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145-463: Psychiatrist Isaac Barr treats Diana Baylor for obsessive–compulsive disorder . Diana suggests Isaac meet her sister, Heather Evans, who may be able to shed light on her neuroses. Heather tells him that Diana was sexually abused by their father after their mother left. Their father died in a fire, which Diana was suspected of starting. Heather further reveals that she is unhappily married to gangster Jimmy Evans. Isaac and Heather eventually have sex. At

290-402: A marina . Before going to the hospital, Pepe directs Isaac to the marina, where Isaac takes the dumbbell from Heather. She kidnaps both him and Huggins, and forces the latter to drive away from the marina. A rainstorm hits, and Huggins crashes into the ocean. Isaac escapes the sinking car and Heather follows him to the lighthouse. As she chases Isaac onto the balcony, he deduces that Heather was

435-442: A 103-foot (31 m) tall cross built in 1934. Dominating this area is Sutro Tower , a large red and white radio and television transmission tower reaching 1,811 ft (552 m) above sea level. The nearby San Andreas and Hayward Faults are responsible for much earthquake activity, although neither physically passes through the city itself. The San Andreas Fault caused the earthquakes in 1906 and 1989. Minor earthquakes occur on

580-416: A GDP of $ 729 billion in 2022 . The wider San Jose–San Francisco–Oakland Combined Statistical Area is the nation's fifth-most populous, with around nine million residents, and the third-largest by economic output, with a GDP of $ 1.32 trillion in 2022 . In the same year, San Francisco proper had a GDP of $ 252.2 billion, and a GDP per capita of $ 312,000. San Francisco was ranked fifth in the world and second in

725-578: A busy port, making it the largest city on the West Coast at the time; between 1870 and 1900, approximately one quarter of California's population resided in the city proper. In 1856, San Francisco became a consolidated city-county . After three-quarters of the city was destroyed by the 1906 earthquake and fire , it was quickly rebuilt, hosting the Panama–Pacific International Exposition nine years later. In World War II , it

870-485: A common comorbidity, with schizotypal and OCPD having poor treatment response. The condition is also associated with a general increase in suicidality . The phrase obsessive–compulsive is sometimes used in an informal manner unrelated to OCD to describe someone as excessively meticulous, perfectionistic , absorbed, or otherwise fixated. However, the actual disorder can vary in presentation, and individuals with OCD may not be concerned with cleanliness or symmetry. OCD

1015-623: A common place to live for people employed in Silicon Valley companies such as Apple and Google . The early 2020s featured an exodus of tech companies from Downtown San Francisco in the wake of the COVID-19 pandemic and struggles with homelessness and public drug use. Although some observers have raised the possibility that office vacancies and declining tax revenues could cause San Francisco to enter an economic doom loop , other sources have refuted this broad-based characterization of

1160-506: A defining identity. In adolescent OCD patients, OVI is considered a severe symptom. Historically, OVI has been thought to be linked to poorer treatment outcome in patients with OCD, but it is currently considered a poor indicator of prognosis. The Overvalued Ideas Scale (OVIS) has been developed as a reliable quantitative method of measuring levels of OVI in patients with OCD, and research has suggested that overvalued ideas are more stable for those with more extreme OVIS scores. Though OCD

1305-626: A dreaded event from occurring, or push the event from their thoughts. In any case, their reasoning is so idiosyncratic or distorted that it results in significant distress, either personally, or for those around the affected individual. Excessive skin picking , hair pulling , nail biting , and other body-focused repetitive behavior disorders are all on the obsessive–compulsive spectrum . Some individuals with OCD are aware that their behaviors are not rational, but they feel compelled to follow through with them to fend off feelings of panic or dread. Furthermore, compulsions often stem from memory distrust ,

1450-647: A flood of treasure seekers (known as "forty-niners," as in "1849"). With their sourdough bread in tow, prospectors accumulated in San Francisco over rival Benicia , raising the population from 1,000 in 1848 to 25,000 by December 1849. The promise of wealth was so strong that crews on arriving vessels deserted and rushed off to the gold fields, leaving behind a forest of masts in San Francisco harbor. Some of these approximately 500 abandoned ships were used at times as storeships , saloons , and hotels; many were left to rot, and some were sunk to establish title to

1595-416: A former client, to follow Diana when she visits her sister. Although Heather wants Diana to deliver the dumbbell to Huggins, Diana is too nervous to go through with it. Heather coerces her to switch clothes in the bathroom, allowing Heather to escape the hospital as "Diana". Pepe follows Heather and tries to steal the dumbbell, but she shoots him in the chest. She telephones Huggins and arranges to meet him at

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1740-458: A fort on Alcatraz Island to secure San Francisco Bay. San Francisco County was one of the state's 18 original counties established at California statehood in 1850. Until 1856, San Francisco's city limits extended west to Divisadero Street and Castro Street, and south to 20th Street. In 1856, the California state government divided the county. A straight line was then drawn across the tip of

1885-577: A four-factor grouping structure to be most reliable: symmetry factor, forbidden thoughts factor, cleaning factor, and hoarding factor. The symmetry factor correlates highly with obsessions related to ordering, counting, and symmetry, as well as repeating compulsions. The forbidden thoughts factor correlates highly with intrusive thoughts of a violent, religious, or sexual nature. The cleaning factor correlates highly with obsessions about contamination and compulsions related to cleaning. The hoarding factor only involves hoarding-related obsessions and compulsions, and

2030-407: A general sense of disarray or tension, accompanied by a belief that life cannot proceed as normal while the imbalance remains. A more intense obsession could be a preoccupation with the thought or image of a close family member or friend dying, or intrusive thoughts related to relationship rightness . Other obsessions concern the possibility that someone or something other than oneself—such as God ,

2175-506: A genetic correlation between anorexia nervosa and OCD, suggesting a strong etiology. First and second hand relatives of probands with OCD have a greater risk of developing anorexia nervosa as genetic relatedness increases. A mutation has been found in the human serotonin transporter gene hSERT in unrelated families with OCD. A systematic review found that while neither allele was associated with OCD overall, in Caucasians ,

2320-484: A gourmet marketplace. San Francisco has a warm-summer Mediterranean climate ( Köppen : Csb , Trewartha : Csll), characteristic of California's coast, with moist winters and dry summers. San Francisco's weather is strongly influenced by the cool currents of the Pacific Ocean on the west side of the city, and the water of San Francisco Bay to the north and east. This moderates temperature swings and produces

2465-671: A history of child abuse or other stress -inducing events such as during the postpartum period or after streptococcal infections . Diagnosis is based on clinical presentation and requires ruling out other drug-related or medical causes; rating scales such as the Yale–Brown Obsessive–Compulsive Scale (Y-BOCS) assess severity. Other disorders with similar symptoms include generalized anxiety disorder , major depressive disorder , eating disorders , tic disorders , body-focused repetitive behavior , and obsessive–compulsive personality disorder . Personality disorders are

2610-566: A large African American population after World War II . The Western Addition is usually divided into smaller neighborhoods including Hayes Valley , the Fillmore , and Japantown , which was once the largest Japantown in North America but suffered when its Japanese American residents were forcibly removed and interned during World War II. The Western Addition survived the 1906 earthquake with its Victorians largely intact, including

