Formal diagnosis may be performed by a psychologist, psychiatrist, clinical social worker, or other licensed mental health professional. To be diagnosed with OCD, a person must have obsessions, compulsions, or both, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM). The Quick Reference to the 2000 edition of the DSM suggests that several features characterize clinically significant obsessions and compulsions. Such obsessions, the DSM says, are recurrent and persistent thoughts, impulses, or images that are experienced as intrusive and that cause marked anxiety or distress. These thoughts, impulses, or images are of a degree or type that lies outside the normal range of worries about conventional problems. A person may attempt to ignore or suppress such obsessions, or to neutralize them with some other thought or action, and will tend to recognize the obsessions as idiosyncratic or irrational.

Compulsions become clinically significant when a person feels driven to perform them in response to an obsession, or according to rules that must be applied rigidly, and when the person consequently feels or causes significant distress. Therefore, while many people who do not suffer from OCD may perform actions often associated with OCD (such as ordering items in a pantry by height), the distinction with clinically significant OCD lies in the fact that the person who suffers from OCD ”must” perform these actions, otherwise they will experience significant psychological distress. These behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these activities are not logically or practically connected to the issue, or they are excessive. In addition, at some point during the course of the disorder, the individual must realize that their obsessions or compulsions are unreasonable or excessive. Moreover, the obsessions or compulsions must be time-consuming (taking up more than one hour per day) or cause impairment in social, occupational, or scholastic functioning. It is helpful to quantify the severity of symptoms and impairment before and during treatment for OCD. In addition to the patient’s estimate of the time spent each day harboring obsessive-compulsive thoughts or behaviors, Fenske and Schwenk in their article “Obsessive-Compulsive Disorder: Diagnosis and Management,” argue that more concrete tools should be used to gauge the patient’s condition (2009). This may be done with rating scales, such as the most trusted Yale–Brown Obsessive Compulsive Scale (Y-BOCS). With measurements like these, psychiatric consultation can be more appropriately determined because it has been standardized.

Differential diagnosis

OCD is often confused with the separate condition obsessive–compulsive personality disorder. OCD is ”ego dystonic”, meaning that the disorder is incompatible with the sufferer’s self-concept. Because disorders that are ego dystonic go against a person’s self-concept, they tend to cause much distress. OCPD, on the other hand, is ”ego syntonic”—marked by the person’s acceptance that the characteristics displayed as a result of this disorder are compatible with his or her self-image.

People with OCD are often aware that their behavior is not rational and are unhappy about their obsessions but nevertheless feel compelled by them. People with OCPD are not aware of anything abnormal about themselves; they will readily explain why their actions are rational, and it is usually impossible to convince them otherwise.

People with OCD are ridden with anxiety; by contrast, people with OCPD tend to derive pleasure from their obsessions or compulsions.

Some OCD sufferers exhibit what is known as ”overvalued ideas”. In such cases, the person with OCD will truly be uncertain whether the fears that cause them to perform their compulsions are irrational or not. After some discussion, it is possible to convince the individual that their fears may be unfounded. It may be more difficult to do ERP therapy on such patients because they may be unwilling to cooperate, at least initially. For this reason OCD has often been likened to a disease of pathological doubt, in which the sufferer, though not usually delusional, is often unable to realize fully which dreaded events are reasonably possible and which are not. There are severe cases in which the sufferer has an unshakeable belief in the context of OCD that is difficult to differentiate from psychosis.

OCD is different from behaviors such as gambling addiction and overeating. People with these disorders typically experience at least some pleasure from their activity; OCD sufferers do not actively want to perform their compulsive tasks and experience no pleasure from doing so.

OCD can, like many forms of chronic stress, lead to clinical depression over time. The constant stress of the condition can cause sufferers to develop a deadening of spirit, a numbing frustration, or sense of hopelessness. OCD’s effects on day-to-day life, particularly its substantial consumption of time, can produce difficulties with work, finances, and relationships. There is no known cure for OCD, but a number of successful treatment options are available.

Adapted from the Wikipedia article Obsessive–compulsive disorder, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Bruxism can sometimes be difficult to diagnose by visual evidence alone, as it is not the only cause of tooth wear. Over-vigorous brushing, abrasives in toothpaste, acidic soft drinks and abrasive foods can also be contributing factors, although each causes characteristic wear patterns that a trained professional can identify. Additionally, the presenting symptoms may be difficult for a physician to attribute to bruxism.

