Lucinda, a twenty-year-old college female, has been performing time-consuming cleaning behavior. Her diagnosis is obsessive-compulsive disorder based on DSM IV-TR criteria. The essential features of this disorder are recurrent obsessions and compulsions that can be either of the following: a) severe and to the point of being time-consuming and taking up more than 1 hour of the day or b) causing significant lifestyle impairment that interferes with a person’s normal routine, occupational or academic functioning, or social activities and relationships (Barlow & Durand, 2012).
Lucinda’s case fits this criterion because she has impairment of academic functioning. She repeatedly is late to class, misses multiple class periods every semester, and ends up having to drop classes every semester due to her obsessional fear of germs and her compulsive cleaning of her house and bathroom delaying her arrival to class. In addition to the time-consuming cleaning rituals she performs, her relationships are beginning to strain and become impaired, as she has been secluding herself from social events with friends and family. She has a great concern that restaurants and her friends homes are not be clean enough and she fears she would come in contact with germs.
Lucinda suffers from one of the most common types of obsessions: fear of germs/contaminants. Her obsession with germs consumes most of her day in the form of anxiety and these intrusive and persistent thoughts fit the criteria for the obsession part of the disorder as stated in DSM-IV-TR. In addition she tries to calm these impulsive thoughts by cleaning extensively in an effort to suppress her fear of germs and contaminants. Even though she uses hand sanitizer multiple times throughout the day she is still highly concerned that she will accidently come in contact with germs and continues to have anxiety. Finally, she meets the DSM-IV criteria because she realizes her obsessions are increasing and a product of her mind. Although she has grown up appreciating things clean and organized she realizes her anxiety levels are increasing and the time she spends cleaning everyday has been increasing as well.
Compulsions, as defined by DSM-IV-TR and best fit with Lucinda’s case have the following components: a) repetitive behaviors that a person feels they need to perform as a response to an obsession and b) the behaviors are aimed at reducing distress or preventing the dreaded situation (Barlow & Durand, 2012). Lucinda has been experiencing one of the most prevalent behavioral forms of compulsions: washing and cleaning. Specifically, she has to clean her apartment, shower, and clean her bathroom thoroughly before leaving for class in order to reduce her anxiety along with arriving early to class in order to clean and disinfect her desk in order to restore a sense of safety and control from germs. After many times experiencing heavy anxiety when going to class without finishing her cleaning or being...