Obsessive compulsive and related disorders Flashcards
Characteristics
I
Types of and common obsessions and compulsions
-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
Hoarding
-great difficulty getting rid of possessions
-feel distress regarding discarding possessions
Body Dysmorphic Disorder (BDD)
-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
Case study ‘Charles’
-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
Measures: Maudsley Obsessive-Compulsive Inventory MOCI
-30 items either true or false
-scores between 0-30
-quick assessment tool for clinician rather than diagnostic tool
Yale-Brown Obsessive Compulsive Scale Y-BOCS
-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
Evaluation: measures
+concurrent validity
+test-retest reliability
-self-rated, subjective
Explanations
II
Biomedical: Genetic
-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
Biomedical: Biochemical
-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
Biomedical: Neurological
-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
Cognitive and Behavioural
- 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
Psychodynamic
-unconscious beliefs and desires
-symptoms appear because of internal conflicts between id and ego
-such conflict arises in the anal stage during psychosexual development
Evaluation: Genetic
+objective and well controlled under lab condition
+highly replicable, reliability
-doesn’t explain why some carry the genes related to OCD
Evaluation: biochemical
-difficult to establish cause and effect between hormones and OCD
Evaluation: neurological
-evidence relating damaged basal ganglia and OCD is based on a case study, therefore there is a lack of generalisability
Evaluation: cognitive and behavioural
-much research relies on self-report, including the measures ->bias
Evaluation: Psychodynamic
-lack of empirical research because you cannot control the variables involved -> difficult to demonstrate cause and effect
Treatment and management
III
Biomedical (SSRIs)
-work on neurotransmitter serotonin alone
Soomro et al
-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
Psychological: Cognitive
-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
Exposure and response prevention
-ERP is a form of CBT
-ERP consists of:
1) gathering information about existing symptoms
2) therapist initiated ERP
3) generalisation and relapse training
Lehmkuhl et al
-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
Evaluation: Lovell et al
+independent measures design -> removing researcher bias
+face-to-face as control group enables comparison ->cause and effect
+standardised +measures ->high validity and reliability
Evaluation: Lehmkuhl et al
-limited generalisability bcs case study
-limited generalisability bcs autism
-child -> ethics
+in depth qualitative data regarding ERP experience
+quantitative data through measures