The effects of bruxism may be quite advanced before sufferers are aware they brux. Abraded teeth are usually brought to the patient’s attention during a routine dental examination. If enough enamel has been abraded, the softer dentin will be exposed, and abrasion will accelerate. This opens the possibility of dental decay and tooth fracture, and in some people, gum recession. Early intervention by a dentist is advisable.

The most reliable way to diagnose bruxism is through EMG (electromyographic) measurements. These measurements pick up electrical signals from the chewing muscles (masseter and temporalis). This is the method used in sleep labs. There are three forms of EMG measurement available to consumers for use outside sleep labs. The first is bedside EMG units similar to those used by sleep labs. These units can be purchased for about $2000 and pick up their signals from facial muscles through wires connecting the bedside unit to electrodes that are adhesively attached to the user’s face. TENS electrodes or ECG electrodes may be used.

The second type of EMG measurement available to consumers is a self-contained EMG measurement headband sold under the trade name ”SleepGuard”, available on loan from some dentists or at a rental rate of $50 per month from the manufacturer. The EMG measurement headband does not require adhesive electrodes or wires attached to the face. While it does not record the exact time, duration, and strength of each clenching incident as the most expensive bedside EMG monitors do, it does record the total number of clenching incidents and the total clenching time each night. These two numbers easily distinguish clenching from rhythmic grinding and allow dentists to quantify severity levels accurately.

Bedside EMG units and the self-contained EMG measurement headband can both be used either in silent mode as a diagnosis measurement or in biofeedback mode as a treatment.

A third method of diagnosis using EMG is available in disposable form under the trade name BiteStrip. The BiteStrip is a self-contained EMG module that adhesively mounts to the side of the face over the masseter muscle. The BiteStrip can only do one night of measurement and does not display the clench count or total clenching time, but rather provides a single-digit display related to bruxism severity. The BiteStrip provides significantly less information than an EMG bedside unit or EMG headband and costs about $60 per day to use.

Associated factors

The following factors are associated with bruxism:

*Disturbed sleep patterns and other sleep disorders (obstructive sleep apnea, hypopnea, snoring, moderate daytime sleepiness)

*Malocclusion, in which the upper and lower teeth occlude in a disharmonic way, e.g., through premature contact of back teeth

*Relatively high levels of consumption of caffeinated drinks and foods, such as coffee, colas, and chocolate

*High levels of blood alcohol

*Smoking

*High levels of anxiety, stress, work-related stress, irregular work shifts, stressful profession and ineffective coping strategies

*Drug use, such as SSRIs and stimulants, including methylenedioxymethamphetamine (ecstasy), methylenedioxyamphetamine (MDA), methylphenidate and other amphetamines, including those taken for medical reasons

*Hypersensitivity of the dopamine receptors in the brain

*GHB and similar GABA-inducing analogues such as Phenibut, when taken with high frequency

*Disorders such as Huntington’s and Parkinson’s diseases

*Obsessive Compulsive Disorder

Adapted from the Wikipedia article Bruxism, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Formal diagnosis may be performed by a psychologist, psychiatrist, clinical social worker, or other licensed mental health professional. To be diagnosed with OCD, a person must have obsessions, compulsions, or both, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM). The Quick Reference to the 2000 edition of the DSM suggests that several features characterize clinically significant obsessions and compulsions. Such obsessions, the DSM says, are recurrent and persistent thoughts, impulses, or images that are experienced as intrusive and that cause marked anxiety or distress. These thoughts, impulses, or images are of a degree or type that lies outside the normal range of worries about conventional problems. A person may attempt to ignore or suppress such obsessions, or to neutralize them with some other thought or action, and will tend to recognize the obsessions as idiosyncratic or irrational.

Compulsions become clinically significant when a person feels driven to perform them in response to an obsession, or according to rules that must be applied rigidly, and when the person consequently feels or causes significant distress. Therefore, while many people who do not suffer from OCD may perform actions often associated with OCD (such as ordering items in a pantry by height), the distinction with clinically significant OCD lies in the fact that the person who suffers from OCD ”must” perform these actions, otherwise they will experience significant psychological distress. These behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these activities are not logically or practically connected to the issue, or they are excessive. In addition, at some point during the course of the disorder, the individual must realize that their obsessions or compulsions are unreasonable or excessive. Moreover, the obsessions or compulsions must be time-consuming (taking up more than one hour per day) or cause impairment in social, occupational, or scholastic functioning. It is helpful to quantify the severity of symptoms and impairment before and during treatment for OCD. In addition to the patient’s estimate of the time spent each day harboring obsessive-compulsive thoughts or behaviors, Fenske and Schwenk in their article “Obsessive-Compulsive Disorder: Diagnosis and Management,” argue that more concrete tools should be used to gauge the patient’s condition (2009). This may be done with rating scales, such as the most trusted Yale–Brown Obsessive Compulsive Scale (Y-BOCS). With measurements like these, psychiatric consultation can be more appropriately determined because it has been standardized.

