PSYC652 - In-depth Analysis of Obsessive-Compulsive Disorder Exam

This assignment provides a comprehensive analysis of Obsessive-Compulsive Disorder (OCD) through a take-home exam format. It includes short answer questions defining behavior, reinforcers, and schedules of reinforcement, followed by detailed case studies of individuals exhibiting OCD-related behaviors. The case studies involve analyzing antecedents, behaviors, consequences, and motivations, with proposed interventions. A detailed case study of an individual named Anita explores DSM-5 diagnosis, nomothetic and idiographic formulations, and evidence-based treatment approaches, including cognitive therapy and psycho-educational interventions. The assignment concludes with recommendations for treatment goals, intervention strategies, and the importance of family therapy in managing OCD symptoms. The document includes references to support the analysis and proposed interventions.

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Take Home Exam
Obsessive-Compulsive Disorder
Name
Institution

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Part A
Question 1
a) Stirling goes fishing is the behavior.
b) Stirling catches a fish is the reinforcer of his behavior.
c) He sometimes catches a fish and sometimes he does not catch a fish.
Question 2
a) The behavior is Lucy pretending to be a Dog in class.
b) Getting bored and when she finds the work challenging.
c) Teacher offering assistance to Lucy.
Part B
Case study 1 Stephen
Question 1
a) Antecedents are those things either events or actions which happen prior to a certain
behavior.
The antecedents in this case study are coloring and playing with Daisy the family dog.
Stephen gets upset especially when doing these actions. These two antecedents make him
portray some funny behaviors such as crying, screaming and throwing objects.
b) The behaviors that Stephen has include crying, screaming and throwing away objects
c) Consequences are those responses given right after showing a certain behavior.
Question 2

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The motivations for Stephen’s behavior include her mother letting him do
whatever he is doing. The other motivation is that her mother packs the school bag for
Stephen.
Question 3
The intervention to curb the behavior of Stephen; one is by chasing daisy away from the
house. This will help because daisy being an antecedent to Stephen's behavior is chased away
and Stephen is not able to play with the dog while it is away. The other thing to do to stop the
behavior of Stephen is by putting the colors away or by taking him in an environment which will
not allow him to do the coloring. This will make it easy to advise him to pack for school.
Case study 2 Betty
Question 1
a) The antecedents in Betty’s case include that Betty loves babies and young children.
b) The behaviors Betty had included sorting clothes, window shopping, having a cup of
coffee, buying woman magazine and also buying something for her doll. Betty has also a
behavior of cuddling or picking up small children.
c) The consequences caused by Betty’s behavior are the shopping center security calling her
mother, the security is also alerted when a child cries and her mother started
accompanying her to the shopping center and this makes Betty try to pick a child while
her mother is distracted.
Question 2
What motivates the behaviors portrayed by Betty is that her mum is distracted when she
accompanies her to the shopping center. This helps Betty to keep her behavior because her
mother is not always concentrating on watching Betty.

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Question 3
Interventions that can stop Betty’s behavior include her mother paying attention to Betty
while with Betty in the shopping center. Her mother shouting at her and speaking harshly to her.
Informing the security officers in the shopping area will also curb the behavior of Betty
to deal with small babies and young people.
Part C
Detailed case study
Anita
Question 1
a) Repetitively checking report card grades
b) Retracing her driving route for fear that she has run over someone or something.
c) Having persistent thoughts about harm coming to her parents.
d) Difficulty grocery shopping alone.
e) Repeatedly checking on her stove and her hair straightener before leaving the house during her
time in high school.
f) Re-reading textbooks pages repeatedly during exams.
g) She spends a lot of time in checking behaviour; between 3 to 4 hours.
h) She has an obsessional thought about harm coming to her parents
i) For her, it is compulsory to call her mother to make sure she is safe regardless of how
inconvenient that can be.
j) She becomes fixated on the thought that if she misses the call to check up on her mother
something wrong will happen to her or her mother may have a stroke and die.
k) She sees it as a fault failing to call her mother then stroke strikes her and she dies.
l) She spends a lot of time praying ritual prayers which she believes that they keep her parents safe.

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m) She repeats the prayers again and again when she realizes that she has made a small mistake or a
little error.
n) She feels frightened and guilty when she tries to omit these ritual prayers from her routine.
o) She is increasingly isolated because of her behaviors and thoughts.
p) She also has doubts whether she wants a child or not.
q) She also needs a company from her husband because of the increased marital tension.
r) She is also suspecting that she is pregnant and this is contributing to a marital conflict within her
and her husband.
Question 2
The possible class of DSM-5 diagnosis in Anita’s situation is Obsessive-compulsive and related
disorders.
Question 3
Nomothetic formulation considers the personalities we share with others. For example, in Anita's
case, we can see she shares some of her extreme personalities with other people, these include re-reading
textbooks pages repetitively, doing grocery shopping alone, rechecking over things to confirm if they can
cause any danger (Persons & Tompkins, 2013). People are not also sure whether they want a child or not.
Conflicts due to pregnancies in families also exist in large numbers. Repeatedly saying things that they
had already mentioned is another case with Anita and is common among people. Also the issue of not
being sure whether you need a child or not is common among many in the world and it was an issue to
Anita. Suspecting that she was pregnant also made her bring about marital issues and this happens in
every corner of the world.
Cognitive therapy can help Anita to stop fearful and guilty thoughts which run through her mind.
These thoughts can be replaced with others or Anita given the sense that nothing can happen because she
is thinking it will ((Van Oppen & Arntz, 1994).

