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People with Pure O still experience mental rituals and avoidance behaviors, making it just as distressing. This is one reason OCD is so misunderstood, says Kastens, who herself has OCD.
Avoidant personality disorder (AvPD), or anxious personality disorder, is a cluster C personality disorder characterized by excessive social anxiety and inhibition, fear of intimacy (despite an intense desire for it), severe feelings of inadequacy and inferiority, and an overreliance on avoidance of feared stimuli (e.g., self-imposed social isolation) as a maladaptive coping method. [1]
These behaviors are aimed to reduce fear or anxiety in a currently threatening situation. [12] Examples include: Escaping the situation [4] Using safety signals such as looking at cell phones to reduce social anxiety [4] Subtle avoidance behaviors such as breathing techniques [4] Compulsive behaviors such as repeatedly washing hands [4]
Affective dysregulation due to blunted reward, and elevated fear sensitivity may promote compulsivity by assigning excessive motivational salience to avoidance behavior. [ 5 ] The ventral striatum is important in action selection, and receives inputs from the medial OFC that signal various aspects of value for stimulus association outcomes.
For people with primarily obsessional OCD, there are fewer observable compulsions, compared to those commonly seen with the typical form of OCD (checking, counting, hand-washing, etc.). While ritualizing and neutralizing behaviors do take place, they are mostly cognitive in nature, involving mental avoidance and excessive rumination. [3]
Obsessive–compulsive disorder (OCD) is a mental and behavioral disorder in which an individual has intrusive thoughts (an obsession) and feels the need to perform certain routines (compulsions) repeatedly to relieve the distress caused by the obsession, to the extent where it impairs general function. [1] [2] [7]
Thought suppression has been seen as a form of "experiential avoidance". Experiential avoidance is when an individual attempts to suppress, change, or control unwanted internal experiences (thoughts, feelings, bodily sensations, memories, etc.). [22] [23] This line of thinking supports relational frame theory.
Failure to assess avoidance. Most OCD symptom measures do not capture avoidance behavior, which is a major symptom for many people with OCD. People with OCD who do not have many compulsions, for example, often have extensive avoidance patterns that contribute to the overall severity and interference in functioning associated with the disorder ...