Differential diagnosis

OCD is often confused with the separate condition obsessive–compulsive personality disorder. OCD is ”ego dystonic”, meaning that the disorder is incompatible with the sufferer’s self-concept. Because disorders that are ego dystonic go against a person’s self-concept, they tend to cause much distress. OCPD, on the other hand, is ”ego syntonic”—marked by the person’s acceptance that the characteristics displayed as a result of this disorder are compatible with his or her self-image.

People with OCD are often aware that their behavior is not rational and are unhappy about their obsessions but nevertheless feel compelled by them. People with OCPD are not aware of anything abnormal about themselves; they will readily explain why their actions are rational, and it is usually impossible to convince them otherwise.

People with OCD are ridden with anxiety; by contrast, people with OCPD tend to derive pleasure from their obsessions or compulsions.

Some OCD sufferers exhibit what is known as ”overvalued ideas”. In such cases, the person with OCD will truly be uncertain whether the fears that cause them to perform their compulsions are irrational or not. After some discussion, it is possible to convince the individual that their fears may be unfounded. It may be more difficult to do ERP therapy on such patients because they may be unwilling to cooperate, at least initially. For this reason OCD has often been likened to a disease of pathological doubt, in which the sufferer, though not usually delusional, is often unable to realize fully which dreaded events are reasonably possible and which are not. There are severe cases in which the sufferer has an unshakeable belief in the context of OCD that is difficult to differentiate from psychosis.

OCD is different from behaviors such as gambling addiction and overeating. People with these disorders typically experience at least some pleasure from their activity; OCD sufferers do not actively want to perform their compulsive tasks and experience no pleasure from doing so.

OCD can, like many forms of chronic stress, lead to clinical depression over time. The constant stress of the condition can cause sufferers to develop a deadening of spirit, a numbing frustration, or sense of hopelessness. OCD’s effects on day-to-day life, particularly its substantial consumption of time, can produce difficulties with work, finances, and relationships. There is no known cure for OCD, but a number of successful treatment options are available.

Adapted from the Wikipedia article Obsessive–compulsive disorder, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Some approaches believe that conscious understanding and mediation of that information is important for the training process; however, this claim has never actually been verified. Those approaches also believe that neurofeedback training can be understood as being based on a form of operant and/or classical conditioning. In that frame of reference, when brain activity changes in the direction desired by the trainer directing the training, a positive “reward” feedback is given to the individual, and if the change is in the opposite direction from what was intended, then either different feedback is given or the provision of otherwise attained “positive” feedback is inhibited (or blocked). These ideas can be applied in various combinations depending on the protocol decided upon by the trainer. Rewards/Reinforcements can be as simple as a change in pitch of a tone or as complex as a certain type of movement of a character in a video game. This experience could be called operant conditioning for internal states even though no research has yet demonstrated that clear operant response curves occur under those scenarios.

Nonetheless, a number of different brainwave goals have been proposed by different researchers in the field following on these general ideas. Usually, these goals are based upon extrapolations from research describing abnormal EEG patterns or on results from a quantitative EEG (QEEG – also known as brain mapping) upon the particular client being offered neurofeedback training. A popular goal is the increase of activity in the 12–18 Hz band (mu rhythm/ sensorimotor rhythm) and a decrease in the 4–8 Hz and/or 22–28 Hz bands (theta and/or beta). The most common and well-documented use of neurofeedback is in the treatment of attention deficit hyperactivity disorder: multiple studies have shown neurofeedback to be useful in the treatment of ADHD. QEEG has been ambivalent with some studies showing that some forms of ADHD can be characterized by an abundance of slow brainwaves and a diminished quantity of fast wave activity; however, alternative patterns have also been described making the overall picture inconclusive at this time.

Some ADHD researchers are unconvinced by these studies, including the psychiatry professor and author of several books on ADHD, Russell Barkley. Barkley opines that neurotherapy’s effectiveness in treating ADHD can be ascribed to either uncontrolled case studies or the placebo effect. In return, neurofeedback advocates note that Barkley has received research funds and personal remuneration from drug giant Eli Lilly and Company and other drug companies.

