A nurse is assessing a client who has been diagnosed with obsessive-compulsive disorder (OCD) Which statement by the client indicates an obsession?

Choice A rationale:

The limbic circuit consisting of the hippocampus, amygdala, and hypothalamus is not the main brain circuit involved in obsessive-compulsive disorders (OCDs) The limbic circuit is more closely associated with emotions and memory, rather than the cognitive processes that drive OCD symptoms.

Choice B rationale:

The central executive circuit comprising the prefrontal cortex and temporal lobes is responsible for higher-level cognitive functions like decision-making and working memory. However, this circuit is not primarily implicated in the pathophysiology of OCD.

Choice C rationale:

The correct choice. The cortico-striato-thalamo-cortical (CSTC) circuit plays a central role in the development of OCD. This circuit involves several key components: Orbitofrontal cortex: Responsible for assessing potential risks and rewards, and for decision-making. Anterior cingulate cortex: Involved in error detection, emotional processing, and regulating cognitive flexibility. Striatum: Responsible for habit formation and reward-based learning. Thalamus: Acts as a relay station for information between various brain regions. This circuit's malfunction can lead to repetitive behaviors and intrusive thoughts characteristic of OCD.

Choice D rationale:

The ventral tegmental circuit involving the substantia nigra and ventral tegmental area is primarily associated with the brain's reward system and the regulation of mood and motivation. It is not a key player in OCD's pathophysiology.

Choice A rationale:

Encouraging the client to challenge negative thoughts is an effective cognitive-behavioral approach. It helps the client reframe their thinking patterns and build healthier self-esteem.

Choice B rationale:

Providing a list of alternative compulsions supports the client in finding healthier ways to cope with their anxiety. This can lead to a sense of accomplishment and improved self-esteem.

Choice C rationale:

Suggesting complete avoidance of anxiety triggers might seem helpful, but in the context of OCD, avoidance can reinforce the obsessions and compulsions. Gradual exposure and response prevention are evidence-based strategies.

Choice D rationale:

Assigning more exposure therapy sessions should be based on the client's progress and therapist's assessment. Increasing sessions solely for the sake of it might not be effective and could lead to frustration.

Choice E rationale:

Acknowledging the client's efforts in therapy fosters a positive therapeutic relationship and boosts their self-esteem. Recognizing progress and hard work encourages continued engagement in treatment.