Obsessive compulsive and related disorders

Question 1

Characteristics

Answer 1

I

Question 2

Types of and common obsessions and compulsions

Answer 2

-obsessive thinking, intrusive recurrent thoughts and urges
-compulsive behaviours, repetitive rituals impairing normal functioning
-will attempt to surpress unwanted obsessive thoughts by performing behaviours; such behaviours are intended to reduce anxiety and produce relief
-however, these are excessive and don’t produce relief

Question 3

Hoarding

Answer 3

-great difficulty getting rid of possessions
-feel distress regarding discarding possessions

Question 4

Body Dysmorphic Disorder (BDD)

Answer 4

-obsessive thoughts regarding perceived thoughts about one’s physical appearance
-these are likely to be slight or not at all obvious to others
-the anxiety regarding this causes repetitive behaviours

Question 5

Case study ‘Charles’

Answer 5

-Rapoport
-14 yr old with ocd
-fear of contamination
-spent hours washing hands and 3 hours in the shower
-dropped out of school
-took drugs but then relapsed in a year

Question 6

Measures: Maudsley Obsessive-Compulsive Inventory MOCI

Answer 6

-30 items either true or false
-scores between 0-30
-quick assessment tool for clinician rather than diagnostic tool

Question 7

Yale-Brown Obsessive Compulsive Scale Y-BOCS

Answer 7

-Goodman et al
-measures the nature and severity of symptom
-semi-structured interview that takes 30 minutes
-checklist for obsessions and compulsions with 10 item severity scale
-scores 0-40
-above 16

Question 8

Evaluation: measures

Answer 8

+concurrent validity
+test-retest reliability
-self-rated, subjective

Question 9

Explanations

Answer 9

II

Question 10

Biomedical: Genetic

Answer 10

-may have genetic bias
-Mattheisen et al large scale study: -1406 patients with OCD and other members of the general population
-PTPRD and SLITRK3 both of which interact to regulate particular synapses in the brain

Question 11

Biomedical: Biochemical

Answer 11

-oxytocin: trust and attachment
-but also shown to improve distrust and fear of certain stimuli which pose a threat to survival
-by analysing cerebral spinal fluid, Leckman et al found that some forms of OCD were related to oxytocin dysfunction

Question 12

Biomedical: Neurological

Answer 12

-abnormalities of brain structure and function
-damaged basal ganglia has been linked with OCD
-its function is to send and check warning messages about threats
-if it doesn’t work well it will continually get messages about ‘threats’ that are not there

Question 13

Cognitive and Behavioural

Answer 13

• OCD is composed of: Cognitive obsessions and Behavioural compulsions
  -the cognitive explanation considers that faulty reasoning is at play for obsessions
  -compulsive behaviours are an outcome of such erroneous thinking and attempts to alleviate unwanted thoughts and anxiety
  -compulsive behaviours can be explained through operant conditioning
  -negative and positive reinforcement

Question 14

Psychodynamic

Answer 14

-unconscious beliefs and desires
-symptoms appear because of internal conflicts between id and ego
-such conflict arises in the anal stage during psychosexual development

Question 15

Evaluation: Genetic

Answer 15

+objective and well controlled under lab condition
+highly replicable, reliability
-doesn’t explain why some carry the genes related to OCD

Question 16

Evaluation: biochemical

Answer 16

-difficult to establish cause and effect between hormones and OCD

Question 17

Evaluation: neurological

Answer 17

-evidence relating damaged basal ganglia and OCD is based on a case study, therefore there is a lack of generalisability

Question 18

Evaluation: cognitive and behavioural

Answer 18

-much research relies on self-report, including the measures ->bias

Question 19

Evaluation: Psychodynamic

Answer 19

-lack of empirical research because you cannot control the variables involved -> difficult to demonstrate cause and effect

Question 20

Treatment and management

Answer 20

III

Question 21

Biomedical (SSRIs)

Answer 21

-work on neurotransmitter serotonin alone

Question 22

Soomro et al

Answer 22

-meta analysis
-reviewed 17 studies comparing the effectiveness of SSRIs with placebo
-totaling 3097 patients
-SSRIs as a group were more efficient at reducing symptoms 6-13 weeks after treatment using Y-BOCS
-they reduce the severity of symptoms as they reduce anxiety around them

Question 23

Psychological: Cognitive

Answer 23

-Lovell et al
-randomised control trial
-compare the effectiveness of CBT by phone or face-to-face
-72 participants
-10 weekly sessions
-changes in well-being measured by Y-BOCS, BDI, client satisfaction questionnaire
-6 months follow up, Y-BOCS measures showed significant improvement in symptoms
-highly satisfied with both phone or face-to-face

Question 24

Exposure and response prevention

Answer 24

-ERP is a form of CBT
-ERP consists of:
1) gathering information about existing symptoms
2) therapist initiated ERP
3) generalisation and relapse training

Question 25

Lehmkuhl et al

Answer 25

-ERP on case study -Jason, 12yr both OCD and autism(ASD) -several hours each day engaging in compulsive behaviour -10 50 minute sessions over 16 weeks -modified techniques -next step involved exposing him to stimuli -told to touch 'contaminated' objects until he became 'habituated' and his anxiety dropped -exposures became increasingly difficult -practiced in-between sessions -after: Y-BOCS dropped from 18 to 3

Question 26

Evaluation: Lovell et al

Answer 26

+independent measures design -> removing researcher bias +face-to-face as control group enables comparison ->cause and effect +standardised +measures ->high validity and reliability

Question 27

Evaluation: Lehmkuhl et al

Answer 27

-limited generalisability bcs case study -limited generalisability bcs autism -child -> ethics +in depth qualitative data regarding ERP experience +quantitative data through measures