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  • Homosexual Obsessive Compulsive Disorder

    HOCD is exemplified by a man worrying about being gay so constantly and compulsively that it takes up a good deal of his life and causes him significant anxiety. 

    Perhaps the most extreme form of anxiety over gay identity is Homosexual Obsessive Compulsive Disorder. HOCD is exemplified by a man worrying about being gay so constantly and compulsively that it takes up a good deal of his life and causes him significant anxiety. While this is not an official diagnosis sanctioned by the American Psychological Association, those suffering from HOCD have taken it upon themselves to label and address it. 

     

    The following is link to the actual paper: http://www.psychologytoday.com/files/attachments/72634/williamshocd2008.pdf

     

    The above chart is also referenced on a website called Neurotic Planet. While not an official diagnosis in the DSM IV by psychologists, social workers or psychiatrists, there are those whose OCD symptoms are primarily focused on whether or not they might be homosexual. For more information click here.

     

    What is Obsessive Compulsive Disorder (OCD)? 

    According to the DSM IV:

    A. Either obsessions or compulsions:

    Obsessions as defined by (1), (2), (3), and (4):

    1. Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.

    2. The thoughts, impulses, or images are not simply excessive worries about real-life problems.

    3. The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.

    4. The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion).

    Compulsions as defined by (1) and (2):  

    1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.

    2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

     

    DIAGNOSTIC FEATURES 

    The essential features of Obsessive-Compulsive Disorder are recurrent obsessions or compulsions (Criterion A) that are severe enough to be time consuming (i.e., they take more than 1 hour a day) or cause marked distress or significant impairment (Criterion C). At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable (Criterion B). If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it (Criterion D). The disturbance is not due to the direct physiological effects of a substance (e.g., drug of abuse, a medication) or a general medical condition. (Criterion E).

     

    Obsessions are persistent ideas, thoughts, impulses, or images that are experienced as intrusive or inappropriate and that cause marked anxiety or distress. The intrusive and inappropriate quality of the obsessions has been referred to as “ego-dystonic.” This refers to the individual’s sense that the content of the obsession is alien, not within his or her own control, and not the kind of thought that he or she would expect to have. However, the individual is able to recognize that the obsessions are a product of his or her own mind and are not imposed from without (as in thought insertion).

    The most common obsessions are repeated thoughts about contamination (e.g., becoming contaminated by shaking hands), repeated doubts (e.g., wondering whether one has performed some act such as having hurt someone in a traffic accident or having left a door unlocked), a need to have things in a particular order (e.g., intense distress when objects are disordered or asymmetrical), aggressive or horrific impulses (e.g., to hurt one’s child or to should an obscenity in church), and sexual imagery (e.g., a recurrent pornographic image). The thoughts, impulses, or images are not simply excessive worries about real-life problems (e.g., concerns about current ongoing difficulties in life, such as financial, work, or school problems) and are unlikely to be related to a real-life problem.

    The individual with obsessions usually attempts to ignore or suppress such thoughts or impulses or to neutralize them with some other thought or action (i.e., a compulsion). For example, an individual plagued by doubts about having turned off the stove attempts to neutralize them by repeatedly checking to make sure that it is off.

    Compulsions are repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) the goal of which is to reduce anxiety or distress, not to provide pleasure or gratification. In most cases, the person feels driven to perform the compulsion to reduce the distress that accompanies an obsession or to prevent some dreaded event or situation.

    For example, individuals with obsessions about being contaminated may reduce their mental distress by washing their hands until their skin is raw; individuals distressed by obsessions about having left a door unlocked may be driven to check the lock every few minutes; individuals distressed by unwanted blasphemous thoughts may find relief in counting to 10 backward and forward 100 times for each thought. In some cases, individuals perform rigid or stereotyped acts according to idiosyncratically elaborated rules without being able to indicate why they are doing them. By definition, compulsions are either clearly excessive or are not connected in a realistic way with what they are designed to neutralize or prevent. The most common compulsions involve washing and cleaning, counting, checking, requesting or demanding assurances, repeating actions, and ordering. 

    By definition, adults with Obsessive-Compulsive Disorder have at some point recognized that the obsessions or compulsions are excessive or unreasonable. This requirement does not apply to children because they may lack sufficient cognitive awareness to make this judgment. However, even in adults there is a broad range of insight into the reasonableness of their obsessions or compulsions.

    Some individuals are uncertain about the reasonableness of their obsessions or compulsions, and any given individual’s insight may vary across time and situations. For example, the person may recognize a contamination compulsion as unreasonable when discussing it in a “safe situation” (e.g., in the therapist’s office), but not when forced to handle money. At those times when the individual recognizes that the obsessions and compulsions are unreasonable, he or she may desire or attempt to resist them.

    When attempting to resist a compulsion, the individual may have a sense of mounting anxiety or tension that is often relieved by yielding to the compulsion. In the course of the disorder, after repeated failure to resist the obsessions and compulsions, the individual may give into them, no longer experience a desire to resist them, and may incorporate the compulsions into his or her daily routines.

    The obsessions or compulsions must cause marked distress, be time consuming (take more than 1 hour per day), or significantly interfere with the individuals normal routine, occupational functioning, or usual social activities or relationships with others. Obsessions or compulsions can displace useful and satisfying behavior and can be highly disruptive to overall functioning.

    Because obsessive intrusions can be distracting, they frequently result in inefficient performance of cognitive tasks that require concentration, such as reading or computation. In addition, many individuals avoid objects or situations that provoke obsessions or compulsions. Such avoidance can become extensive and can severely restrict general functioning.