2755-599: A magnet for America's counterculture movement . Beat Generation writers fueled the San Francisco Renaissance and centered on the North Beach neighborhood in the 1950s. Hippies flocked to Haight-Ashbury in the 1960s, reaching a peak with the 1967 Summer of Love . In 1974, the Zebra murders left at least 16 people dead. In the 1970s, the city became a center of the gay rights movement , with

2900-664: A major depressive episode in their lifetime. Comorbidity rates have been reported at between 19 and 90%, as a result of methodological differences. Between 9–35% of those with bipolar disorder also have OCD, compared to 1–2% in the general population. About 50% of those with OCD experience cyclothymic traits or hypomanic episodes. OCD is also associated with anxiety disorders. Lifetime comorbidity for OCD has been reported at 22% for specific phobia , 18% for social anxiety disorder , 12% for panic disorder , and 30% for generalized anxiety disorder . The comorbidity rate for OCD and ADHD has been reported to be as high as 51%. The cause of OCD

3045-467: A mean age of onset of less than 25. Some OCD subtypes have been associated with improvement in performance on certain tasks, such as pattern recognition (washing subtype) and spatial working memory (obsessive thought subtype). Subgroups have also been distinguished by neuroimaging findings and treatment response, though neuroimaging studies have not been comprehensive enough to draw conclusions. Subtype-dependent treatment response has been studied, and

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3190-596: A number of other conditions, including obsessive–compulsive personality disorder (OCPD), autism spectrum disorder (ASD), or disorders in which perseveration is a possible feature (ADHD, PTSD , bodily disorders, or stereotyped behaviors ). Some cases of OCD present symptoms typically associated with Tourette syndrome, such as compulsions that may appear to resemble motor tics ; this has been termed tic-related OCD or Tourettic OCD . OCD frequently occurs comorbidly with both bipolar disorder and major depressive disorder . Between 60 and 80% of those with OCD experience

3335-427: A patient of Sigmund Freud who had persistent dreams of arranging flowers, the same dream Diana had described to him during a session; Isaac realizes that she fabricated those stories. He talks to a bailiff who recognized Heather before her trial, and he recalls that she had been a spectator in the courthouse whenever Isaac testified as an expert witness. Mike tells Isaac that Jimmy's brother recently died, making Heather

3480-440: A port and naval base, post-Conquest San Francisco was still a small settlement with inhospitable geography. Situated at the tip of a windswept peninsula without water or firewood, San Francisco lacked most of the basic facilities for a 19th-century settlement. These natural disadvantages forced the town's residents to bring water, fuel and food to the site. Its 1847 population was said to be 459. The California gold rush brought

3625-665: A recent meta-analysis showed that women are 1.6 times more likely to experience OCD. Based on data from 34 studies, the worldwide prevalence rate is 1.5% in women and 1% in men. OCD can present with a wide variety of symptoms. Certain groups of symptoms usually occur together as dimensions or clusters, which may reflect an underlying process. The standard assessment tool for OCD, the Yale–Brown Obsessive Compulsive Scale (Y-BOCS), has 13 predefined categories of symptoms. These symptoms fit into three to five groupings. A meta-analytic review of symptom structures found

3770-424: A regular basis. The threat of major earthquakes plays a large role in the city's infrastructure development. The city constructed an auxiliary water supply system and has repeatedly upgraded its building codes, requiring retrofits for older buildings and higher engineering standards for new construction. However, there are still thousands of smaller buildings that remain vulnerable to quake damage. USGS has released

3915-405: A restaurant with Jimmy, Heather has an episode of " pathological intoxication " after drinking wine and is taken to the hospital. After recovering, she sneaks away with Isaac to an abandoned lighthouse. While climbing the stairs, she drops her purse and lets loose a metal dumbbell handle, which she claims she keeps for protection. Isaac's friend, defense attorney Mike O'Brien, informs him that Jimmy

4060-603: A significant portion of the Comstock Lode 's gold and silver mines, establishing a virtual monopoly. Using his incredible clout, Ralston was able to generate millions of dollars for San Francisco during its heady boom years. He founded the Bank of California , the first bank in the Western United States, and built the opulent Palace Hotel, a symbol of San Francisco's newfound prosperity and the largest hotel in

4205-509: A small but significant association between a polymorphism in SLC1A1 and OCD. The relationship between OCD and Catechol-O-methyltransferase (COMT) has been inconsistent, with one meta-analysis reporting a significant association, albeit only in men, and another meta analysis reporting no association. San Francisco San Francisco , officially the City and County of San Francisco ,

4350-528: A spacious public park, resulting in plans for Golden Gate Park . San Franciscans built schools, churches, theaters, and all the hallmarks of civic life. The Presidio developed into the most important American military installation on the Pacific coast. By 1890, San Francisco's population approached 300,000, making it the eighth-largest city in the United States at the time. Around 1901, San Francisco

4495-443: A study found the average ages of onset to be 21 and 24 for males and females respectively. While some studies have shown that OCD with earlier onset is associated with greater severity, other studies have not been able to validate this finding. Looking at women specifically, a different study suggested that 62% of participants found that their symptoms worsened at a premenstrual age. Across the board, all demographics and studies showed

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4640-446: A substantially higher rate than the general public. Moreover, severe OCD symptoms are consistently associated with greater sleep disturbance . Reduced total sleep time and sleep efficiency have been observed in people with OCD, with delayed sleep onset and offset. Some research has demonstrated a link between drug addiction and OCD. For example, there is a higher risk of drug addiction among those with any anxiety disorder, likely as

4785-672: A symptom of OCD characterized by insecurity in one's skills in perception , attention , and memory , even in cases where there is no clear evidence of a deficit. Common compulsions may include hand washing, cleaning, checking things (such as locks on doors), repeating actions (such as repeatedly turning on and off switches), ordering items in a certain way, and requesting reassurance. Although some individuals perform actions repeatedly, they do not necessarily perform these actions compulsively; for example, morning or nighttime routines and religious practices are not usually compulsions. Whether behaviors qualify as compulsions or mere habit depends on

4930-484: A wave of " Manhattanization " that lasted until the late 1980s, a period of extensive high-rise development downtown. The 1980s also saw a dramatic increase in the number of homeless people in the city, an issue that remains today, despite many attempts to address it. The 1989 Loma Prieta earthquake caused destruction and loss of life throughout the Bay Area. In San Francisco, the quake severely damaged structures in

5075-535: A way of coping with the heightened levels of anxiety. However, drug addiction among people with OCD may be a compulsive behavior. Depression is also extremely prevalent among people with OCD. One explanation for the high depression rate among OCD populations was posited by Mineka, Watson, and Clark (1998), who explained that people with OCD, or any other anxiety disorder, may feel "out of control". Someone exhibiting OCD signs does not necessarily have OCD. Behaviors that present as obsessive–compulsive can also be found in

5220-601: A worldwide gross of $ 75 million. Final Analysis has an approval rating at Rotten Tomatoes of 56% based on 27 reviews. Roger Ebert liked the screenplay and thought director Alfred Hitchcock , known for these types of thrillers, would have liked it as well, though he thought the film was needlessly complex. Vincent Canby , film critic for The New York Times , praised the acting in the film and called Roberts "the film's electrical force". Variety magazine called Final Analysis "a crackling good psychological melodrama" with "tantalizing double-crosses". Kathleen Maher of