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For example, the thought that her mother will die if she fails to call her, it can be replaced with
another thought that her mother will sleep and wake tomorrow even if a call is not made to her.
Question 4
Idiographic formulation deals with those issues which affect and only circulate among family
members (Ladouceur & Dumont, 1993). In Anita's case, she feels that her mother will not be ok if she
fails to call her daily. She suspects that is she fails to make a phone call her mother will have a stroke or
die. Also, on the other hand, Anita is not in good terms with her husband because of pregnancy and the
fact that she cannot tell whether she needs a child or not. Anita behaviours are triggered by the fears she
has, the fact that she feels that something wrong will happen triggers her to recheck on the same thing
repetitively. Her thoughts are also triggering the she behaves, for example she thinks that she might have
ran over something while driving and this makes her to retrace her way back. The fact that she is not sure
of things happening to her like being pregnancy also triggers her behaviour.
The situation of Anita can be maintained through several ways, the family members can try to
convince Anita that they are okay even when she fails to make a call or try to expose her in an
environment where she can't make calls, maybe by stay with her near and doing other things to keep her
behaviour away. Her situation can be maintained by relaxing and training her, offering exposure and
response prevention, medication, and lifestyle and personality changes.
Question 5
Evidence-based approach is a psychology that only decides to work with the only proven work to give a
treatment. The recommendation I can give is to use samples from two RCTs. The time taken for CBT
conducted in a group versus single person format is examined and the differential efficacy of cognitive
and behavioural classifications assessed. In this evidence-based approach treatment follow up at group
level and individual level should be maintained at two years. Recovery and lapse must be the same
between the two, and cognitive therapy and EPR should be equally beneficial. Participants in group

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receiving ERP show fewer OCD symptoms than those in a cognitive therapy group (Whittal & McLean,
2008). Cognitive therapy. This is where thoughts are replaced with other thoughts in order to curb fear,
superstition and guilty thoughts (Van Oppen & Arntz, 1994). For example, the thought that her
mother will die if she fails to make a call to her can be replaced with another thought like even if
I fail to call my mother I will see tomorrow while she is alive. Goals for the treatment.
1. To offer increased quality treatment to the patient.
2. To increase accountability so that patients will only pay out for a tested and proven treatment.
3. Evidence based approaches are cost effective
4. To reduce time spend when giving trial treatments.
 Intervention strategies
A psycho-educational intervention which includes biological, psychological, and general
characters of obsessive-compulsive disorders and the effects of this disorder and the plans to rescue
themselves from this problem (Steele & Wade, 2013).
Family therapy is also needed to help family members to deal cope with discouraging behaviors
and situations to encourage communication among members and re-establish normal routines for an easy
life (Neziroglu & Yaryura-Tobias, 2000). Communication training should also be done to the family
members this will better their way of communication hence reducing conflict among the family members.
This might also help in managing the symptoms of this disorder.

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References
Van Oppen, P., & Arntz, A. (1994). Cognitive therapy for obsessive-compulsive
disorder. Behaviour Research and Therapy, 32(1), 79-87.
Steele, A. L., Waite, S., Egan, S. J., Finnigan, J., Handley, A., & Wade, T. D. (2013). Psycho-
education and group cognitive-behavioral therapy for clinical perfectionism: a case-series
evaluation. Behavioural and Cognitive Psychotherapy, 41(2), 129-143.
Neziroglu, F., Hsia, C., & Yaryura-Tobias, J. A. (2000). Behavioral, cognitive, and family
therapy for obsessive-compulsive and related disorders. Psychiatric Clinics, 23(3), 657-
670.
Persons, J. B., Beckner, V. L., & Tompkins, M. A. (2013). Testing case formulation hypotheses
in psychotherapy: Two case examples. Cognitive and Behavioral Practice, 20(4), 399-
409.
Ladouceur, R., Freeston, M. H., Gagnon, F., Thibodeau, N., & Dumont, J. (1993). Idiographic
considerations in the behavioral treatment of obsessional thoughts. Journal of behavior
therapy and experimental psychiatry, 24(4), 301-310.
Whittal, M. L., Robichaud, M., Thordarson, D. S., & McLean, P. D. (2008).
Journal of Consulting and Clinical Psychology, 76, 1003-1014.