obsessive-compulsive disorder

Question 1

What is ocd defined as?

Answer 1

ocd is a condition characterised bey either obessions (recurring thoughts, images etc.) and/or complusions (reptitive behaviours).

Question 2

DSM-V catergories of ocd:

Answer 2

ocd and related disorders:
* Trichhotillomania: complusive hair pulling
* Excoriation disorder: complusive skin picking
* Hoarding: complusive gathering of possessions and abllity to part eith anything, regardless of its vaule.

Question 3

What is the common factors between the catergories of ocd?

Answer 3

• All have repetivie behaviours accompained by obsessive thinking
• All involves anxiety (similar to phobias) and irrational thinking.

Question 4

Behavioural characterstics of ocd

Answer 4

• Reptitive complusions: compelled to repeat a behaviour
• Complusions reduce anxiety:majority of sufferers perform complusions to reduce the anxiety produced by the obbessions
• Avoidance: avoiding situations that trigger the anxiety

Question 5

Emotional Characterstics of ocd

Answer 5

• Anxiety and distress- unpleasant and frightening thoughts creates a popwerful anxiety and the urge to do the complusion making them feel overwhelmed.
• Accompanying depression- the anxiety can be accompained by low mood and lack of enjoyment of activites. complusive behaviour relief os only temporary.
• Gluit and disgust- irrational gluit or disgust may be directed at something external or the self.

Question 6

Cognitive characteristics of ocd:

Answer 6

• Obsessive thoughts: obessions are cognitions and recur over and over again. Unpleasant.
• Cognitive coping strategies: Obsessions are the major cognitive aspect of ocd but people response by adopting coping strategies to help manage anxiety, this can appear abnormal and distract from everyday activites.
• They are aware that their obessions and complusions are not rational. Catastrophic thoughts result in justifying anxieties so they tend to be hypervigilant.

Question 7

what is the ocd cycle?

Answer 7

Obessions (unwanted distressing thoughts, urges and mental images) -> anxiety (distress, fear, worry or digust) -> compulsions (behaviour performed to help make the anxiety go away)-> Relief (only temporary and obessions return pertpertuating a cycle).

Question 8

What is the genetic explanation for ocd?

Answer 8

Some people may be predisposed to develop ocd due to their genetic make-up- this is called genetic vulnerability.

Question 9

What did Lewis (1936) find out about ocd

Answer 9

He found evidence that suggests genetic vulnerabillity for ocd runs in families.
* 37% ocd patients had parents with ocd.
* 21% had siblings with ocd.

Question 10

What did Nestadt et al. (2010) find out ocd?

Answer 10

Twin study showed that 68% of identical twins shared ocd and 31% non-identical twins. This strongly suggests there is a genetic influence for ocd.

Question 11

What does the diathesis-stress model say about ocd?

Answer 11

The diathesis-stress model states that the genetic vunerability only triggers ocd if an environmental stressor is experinced (e.g. stressful or tramuatic life event).

Question 12

What are candidate genes?

Answer 12

Candidate genes are specific genes thought to make an individual vunerable to a particular disorder or disease.

Question 13

What is thought to be the candidate gene for OCD?

Answer 13

gene 5HT1-D beta

Question 14

What is gene 5HT1-D beta involved in?

Answer 14

Transporting the neurotransmitter serotonin across synapses. Therefore the serotonin system is believed to be involved in ocd.

Question 15

What studies are there that support a genetic link to ocd?

Answer 15

• Lewis (1936)
• Nestadt et al.

Question 16

What does polygenic mean?

Answer 16

A trait is not caused by one gene, but by many genes.

Question 17

What studies provide supporting evidence that ocd is polygenic?

Answer 17

Taylor (2013) found evidence from previous studies that up to 230 different genes may be involved in ocd.

Question 18

What do the other genes linked to ocd do?

Answer 18

Those associated with the action of serotonin and dopamine- neurotransmitters believed to play a role in regulating mood.

Question 19

What does aetiologically heterogenous mean?

Answer 19

The trait is caused by different genes in different people.

Question 20

What evidence is there to support the belief that OCD is aetiologically heterogenous?

Answer 20

Different types of OCD, e.g. hoarding disorder and religious obession, may be the result of particular genetic variations, or particular sets of genes.

Question 21

Strengths of the genetic explanations for ocd

Answer 21

There is strong supporting evidence that there is genetic vunerability can increase the likelihood of developing ocd. e.g. Nestadt et al.

Question 22

Weaknesses of the genetic explanations for ocd

Answer 22

• Genetic explanations do not consider that environmental facors can also increase the risk of developing ocd, as stated by the diathesis-stress model.
• Cromer et al. (2007) found over 50% of ocd patients in their sample had a tramuatic event in their past. Those with more than one tramua had more severe ocd. This suggests that genetic vulneralbity only provides a partial explanation for ocd.

