Obsessive compulsive disorder (OCD)

Question 1

what are obsessions?

Answer 1

persistent, intrusive, recurring thoughts or images
- 10% of sufferers suffer with just obsessions

Question 2

what are compulsions?

Answer 2

repetitive, ritualistic behaviour e.g. hoarding, excessive washing etc.
- 20% of sufferers suffer with just compulsions

Question 3

percentage of sufferers who suffer with obsessions + compulsions?

Answer 3

70%
- 1 in 50 people have OCD (suggests its a biological cause)

Question 4

what are the DSM-5 categories of OCD?

Answer 4

• Trichotillomania- compulsive hair pulling
• Hoarding disorder- compulsive gathering of possessions + the inability to part with anything regardless of its value
• Excoriation disorder- compulsive skin picking

Question 5

behavioural characteristics of OCD?

Answer 5

• compulsions are repetitive- sufferers feel compelled to repeat behaviour e.g. hand washing
• compulsions reduce anxiety
• avoidance- avoid situations which may trigger their obsessive thoughts + compulsive behaviours

Question 6

emotional characteristics of OCD?

Answer 6

• Anxiety +distress- obsessive thoughts can be frightening + overwhelming, urge to repeat behaviour creates anxiety
• accompanying depression- feel trapped by obsessions + compulsions etc
• guilt + disgust- irrational guilt due to neglecting friends etc or disgust towards external object or self

Question 7

cognitive characteristics of OCD?

Answer 7

• obsessive thoughts
• cognitive coping strategies- helps manage anxiety but makes them appear abnormal + distracts them from everyday tasks
• insight into excessive anxiety- aware obsessions + compulsions aren’t rational. Catastrophising thoughts about worst case scenarios that could occur if anxieties were justified e.g. ‘I may die if I don’t wash my hands’. Hypervigilant + focus on potential hazards

Question 8

what approach explains OCD?

Answer 8

biological

Question 9

what does genetic explanation of OCD assume?

Answer 9

• assumes OCD is inherited via genes across family generations

Question 10

genetic explanation research support?

Answer 10

• research support from family + twin studies
  –> often compare MZ twins + DZ twins for a particular trait –> if trait has a biological basis= expect higher concordance rate between MZ twins than DZ twins as they’re genetically identical –> BUT we never get 100% concordance rate

Question 11

genetic explanation what do biopsychologists suggest?

Answer 11

• suggest that the higher the concordance rate between 2 ppl= more likely the trait is inherited

Question 12

genetic explanation- gene-mapping studies?

Answer 12

comparing genetic material of OCD sufferers with non-sufferers to indicate a link with particular genes that makes ppl more vulnerable to OCD (candidate genes) –> likely to be a combination of genes, not just one (polygenic)

Question 13

genetic explanation- diathesis stress model?

Answer 13

suggests certain genes make some ppl more likely to suffer from OCD, the environmental stress (experience) is necessary to trigger the condition

Question 14

genetic explanation- what are the specific genes implicated in OCD?

Answer 14

COMT gene
SERT gene

Question 15

genetic explanation- COMT gene

Answer 15

• helps to reduce the action of dopamine. Less COMT genes= dopamine isn’t controlled + there’s too much of it –> too much dopamine is associated with OCD

Question 16

genetic explanation- SERT gene

Answer 16

• affects transport of serotonin –> creates lower levels of neurotransmitter serotonin –> serotonin has a role in balancing mood= can regulate obsessive thoughts –> low levels of it link with OCD

Question 17

genetic explanation- strengths

Answer 17

• strong research support- Nestadt et al found 68% of MZ twins both had OCD vs 31% in DZ twins
• can use animal studies for research

Question 18

genetic explanation- limitations

Answer 18

• biological reductionism- doesn’t account environmental factors which could lead to development of OCD –> Kiara Cromer et al found that over 1/2 OCD is more severe in ppl who’ve suffered with traumatic experiences
• animal studies may be useless as they’re not as complex as humans
• never found 100% concordance rate= other factors need to be looked into
• polygenic condition= hard to make correlations between genes linked to OCD, may differ from person to person

Question 19

neural explanation- what does it assume

Answer 19

• assumes neurotransmitters play a role in development of OCD + structures of the brain

Question 20

neural explanation- expand on it

Answer 20

serotonin regulates moods, low levels can lead to depression etc. It plays an active role in orbital frontal cortex + caudate nucleus –> low serotonin levels may lead to abnormal functioning in areas of brain involved in OCD

