OCD Flashcards
What are obsessions
Persistent , intrusive recurring thoughts or images
What are compulsions
Repetitive ritualistic behaviours (common ones include excessive washing and cleaning or hoarding)
What does the DSM 5 recognise OCD as
The DSM recognizes OCD as a range of related disorders. The disorders all have repetitive behavior accompanied by obsessive thinking
What is Trichotillomania
Compulsive hair pulling
What is hoarding disorder
compulsive gathering of possessions and the inability to part with anything regardless of value
What is excoriation disorder
Compulsive skin picking
What are the 3 behavioural characteristics of OCD
- compulsions are repetitive
- compulsions reduce anxiety (anxiety of the obessesion)
- avoidance (reduce anxiety by avoiding situations that trigger their obsessions)
3 emotional characteristics of OCD
- Anxiety and distress
- accompanying depression (anxiety and low mood an lack of enjoyment in activities)
- guilt and disgust (disgust at external object or self)
Cognitive characteristics of OCD
- Obsessive thoughts (90% people with OCD major feature is obsessive thoughts)
- cognitive coping strategies (to deal with obsessions, helps deal with anxiety but distracts from everyday life)
- insight into excessive anxiety (aware its irrational, catastrophic thoughts, hyper-vigilant)
What is the OCD cycle
Obsessive thought —> anxiety—> collusions—> temporary relief
Genetic explanation of OCD
OCD tends to run in families which suggests there may be a genetic link. Twin studied are used to look for particular traits, MZ twins have higher concordance than DZ but never 100%. OCD is probably poly genetic (a combo of genes). Diathesis- stress model suggests certain genes leave people more likely to shudder from OCD, but environmental stress may be necessary to trigger the condition.
Neural explanations of OCD
- Neurotransmitters are chemical ,esangers which carry signals between neurons and other cellos in he body. Serotonin is one linked to mood and is linked to OCD. Seritonin sends mood related info, but if serotonin levels are low then mental process can be affected. Low levels of serotonin have been found in people with OCD.
- drugs called SSRI increase level of serotonin, and people who have taken them show reduction in OCD symptoms
Evaluation of genetic explanation of OCD
- lots of research support: Gerald Nestadt et al (2010) reviewed twin studies and found that 68% of MZ twins shared OCD, opposed to 31% of DZ twins. Also family studies done shown personal with family member diagnosed with OCD is 4x more likely to develop OCD than someone without (Marini and Stebnicki)
- environmental factors, OCD does not appear to be entirely genetic in origin and it seems environmental risk factors can also trigger OCD. Kiara Cromer et al (2007) found that over half of the OCD clients in their sample had experienced a traumatic event in their past. OCD was also more severe to the people with trauma.
- not that many MZ/DZ twins, can’t do large samples or replicate
Evaluation of Neural explanation for OCD
- research support: Choy Et al found that people with OCD have low levels of serotonin. Antidepressants called SSRI that work purely on on increasing serotonin levels are effective for reducing OCD symptoms.
- sertitonin disruption may not be just linked to OCD. Many people with OCD also experience clinical depression. This depression probably involves disruption to the action of serotonin. Seritionin activity could be disrupted in many people with OCD because they have depression as well, this means serotonin may not be relevant to OCD symptoms
- some people might not respond to SSRI
Explain how SSRI work (treatment)
- antidepressant called selective serotonin re uptake inhibitor
- in the brain serotonin is releases by presynaptic neurons and travel across a synapse. Neurotransmitters convert a signal from the presynaptic neurons to the post synaptic neuron then the serotonin is reabsorbed by the presynaptic neurons where it is broken down and reused
- SSRI prevent the reabsorption and increase the levels of serotonin in the synapse, this compensates for whatever is wrong with the serotonin system in OCD
- the dosage is higher for OCD than it is for depression and it may take up to 12 weeks for the drugs to take effect
What might you combine SSRI with (treatment)
Drugs are also used along side CBT to treat OCD. The drugs reduce a persons emotional symptoms so they can engage more effectively with the CBT.
Alternatives to SSRI (treatment)
When SSRI aren’t effective are 4 months they dose ca n be increased or can be combined with other drugs
- Tricyclics, acts on serotonin system in same way as SSRIs, often has more side effects than SSRI so is only kept for people who do not respond to SSRI
- SNRIs, increase levels or serotonin as well as a different neurotransmitter called Noradrenaline, also used for those who don’t respond to SSRI
Evaluation of treatment for OCD: Evidence
- clear evidence showing Thant SSRIs redunce symptoms and improve quality of life
- Soomoro et al reviewed 17 studies that compared SSRI to placebos in treatment of OCD, all studies showed better outcomes for SSRI than placebo
Typically symptoms reduce by 70% of people taking SSRIs, remaining 30% can be helped by alternative drugs and CBT - however may not be most effective treatment as a study was done that showed that cognitive and behavioural therapies were more effective than SSRIs
Evaluation of treatment for OCD: Cost and dissruptive
- drugs ar ost effectuve and non disruptive to peoples lives
- cheap compared to psychological treatments because thousand of tablets or liquid doses can be manufactured in the time it takes to conduct line session of CBT
- good for NHS cause limited funds
- non disruptive as you can just take drugs whereas therapies requires you to spend time attending sessions
Evaluation for treatments of OCD: Side effects
- drugs can have some serous side effects
- although drugs help most people a small minority will get no benefit
- some people also experience side effects such as indigestion, blurred vision. These ae usually temporary, but can be quite distressing and sometimes long lasting
- For those taking Tricyclic, side effects are more serious and common: 1 in 10 people experience weight gain and 1 in 100 become aggressive and experience heart related problems.
- this means some people have reduced quality of life as result of drugs and may stop taking them all together, meaning not help with OCD
