Obsessive Compulsive Disorder Flashcards
What are obsessions?
Repetitive and persistent unwanted and intrusive thoughts and images. Individuals feel unable to control them and may attempt to ignore or suppress them.
What are compulsions?
Repetitive physical or mental actions and behaviours, often carried out in response to an obsession to neutralise negative thoughts.
Define thought-event fusion.
Individuals may believe that their thoughts can influence real-life events and may feel compelled to preform certain behaviours to prevent this.
Explain the diagnostic criteria.
- Obsessions and compulsion that are time-consuming and take up more than one hour per day.
- Symptoms must cause significant distress and negatively impact various aspects of the individual’s life.
State some of the ICD-11 symptoms.
- Fear of contamination of germs.
- Intrusive thoughts of harming oneself or others.
- Excess concern with order.
- Unwanted aggressive or taboo thoughts.
- Fear of losing control.
- Intrusive sexual or religious thoughts.
What is body dysmorphic disorder? (3)
- Obsessive thoughts about one’s perceived faults in their physical appearance, usually slight or not obvious at all.
- The anxiety caused creates compulsive, repetitive behaviours such as frequent mirror checking or constantly comparing one’s appearance with others.
- Such behaviours are intensely time-consuming as these individuals spend several hours a day performing rituals to hide their defects.
Explain Charles - Rapaport’s case study.
History: developed an obsession with sticky substances at age 12. As symptoms worsened it prevented him from attending school as excessive washing rituals took up his entire day. Started seeing Rapaport at age 14 after therapy and medications.
Symptoms: described stickiness as terrible and likening it to some kind of disease. The thought of touching honey was distressing. Would spend long periods of time washing his hands and up to three hours in the shower.
Treatment: prescribe clomipramine a tricyclic anti-depressant. Within a month he was able to touch honey but symptoms relapsed after a year due to tolerance to medication but were manageable this time.
What is the MOCI?
- The Maudsley Obsessive Compulsive Inventory
- 30 true or false items.
- Assess symptoms related to checking, washing, slowness and doubting.
- Scores range from 0-30
- Sample item: I frequently have to check thing several times.
What is the Y-BOCS?
- The Yale-Brown Obsessive-Compulsive Scale
- Semi-structured interview typically lasting 30 minutes.
- Scale of 0-4.
- Additional checklist of over 50 obsessions and compulsions used as reference.
- Scores range from 0-40
- 16+ indicating OCD.
What is the Biological Explanation of OCD?
- Genetic basis; MZ twins have higher concordance rate compared to DZ for OCD.
- PTPRD and SLITRK5 genes were identified to be possibly linked to OCD.
What is the biochemical explanation of OCD?
- Serotonin imbalance.
- Dopamine abnormalities.
- Oxytocin.
How does serotonin imbalance cause OCD?
- Irregularities in serotonin transport, receptor function, or enzyme activity that breaks down serotonin can contribute to OCD vulnerability.
How does dopamine abnormalities cause OCD?
- Imbalances in dopamine may increase susceptibility to OCD.
- Irregularities specifically related to D4 dopamine can play a role in the development of OCD.
Explain the role of oxytocin in OCD?
- One researcher discovered that oxytocin can reduce the repetitive behaviours seen in individuals with OCD and autism.
- Contrasting evidence stated that higher oxytocin levels are linked to more severe OCD symptoms.
What is the cognitive explanation of OCD?
- Suggests that obsessive thinking is based on faulty reasoning.
- Compulsive behaviours are the outcome of these faulty thoughts as an attempt to reduce the unwanted thoughts and the anxiety feeling created.
What is the behavioural explanation of OCD?
- Operant conditioning; suggesting that behaviours are influenced by their consequences.
- Compulsive behaviours develop because they effectively reduce negative emotions.
- These actions act as both positive and negative reinforcers, hence why they are maintained.
What is the psychodynamic explanation of OCD?
- Freud believes these issues are related back to childhood experiences due the conflict between the id and the ego.
- Suggests OCD is due to unresolved conflict during the anal stage of development during potty training.
- If potty training is too early or done too harsh, fixation can occur resulting in traits such as obsessiveness.
Explain the biological treatmentof OCD?
- Medication such as SSRIs, MAOIs and Tricyclics aim to modulate neurotransmitters in the brain to reduce OCD symptoms.
- May take up to 12 weeks to show effective results.
Explain what Exposure and Response Prevention is. (ERP)
- A type of CBT designed for those with OCD.
- Works by exposing clients to stimuli that provoke their obsessions and work on preventing their compulsive behaviours.
- Learn to accept their obsession and become habituated to it.
Explain Lehmkuhl et Al’s example study.
(aim-history-treatments-results-conclusions)
- Investigate the effectiveness on CBT on a 12 year old diagnosed with OCD and ASD.
- Diagnosed with ASD at age 2, and OCD at age 11.
- Attended CBT sessions, inclusive of cognitive restructuring and imagined exposure.
- Y-BOCS score decreased from 18 to 3.
- Study concluded CBT is effective when personalised to meet the individuals needs.
Explain Lovell et Al’s key study.
(aim-methodology-sample-procedure-results-conclusion)
- Compare telephone delivered CBT to face to face CBT for OCD treatments.
- RCTs, independent measures and longitudinal design, self report questionnaires; Y-BOCS, BDI and a satisfaction questionnaire.
- Opportunity sampling, ages 16-65, 72 OCD patients from two Manchester outpatient departments.
- Randomly allocated 36 individuals to each group and conducted baseline assessments and follow up sessions by blind researchers.
- No significant difference in OCD symptom severity, satisfaction scores T: 28.7 and F: 29.9, treatment success T: 77% and F: 67%.
- Equally effective methods of CBT despite telephone CBT sessions being almost 50% shorter, allowing time for more individuals to receive treatments.
