OCD

Question 1

OCD

Answer 1

Anxiety disorder characterised by repetitive behaviour and obsessive thinking (unusual or forbidden images leading to anxiety)

Question 2

Behavioural characteristics of OCD

Answer 2

Compulsive behaviours - observable, repetitive
Hindered daily function - e.g working a job
Social impairment - observer discomfort
Repetitive actions - due to obsessions
Avoidance - of anxiety inducing situations

Question 3

Emotional characteristics of OCD

Answer 3

Anxiety and distress - aware so embarassed
Depression - anxiety leads to low mood
Guilt and disgust - minor/ external issues

Question 4

Cognitive characteristics of OCD

Answer 4

Obsessions - intrusive inappropriate thoughts
Recognised as self generated - not others
Insight of irrationality - but unable to stop
Selective attention/ hyper vigilance - cannot unfocus from stimuli or vigilantly look for them

Question 5

How to distinguish between obsessions and compulsions

Answer 5

Obsessions are internal and cognitive whereas compulsions are external and behavioural

Question 6

Genetic explanations for OCD

Answer 6

Alleles and OCD seems inherited with genetic predisposition - family or twin studies to investigate, could be polygenic so not just by one gene - up to 230 factor genes called candidate genes which vary types of OCD

Question 7

OCD genes

Answer 7

COMT - regulates dopamine production - high levels responsible for drive, motivation, aggression - COMT more common in OCD ppl
SERT - mutation affects transport of serotonin leading to low levels so bad mood and depressive symptoms - hence link between OCD and depression - Ozaki (2003) found 6/7 family members with OCD had mutated SERT

Question 8

OCD genes eval

Answer 8

+ Nestadt(2000) found people with first degree relative with OCD 5x likely to get OCD
+Billett (1998) meta analysed 14 twin studies and found OCD 2x concordant identical MZ twins than DZ
- Concordance rate not 100% so not entirely genetic - incomplete as ignores psychological and environmental factors
- Polygenic and linked to other illnesses like Tourettes - genetic cause is complex and perhaps related to other illnesses, so perhaps genes could be predisposing factors instead
- Contradicts behavioural approach via classical conditioning which is supported and used in therapies like exposure (similar to SD)
- Diathesis stress model argues a combo of genes and environment - incomplete

Question 9

Beekman and Cath

Answer 9

Genetic research meta-analysis of twin studies - 10034 pairs - comparing MZ and DZ - in children inherited via genes and 45-65% genetic influence, in adult inherited by genes and 27% - 47% genetic influence. Older patients had been diagnosed with older criteria and younger new

Question 10

Beekman and Cath eval

Answer 10

• Majority of twin studies were uncontrolled so lacks objectivity and validity
• Gene mapping ignored which can closely look and compare DNA to make results more valid and robust
  + Meta analysis so large sample, valid, reliable
  + Population validity as many twins of different ages studied
  + Family ties supported - + Menzies (2007) studied MRI in OCD patients and immediate family and compared with healthy controlled - less grey matter in key regions and unusual neuroanatomy - abnormal brain structure could be inherited via genes causing OCD

Question 11

Neurotransmitters causing OCD

Answer 11

High dopamine - research in animals show movements resembling compulsive and repetitive area - and overactivity in basal ganglia i.e motor function and learning
Low serotonin so depressive symptoms and obsessive thought - malfunctions caudate nucleus which controls e.g personality, learning, memory - and worry circuit where failure to suppress minor worry signals

Question 12

Neural explanations eval

Answer 12

+ Research support that neurotransmitters cause OCD - antidepressants increase serotonin and less OCD symptoms
- Cause and effect unclear
- OCD coexists with depression so unclear if low serotonin causes OCD or depression or both - needs more research
+ Ciccerone (2000) found drug risperidone lowered dopamine and alleviated OCD
- High dopamine also linked with other disorders like bipolar and schizophrenia - not enough research to prove high dopamine is responsible - could be a combo of factors

Question 13

Jenike and Rauch neuroanatomy and brain damage

Answer 13

Brain damage might affect STM causing a chain reaction of doubt (did i lock front door?) causing compulsions - PET scans of cleaning obsessors shown a dirty thing and front lobes and basal ganglia (motor control) were most active - perhaps overactive
Neural mechanisms may be damaged so inner function breakdown causing OCD e.g lyme disease - frontal cortex also possible damaged - struggle to select control and inhibit behaviour

Question 14

Neuroanatomy eval

Answer 14

• Cause and effect unclear
  + PET is objective and scientific
  + Rapoport (1990) reviewed Great Sleeping sickness in Europe between 1916-1918 widespread viral infections in brain - after epidemic large increase in reported OCD cases possible due to damage and brain abnormalities leading to neural development
• Temporal validity as during a war so natural fear and compulsive desire for protection, also unsure this was actually the reason no real evidence used

Question 15

SSRI

Answer 15

Selective serotonin reuptake inhibitors e.g prozac and fluoxetine - prolongs activity in synpase so higher levels mean less anxiety/ OCD and depressive symptoms - prevents breakdown in brain so continues to stimulate post synaptic neuron and reduces worry circuit - stabilise moods and memory and orbital frontal cortex works properly
3-4 months daily to reduce symptoms

Question 16

SNRI

Answer 16

selective norepinephrine reuptake inhibitors increasing noradrenaline/ norepinephrine similarly - could if cant tolerate prozac or fluoxetine
noradrenaline released from sympathetic nervous system to respond to stress and mobilises brain and body for action

Question 17

SSRI eval

Answer 17

+ Soomro (2009) compared SSRI to placebo drugs and found 17/17 had SSRI more effective esp when combined w CBT
+- 70% decline OCD but 30% tend to combine with psychological therapies so perhaps more effective with other treatments not alone
+ Cheap and cost effective compared
to therapy w.g counselling
- Not work for all patients, alternate drugs like tricyclics may be better
- Side effects that may force to stop taking SSRI like indigestion, blurred vision, lower sex drive
- Koran (2007) says psychotherapies like CBT better as drug therapy is not lasting and has high relapse rate after meds stopped

Question 18

BZ

Answer 18

Benzodiazepines e.g Valium and xanax which reduce CNS activity and brain arousal, blood pressure, heart rate but increase GABA (gamma amino butyric acid) which slows down neuron firing and reduces anxiety and be calmer, bind to GABA receptor site of post synaptic neurone so more Cl ions flow and less stimulation from neurotransmitter action
Helps increase anxiety from obsessive thoughts
But also reduces serotonin, depression?

Question 19

BZ eval

Answer 19

+ Very effective and used by millions
+ Very quick so reduce anxiety and cause relief in a short period of time
+ In the short term minimal side effects
- But in the long term then side effects become severe - depression, drowsiness, accident chance so not suitable
- Ashton (1997) found depression in long term usual while withdrawal leads to high anxiety and OCD
- Tolerance may be built so higher doses will have to be taken to get the same effect
- Stewart (2005) found impairment in speed and verbal learning, meta analysis showing cognitive impairments. While ability recovers after withdrawal, cognitive ability still slightly below those who never took BZ