5365-499: 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. Obsessions are persistent unwanted thoughts, mental images, or urges that generate feelings of anxiety , disgust , or discomfort. Some common obsessions include fear of contamination , obsession with symmetry ,

5510-620: Is a commercial, financial , and cultural center within Northern California . With a population of 808,988 residents as of 2023, San Francisco is the fourth-most populous city in the U.S. state of California behind Los Angeles , San Diego , and San Jose . It covers a land area of 46.9 square miles (121 square kilometers) at the upper end of the San Francisco Peninsula , making it the second-most densely populated major U.S. city behind New York City and

5655-548: Is a lot of similarity between the clinical presentation of OCD in children and adults, and it is considered a highly familial disorder, with a phenotypic heritability of around 50%. Obsessive–compulsive disorder symptoms tend to develop more frequently in children 10–14 years of age, with males displaying symptoms at an earlier age, and at a more severe level than females. In children, symptoms can be grouped into at least four types, including sporadic and tic-related OCD. The Children's Yale–Brown Obsessive–Compulsive Scale (CY-BOCS)

5800-1247: Is an important monitoring tool as it is responsive to pharmacotherapy and psychotherapy. Positive treatment response is characterized by 25% reduction in CY-BOCS total score, and diagnostic remission is associated with a 45%-50% reduction in Total Severity score (or a score <15). CBT is the first line treatment for mild to moderate cases of OCD in children, while medication plus CBT is recommended for moderate to severe cases. Serotonin reuptake inhibitors ( SRIs ) are first-line medications for OCD in children with established AACAP guidelines for dosing. People with OCD may be diagnosed with other conditions as well, such as obsessive–compulsive personality disorder, major depressive disorder , bipolar disorder , generalized anxiety disorder , anorexia nervosa , social anxiety disorder , bulimia nervosa , Tourette syndrome , transformation obsession , ASD, ADHD, dermatillomania , body dysmorphic disorder , and trichotillomania . More than 50% of people with OCD experience suicidal tendencies, and 15% have attempted suicide . Depression, anxiety, and prior suicide attempts increase

5945-546: Is characterized by the acknowledgment that obsessive–compulsive beliefs are not or may not be true, while poor insight, in the middle of the continuum, is characterized by the belief that obsessive–compulsive beliefs are probably true. The absence of insight altogether, in which the individual is completely convinced that their beliefs are true, is also identified as a delusional thought pattern, and occurs in about 4% of people with OCD. When cases of OCD with no insight become severe, affected individuals have an unshakable belief in

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6090-734: Is chronic and long-lasting with periods of severe symptoms followed by periods of improvement. Treatment can improve ability to function and quality of life, and is usually reflected by improved Y-BOCS scores. Treatment for OCD may involve psychotherapy , pharmacotherapy such as antidepressants , or surgical procedures such as deep brain stimulation or, in extreme cases, psychosurgery . Psychotherapies derived from cognitive behavioral therapy (CBT) models, such as exposure and response prevention , acceptance and commitment therapy , and inference based-therapy , are more effective than non-CBT interventions. Selective serotonin reuptake inhibitors (SSRIs) are more effective when used in excess of

6235-494: Is essentially their original form, but most of the city's natural watercourses, such as Islais Creek and Mission Creek , have been partially or completely culverted and built over. Since the 1990s, however, the Public Utilities Commission has been studying proposals to daylight or restore some creeks. An Historical Center of San Francisco monument, where the 1899–1906 City Hall was once located,

6380-408: Is gone." Rebuilding was rapid and performed on a grand scale. Rejecting calls to completely remake the street grid, San Franciscans opted for speed. Amadeo Giannini 's Bank of Italy , later to become Bank of America , provided loans for many of those whose livelihoods had been devastated. The influential San Francisco Planning and Urban Research Association or SPUR was founded in 1910 to address

6525-651: Is growing evidence to support the use of deep brain stimulation and repetitive transcranial magnetic stimulation for treatment-resistant OCD. Obsessive–compulsive disorder affects about 2.3% of people at some point in their lives, while rates during any given year are about 1.2%. More than three million Americans suffer from OCD. According to Mercy , approximately 1 in 40 U.S. adults and 1 in 100 U.S. children have OCD. Although possible at times with triggers such as pregnancy , onset rarely occurs after age 35, and about 50% of patients experience detrimental effects to daily life before age 20. While OCD occurs worldwide,

6670-574: Is identified on a continuum, obsessive-compulsive beliefs are characterized on a spectrum, ranging from obsessive doubt to delusional conviction. In the United States , overvalued ideation (OVI) is considered most akin to poor insight—especially when considering belief strength as one of an idea's key identifiers. Furthermore, severe and frequent overvalued ideas are considered similar to idealized values , which are so rigidly held by, and so important to affected individuals, that they end up becoming

6815-583: Is in United Nations Plaza , at 37°46′48″N 122°24′49″W  /  37.7800397°N 122.4135943°W  / 37.7800397; -122.4135943 The earliest center of San Francisco is Portsmouth Square , in the northeast quadrant of the city anchored by Market Street and the waterfront. Here in the northeast quadrant, the Financial District is centered, with Union Square , the principal shopping and hotel district, and

6960-422: Is sometimes referred to as primarily obsessional obsessive–compulsive disorder (Pure O), it is also considered a misnomer due to associated mental compulsions and reassurance seeking behaviors that are consistent with OCD. Compulsions occur often and typically take up at least one hour per day, impairing one's quality of life. Compulsions cause relief in the moment, but cause obsessions to grow over time due to

7105-441: Is supported by the pattern of memory distrust; the more often compulsions are repeated, the more weakened memory trust becomes, and this cycle continues as memory distrust increases compulsion frequency. For body-focused repetitive behaviors (BFRB) such as trichotillomania (hair pulling), skin picking , and onychophagia (nail biting), behavioral interventions such as habit reversal training and decoupling are recommended for

7250-595: Is the gold standard measure for assessment of pediatric OCD. It follows the Y-BOCS format, but with a Symptom Checklist that is adapted for developmental appropriateness. Insight, avoidance, indecisiveness, responsibility, pervasive slowness, and doubting, are not included in a rating of overall severity. The CY-BOCS has demonstrated good convergent validity with clinician-rated OCD severity, and good to fair discriminant validity from measures of closely related anxiety, depression, and tic severity. The CY-BOCS Total Severity score

7395-420: Is under federal investigation for financial crimes, and warns Isaac to stay away from Heather. Isaac nevertheless follows her and her husband to a restaurant and confronts Jimmy. Claiming she feels ill, Heather leaves the restaurant, and gets a ride home from Isaac. Later, she drinks cough medicine, which brings on another episode. As Jimmy forces a kiss on her, she grabs one of his metal dumbbells and hits him over

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7540-653: Is unknown. Both environmental and genetic factors are believed to play a role. Risk factors include a history of adverse childhood experiences or other stress -inducing events. Some medications, toxin exposures, and drugs, such as methamphetamine or cocaine , can induce obsessive–compulsive symptoms in people without a history of OCD. Atypical antipsychotics such as olanzapine and clozapine can induce OCD in some people, particularly individuals with schizophrenia . The diagnostic criteria include: 1) General OCD symptoms (obsessions, compulsions, skin picking, hair pulling, etc.) that developed soon after exposure to

