OCD Flashcards
OCD definition
A condition characterised by obsessions and/or compulsive behaviour. Obsessions are cognitive whereas compulsions are behavioural
DSM-5 categories of OCD
- OCD
- Trichotillomania
- Hoarding disorder
- Excoriation disorder
Behavioural characteristics of OCD
Compulsions are repetitive
Compulsions reduce anxiety
Avoidance
Emotional characteristics of OCD
Anxiety and distress
Accompanying depression
Guilt and disgust
Cognitive characteristics of OCD
Obsessive thoughts
Cognitive coping strategies
Insight into excessive anxiety
What are the two biological explanations of OCD
Genetic explanation
Neural explanation
Genetic explanation- Candidate genes
Genes create a vulnerability for OCD
Genetic explanation- OCD is polygenic
Different combinations of up to 230 genetic variations/genes causing OCD
Genetic explanation- Different types of OCD
Different combinations of gene variations may cause different kinds of OCD
Genetic explanation evaluation points- Research support
STRENGTH
68% MZ twins and 31% DZ twins have OCD (Nestadt) OCD 4 times more likely if family member has it
Genetic explanation evaluation points- Environmental risk factor
LIMITATION
Over half OCD clients in one sample experienced a traumatic event, and OCD was more severe
Genetic explanation evaluation points- Animal studies
LIMITATION
Candidate genes have been found in e.g. mice, but we can generalise from animal repetitive behaviour to human OCD
Neural explanations- The role of serotonin
Low levels of serotonin = lower mood which is linked to OCD
Neural explanations- Decision making systems
Lateral frontal lobes and parahippocampal gyrus may be malfunctioning
Neural explanations- Worry circuit
These nerve cell connections form a loop in the brain. The caudate nucleus lies between the OFC and the thalamus and regulates signals sent between them. When the thalamus receives a ‘worry’ signal, it becomes excited and sends strong signals back through the loop to the OFC, which interprets them.
Neural explanation evaluation points- Research support
STRENGTH
Antidepressants that work on the serotonin system alleviate OCD, biological conditions have similar symptoms to OCD
Neural explanation evaluation points- No unique neural system
LIMITATION
The apparent serotonin- OCD link may just be co-morbidity with depression- the depression disrupts serotonin
Drug therapy in treating OCD
Treatment involving drugs that have a particular effect on the functioning of the brain or some other parts of the body system.
SSRIs
- Selective Serotonin Reuptake Inhibitors
- Prevents the reabsorption and breakdown, SSRIs effectively increase levels of serotonin at the synapse and thus continue to stimulate the postsynaptic neuron
- Eg. Fluoxetine (daily- takes up to 3-4 months to have impact) in liquid or tablet
Combining SSRIs with other treatments
- SSRIs plus CBT offers best effectiveness
- Used as a combination with other drugs
Alternatives to SSRIs
- Tricyclics e.g. clomipramine (acts on serotonin system and other systems)
- SNRIs (Serotonin-Noradrenaline Reuptake Inhibitors)
Drug therapy evaluation points- Evidence of effectiveness
STRENGTH
17 studies all showed SSRIs more effective than placebos (Soomro)
Drug therapy evaluation points- Serious side effects
LIMITATION
SSRIs may lead to indigestion, blurred vision and loss of sex drive, worse for clomipramine
Drug therapy evaluation points- Cost effective and Non disruptive to life
STRENGTH
Relatively cheap for NHS and don’t involve time spent going to therapy sessions
Drug therapy evaluation points- Biased evidence
LIMITATION
Drug researchers sponsored by drug companies, biased results. But still best available evidence and psychological therapies research may be biased too
