Obsessive Compulsive Disorder (OCD) Flashcards
DSM-5 categories of OCD
Repetitive behaviour along with obsessive thinking
OCD - characterised by either obsessions (recurring images/thoughts) and or compulsions (repetitive behaviour)
Trichotillomania - compulsive hair pulling
Hoarding disorder - compulsive gathering of possessions + inability to part ways with anything
Excoriation disorder - compulsive skin picking
Behavioural characteristics of OCD
Compulsions are repetitive:
- feel compelled to repeat a behaviour; e.g. handwashing, tidying
Compulsions reduce anxiety:
- attempt to manage the anxiety produced by obsessions e.g. compulsive handwashing; response to an obsessive fear of germs
Avoidance:
- try and manage their OCD by avoiding situations that trigger anxiety e.g. compulsive washers avoid germs -> interferes with normal life
Emotional characteristics of OCD
Anxiety and distress:
- obsessive thoughts are unpleasant & frightening, and the anxiety = overwhelming
- OCD = partially unpleasant emotional experience
- urge to repeat behaviour = anxiety
Accompanying depression:
- anxiety accompanied by low mood -> lack of enjoyment in activities
- compulsive behaviours can bring relief (temporary)
Guilt & disgust:
- over minor moral issues, or disgust - can be directed at external (dirt) or the self
Cognitive characteristics of OCD
Obsessive thoughts:
- major cognitive feature of the condition e.g. intruders entering a locked door
Cognitive coping strategies:
- help deal with the obsessions e.g tormented by guilt; may pray (manage the anxiety, but abnormal to others + distract from everyday life
Insight into excessive anxiety:
- are aware that the obsessions + compulsions are not rational
- they have catastrophic thoughts about the worst case scenarios that might occur if their anxieties were justified
- hyper vigilant e.g. alertness
Biological approach to explaining OCD: genetic explanations
Candidate genes:
- they are: genes that create vulnerability to OC
- some of the genes involved in regulating the development of the serotonin system
OCD is polygenic:
- OCD caused by a combination of genetic variations that together increase vulnerability
- genes with relation to OCD = action of dopamine + serotonin (both neurotransmitters involved in regulating mood)
Different types of OCD:
- aetiologically heterogeneous, meaning origins pf OCD vary from one person to another
- suggested that OCD -> result of genetic variations
Neural explanations
The role of serotonin:
- serotonin = neurotransmitter; helps regulate mood
- low levels of serotonin; normal transmission of mood-relevant info. Cant take place = low moods
Decision making:
- hoarding disorder; associated with impaired decision making
- also abnormal functioning of the frontal lobes (front part, responsible for logical decisions)
- left parahippocampal gyrus; associated with unpleasant emotions
Evaluate the genetic explanation
Strength- research support
E.g. twin studies: 68% of Mz twins had OCD and 31% of non-identical Dz twins
E.g. family studies: a person with a family member diagnosed is 4x likely to develop it
Limitation- environmental risk factors
Genetic vulnerability only provides a partial explanation
Env. Risk factors can trigger or increase the risk of developing OCD (traumatic events)
Evaluate neural explanations
Strength- research support:
Antidepressants that work on serotonin are effective in reducing OCD symptoms - suggest that S. may be involved in OCD
Some OCD symptoms are biological in origin (Parkinson’s tremors) - so biological factors may be responsible for OCD
Limitation- no unique neural system:
Serotonin-OCD link not unique to OCD; people with OCD also experience clinical depression (co-morbidity)
Serotonin is disrupted in many people with OCD cas they are depressed as well; not relevant to OCD symptoms
The biological approach to treating OCD: Drug therapy - SSRI’s
- antidepressant = SSRI; works on serotonin in the brain
- s. Released from neuron’s in brain -> released by the pre synaptic neuron’s (travel across synapses) - neurotransmitter chemically conveys signal to postsynaptic neurone - reabsorbed by presynaptic neurone; broken down + reused
- SSRI prevents the reabsorption + breakdown -> increases serotonin levels to stimulate the postsynaptic neurone.
- daily dose of fluoxetine is prescribed
Combining SSRI’s with other treatments
- drugs often used with CBT to treat OCD
- drugs decrease emotional symptoms -> person can engage more with CBT
Alternatives to SSRI’s
Tricyclics - e.g. clomipramine - same effect as SSRI’s but more severe side effects
SNRI’s - increase the levels of serotonin + noradrenaline - used for people who don’t respond to SSRI’s
Strengths of drug therapy
Evidence for effectiveness:
Evidence - SSRI’s reduce symptom severity; typically symptoms reduce for 70% of people taking SSRI’s - drug is helpful
COUNTERPOINT: cognitive and behavioural therapies can be more effective than SSRI’s
Cost effective & non-disruptive:
Cheap compared to psychological treatments (thousands of tablets made in the time of one therapy session); good value for the public health services (NHS) - non disruptive to peoples lives (taking a pill)
Limitation of drug therapies
Serious side effects:
E.g indigestion, blurred vision
Distressing for people - minority, can be long lasting
Some people have a reduced quality of life as a result of taking the drugs