7685-552: The Austin Chronicle said the film does not live up to its influences and was critical of the leads, calling the buildup to their sex scene "excruciating". Rita Kempley, writing in The Washington Post , called the film "an implausible psycho thriller" and said director Joanou "doesn't have any of his own ideas." Obsessive%E2%80%93compulsive disorder Obsessive–compulsive disorder ( OCD )

7830-638: The Bear Flag Revolt in Sonoma and the beginning of the U.S. Conquest of California , American forces from the USS Portsmouth under the command of John B. Montgomery captured Yerba Buena on July 9, 1846, with little resistance from the local Californio population, raising the American flag over Yerba Buena plaza (later renamed Portsmouth Square in commemoration of this event). Following

7975-578: The California earthquake forecast which models earthquake occurrence in California. San Francisco's shoreline has grown beyond its natural limits. Entire neighborhoods such as the Marina , Mission Bay , and Hunters Point , as well as large sections of the Embarcadero , sit on areas of landfill . Treasure Island was constructed from material dredged from the bay as well as material resulting from

8120-838: The Golden Gate Bridge , cable cars , and Alcatraz . The city is home to a number of educational and cultural institutions, such as the University of California, San Francisco , the University of San Francisco , San Francisco State University , the San Francisco Conservatory of Music , the de Young Museum , the San Francisco Museum of Modern Art , the San Francisco Symphony , the San Francisco Ballet ,

8265-501: The Marina and South of Market districts and precipitated the demolition of the damaged Embarcadero Freeway and much of the damaged Central Freeway , allowing the city to reclaim The Embarcadero as its historic downtown waterfront and revitalizing the Hayes Valley neighborhood. The two recent decades have seen booms driven by the internet industry. During the dot-com boom of the late 1990s, startup companies invigorated

8410-678: The San Francisco County Superior Court , the Letterman Army Hospital , and the Kimpton Sir Francis Drake Hotel . Television comedy writer Susan Harris provided uncredited script rewrites. The first week's gross was $ 6,411,441 and the total receipts for the film's run were $ 28,590,665. In its widest release the film was featured in 1,504 theaters across the United States. The film grossed $ 47 million overseas for

8555-848: The San Francisco Opera , the SFJAZZ Center , and the California Academy of Sciences . Two major league sports teams, the San Francisco Giants and the Golden State Warriors , play their home games within San Francisco proper. San Francisco International Airport (SFO) offers flights to over 125 destinations, while a light rail and bus network , in tandem with the BART and Caltrain systems, connects nearly every part of San Francisco with

8700-501: The Tenderloin nearby. Cable cars carry riders up steep inclines to the summit of Nob Hill , once the home of the city's business tycoons, and down to the waterfront tourist attractions of Fisherman's Wharf , and Pier 39 , where many restaurants feature Dungeness crab from a still-active fishing industry. Also in this quadrant are Russian Hill , a residential neighborhood with the famously crooked Lombard Street ; North Beach ,

8845-440: The devil , or disease —will harm either the patient or the people or things the patient cares about. Others with OCD may experience the sensation of invisible protrusions emanating from their bodies, or feel that inanimate objects are ensouled . Another common obsession is scrupulosity , the pathological guilt/anxiety about moral or religious issues. In scrupulosity, a person's obsessions focus on moral or religious fears, such as

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8990-458: The fifth-most densely populated U.S. county , behind four of New York City's boroughs . Among the 92 U.S. cities proper with over 250,000 residents, San Francisco is ranked first by per capita income and sixth by aggregate income as of 2022. San Francisco anchors the 13th most populous metropolitan statistical area in the United States , with almost 4.6 million residents in 2023. The larger San Jose–San Francisco–Oakland combined statistical area ,

9135-466: The 1910s, a wave of Central American immigrants settled in the Mission and, in the 1950s, immigrants from Mexico began to predominate. In recent years, gentrification has changed the demographics of parts of the Mission from Latino, to twenty-something professionals. Noe Valley to the southwest and Bernal Heights to the south are both increasingly popular among young families with children. East of

9280-535: The Bay Area a center for trade. Catering to the needs and tastes of the growing population, Levi Strauss opened a dry goods business and Domingo Ghirardelli began manufacturing chocolate. Chinese immigrants made the city a polyglot culture, drawn to "Old Gold Mountain," creating the city's Chinatown quarter. By 1880, Chinese made up 9.3% of the population. The first cable cars carried San Franciscans up Clay Street in 1873. The city's sea of Victorian houses began to take shape, and civic leaders campaigned for

9425-705: The Birdman of Alcatraz. San Francisco later celebrated its regained grandeur with a World's fair , the Golden Gate International Exposition in 1939–40, creating Treasure Island in the middle of the bay to house it. During World War II , the city-owned Sharp Park in Pacifica was used as an internment camp to detain Japanese Americans . Hunters Point Naval Shipyard became a hub of activity, and Fort Mason became

9570-563: The L allele was associated with OCD. Another meta-analysis observed an increased risk in those with the homozygous S allele, but found the LS genotype to be inversely associated with OCD. A genome -wide association study found OCD to be linked with single-nucleotide polymorphisms (SNPs) near BTBD3 , and two SNPs in DLGAP1 in a trio-based analysis, but no SNP reached significance when analyzed with case-control data. One meta-analysis found

9715-522: The Mission is the Potrero Hill neighborhood, a mostly residential neighborhood that features sweeping views of downtown San Francisco. West of the Mission, the area historically known as Eureka Valley , now popularly called the Castro , was once a working-class Scandinavian and Irish area. It has become North America's first gay village , and is now the center of gay life in the city. Located near

9860-731: The Outer Richmond and Outer Sunset can refer to the more western portions of their respective district and the Inner Richmond and Inner Sunset can refer to the more eastern portions. Many piers remained derelict for years until the demolition of the Embarcadero Freeway reopened the downtown waterfront, allowing for redevelopment. The centerpiece of the port, the Ferry Building , while still receiving commuter ferry traffic, has been restored and redeveloped as

10005-586: The Presidio garrison, commanded by Mariano Vallejo , relocated to the Presidio of Sonoma , which was regarded as needing a greater military presence due the proximity of the Russian settlement at Fort Ross . Only a small detachment remained at the Presidio of San Francisco. Mission Dolores sold most of its property in 1836, retaining only the church and related structures. In 1833, Juana Briones de Miranda

10150-709: The San Francisco Peninsula just north of San Bruno Mountain . Everything south of the line became the new San Mateo County while everything north of the line became the new consolidated City and County of San Francisco. The California Gold Rush triggered a wave of entrepreneurial activity as individuals sought to capitalize on the newfound wealth. The discovery of silver deposits, notably the Comstock Lode in Nevada in 1859, further fueled rapid population growth and economic expansion. San Francisco, as

10295-457: The San Francisco economy. Large numbers of entrepreneurs and computer application developers moved into the city, followed by marketing, design, and sales professionals, changing the social landscape as once poorer neighborhoods became increasingly gentrified . Demand for new housing and office space ignited a second wave of high-rise development, this time in the South of Market district. By 2000,

