🟠 Psychopathology - OCD

Question 1

What is OCD

Answer 1

an anxiety disorder, characterised by irrational, persistent and intrusive thoughts (obsessions) and intense, uncontrollable urges to complete tasks (compulsions)

Question 2

Behavioural characteristics of OCD

Answer 2

• COMPULSIONS, they are repetitive (compelled to repeat a behaviour) and they reduce anxiety by performing these obsessions
• AVOIDANCE, sufferers may try to reduce anxiety by staying away from situations. For example, the sufferer may have irrational thoughts about germs in a bin so they don’t go near it

Question 3

Emotional characteristics of OCD

Answer 3

• ANXIETY AND DISTRESS, caused by powerful axiety DEPRESSION obsessions and compulsions
• DEPRESSION, due to discomfort and interference
• GUILT AND DISGUST, directed internally or externally at the world

Question 4

Cognitive characteristics of OCD

Answer 4

• OBSESSIVE THOUGHTS: 90% of OCD sufferers main cognitive features recur over and over
• COGNITIVE STRATEGIES: sufferers can respond to obsessive thoughts by using cognitive coping stragetiesm
• INSIGHT TO EXCESSIVE ANXIETY: sufferers are aware that their obsessions and compulsions are irrational

Question 5

OCD CYCLE

Answer 5

obsessive thoughts

Anxiety

Compulsive behaviour

Temporary relief

Question 6

Concordance rate

Answer 6

Measure of genetic similarity

Question 7

Dopamine

Answer 7

A key neurotransmitter in the brain which effects motivation and drive

Question 8

Serotonin

Answer 8

Another neurotranmitter which is believed to have an effect on mood regulation

Question 9

Diathesis stress model

Answer 9

psychological theory that explains mental disorders as a result of a combination of environmental stressors and a person’s inherent vulnerability

Question 10

What is the COMT gene

Answer 10

The gene is associated with the production of an enzyme that regulates the function of dopamine

Question 11

What does the variation of the COMT gene do

Answer 11

Decreases the amount of COMT available and so dopamine is not controlled and there is probably too much dopamine (associated with OCD)

Question 12

Why does too much dopamine cause OCD

Answer 12

Disrupts the brain reward system, Leads to increased focus on repetitive behaviors (compulsions) that are aimed at achieving a sense of relief from anxiety caused by intrusive thoughts (obsessions)

Question 13

What does SERT gene do

Answer 13

Affects the transport of serotonin

Question 14

What happens to people’s sert gene with OCD

Answer 14

the sert gene mutates which decreases levels of serotonin

Question 15

How does little serotonin cause ocd

Answer 15

If you don’t have much serotonin floating around in your brain, you might feel depressed or anxious which could lead to ocd

Question 16

What are candidate genes .

Answer 16

Candidate genes are the genes which create vulnerability for OCD e,g COMT and SERT

Question 17

What does it mean by saying OCD is polygenic

Answer 17

Not a single gene implicates OCD, multiple do. Complex and unclear disorder.

Taylor (2013) meta analysis found evidence of up to 230 different genes involved with OCD

Question 18

What does aetiologically heterogeneous mean

Answer 18

Different types of OCD, a number of different colonisations of genes

Question 19

Supporting evidence of biological explanations of OCD

Answer 19

Family studies (Lewis 1936)

Twin studies (nestadt et al 2010)

Question 20

Family studies

Answer 20

Lewis 1936’ assessed ocd sufferers and found that 37% had parents who also had the disorder. 21% of sufferers also had siblings who had the disorder

This suggests a biological influence on OCD, as a significant proportion of sufferers had parents (37%) or siblings (21%) with the disorder, indicating a potential genetic or familial link.

Question 21

Twin studies

Answer 21

Nestadt et al 2010, reviewed twin studies examining OCD, found concordance rate of 68% in identical twins, and 31% of non identical twins

Question 22

Positives of biological explanation of OCD

Answer 22

• good supporting evidence, but concordance rate is not 100% so environment must play a role

Question 23

Negatives of biological explanation to OCD

Answer 23

• too many candidate genes which means they can’t provide a useful, predictive value for the disorder
• culturally transmitted, families may be more vulnerable to OCD as the family members may observe and imitate each ither’s behabiour
• in studies concordance rate isnt 100% so environent must play a role

Question 24

OFC

Answer 24

Orbitofrontal cortex

Question 25

Worry circuit

Answer 25

1. OFC notices when something is wrong 2. OFC sends signals to the thalamus about this that are worrying 3. The caudate nucleus (in basal ganglia) is in between and it regulates the signals from OFC, so thalamus doesn’t get hyperactive

Question 26

Worry circuit for someone with ocd

Answer 26

When caudate nucleus is damaged or abnormal, it fails to suppress worries. Thalamus is alerted which sends signals back to OFC. anxiety and impulsive behaviours occur c-shaped caudate nucleus:

Question 27

Animal Research supporting dopamine to do with OCD

Answer 27

Szechtman et al 1998 High dose of drugs enhances dopamine movement , resembling compulsive behaviours found in OCD (animal study)

Question 28

Research supporting serotonin role in OCD

Answer 28

Antidepressant drugs that increase serotonin activity have been seen to reduce OCD symptoms

Question 29

Research supporting worry circuit

Answer 29

Surgery which disconnects the basal ganglia (caudate nucleus) from the frontal cortex can reduce symptoms of severe OCD

Question 30

3 biological explanations of OCD

Answer 30

SERT COMT WORRY CIRCUIT

Question 31

What does drug therapy aim to do

Answer 31

Increase or decrease levels, or activity of neurotransmitters in the brain

Question 32

What does SSRIs stand for

Answer 32

Selective serotonin reuptake inhibitor. Work on the serotonin system in the brain. Available in liquid or capsules. Takes up to 3 to 4 months of daily use

Question 33

3 types of SSRIs

Answer 33

- citalopram - escitalopram - fluoxetine

Question 34

Combination of SSRI and CBT

Answer 34

1 - SSRIs biological intervention. Can reduce symptoms enough to be able to engage with taking therapy 2 - CBT, cognitive intervention, can help sufferers learn to cognitively cope with their obsessions and compulsions

Question 35

SNRIs

Answer 35

Serotonin-noradrenaline reuptake inhibitors

Question 36

What do SNRIs do

Answer 36

Increase serotonin and noradrenaline, used to treat OCD for patients who don’t respond to SSRIs

Question 37

3 drugs to treat OCD

Answer 37

- SSRIs - SNRIs - tricyclics (antidepressants - inc serotonin)

Question 38

What are tricyclics

Answer 38

Older type of antidepressant. Same effect on serotonin as SSRIs. More severe side effects only used if SSRIs aren’t effective

Question 39

Positives of drug treatment for OCD

Answer 39

- effective alleviation of symptoms Clear evidence showing SSRIs are effective in reducing severity of OCD symptoms Decline by 70% after SSRIs - cheap compared to therapy, don’t disrupt patients lives, no hard work

Question 40

negatives of drug treatment for OCD

Answer 40

- side effects, e.g blurred vision