What are Obsessive Compulsive Related Disorders?
Obsessive compulsive related disorders present with symptoms that seem as if they could be lumped into the diagnosis OCD, however, the approach to diagnosis and treatment are unique for each of these disorders. The disorders related to OCD are Hoarding Disorder, Body Dysmorphic Disorder, Body Focused Repetitive Behaviors and Olfactory Reference Syndrome. Though these disorders have similar clinical characteristics, and it is hypothesized that they may have the same underlying neurobiological causes as OCD, they are distinct and require specialized treatment.
Body Dysmorphic Disorder
Body Dysmorphic Disorder (BDD) is characterized by thinking too much about an imagined or slight flaw in a person’s own looks (APA, 2000). The unpleasant feelings caused by this perceived or minor flaw are all consuming. An individual with BDD may have a fixation about his/her appearance, spend a lot of time engaging in mirror checking behaviors or have a complete avoidance of mirror/reflective surfaces. His/Her belief is very strong even if evidence does not support the belief. The individual may also engage in reassurance seeking, or engaging in behaviors to conceal the afflicted area. Some individuals may also seek out unnecessary plastic surgery.
Hoarding Disorder is a psychological disorder in which an individual has difficulty getting rid of items that are no longer useful, and efforts to get rid of these items while not acquiring new items cause significant distress.
Body Focused Repetitive Behaviors:
Trichotillomania (Hair Pulling)
Trichotillomania is a compulsive behavior in which an individual pulls out their hair. The repeated pulling out of one’s hair results in noticeable hair loss and there is an increasing sense of tension immediately before pulling out the hair or when attempting to resist the behavior. Once the individual pulls out the hair, there is a sense of pleasure, satisfaction or relief.
Excoriation (Skin Picking)
Excoriation Disorder is a compulsive behavior in which an individual picks at their skin. The picking of their skin results in damaged skin or sores. Prior to picking at their skin, or while trying to resist the urge, an individual may feel increased tension. Once the individual engages in the skin picking, there is a sense of pleasure, satisfaction or relief.
Olfactory Reference Syndrome
Olfactory Reference Syndrome (ORS) has similarities to obsessive compulsive disorder and body dysmorphic disorder. Individuals with ORS believe they smell bad, when in reality they do not. There is a mismatch between their own perception, and the perception of others. Individuals with ORS perform excessive repetitive behaviors in response to the distress that their body odor preoccupations cause.