OCD Diagnosis From an ACT Perspective

Michelle-Woidneck2

Utah State University
Boys Town Center for Behavioral Health

Key Points

  1. Stacy’s experiences are indicative of OCD rather than an adjustment disorder, as evidenced by the pre-existing and intense nature of her thoughts and her compulsive behaviors.
  2. The ACT approach focuses on the functional aspects of Stacy’s behaviors and thoughts, viewing mental compulsions as a form of intentional behavior with an escape function.
  3. Both the mental compulsions and avoidance behaviors in Stacy’s case are negatively reinforced, contributing to the persistence of her OCD symptoms.
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Understanding Stacy's Condition: Beyond Adjustment Disorder

Upon a deeper assessment of Stacy's situation, it becomes clear that her experience is more aligned with obsessive-compulsive disorder (OCD) rather than an adjustment disorder. This conclusion is drawn from several key observations:

  1. Pre-existing symptoms: Stacy had similar thoughts before her engagement, indicating that the issue is not solely related to adjustment to a new life event.
  2. Recurring pattern: These obsessive thoughts were not exclusive to her current relationship but were also present in her past relationships, leading to avoidance of dating or ending relationships.
  3. Intensity and interference: The level of distress and interference in daily life caused by these thoughts goes beyond what is typical in adjustment disorders.
  4. Compulsive behaviors: The presence of compulsive actions aimed at alleviating distress further supports the diagnosis of OCD.
  5. Insight into her condition: Initially, Stacy had poor insight into her condition, taking her thoughts quite literally and not recognizing them as symptoms of OCD.

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