A nurse is educating a group of nursing students about the differential diagnosis of obsessive-compulsive disorders (OCDs) in comparison to other mental disorders. Which factor helps differentiate OCDs from other mental disorders?

Choice A rationale:

Cognitive-behavioral therapy (CBT) often involves exposing individuals to feared stimuli or situations in a controlled and gradual manner, a technique known as exposure therapy. This exposure helps individuals confront their anxieties and gradually reduce their distress over time. Exposure therapy is a cornerstone of CBT for anxiety disorders, including OCD.

Choice C rationale:

Exposure and response prevention (ERP) is a critical component of CBT for OCD. This technique involves exposing the individual to anxiety-provoking situations or thoughts (exposure) while preventing the usual compulsive responses (response prevention). Through repeated exposures without engaging in compulsions, the individual learns that their anxiety naturally decreases over time, leading to habituation to the anxiety-provoking stimuli.

Choice E rationale:

Cognitive therapy within CBT aims to challenge and modify cognitive distortions and unrealistic beliefs that underlie OCD. Individuals with OCD often have distorted thought patterns, such as catastrophic thinking or black-and-white reasoning. Cognitive therapy helps individuals recognize and reframe these distorted thoughts, leading to more adaptive and realistic thinking patterns.

Choice B rationale:

This choice is not accurate. CBT does not primarily focus on replacing distorted thoughts with unrealistic beliefs. Instead, it focuses on identifying and modifying irrational or negative thought patterns.

Choice D rationale:

While CBT does aim to enhance positive emotional outcomes, this choice is not entirely accurate in describing the main goal of CBT for OCD. The primary goal of CBT is to reduce the symptoms and distress associated with obsessions and compulsions by addressing the cognitive and behavioral factors that maintain the disorder.

Choice A rationale:

The statement "I have to check the locks on the door 10 times before I can leave my house" is indicative of checking compulsions often seen in OCD. This involves repetitive behaviors performed to reduce distress, such as checking locks multiple times. However, this choice is less likely because it focuses on checking rather than washing.

Choice B rationale:

The correct answer. This statement reflects a common manifestation of OCD, specifically contamination-related obsessions and cleaning compulsions. The client's fear of getting sick from not washing their hands is a classic example of obsessive thoughts leading to repetitive behaviors aimed at reducing anxiety.

Choice C rationale:

The statement "I think I'm going crazy because I keep thinking about these things" indicates the presence of intrusive and distressing thoughts, which are characteristic of OCD. However, this choice does not encompass the compulsive behaviors that are essential for an OCD diagnosis. It primarily highlights the emotional distress associated with the thoughts.

Choice D rationale:

The statement "I'm not sure if I'm really sick or if I'm just imagining it" suggests uncertainty and doubt, which are common features of OCD. However, this choice does not emphasize the typical compulsions that accompany OCD. It focuses more on self-doubt rather than specific ritualistic behaviors.