Question 21

neural explanation- strengths

Answer 21

• antidepressants regulate serotonin levels = reduces OCD symptoms
• research often uses objective clinical methods e.g. fMRI scanning = increase reliability

Question 22

neural explanation- limitations

Answer 22

• not all OCD sufferers respond positively to antidepressants= reduces external validity
• correlations don’t necessarily suggest cause + effect relationships (may be a third factor)

Question 23

brain structure/neuroanatomy- OCD vs normal brain

Answer 23

• orbitofrontal cortex
  OCD- detects error when isn’t one + sends ‘worry’ signals
  N- integrates sensory info makes decisions, anticipates reward or punishment
• cingulate gyrus
  OCD- adds emotion like anxiety etc
  N- adds emotional responses to thoughts
• caudate nucleus
  OCD- can’t filter anxious thoughts
  N- process info + removes unwanted things
• basal ganglia
  OCD- causes repetitive behaviours
  N- controls movements, thinking

Question 24

brain structure/neuroanatomy- the worry circuit

Answer 24

• if caudate nucleus is damaged, it can’t suppress minor ‘worry signals’ + thalamus is alerted = sends signals to OFC + confirms worry= triggers compulsions + anxiety –> low levels of serotonin in brain areas could be linked to problem of signal regulation

Question 25

brain structure/neuroanatomy- neurosurgery

Answer 25

- can treat parts of brain linked to OCD to improve symptoms (neurosurgery) --> support for biological explanations as treating biological part= symptoms reduced

Question 26

the OCD cycle

Answer 26

OBSESSIVE THOUGHTS --> ANXIETY --> COMPULSIONS --> TEMPORARY RELIEF (then back to obsessive thoughts

Question 27

the ocd cycle expansion

Answer 27

OBSESSIVE THOUGHTS (recurrent, intrusive unwanted distressing thoughts, images etc ANXIETY (extreme fear, shame, guilt) COMPULSIONS (reduced anxiety by performing behaviours/compulsions TEMPORARY RELIEF (relief is only short term)

Question 28

biological approach in treating OCD

Answer 28

drug therapy, antidepressants SSRI's e.g. fluoxetine, CBT

Question 29

drug therapy

Answer 29

- aims to increase or decrease levels of neurotransmitters in the brain --> drugs for OCD aim to increase serotonin in the brain - drug treatment used if CBT doesn't work

Question 30

antidepressants (SSRI's)

Answer 30

- most commonly used drug treatment for OCD - they prevent the reuptake of serotonin in the synaptic cleft back into the presynaptic neuron --> prevention of uptake= serotonin more accessible in the brain + available to improve transmissions of messages between neurons

Question 31

other treatments of OCD (drug)

Answer 31

- BZs- anti-anxiety drug, reduces action of neurotransmitter GABA (which controls neuron hyperactivity= fear anxiety etc)= slows down brain= reduce obsessive thoughts etc - SNRI's- increase serotonin levels BUT have more side effects than SSRI's

Question 32

CBT

Answer 32

- first choice of treatment - aims to change thought processes + behaviours cognitive component: - aims to change beliefs that OCD person triggers. prevent cognitive distortion of catastrophising- help deal with obsessions behavioural component: - exposure and response prevention therapy focuses on compulsions - exposes clients to situations that cause anxiety to help person resist performing behaviour --> uses exposure hierarchy (building up from situation that causes mild anxiety to full) --> repeated exposure till anxiety reduces + client resists + refrains from compulsive behaviour

Question 33

biological approach in treating OCD- strengths

Answer 33

- drug therapy= less effective + widely available + non-disruptive (compared to CBT) --> good for economy as ppl return to work quicker + more for health service budget to spend on other things - SSRI's = shown to be effective Soomro et al found 17 studies showed better results from SSRI's than placebos BUT shapinakis et al found that CBT= more effective than SSRIs - little effort to take drugs - can use CBT + drugs= more effective

Question 34

biological approach in treating OCD- limitations

Answer 34

- serious side effects of drugs --> SSRIs= blurred vision, nausea, insomnia BUT only temporary --> BZ's= long term memory impairment - biased evidence --> as research funded by research companies, publication= bias towards studies that have a positive outcome --> unethical? lower validity, are the drugs truly effective?