Information Guides 


Obsessive-Compulsive, Anxiety, and Related Disorders (OCRD) Information Guides 

Though information is believed to be accurate, the views and opinions expressed by the below resources do not necessarily reflect those of the University of Florida or UF Health. Descriptions of disorders are taken from the current Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5-TR; APA, 2022), unless otherwise specified.

Obsessive-Compulsive & Related Disorders


Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) is characterized by the presence of recurrent and persistent thoughts, images, or impulses that are intrusive and unwanted and cause increased anxiety or distress (obsessions), as well as repetitive behaviors or mental acts to prevent or reduce anxiety or adverse events (compulsions), though these compulsions do not have a realistic connection to the event they are intended to prevent, or are excessive in nature.

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Perinatal Obsessive-Compulsive Disorder

Perinatal OCD is OCD that has onset or worsening during the perinatal period. In perinatal OCD, the intrusive thoughts most often focus on fear of harm coming to unborn baby or new infant, and compulsions center around preventing that harm. Perinatal OCD has been shown to occur in both childbearing and non-childbearing parents, though there is still ongoing research into this OCD presentation. Perinatal OCD has been shown to respond to treatments that are successful with other OCD presentations such as psychotherapy including Cognitive Behavioral Therapy with Exposure and Response Prevention and psychopharmacological interventions including Selective Serotonin Reuptake Inhibitors. Collaboration with patient’s family, OB/GYN, and child’s pediatrician is common when treating perinatal OCD.

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Hoarding Disorder

Hoarding Disorder (HD) is characterized by persistent difficulty discarding items, regardless of actual value. Distress is associated with perceived need to save the item and distress associated with discarding them.

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Body Focused Repetitive Behaviors

Body Focused Repetitive Behaviors (BFRBs) include Trichotillomania (Hair-Pulling Disorder; TTM) and Excoriation (Skin-Picking Disorder). TTM involves the recurrent pulling out of one’s own hair, resulting in significant hair loss with repeated failed attempts at stopping the pulling behavior. Excoriation involves recurrent skin picking, resulting in lesions with repeated failed attempts to stop the picking behavior.

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Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) is a preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or are slight to others with related repetitive behavior or mental acts in response to appearance concerns.

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Anxiety Disorders

Social Anxiety Disorder

Social Anxiety Disorder manifests as marked fear or anxiety about one or more social situations where they may be negatively evaluated by others. The most robust treatment for social anxiety is CBT-E/RP. Appropriate social skill psychoeducation and practice should also be integrated into treatment as needed, especially with individuals with comorbid Autism or Social Pragmatic Communication Disorder.

Specific Phobia

Specific Phobias are characterized by significant fear or anxiety related to a specific object or situation which is out of proportion to the actual object or event. The trigger almost always results in immediate fear or anxiety, and the individual engages in avoidance of the trigger or endurance of the trigger with intense fear or anxiety. Common examples of specific phobias include fear of: needles, flying, driving, vomit, or animals/insects. The most robust treatment for specific phobia is CBT-E/RP.

Panic Disorder and Agoraphobia

Panic Disorder involves recurrent unexpected panic attacks with persistent worry about having another panic attack and/or change in behavior to avoid having another panic attack. Agoraphobia is clinically significant anxiety in response to varied situations (using public transportation, being in open or enclosed spaces, standing in line or being in a crowd, being outside of the home alone) which the individual avoids due to fear of inability to escape, experience of panic symptoms, or other incapacitating or embarrassing symptoms. The most robust treatment for panic disorder is CBT-E/RP, specifically focusing on experiential interoceptive exposures.

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Other Related Disorders

Misophonia

Though not currently an official diagnosis in the DSM-5-TR, Misophonia indicates a preoccupation with specific aversive human sounds that trigger anger, agitation, disgust, and/or anxiety and “fight or flight” reflex (Mattson et al., 2023). Therapies for Misphonia include provides Cognitive Behavioral Therapy (CBT) or Acceptance and Commitment Therapy (ACT). These approaches combine values-based behavioral activation interventions with exposures and distress tolerance skill building. If applicable, the individual who produces the trigger sounds for the patient should be included in treatment for in vivo exposures and to help the patient increase management of maladaptive response behaviors.

Tic Disorders and Tourette’s Disorder

A Tic is a sudden, rapid, recurrent, nonrhythmic motor movement or vocalization, and Tourette’s Disorder involves experiencing both motor and vocal tics at some time during the illness. Onset of tics is before age 18. Tic/Tourette Disorder is often treated by either neurologists or psychiatrists. Common behavioral interventions include Habit Reversal Training (HRT) for mild tics, and Comprehensive Behavioral Intervention for Tics (CBIT) for moderate to severe tics. At UF, CBIT is provided by our occupational therapy team at the Norman Fixel Institute for Neurological Diseases.

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