CLINICAL- Obsessive Compulsive Disorder Flashcards
What is the diagnosis for OCD
- This is characterized by the presence of persistent obsessions or compulsions or most commonly both.
- Obsessions: unwanted repetitive thoughts
- Compulsions: Repetitive behaviors as a response to obsessions
- The obsessions and compulsions must take up more than an hour per day and must result in significant distress and impairment of functioning
Describe the boy in Rapoports case study
- 14 year old boy
- Would spend 3 hours or more showering
- and at least 2 hours getting ready
- He had a repetitive routine of holding soap in one hand
- He dropped out of school due to the washing rituals he had
What are the 2 measures used to assess OCD
- Maudsley Obsessive -Compulsive Inventory (MOCI)
- Yale- Brown Obsessive Compulsive Scale (Y-BOCS)
Describe the MOCI
- 30 items
- responses are either “TRUE” or “FALSE”
- It assess symptoms relating to; checking, washing, slowness and doubting
- produces a score range of 0-30 and takes 5 mins to complete
EXAMPLE:
“I frequently have to check things(gas, doors, e.t.c”
Describe the Y-BOCS
- A semi - structured interview developed by Goodman et al.
- measures the nature and severity of symptoms
- takes 30 mins to conduct
- Involves a checklist of several obsessions and compulsions with a 10-item scale
EXAMPLE:
Obsessions> Aggressive
Compulsions>Washing - scores range from 0-40 and scores above 16 are the clinical range
Evaluate the 2 measures
- They have good concurrent validity
- have good test-retest validity
- Socially desirable responses reduces validity
Describe the biochemical explanation
- Research has shown ( Szechtman et al.) that those with OCD tend to have abnormally high levels of dopamine . Increased level of dopamine in rats resulted to repetitive behaviours.
- Research also shows that those with OCD tend to have abnormally low levels of serotonin due to evidence from anti-depressants that increase its levels
- The biochemical, oxytocin also plays a role as it involves trust and attachment.
- there is mixed evidence surrounding it from Leckman et al proving that forms of OCD is related oxytocin dysfunction but is countered by Den Boer et al. showing theres no link
Describe the genetic explanation
- Monzani et al. found a strong concordance between MZ twins (52%) compared to DZ twins (21%)
- The SERT gene which is responsible for serotonin levels had a mutation which leads to its low levels in OCD - Ozaki et al.
- Another study found the PTPRD gene and SLITRK 3 gene which both regulate particular synapses in the brain
Evaluate the biological explanation
- Reductionist
- Deterministic
- Individualistic as it focuses primarily on their hormonal abnormalities
- Supports the nature side
- supported by scientific research which is objective through gene testing
Describe the cognitive (thinking error) explanation
- They base their reasoning on faulty thinking as a result of obsessive thoughts
- these mistakes in cognition worsen under stressful conditions
- the compulsive behaviour will remove the unwanted thoughts and anxiety created
e.g washing hands because they believe they have harmful germs that could kill them
Describe the behavioral (operational condition) explantion
-The compulsive behaviour will act as a negative reinforcer as it has relieved something unpleasant
- They can also be a positive reinforcer because the person is ‘rewarded’ by knowing they have clean hands
Evaluate the cognitive and behavioural explanation
- Application to everyday life has led to treatments including CBT
- Individual side due to faulty though processes
- Holistic as it considers distorted thoughts and reinforcements in explaining OCD
- Nurture side of debate
- Deterministic as we have no control to influence the automatic thinking processes HOWEVER free will as they can unlearn the behaviour through therapy
Describe the psychodynamic explanation
- it claims that symptoms of OCD are a result of conflict between the id and ego and such conflict will arise in the anal stage of psychosexual development
- This is due to tension between parents and children when potty training them. In an attempt to regain control, the child will be anally expulsive; messy and careless.
- OR they may fear their harsh responses and retain urine to regain control
- This will lead to to anally retentive behaviour which is the compulsive need for everything to be neat
- obsessive thoughts from the id will disturb the rational part of self leading to obsessive rituals later on in life due to childhood trauma
Evaluate the psychodynamic explanation
- Holistic as it focuses on the psychosexual stages
- Application to everyday life for treating OCD from knowing its origin
- Situational factors due to early relationship conflicts can affect their life later
- has no empirical evidence
describe the biological treatment in OCD
- Selective serotonin reuptake Inhibitors (SSRIs) are used to treat OCD but at a higher dosage
- They work by blocking the serotonin from being reabsorbed once a message has been passed from one neuron to another so serotonin levels remain high
- Soomro et al. provides evidence from 17 studies. It showed SSRIs were most effective in reducing symptoms than placebos