10440-510: The Spanish ship San Carlos , commanded by Juan Manuel de Ayala , became the first ship to anchor in the bay. Soon after, on March 28, 1776, Anza established the Presidio of San Francisco . On October 9, Mission San Francisco de Asís , also known as Mission Dolores, was founded by Padre Francisco Palóu . In 1794, the Presidio established the Castillo de San Joaquín , a fortification on

10585-501: The United States on the Global Financial Centres Index as of September 2023 . Despite a continuing exodus of businesses from the downtown area of San Francisco, the city is still home to numerous companies inside and outside of technology, including Salesforce , Uber , Airbnb , X , Levi's , Gap , Dropbox , and Lyft . In 2022, San Francisco had more than 1.7 million international visitors –

10730-549: The affected individual, and even to those around them, as a crisis of sexual identity . Furthermore, the doubt that accompanies OCD leads to uncertainty regarding whether one might act on the troubling thoughts, resulting in self-criticism or self-loathing. Most people with OCD understand that their thoughts do not correspond with reality; however, they feel that they must act as though these ideas are correct or realistic. For example, someone who engages in compulsive hoarding might be inclined to treat inorganic matter as if it had

10875-464: The area. Further development is taking place just to the south in Mission Bay area, a former railroad yard, which now has a second campus of the University of California, San Francisco and Chase Center , which opened in 2019 as the new home of the Golden State Warriors . West of downtown, across Van Ness Avenue , lies the large Western Addition neighborhood, which became established with

11020-507: The arts and sciences, spurred by leading universities , high-tech , healthcare, finance, insurance, real estate, and professional services sectors. As of 2020 , the metropolitan area, with 4.5 million residents, ranked 5th by GDP ($ 874 billion) and 2nd by GDP per capita ($ 131,082) across the OECD countries, ahead of global cities like Paris , London , and Singapore . It is the fourth-largest by aggregate income and economic output, with

11165-597: The beginning of the assimilation of the Ramaytush people, and the decline of their language and culture. The Spanish Empire claimed San Francisco as part of Las Californias , a province of the Viceroyalty of New Spain . The Spanish first arrived in what is now San Francisco on November 2, 1769, when the Portolá expedition led by Don Gaspar de Portolá and Juan Crespí arrived at San Francisco Bay . Having noted

11310-676: The behavioral pattern, but to each individual occurrence. For example, someone compulsively checking the front door may argue that the time and stress associated with one check is less than the time and stress associated with being robbed, and checking is consequently the better option. This reasoning often occurs in a cyclical manner, and can continue for as long as the affected person needs it to in order to feel safe. In cognitive behavioral therapy (CBT), OCD patients are asked to overcome intrusive thoughts by not indulging in any compulsions. They are taught that rituals keep OCD strong, while not performing them causes OCD to become weaker. This position

11455-523: The beneficiary of Jimmy's $ 4 million life insurance policy. Isaac goes to the hospital to confront Heather, who admits to the ruse and threatens to incriminate him with the dumbbell she used to murder Jimmy, which has Isaac's fingerprints on it. Police detective Huggins, who suspects Isaac of killing Jimmy, reveals that he is being watched. Isaac tells Heather that he has reported to two assistant district attorneys who want to interview her. She agrees, confident that double jeopardy will protect her. During

11600-426: The capture, U.S. forces appointed both José de Jesús Noé and Washington Allon Bartlett to serve as co- alcaldes (mayors), while the conquest continued on in the rest of California. On January 30, 1847, Mayor Bartlett ordained that the city should officially change its name from "Yerba Buena" to "San Francisco", as the former name was only locally recognized and the latter name was in use on international maps. There

11745-723: The cause of onset, researchers asked participants in one study what they felt was responsible for triggering the initial onset of their illness. 29% of patients answered that there was an environmental factor in their life that did so. Specifically, the majority of participants who answered with that noted their environmental factor to be related to an increased responsibility. Obsessions are stress-inducing thoughts that recur and persist, despite efforts to ignore or confront them. People with OCD frequently perform tasks, or compulsions , to seek relief from obsession-related anxiety. Within and among individuals, initial obsessions vary in clarity and vividness. A relatively vague obsession could involve

11890-476: The city and burned out of control for several days. With water mains out of service, the Presidio Artillery Corps attempted to contain the inferno by dynamiting blocks of buildings to create firebreaks. More than three-quarters of the city lay in ruins, including almost all of the downtown core. Contemporary accounts reported that 498 people died, though modern estimates put the number in

12035-521: The city as a whole, asserting that the issues of concern are restricted primarily to the urban core of San Francisco. As of March 2024, Union Square was in "sorry shape" and had lost its traditional position as the Bay Area's regional shopping hub to Westfield Valley Fair in San Jose. The Ferry Station Post Office Building , Armour & Co. Building , Atherton House , and YMCA Hotel are historic buildings among dozens of historical landmarks in

12180-548: The city's Little Italy and the former center of the Beat Generation ; and Telegraph Hill , which features Coit Tower . Abutting Russian Hill and North Beach is San Francisco's Chinatown , the oldest Chinatown in North America. The South of Market , which was once San Francisco's industrial core, has seen significant redevelopment following the construction of Oracle Park and an infusion of startup companies . New skyscrapers, live-work lofts, and condominiums dot

12325-479: The city's alcalde , renamed it from Yerba Buena (Spanish for "Good Herb"), which had been the name of the first civilian pueblo in San Francisco, as well as the name of Yerba Buena Cove , which the pueblo was on the shore of. Earlier in San Francisco's history, the uninhabited area on the northeastern side of San Francisco was called El Paraje de Yerba Buena , after the herb that was growing abundantly there. The name Yerba Buena continues to be used in locations in

12470-417: The city's population reached new highs, surpassing the previous record set in 1950. When the bubble burst in 2001 and again in 2023, many of these companies folded and their employees were laid off. Yet high technology and entrepreneurship remain mainstays of the San Francisco economy. By the mid-2000s (decade), the social media boom had begun, with San Francisco becoming a popular location for tech offices and

12615-576: The city's southern border, the Excelsior District is one of the most ethnically diverse neighborhoods in San Francisco. The Bayview-Hunters Point in the far southeast corner of the city is one of the poorest neighborhoods, though the area has been the focus of several revitalizing and urban renewal projects. The construction of the Twin Peaks Tunnel in 1918 connected southwest neighborhoods to downtown via streetcar, hastening

12760-571: The city, according to the National Register of Historic Places listings in San Francisco . San Francisco is located on the West Coast of the United States , at the north end of the San Francisco Peninsula and includes significant stretches of the Pacific Ocean and San Francisco Bay within its boundaries. Several picturesque islands — Alcatraz , Treasure Island and the adjacent Yerba Buena Island , and small portions of Alameda Island , Red Rock Island , and Angel Island —are part of

12905-865: The city, such as on Yerba Buena Island and in the Yerba Buena Center for the Arts and Yerba Buena Gardens . While people residing outside the San Francisco Bay Area use nicknames including "Frisco" and "San Fran", local residents in the Bay Area sometimes refer to San Francisco as "the City" or "SF". The choice of nickname a person uses is a common way for locals to distinguish long-time residents from tourists and recent arrivals. "San Fran" and "Frisco" are sometimes considered controversial as nicknames among San Francisco residents. The earliest archeological evidence of human habitation of

