4.1.4 - OCD Flashcards
What are the 3 types of characteristics of OCD
- cognitive
- behavioural
- emotional
What are the cognitive characteristics
- obsessive thoughts (irrational)
- cognitive coping strategies( performed to temporarily remove anxiety)
- selective attention
What are the emotional characteristics
- accompanying depression
- guilt and disgust
- anxiety and distress
What are the behavioural characteristics
- avoidance
- compulsive behaviour
Describe obsessive thoughts
- for 90% of OCD sufferers, the major feature is obsessive thoughts
- the thoughts are always unpleasant although they differ in nature
- obsessive thoughts recur over and over again
Eg: fear of cross contamination
Describe cognitive strategies to deal with obsessions
- cognitive coping strategies are used to reduce the obsessive thoughts. They help to reduce anxiety but makes them appear abnormal and distracts everyday tasks
- eg: religious people tormented by guilt may pray or meditate
Describe insight into excessive anxiety
- ocd sufferers are aware that their compulsions and thoughts are irrational (irrationality is part of diagnosis’)
- sufferers have catastrophic thoughts about worse case scenarios that could occur is their anxieties were justified
- sufferers are hyper vigilant, have constant anxiety and focus on potential hazards
Describe accompanying depression
- ocd is comorbid with depression so anxiety can be accompanied by low mood and a lack of enjoyment when participating in activities
- compulsive behaviours only provide a temporary relief from the anxiety
Describe anxiety and distress
- ocd is regarded as a particularly unpleasant emotional experience because of the powerful anxiety that accompanies both the compulsions and obsessions
- obsessive thoughts are unpleasant and frightening, and the anxiety that goes with these can be overwhelming
- the urge to repeat a behaviour ( a compulsion) is what creates the anxiety
Describe guilt and disgust
- ocd can also involve other negative emotions such as irrational guilt over minor moral issues for example
- discuss can also be present which is directed against something external or themselves.
Describe compulsive behaviour
- ritualistic behaviours
- compulsions are repetitive: typically sufferers with ocd feel compelled to repeat a behaviour.
- compulsions also reduce anxiety: around 10% of ocd sufferers show compulsive behaviour alone, they would have no obsessions just a general ensue of irrational anxiety
- however the vast majority of compulsive behaviours are performed in an attempt to manage anxiety that is produces by obsessions.
Describe avoidance
- behaviour of ocd sufferers may also be characterised by their avoidance as they attempt to reduce anxiety by keeping away from situations that trigger it. (Negative reinforcement)
- this avoidance can lead to ocd sufferers avoiding very ordinary situations, making it more difficult to live a ‘normal’ life.
What are the 3 biological explanations of OCD
- genetic (inheritance)
- chemical ( neurotransmitters)
- structural (brain)
What is the genetic basis of ocd
- ocd tends to run in families which suggests there may be a genetic link
- ocd may be a disorder that is inherited via the genes across generations in families
- research to support this argument has come from family and twin studies
What type of research is used to support genetic arguments
Concordance rate: the % similarity between 2 people for a trait
-the higher the % Concordance rate, the more likely an inherited trait is
How do family studies explain ocd
- Lewis(1936) found that the concordance rate of ocd in:
-> parents and children is 37%
-> between siblings is 21%
Limitation of family studies
Families grow up in the same environment have similar experiences so it is difficult to differentiate between genetic and learnt behaviour
How are twin studies used to explain ocd
- you compare MZ and DZ twins for a particular trait
- if ocd is inherited, ten the concordance rate will be higher for MZ twins
Why do only some siblings display ocd
The diathesis stress model is used to explain this
What is the diathesis stress model
- both siblings share a genetic vulnerability to the ocd gene, however one sibling experiences an environmental trigger that could activate the ocd gene (eg: exams, trauma etc..)
How are gene mapping studies used to explain ocd
- Genetic material from ocd sufferers is compared to genetic material from non-ocd sufferers
- gene mapping studies indicates a genetic link between particular genes that make some people more vulnerable to developing ocd
What type of genes cause ocd
- ocd is polygenic, so has multiple genes that are linked to ocd
- it is likely to be a combination of several genes rather than just a single gene alone
Taylor (2013)
- found that there are up to 230 genes that are linked to ocd
- However this is a simple explanation for a complex biological and potentially psychological concept - REDUCTIONIST
What’s are the candidate genes that are known to be linked to ocd
- SERT (serotonin transmission)
- 5HT1-Dbeta
- COMT (dopamine transmission)
What do neurotransmitters do
- neurotransmitters carry, boost and regulate signals between euros and other cells in the body. They are linked to mood
What is serotonin and how does it link to ocd
- a neurotransmitter linked to ocd that regulates mood
- if a person has low levels of serotonin then normal transmission of mood-relevant information cannot take place
- meaning that mood and mental processes can be affected.
