Obsessive Compulsive Disorder (Psychopathology)

Question 1

Obsession

Answer 1

A persistent thought, idea, impulse or image that is experienced repeatedly, feels intrusive and causes anxiety.

Question 2

Compulsion

Answer 2

A repetitive and rigid behaviour or mental act that a person feels driven to perform in order to prevent or reduce anxiety.

Question 3

Categories of OCD and what they all have in common

Answer 3

-Regular OCD: characterised by obsessions and/or compulsions
-Trichotillomania: compulsive hair pulling
-Hoarding Disorder: the compulsive gathering of possessions and the inability to part with anything regardless of its value
-Excoriation Disorder: compulsive skin picking
These are alike in their repetitive behaviour accompanied by obsessive thinking.

Question 4

The DSM describes the main symptoms of obsessive compulsive disorder as:

Answer 4

-recurrent obsessions and compulsions
-recognition by the individual that the obsessions and compulsions are excessive and/or unreasonable
-the person is distressed or impaired, and daily life is disrupted by the obsessions and compulsions

Question 5

Emotional Characteristics of OCD

Answer 5

OCD may feel depressed and/or other negative emotions.

Guilt and disgust.

Question 6

Behavioural characteristics of OCD

Answer 6

How actions which typically leads to the carrying out of repetitive actions to reduce anxiety. This leads to avoidance.

Question 7

Cognitive characteristics of OCD

Answer 7

Sufferers are usually plagued with obsessive thoughts. They also tend to develop cognitive strategies.

Anxiety.

Question 8

Biological Explanation for OCD

Answer 8

Genetics: genes can predispose individuals to the illness. It only suggests that this is part of the reason, as patients often have family members with the condition.

Question 9

Billet et al 1998 and Bellodi et al 2001

Answer 9

claim that genetic factors play a role. Using evidence from twin studies and family studies, they showed that close relatives are more likely to have the disorder than more distant relatives

Question 10

Mckeon and Murray 1987

Answer 10

patients with OCD are more likely to have first degree relatives who suffer from anxiety disorders

Question 11

Lewis 1936 and Pauls et al 2005

Answer 11

there is a higher percentage of OCD sufferers in relatives of patients than in a control group.

Question 12

Polygenetic

Answer 12

OCD is thought to be polygenic- meaning that development is not determined by a single gene, but rather 230 genes. This means that there is little predictive power from this explanation.

Question 13

Candidate genes

Answer 13

Candidate genes are ones which, through research, have been implicated in the development of OCD
-a possible candidate gene is the SERT gene which is involved in regulating serotonin, a neurotransmitter which facilitates message transfer across synapses (5HT1-D beta).
-Another possible candidate gene is the COMT gene, which regulates the production of dopamine
-Dopamine affects motivation and drive, and so may motivate the repetitive behaviour. The opposite occurs in depression

Question 14

The diathesis stress model

Answer 14

The diathesis-stress model suggests that people gain a vulnerability towards OCD through genes but an environmental stressor is also required. This could be a stressful event, for example a bereavement

Question 15

Aetiologically heterogeneous

Answer 15

-the development of OCD has different causes
-different genetic variation or genes cause the disorder in different people

Question 16

Evaluation of genetic explanations

Answer 16

P: There is some evidence to suggest there is a genetic component to the disorder. One of the best sources of evidence for the importance of genes is twin studies (Nestadt 2010)

N: Family studies could also be used to explain environmental influences
Close relatives of OCD sufferers may have observed and imitated the behaviour SLT
It is difficult to untangle the effects of environmental and genetic factors

Question 17

Evaluation of candidate genes

Answer 17

P: candidate genes have been linked to OCD through research

N: there are too many genes involved
psychologists haven’t pinned down all of the genes involved
each genetic variation only increases the risk of OCD by a fraction

Question 18

Evaluation of diathesis stress model

Answer 18

P: individuals may gain a vulnerability towards OCD through genes that is then triggered by an environmental stressor

N: Cromer 2007 found that over half of OCD patients in their sample had a traumatic event in the past, and that OCD was more severe in those with more than one trauma

Question 19

Neural explanations

Answer 19

An implicated part of the brain is the basal ganglia, which is responsible for innate psychomotor functions. Rapoport and Wise 2010 proposed the hypersensitivity of the basal ganglia gives a rise to the repetitive motor behaviours seen in OCD, for example, repetitive washing/cleaning/checking.

Other areas are believed to be the orbitofrontal cortex (OFC), which are involved in decision making and worry about social and other behaviour, and the thalamus
An overactive thalamus results in motivation for cleaning, checking and other safety behaviours. The OFC would also become overactive if the thalamus does.

Serotonin levels: Lower levels of serotonin causes normal transmission of mood-relevant information to take place. Lower levels can lead to depression and mood instability. This affects mood and other mental processes.

Question 20

Evaluation of the role of neurotransmitters

Answer 20

P: Allows medication to be developed which helps sufferers

N: Drugs are not completely effective
Just because administering SSRIs decreases OCD symptoms does not mean that serotonin deficiency was the cause in the first place
There is time delay between taking drugs to target the condition and any improvements being made and yet the chemical imbalance is addressed in hours

Question 21

Evaluation for areas of the brain

Answer 21

P: Advances in technology allow researchers to investigate specific area of the brain more accurately and OCD sufferers do seem to have excessive activity in the orbital frontal cortex
Cleaning and checking behaviours are “hard-wired” in the thalamus

N: The repetitive compulsions may be explained by the structural abnormality of the basal ganglia but not necessarily the obsessional thoughts.
There are inconsistencies found in the research as no system has been found that always plays a role in OCD.
These neural changes could be as a result of suffering from the disorder, not necessarily the cause of it.

Question 22

SSRI

Answer 22

SSRI (selective serotonin reuptake inhibitors): SSRIs work on increasing certain neurotransmitters in the brain by preventing the re-absorption of serotonin. By preventing the re-absorption of serotonin, SSRIs effectively increase the levels of serotonin in the synapse and thus continue to stimulate the post-synaptic neuron.

Question 23

Tricyclics

Answer 23

an older type of antidepressant that has the same effect on serotonin as SSRI. (clomipramine)

Question 24

SNRIs

Answer 24

serotonin-noradrenaline reuptake inhibitors. Second line of defence for patients who do not respond well to SSRIs.

Question 25

NASSAs

Answer 25

Noradrenaline and specific serotonergic antidepressants.

Question 26

Evaluation of biological treatments

Answer 26

-Drug therapy is effective at tackling OCD symptoms
there is clear research to suggest that SSRIs are effective in reducing the severity of OCD symptoms (Soomro 2009)

-Drugs are cost-effective and non-disruptive
cheap in comparison to psychological treatments and, unlike psychotherapy they are non-disruptive to patients’ lives

-Drugs can have side-effects
a significant minority receive no benefit or suffer from side-effects (weight gain, dry mouth, sexual dysfunction and loses of memory). Coming off a drug is a slow process in which the dosage has to be gradually reduced over a period of six months- risk of relapse.