13050-432: The city. Also included are the uninhabited Farallon Islands , 27 miles (43 km) offshore in the Pacific Ocean. The mainland within the city limits roughly forms a "seven-by-seven-mile square," a common local colloquialism referring to the city's shape, though its total area, including water, is nearly 232 square miles (600 km ). There are more than 50 hills within the city limits. Some neighborhoods are named after

13195-609: The context in which they are performed. For instance, arranging and ordering books for eight hours a day would be expected of someone who works in a library, but this routine would seem abnormal in other situations. In other words, habits tend to bring efficiency to one's life, while compulsions tend to disrupt it. Furthermore, compulsions are different from tics (such as touching, tapping, rubbing, or blinking) and stereotyped movements (such as head banging, body rocking, or self-biting), which are usually not as complex and not precipitated by obsessions. It can sometimes be difficult to tell

13340-515: The country at the time. His financial empire, however, collapsed in 1875 as a result of the Panic of 1873 , triggering a major economic crisis in San Francisco. Development of the Port of San Francisco and the establishment in 1869 of overland access to the eastern U.S. rail system via the newly completed Pacific Railroad (the construction of which the city only reluctantly helped support ) helped make

13485-683: The development of West Portal , and nearby affluent Forest Hill and St. Francis Wood . Further west, stretching all the way to the Pacific Ocean and north to Golden Gate Park lies the vast Sunset District , a large middle-class area with a predominantly Asian population. The northwestern quadrant of the city contains the Richmond , a mostly middle-class neighborhood north of Golden Gate Park, home to immigrants from other parts of Asia as well as many Russian and Ukrainian immigrants. Together, these areas are known as The Avenues . These two districts are each sometimes further divided into two regions:

13630-441: The difference between compulsions and complex tics, and about 10–40% of people with OCD also have a lifetime tic disorder. People with OCD rely on compulsions as an escape from their obsessive thoughts; however, they are aware that relief is only temporary, and that intrusive thoughts will return. Some affected individuals use compulsions to avoid situations that may trigger obsessions. Compulsions may be actions directly related to

13775-509: The emergence of The Castro as an urban gay village , the election of Harvey Milk to the Board of Supervisors , and his assassination , along with that of Mayor George Moscone , in 1978. Bank of America , now based in Charlotte , North Carolina , was founded in San Francisco; the bank completed 555 California Street in 1969. The Transamerica Pyramid was completed in 1972, igniting

13920-425: The evaluation, Heather fabricates a story about Isaac killing Jimmy. At her request, Diana joins her, but fails to bring the dumbbell; the investigators, meanwhile, are revealed to be psychiatrists. Heather loses her temper and threatens both Isaac and Diana, and has to be sedated. Isaac meets with Diana, who assures him that she dropped the dumbbell into the bay, but Isaac does not trust her. Isaac enlists Pepe Carrero,

14065-774: The excavation of the Yerba Buena Tunnel through Yerba Buena Island during the construction of the Bay Bridge. Such land tends to be unstable during earthquakes. The resulting soil liquefaction causes extensive damage to property built upon it, as was evidenced in the Marina district during the 1989 Loma Prieta earthquake . A few natural lakes and creeks ( Lake Merced , Mountain Lake , Pine Lake , Lobos Creek , El Polin Spring ) are within parks and remain protected in what

14210-520: The fact that there were no churches to be found, prompted missionaries like William Taylor to come to San Francisco where he began preaching in the streets, using an upright barrel as his pulpit. Taylor was able to garner enough generous donations from successful gold miners with which he used to build a church. One of the most influential figures of this era was William Chapman Ralston . A shrewd banker and investor, Ralston amassed considerable wealth and influence in San Francisco. He gained control over

14355-497: The famous " Painted Ladies ," standing alongside Alamo Square . To the south, near the geographic center of the city is Haight-Ashbury , famously associated with 1960s hippie culture. The Haight is now home to some expensive boutiques and a few controversial chain stores, although it still retains some bohemian character. North of the Western Addition is Pacific Heights , an affluent neighborhood that features

14500-547: The fear of acting blasphemously , the sufferer's sexual orientation , and the fear of possibly harming others or themselves. Compulsions are repeated actions or routines that occur in response to obsessions to achieve a relief from anxiety. Common compulsions include excessive hand washing , cleaning , counting , ordering, repeating, avoiding triggers, hoarding , neutralizing, seeking assurance, praying, and checking things. People with OCD may only perform mental compulsions such as needing to know or remember things. While this

14645-821: The fear of being an evil person or the fear of divine retribution for sin. Mysophobia , a pathological fear of contamination and germs , is another common obsession theme. Some people with OCD experience sexual obsessions that may involve intrusive thoughts or images of "kissing, touching, fondling, oral sex , anal sex , intercourse , incest , and rape " with "strangers, acquaintances, parents, children, family members, friends, coworkers, animals, and religious figures", and can include heterosexual or homosexual contact with people of any age. Similar to other intrusive thoughts or images, some disquieting sexual thoughts are normal at times, but people with OCD may attach extraordinary significance to such thoughts. For example, obsessive fears about sexual orientation can appear to

14790-727: The fifth-largest urban region in the U.S., had a 2023 estimated population of over 9 million. Prior to European settlement , the modern city proper was inhabited by the Yelamu , who spoke a language now referred to as Ramaytush Ohlone . On June 29, 1776, settlers from New Spain established the Presidio of San Francisco at the Golden Gate , and the Mission San Francisco de Asís a few miles away, both named for Francis of Assisi . The California gold rush of 1849 brought rapid growth, transforming an unimportant hamlet into

14935-407: The fifth-most visited city from abroad in the United States after New York City, Miami , Orlando , and Los Angeles – and approximately 20 million domestic visitors for a total of 21.9 million visitors. It is known for its steep rolling hills and eclectic mix of architecture across varied neighborhoods , its Chinatown and Mission districts, its cooling summers, fog , and landmarks including

15080-610: The first land grant in Yerba Buena: to William Richardson , a naturalized Mexican citizen of English birth. Richardson had arrived in San Francisco aboard a whaling ship in 1822. In 1825, he married Maria Antonia Martinez, eldest daughter of the Californio Ygnacio Martínez . Yerba Buena began to attract American and European settlers; an 1842 census listed 21 residents (11%) born in the United States or Europe, as well as one Filipino merchant. Following

15225-518: The gateway to the goldfields, experienced a surge in population and commercial activity. However, the influx of fortune seekers also brought challenges. Lawlessness was rampant, and the Barbary Coast district became synonymous with vice, attracting criminals, prostitutes, and illicit activities, including but not limited to prostitution, bootlegging , and gambling. The rapidly growing population, with its lawlessness, gambling and other vices, and

15370-399: The head, killing him. Heather is arrested for murdering Jimmy. Isaac hires Mike to represent her and enlists an expert witness on pathological intoxication to testify on her behalf. Heather is found not guilty by reason of insanity . She is sentenced to confinement at a psychiatric facility, where she will be evaluated. Isaac assures Heather she will be released soon. Isaac later hears of

15515-457: The hill on which they are situated, including Nob Hill , Potrero Hill , and Russian Hill . Near the geographic center of the city, southwest of the downtown area, are a series of less densely populated hills. Twin Peaks , a pair of hills forming one of the city's highest points, forms an overlook spot. San Francisco's tallest hill, Mount Davidson , is 928 feet (283 m) high and is capped with