Question 23

What are neural explanations?

Answer 23

The view that physcial and psychological characteristics are determined by the behaviour of the nervous system (brain and neurons).

Question 24

What do genes associated with ocd affect abnormally?

Answer 24

• Levels of neurotransmitters
• Certain brain structures

Question 25

What is serotonin involved in?

Answer 25

Serotonin is a neurotransmitter involved in mood regulation.

If there are low levels, normal transmission of mood relevant information does not take place and mood (and other mental processes) are affected. Perhaps even reduced function of the serotonin system in the brain.

Question 26

How might OCD affect decision-making systems?

Answer 26

• Some ocd cases (hoarding disorders) may be associated with impaired decision making.
• Abnormal functioning of the lateral frontal lobes (responsible for logical thinking and decision making).
• Some evidence suggests that the left parahippocampal gyrus associated with processing unpleasant emotions, does not function normally.

Question 27

Strengths of neural explanations for ocd

Answer 27

• There is some supporting evidence.
• Antidepressants that work purely on the serotonin system to increase levels sertinon, reduce symptoms of ocd.
• Antidepressants that don’t work on sertonin systems have no effect on OCD.

Question 28

Weaknesses for the neural explanations for ocd

Answer 28

The sertonin-ocd link is not unique to ocd. Many people with depression also experience this.
Much research shows low levels of sertonin has a negative relation with symptoms of clincial depression. This means the neural explaination only appiled because the patients with ocd are depressed. Therefore sertonin levels may not be a relevant symptom of OCD.

Question 29

What do drug therapies do?

Answer 29

Contain chemicals that can:
• Increase or decrease levels of neurotransmitters in the brain.
• To increase or decrease their brain activity.
• To have a particular effect on the functioning of the brain or some other body system.

Question 30

What system does drugs for ocd work on?

Answer 30

• Serotonin system in the brain
• Low levels of serotonin are associated with OCD so drugs for ocd work in various ways to increase the level of serotonin in the brain.

Question 31

What do SSRIs stand for?

Answer 31

Selective Serotonin Reuptake Inhibitors

Standard medical treatments used to tackle symptoms of OCD.

Question 32

How do SSRIs increase the levels of serotonin?

Answer 32

Neurotransmitter chemically conveys the signal from presynaptic to the postsynaptic neuron. It is then reabsorbed by the presynapstic neuron where it is broken down and re-used.

They prevent the reabsorption and breakdown of serotonin, which effectively increases levels of serotonin in the synapse and thus continue to stimulate the postsynaptic neuron.

This compensates for whatever is wrong with the serotonin system of the OCD patient.

Question 33

How long does it take for SSRIs to have an impact on symptoms of ocd?

Answer 33

Usually about 3-4 months

Question 34

How are SSRIs combined with other treatments?

Answer 34

SSRIs can be combined with other treatments such as CBT. SSRIs can help patients engage more effectively in CBT.

People respond differently to these treatments. Some may respond better with CBT only.

Question 35

What can be done if the SSRI is not effective in reducing symptoms?

Answer 35

• When an SSRI is not effective after 3-4 months, the dose can be increased or it can be combined with other drugs.
• Sometimes different antidepressants can be tried because patients can respond very differently to different drugs.

Question 36

Strengths of drug therapies for treating ocd

Answer 36

• It is effective for tackling OCD symptoms
• Evidence shows that SSRIs are effective at reducing severity of OCD symptoms and so improves quality of life for ocd patients.
• Soomro et al (2009) reviewed studies comparing SSRIs to placebos in OCD treatments and concluded all 17 studies showed significantly better results for the SSRIs than for placebo conditions.
• Effectiveness is greatest when SSRIs are combined with a psychological treatment, usually CBT is used. This demonstrates the validity of using SSRIs as a treatment for OCD.
• Drugs are a cost-effective; cheaper compared to psychological treatments. Therefore is good value for the NHS.
• Is a non-disruptive method ocd treatment because they don’t need to engage in therapy, which can be a time-consuming and emotionally draining for the patients.

Question 37

Weaknesses of drug therapies for treating ocd

Answer 37

• Drugs can have side effects. However these are usually temporary. Includes: indigestion, blurred vision and loss of sex drive.
• A significant minority will get no benefits for SSRIs.
• Clomipramine is a drug that has more serious side effects- tremors, aggression, disruption to blood pressure and heart rhythm.
• These factors reduce the effectiveness of the treatment because people may stop taking them.
• The evidence demonstrating the effectiveness of the drug treatments are unreliable. Therefore this is some controversial attached.
• Some psychologists believe evidence favouring drug treatments are biased because research is sponsored by drug companies who do not report all the evidence (Goldacre, 2013).
• Some cases of ocd follow trauma or a range of other causes and do not appear to be biological in origin. However, the predisposition for OCD is largely believed to be biological in nature. As much a biological traetment to counter makes sense.