4.1.4 - OCD Flashcards

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1
Q

What are the 3 types of characteristics of OCD

A
  • cognitive
  • behavioural
  • emotional
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2
Q

What are the cognitive characteristics

A
  • obsessive thoughts (irrational)
  • cognitive coping strategies( performed to temporarily remove anxiety)
  • selective attention
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3
Q

What are the emotional characteristics

A
  • accompanying depression
  • guilt and disgust
  • anxiety and distress
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4
Q

What are the behavioural characteristics

A
  • avoidance
  • compulsive behaviour
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5
Q

Describe obsessive thoughts

A
  • 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

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6
Q

Describe cognitive strategies to deal with obsessions

A
  • 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
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7
Q

Describe insight into excessive anxiety

A
  • 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
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8
Q

Describe accompanying depression

A
  • 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
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9
Q

Describe anxiety and distress

A
  • 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
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10
Q

Describe guilt and disgust

A
  • 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.
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11
Q

Describe compulsive behaviour

A
  • 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.
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12
Q

Describe avoidance

A
  • 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.
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13
Q

What are the 3 biological explanations of OCD

A
  • genetic (inheritance)
  • chemical ( neurotransmitters)
  • structural (brain)
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14
Q

What is the genetic basis of ocd

A
  • 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
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15
Q

What type of research is used to support genetic arguments

A

Concordance rate: the % similarity between 2 people for a trait
-the higher the % Concordance rate, the more likely an inherited trait is

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16
Q

How do family studies explain ocd

A
  • Lewis(1936) found that the concordance rate of ocd in:
    -> parents and children is 37%
    -> between siblings is 21%
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17
Q

Limitation of family studies

A

Families grow up in the same environment have similar experiences so it is difficult to differentiate between genetic and learnt behaviour

18
Q

How are twin studies used to explain ocd

A
  • you compare MZ and DZ twins for a particular trait
  • if ocd is inherited, ten the concordance rate will be higher for MZ twins
19
Q

Why do only some siblings display ocd

A

The diathesis stress model is used to explain this

20
Q

What is the diathesis stress model

A
  • 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..)
21
Q

How are gene mapping studies used to explain ocd

A
  • 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
22
Q

What type of genes cause ocd

A
  • 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

23
Q

What’s are the candidate genes that are known to be linked to ocd

A
  • SERT (serotonin transmission)
  • 5HT1-Dbeta
  • COMT (dopamine transmission)
24
Q

What do neurotransmitters do

A
  • neurotransmitters carry, boost and regulate signals between euros and other cells in the body. They are linked to mood
25
Q

What is serotonin and how does it link to ocd

A
  • 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
26
Q

How are serotonin levels increased

A
  • 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
27
Q

How does brain structure explain ocd

A

People with ocd have a different brain structures

28
Q

What are the 3 areas of the brain involved with ocd

A
  • orbital frontal cortex
  • thalamus
  • caudate nucleus
29
Q

How do non-ocd brain respond to a problem

A
  • 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.
30
Q

How does an ocd brain respond to a problem

A
  • 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
31
Q

What are the 3 drug therapies used to treat ocd

A
  • ssris
  • tricyclics
  • benzodiazepines
32
Q

Are drug therapies effective

A
  • they are the most common treatments for ocd in the uk
  • 70% of sufferers symptoms are effectively reduced by drug therapies
33
Q

What are the side effects of SSRIs

A
  • nausea
  • headaches
  • insomnia

Although these side effects aren’t severe, they could lead to disruptions in how people ca live their everyday lives

34
Q

How are tryclilics used to reduce ocd symptoms

A
  • 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
35
Q

What are the side effects on tricyclics

A
  • blurring of vision
  • constipation
  • dizziness
  • weight gain
  • excessive sweating
36
Q

Why are tricyclics not as commonly used than SSRIs

A

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

37
Q

How do benzodiazepines treat ocd

A
  • 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
38
Q

Wat are the side effects of benzodiazepines

A
  • 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

39
Q

Why should drug therapies to be used

A
  • 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)
40
Q

What are some alternative treatment options

A

Talking therapies are very effective, but are time consuming and expensive:
- CBT is often used alongside exposure and response prevention (ERP)

41
Q

How is CBT used to reduce symptoms on ocd

A
  • 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