15660-420: The hoarding subtype has consistently been least responsive to treatment. While OCD is considered a homogeneous disorder from a neuropsychological perspective, many of the symptoms may be the result of comorbid disorders. For example, adults with OCD have exhibited more symptoms of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) than adults without OCD. In regards to

15805-562: The homes built by wealthy San Franciscans in the wake of the 1906 earthquake. Directly north of Pacific Heights facing the waterfront is the Marina , a neighborhood popular with young professionals that was largely built on reclaimed land from the Bay. In the southeast quadrant of the city is the Mission District —populated in the 19th century by Californios and working-class immigrants from Germany, Ireland, Italy, and Scandinavia. In

15950-538: The larger Port of Oakland . The city began to lose industrial jobs and turned to tourism as the most important segment of its economy. The suburbs experienced rapid growth, and San Francisco underwent significant demographic change, as large segments of the white population left the city, supplanted by an increasing wave of immigration from Asia and Latin America. From 1950 to 1980, the city lost over 10 percent of its population. Over this period, San Francisco became

16095-419: The missions were made to divest themselves of their extensive landholdings and emancipate the indigenous people under their control. As part of the process of secularization, Governor José Figueroa opened up San Francisco to civilian settlement. Prior to secularization, the only settlements in San Francisco had been the military settlement at the Presidio and the religious settlement at Mission Dolores. In 1835,

16240-719: The obsession, such as someone obsessed with contamination compulsively washing their hands, but they can be unrelated as well. In addition to experiencing the anxiety and fear that typically accompanies OCD, affected individuals may spend hours performing compulsions every day. In such situations, it can become difficult for the person to fulfill their work, familial, or social roles. These behaviors can also cause adverse physical symptoms; for example, people who obsessively wash their hands with antibacterial soap and hot water can make their skin red and raw with dermatitis . Individuals with OCD often use rationalizations to explain their behavior; however, these rationalizations do not apply to

16385-467: The one who was raped by her father, not Diana, and started the fire that killed him. Huggins appears to arrest Heather, who tries to shoot him. Isaac pulls her over the edge of the balcony, sending her falling to her death. Diana is tried as Heather’s accomplice but is found not guilty. She then goes on a date with a wealthy man, posing as Heather. Harold Becker , Joel Schumacher , and John Boorman were variously attached as director. The original script

16530-484: The period of Mexican rule , although it was not until 1833 that the missions would be secularized. Agricultural land became largely privatized as ranchos , as was occurring in other parts of California. Coastal trade increased, including a half-dozen barques from various Atlantic ports which regularly sailed in California waters. With the enactment of the Mexican Secularization Act of 1833 ,

16675-533: The primary port of embarkation for service members shipping out to the Pacific Theater of Operations . The explosion of jobs drew many people, especially African Americans from the South , to the area. After the end of the war, many military personnel returning from service abroad and civilians who had originally come to work decided to stay. The United Nations Charter creating the United Nations

16820-605: The quality of housing after the earthquake. The earthquake hastened development of western neighborhoods that survived the fire, including Pacific Heights , where many of the city's wealthy rebuilt their homes. In turn, the destroyed mansions of Nob Hill became grand hotels. City Hall rose again in the Beaux Arts style, and the city celebrated its rebirth at the Panama–Pacific International Exposition in 1915. During this period, San Francisco built some of its most important infrastructure. Civil Engineer Michael O'Shaughnessy

16965-617: The reality of their delusions, which can make their cases difficult to differentiate from psychotic disorders . Some people with OCD exhibit what is known as overvalued ideas , ideas that are abnormal compared to affected individuals' respective cultures, and more treatment-resistant than most negative thoughts and obsessions. After some discussion, it is possible to convince the individual that their fears are unfounded. It may be more difficult to practice exposure and response prevention therapy (ERP) on such people, as they may be unwilling to cooperate, at least initially. Similar to how insight

17110-666: The recommended depression dosage; however, higher doses can increase side effect intensity. Commonly used SSRIs include sertraline , fluoxetine , fluvoxamine , paroxetine , citalopram , and escitalopram . Some patients fail to improve after taking the maximum tolerated dose of multiple SSRIs for at least two months; these cases qualify as treatment-resistant and can require second-line treatment such as clomipramine or atypical antipsychotic augmentation. While SSRIs continue to be first-line, recent data for treatment-resistant OCD supports adjunctive use of neuroleptic medications, deep brain stimulation, and neurosurgical ablation. There

17255-516: The repeated reward-seeking behavior of completing the ritual for relief. Many adults with OCD are aware that their compulsions do not make sense, but they still perform them to relieve the distress caused by obsessions. For this reason, thoughts and behaviors in OCD are usually considered egodystonic . In contrast, thoughts and behaviors in obsessive–compulsive personality disorder (OCPD) are usually considered egosyntonic , helping differentiate between

17400-551: The rise of the beatnik and hippie countercultures, the sexual revolution , the peace movement growing from opposition to United States involvement in the Vietnam War , and other factors led to the Summer of Love and the gay rights movement, cementing San Francisco as a center of liberal activism in the United States . San Francisco and the surrounding San Francisco Bay Area are a global center of economic activity and

17545-429: The risk of future suicide attempts. It has been found that between 18 and 34% of females currently experiencing OCD scored positively on an inventory measuring disordered eating. Another study found that 7% are likely to have an eating disorder, while another found that fewer than 5% of males have OCD and an eating disorder. Individuals with OCD have also been found to be affected by delayed sleep phase disorder at

17690-447: The same disorders than matched controls . In cases in which OCD develops during childhood, there is a much stronger familial link in the disorder than with cases in which OCD develops later in adulthood. In general, genetic factors account for 45–65% of the variability in OCD symptoms in children diagnosed with the disorder. A 2007 study found evidence supporting the possibility of a heritable risk for OCD. Research has found there to be

17835-483: The sentience or rights of living organisms, despite accepting that such behavior is irrational on an intellectual level. There is debate as to whether hoarding should be considered an independent syndrome from OCD. Some people with OCD perform compulsive rituals because they inexplicably feel that they must do so, while others act compulsively to mitigate the anxiety that stems from obsessive thoughts. The affected individual might feel that these actions will either prevent

17980-542: The several thousands. More than half of the city's population of 400,000 was left homeless. Refugees settled temporarily in makeshift tent villages in Golden Gate Park, the Presidio, on the beaches, and elsewhere. Many fled permanently to the East Bay . Jack London is remembered for having famously eulogized the earthquake: "Not in history has a modern imperial city been so completely destroyed. San Francisco

18125-543: The southern side of the Golden Gate , which later came to be known as Fort Point. In 1804, the province of Alta California was created, which included San Francisco. At its peak in 1810–1820, the average population at the Mission Dolores settlement was about 1,100 people. In 1821, the Californias were ceded to Mexico by Spain. The extensive California mission system gradually lost its influence during

18270-576: The strategic benefits of the area due to its large natural harbor, the Spanish dispatched Pedro Fages in 1770 to find a more direct route to the San Francisco Peninsula from Monterey , which would become part of the El Camino Real route. By 1774, Juan Bautista de Anza had arrived to the area to select the sites for a mission and presidio . The first European maritime presence in San Francisco Bay occurred on August 5, 1775, when

