem simply has to “push” him or herself in order to change. As with any other psychological condition, this attitude is very unhelpful and can often make the compulsive hoarder feel alienated and more resistant to change!

Another common mistake loved ones make is trying to “help” by throwing out materials themselves – either with or without the consent of the compulsive hoarder. They may even hire a cleaning service to remove all of the materials if their patience runs thin! This is unhelpful, as it often causes the compulsive hoarder to experience great distress (which can impact relationships), and ultimately, unless the person is successfully treated, he or she will likely start to acquire and save again over time.

And yet another mistake loved ones make is to not address the problem at all! Either by ignoring it, limiting it to certain areas that they are willing to “live” with, or writing it off as part of the person’s “quirkiness” – in order to not upset him/her. Although this may “help” the person in the short-term, it only allows the problematic behaviors and thoughts to grow over time..." More

BOOK: 'Obsessive-Compulsive Disorder Demystified'

By Sharyn Betz

'Obsessive-Compulsive Disorder Demystified'

Clinical psychologist Dr. Cheryl Carmin tells us that 6 to 9 million Americans are affected by OCD in her book "Obsessive-Compulsive Disorder Demystified: An Essential Guide for Understanding and Living with OCD" (Da Capo Lifelong Books; $15.95). Step-by-step she walks you through the disease, dispelling myths, describing symptoms and telling stories of patients (Sarah's contamination symptoms, Jonathan's diagnosis story, Kenny's hoarding story, etc.). At the end of each chapter, from the biology of OCD to the role of medication, are frequently asked questions. The book ends with a glossary of terms, resources and more FAQs..." More

Link to Amazon

Pssst...OCD is NOT an Adjective

Dear Readers Without OCD,

On behalf of the OCD community, I'd--

Yikes! I can only imagine how pretentious that must sound. Who am I to speakon behalf of the OCD community? It's not as if we're some organized group (though I suppose many of us, ourselves, are extremely organized) or that we require membership in some exclusive club (imagine the Purell involved in that secret handshake!). That said, if you'll indulge me, I will, in fact, attempt to speak here on behalf of the vast majority of OCD sufferers that I've had the opportunity to meet in my outreach travels. I've come to find that we, collectively, have a gentle reminder we'd like to pass along, ever so respectfully:

"OCD" is not an adjective; and more to the point, it is not a synonym for fastidious or anal-retentive.

Perhaps you've noticed this growing misuse. Maybe you, yourself, are even guilty of an occasional infraction. (It's okay; we forgive you.) I'm talking about comments such as this: "My boyfriend is so OCD about keeping his apartment clean." Or this: "Ever since starting high school, I've become so OCD about doing my homework." I overhear someone saying something like this at least once or twice a week. And if you think I'm overstating the trend, try this little experiment: type the words "so OCD" into a Google or Twitter search box and tally up the results. (Just don't spend too much time doing this, lest some misguided observer accuses you of being so OCD about research.)..." More

American Psychiatric Association: DSM-5 Development

Proposed Revisions

301.4 Obsessive-Compulsive Personality Disorder

The work group is recommending that this disorder be reforumulated as the Obsessive-Compulsive Type.

Individuals who match this personality disorder type are ruled by their need for order, precision, and perfection. Activities are conducted in super-methodical and overly detailed ways. They have intense concerns with time, punctuality, schedules, and rules. Affected individuals exhibit an overdeveloped sense of duty and obligation, and a need to try to complete all tasks thoroughly and meticulously. The need to try to do things perfectly may result in a paralysis of indecision, as the pros and cons of alternatives are weighed, such that important tasks may not ever be completed. Tasks, problems, and people are approached rigidly, and there is limited capacity to adapt to changing demands or circumstances. For the most part, strong emotions – both positive (e.g., love) and negative (e.g., anger) – are not consciously experienced or expressed. At times, however, the individual may show significant insecurity, lack of self confidence, and anxiety subsequent to guilt or shame over real or perceived deficiencies or failures.Additionally, individuals with this type are controlling of others, competitive with them, and critical of them. They are conflicted about authority (e.g., they may feel they must submit to it or rebel against it), prone to get into power struggles either overtly or covertly, and act self-righteous or moralistic. They are unable to appreciate or understand the ideas, emotions, and behaviors of other people.

Instructions

A. Type rating. Rate the patient’s personality using the 5-point rating scale shown below. Circle the number that best describes the patient’s personality.

5 = Very Good Match: patient exemplifies this type

4 = Good Match: patient significantly resembles this type

3 = Moderate Match: patient has prominent features of this type

2 = Slight Match: patient has minor features of this type

1 = No Match: description does not apply

B. Trait ratings. Rate extent to which the following traits associated with the Obsessive-Compulsive Type are descriptive of the patient using this four-point scale:

0 = Very little or not at all descriptive

1 = Mildly descriptive

2 = Moderately descriptive

3 = Extremely descriptive

1. Compulsivity: Perfectionism

Insistence on everything being flawless, without errors or faults, including own and others’ performance; conviction that reality should conform to one’s own ideal vision; holding oneself and others to unrealistically high standards; sacrificing of timeliness to ensure every detail is correct

2. Compulsivity: Rigidity

Being rule- and habit-governed; belief that there is only one right way to do things; insistence on an unchanging routine; difficulty adapting behaviors to changing circumstances; processing of information on the basis of fixed ideas and expectations; difficulty changing ideas and/or viewpoint, even with overwhelming contrary evidence

3. Compulsivity: Orderliness

Need for order and structure; insistence on everything having a correct place or order and on keeping them so; intolerance of things being “out of place”; concern with details, lists, arrangements, schedules

4. Compulsivity: Perseveration

Persistence at tasks long after behavior has ceased to be functional or effective; belief that lack of success is due solely to lack of effort or skill; continuance of the same behavior despite repeated failures.

5. Negative Emotionality: Anxiousness

Feelings of nervousness, tenseness, and/or being on edge; worry about past unpleasant experiences and future negative possibilities; feeling fearful and threatened by uncertainty

6. Negative Emotionality: Pessimism

Having a negative outlook on life; focusing on and accentuating the worst aspects of current circumstances; expecting the worst outcome

7. Negative Emotionality: Guilt/shame

Having frequent and persistent feelings of guilt/ shame/ blameworthiness, even over minor matters; believing one deserves punishment for wrongdoing

8. Introversion: Restricted Affectivity

Lack of emotional experience and display; emotional reactions, when evident, are shallow and transitory; unemotional, even in normally emotionally arousing situations

9. Antagonism: Oppositionality

Displaying defiance by refusing to cooperate with requests, meet obligations, or complete tasks; behavioral resistance to performance expectations; resentment and undermining of authority figures

Obsessive-Compulsive Personality Disorder

A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

(1) is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost

(2) shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met)

(3) is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)

(4) is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)

(5) is unable to discard worn-out or worthless objects even when they have no sentimental value

(6) is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things

(7) adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes

(8) shows rigidity and stubbornness

More

The process:

DSM-5: The Future of Psychiatric Diagnosis

Publication of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in May 2013 will mark one the most anticipated events in the mental health field. As part of the development process, the preliminary draft revisions to the current diagnostic criteria for psychiatric diagnoses are now available for public review and comment. We thank you for your interest in DSM-5 and hope that you use this opportunity not only to learn more about the proposed changes in DSM-5, but also about its history, its impact, and its developers. Please continue to check this site for updates to criteria and for more information about the development process...." More