- low serotonin levels are linked to ocd
How are serotonin levels increased
- take SSRI’s which stop the re absorption of serotonin
they block the serotonin from returning back into the pre -synaptic neuron - the serotonin diffuses though the synapse and is forced to enter the receptor sites in the post synaptic neuron
- a higher volume of serotonin is in the body because more is absorbed into the post synaptic neuron
- this will improved the mood and reduce the anxiety experienced by ocd sufferers
How does brain structure explain ocd
People with ocd have a different brain structures
What are the 3 areas of the brain involved with ocd
- orbital frontal cortex
- thalamus
- caudate nucleus
How do non-ocd brain respond to a problem
- the orbital frontal cortex notices that there is a problem
- it sends a signal to the thalamus to take action
- once the resolution has been carried out, the caudate nucleus will cut this communication.
How does an ocd brain respond to a problem
- the orbital frontal cortex notices the problem
- it sends a signal to the thalamus to action a resolution
- once the solution has occurred the thalamus sends a dog Lam back to the ofc
- this communication isn’t interrupted by the caudate nucleus
- meaning the ofc continues to tell the thalamus to action a resolution ( signals rebound) which causes repetitive obsessions
What are the 3 drug therapies used to treat ocd
- ssris
- tricyclics
- benzodiazepines
Are drug therapies effective
- they are the most common treatments for ocd in the uk
- 70% of sufferers symptoms are effectively reduced by drug therapies
What are the side effects of SSRIs
- nausea
- headaches
- insomnia
Although these side effects aren’t severe, they could lead to disruptions in how people ca live their everyday lives
How are tryclilics used to reduce ocd symptoms
- they were the first antidepressants to be used to treat ocd. They are now more commonly used to treat ocd compared to depression.
- they work by blocking the transporter mechanism that reabsorbs both serotonin and noradrenaline into the pre synaptic cells
- therefore neurotransmitters are eft in the synapse that prolonged their activity
What are the side effects on tricyclics
- blurring of vision
- constipation
- dizziness
- weight gain
- excessive sweating
Why are tricyclics not as commonly used than SSRIs
Due to the side effects of tricyclics being more severe than the side effects of SSRIs, it is usually the second-line treatment for ocd sufferers
- this is done to avoid the patients from experiencing serene side effects that have potential possibilities to severely effect their everyday lives
- therefore they are only used to treat patients when SSRIs are not effective
How do benzodiazepines treat ocd
- BZs work by enhancing the action of the neurotransmitter GABA
- GABA tells the neurons in the brain to “slow down” and “stop firing”. This reduces the the number of thoughts and heightened emotions that are experienced at one time
- 40% of the neurons in the brain are responsive to this drug, so there is an overall questioning influence on the brain which reduces overall anxiety caused by the obsessive thoughts
Wat are the side effects of benzodiazepines
- highly addictive
- increased aggression
- long-term memory impairments
Due to these side effects, BZ is the only prescribed for the short term, so cannot be used as a permanent treatment option
Why should drug therapies to be used
- drug therapies use little input from the patient and therefore require minimal effort and are also very time effective
- drug therapies are cheaper than other methods of treatment, so are more economical for he health service
- patients don’t have to be motivated Mike in CBT, so is an easy option if patients lack motivation or suffer from severe anxiety or depression ( more manageable)
What are some alternative treatment options
Talking therapies are very effective, but are time consuming and expensive:
- CBT is often used alongside exposure and response prevention (ERP)
How is CBT used to reduce symptoms on ocd
- treatment involves working with therapists to discuss the problems that are due to the patients ocd in separate parts: these parts include thoughts, feelings, actions etc..
- in order for this method to be effective patients must be motivated and willing to be fully truthful
- people with mild ocd usually require yurt o 10 hours of therapist treatments to notice significant improvements of their symptoms