Other areas where neurofeedback has been researched include treatment of substance abuse,, anxiety, depression, epilepsy, OCD, learning disabilities, bipolar disorder, conduct disorder,, cognitive impairment, migraines, headaches, chronic pain, autism spectrum disorders, sleep dysregulation, PTSD and concussion. Studies have shown that use of neurofeedback may improve memory by up to 10%.

Other approaches to understanding and providing neurofeedback training use non-linear dynamical control processes and joint time-frequency analyses to characterize the ongoing dynamics of EEG during the training process itself. These approaches understand the functioning of the CNS in a more integrated or comprehensive fashion, including the structural ideas of the Russian neuropsychologist Luria and neuropsychiatrist Karl Pribram.

Related technologies include hemoencephalography biofeedback (HEG).

Adapted from the Wikipedia article Neurofeedback, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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Effects of sexual harassment can vary depending on the individual, and the severity and duration of the harassment. Often, sexual harassment incidents fall into the category of the “merely annoying.” However, many situations can, and do, have life-altering effects particularly when they involve severe/chronic abuses, and/or retaliation against a victim who does not submit to the harassment, or who complains about it openly. Indeed, psychologists and social workers report that severe/chronic sexual harassment can have the same psychological effects as rape or sexual assault. (Koss, 1987) For example, in 1995, Judith Coflin committed suicide after chronic sexual harassment by her bosses and coworkers. (Her family was later awarded 6 million dollars in punitive and compensatory damages.) Backlash and victim-blaming can further aggravate the effects. Moreover, every year, sexual harassment costs hundreds of millions of dollars in lost educational and professional opportunities, mostly for girls and women. (Boland, 2002)

Common effects on the victims

Common professional, academic, financial, and social effects of sexual harassment:

* Decreased work or school performance; increased absenteeism

* Loss of job or career, loss of income

* Having to drop courses, change academic plans, or leave school (loss of tuition)

* Having one’s personal life offered up for public scrutiny—the victim becomes the “accused,” and his or her dress, lifestyle, and private life will often come under attack.

* Being objectified and humiliated by scrutiny and gossip

* Becoming publicly sexualized (i.e. groups of people “evaluate” the victim to establish if he or she is “worth” the sexual attention or the risk to the harasser’s career)

* Defamation of character and reputation

* Loss of trust in environments similar to where the harassment occurred

* Loss of trust in the types of people that occupy similar positions as the harasser or his or her colleagues

* Extreme stress upon relationships with significant others, sometimes resulting in divorce; extreme stress on peer relationships, or relationships with colleagues

* Weakening of support network, or being ostracized from professional or academic circles (friends, colleagues, or family may distance themselves from the victim, or shun him or her altogether)

* Having to relocate to another city, another job, or another school

* Loss of references/recommendations

Some of the psychological and health effects that can occur in someone who has been sexually harassed:

depression, anxiety and/or panic attacks, sleeplessness and/or nightmares, shame and guilt, difficulty concentrating, headaches, fatigue or loss of motivation, stomach problems, eating disorders (weight loss or gain), alcoholism, feeling betrayed and/or violated, feeling angry or violent towards the perpetrator, feeling powerless or out of control, increased blood pressure, loss of confidence and self esteem, withdrawal and isolation, overall loss of trust in people, traumatic stress, post-traumatic stress disorder (PTSD), complex post-traumatic stress disorder, suicidal thoughts or attempts, suicide.

Effects of sexual harassment on organizations

* Decreased productivity and increased team conflict

* Decrease in success at meeting financial goals (because of team conflict)

* Decreased job satisfaction

* Loss of staff and expertise from resignations to avoid harassment or resignations/firings of alleged harassers; loss of students who leave school to avoid harassment

* Decreased productivity and/or increased absenteeism by staff or students experiencing harassment

* Increased health care costs and sick pay costs because of the health consequences of harassment

* The knowledge that harassment is permitted can undermine ethical standards and discipline in the organization in general, as staff and/or students lose respect for, and trust in, their seniors who indulge in, or turn a blind eye to, sexual harassment

* If the problem is ignored, a company’s or school’s image can suffer

* Legal costs if the problem is ignored and complainants take the issue to court.(Boland 1990)

Adapted from the Wikipedia article Sexual harassment, under the G. N. U. Free Documentation License. Please also see http://en.wikipedia.org/wiki

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