18415-675: The substance or medication which can produce such symptoms. 2) The onset of symptoms cannot be explained by an obsessive–compulsive and related disorder that is not substance/medication-induced and should last for a substantial period of time (about 1 month) 3) This disturbance does not only occur during delirium . 4) Clinically induces distress or impairment in social, occupational, or other important areas of functioning. There appear to be some genetic components of OCD causation, with identical twins more often affected than fraternal twins. Furthermore, individuals with OCD are more likely to have first-degree family members exhibiting

18560-493: The territory of San Francisco dates to 3000 BCE. The Yelamu group of the Ramaytush people resided in a few small villages when an overland Spanish exploration party arrived on November 2, 1769, the first documented European visit to San Francisco Bay . The Ohlone name for San Francisco was Ahwaste , meaning, "place at the bay." The arrival of Spanish colonists, and the implementation of their Mission system, marked

18705-468: The treatment of compulsive behaviors. OCD sometimes manifests without overt compulsions, which may be termed "primarily obsessional OCD." OCD without overt compulsions could, by one estimate, characterize as many as 50–60% of OCD cases. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), identifies a continuum for the level of insight in OCD, ranging from good insight (the least severe) to no insight (the most severe). Good or fair insight

18850-399: The two. Although the exact cause of OCD is unknown, several regions of the brain have been implicated in its neuroanatomical model including the anterior cingulate cortex , orbitofrontal cortex , amygdala , and BNST . The presence of a genetic component is evidenced by the increased likelihood for both identical twins to be affected than both fraternal twins . Risk factors include

18995-402: The underwater lot. By 1851, the harbor was extended out into the bay by wharves while buildings were erected on piles among the ships. By 1870, Yerba Buena Cove had been filled to create new land. Buried ships are occasionally exposed when foundations are dug for new buildings. California was quickly granted statehood in 1850, and the U.S. military built Fort Point at the Golden Gate and

19140-421: The wider region. San Francisco, which is Spanish for "Saint Francis," takes its name from Mission San Francisco de Asís , which in turn was named after Saint Francis of Assisi . The mission received its name in 1776, when it was founded by the Spanish under the leadership of Padre Francisco Palóu . The city has officially been known as San Francisco since 1847, when Washington Allon Bartlett , then serving as

19285-477: Was a major city known for its flamboyant style, stately hotels, ostentatious mansions on Nob Hill , and a thriving arts scene. The first North American plague epidemic was the San Francisco plague of 1900–1904 . At 5:12 am on April 18, 1906, a major earthquake struck San Francisco and northern California. As buildings collapsed from the shaking, ruptured gas lines ignited fires that spread across

19430-613: Was a major port of embarkation for naval service members shipping out to the Pacific Theater . In 1945, the United Nations Charter was signed in San Francisco, establishing the United Nations and in 1951, the Treaty of San Francisco re-established peaceful relations between Japan and the Allied Powers . After the war, the confluence of returning servicemen, significant immigration , liberalizing attitudes,

19575-500: Was also concern that a new town being planned by General Vallejo on the Carquinez Strait was to be called "Francisca", after the first name of his wife. After the name change to "San Francisco", the name of Vallejo's town was changed to Benicia , after his wife's middle name. Following the Treaty of Guadalupe Hidalgo in 1848, Alta California was ceded from Mexico to the United States . Despite its attractive location as

19720-662: Was at the height of the Great Depression that San Francisco undertook two great civil engineering projects, simultaneously constructing the San Francisco–Oakland Bay Bridge and the Golden Gate Bridge , completing them in 1936 and 1937, respectively. It was in this period that the island of Alcatraz , a former military stockade, began its service as a federal maximum security prison, housing notorious inmates such as Al Capone , and Robert Franklin Stroud ,

19865-464: Was centered on a plaza that is now Portsmouth Square . A land survey of Yerba Buena was made by the Swiss immigrant Jean Jacques Vioget as prelude to the city plan. Francisco de Haro , a non- Californio Mexican native, became the first alcalde of Yerba Buena. The second alcalde José Joaquín Estudillo was a Californio from a prominent Monterey family. In 1835, while in office, he approved

20010-536: Was drafted and signed in San Francisco in 1945 and, in 1951, the Treaty of San Francisco re-established peaceful relations between Japan and the Allied Powers . Urban planning projects in the 1950s and 1960s involved widespread destruction and redevelopment of west-side neighborhoods and the construction of new freeways , of which only a series of short segments were built before being halted by citizen-led opposition . The onset of containerization made San Francisco's small piers obsolete, and cargo activity moved to

20155-437: Was granted a small rancho at El Polín Spring , near the Presidio, founding the first non-indigenous civilian household in San Francisco. In 1834, the pueblo of Yerba Buena was founded. Yerba Buena Cove (named after a native herb ) was already a favored anchorage spot and the new settlement and trading post was founded by its shores. Yerba Buena was located in what is now the city's Chinatown and Financial District and

20300-837: Was hired by San Francisco Mayor James Rolph as chief engineer for the city in September 1912 to supervise the construction of the Twin Peaks Reservoir, the Stockton Street Tunnel , the Twin Peaks Tunnel , the San Francisco Municipal Railway , the Auxiliary Water Supply System , and new sewers. San Francisco's streetcar system, of which the J , K , L , M , and N lines survive today, was pushed to completion by O'Shaughnessy between 1915 and 1927. It

20445-575: Was identified as being distinct from other symptom groupings. When looking into the onset of OCD, one study suggests that there are differences in the age of onset between males and females, with the average age of onset of OCD being 9.6 for male children and 11.0 for female children. Children with OCD often have other mental disorders, such as ADHD, depression, anxiety, and disruptive behavior disorder. Continually, children are more likely to struggle in school and experience difficulties in social situations (Lack 2012). When looking at both adults and children

20590-653: Was not significantly affected. People with OCD show impairment in formulating an organizational strategy for coding information, set-shifting , and motor and cognitive inhibition . Specific subtypes of symptom dimensions in OCD have been associated with specific cognitive deficits. For example, the results of one meta-analysis comparing washing and checking symptoms reported that washers outperformed checkers on eight out of ten cognitive tests. The symptom dimension of contamination and cleaning may be associated with higher scores on tests of inhibition and verbal memory. Approximately 1–2% of children are affected by OCD. There

20735-403: Was once believed to be associated with above-average intelligence, this does not appear to necessarily be the case. A 2013 review reported that people with OCD may sometimes have mild but wide-ranging cognitive deficits , most significantly those affecting spatial memory and to a lesser extent with verbal memory , fluency , executive function , and processing speed , while auditory attention

20880-518: Was set in New York City , but was changed due to an ongoing union strike. San Francisco was chosen due to its "character" and iconic locations. The climax originally took place on the Golden Gate Bridge , but the sequence was re-written due to budget constraints. The climax instead took place at a lighthouse, filmed at Pigeon Point Lighthouse in Pescadero . Other filming locations included

21025-410: Was the O'Shaughnessy Dam , Hetch Hetchy Reservoir , and Hetch Hetchy Aqueduct that would have the largest effect on San Francisco. An abundant water supply enabled San Francisco to develop into the city it has become today. In ensuing years, the city solidified its standing as a financial capital; in the wake of the 1929 stock market crash , not a single San Francisco-based bank failed. Indeed, it

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