OCD Flashcards
What is the DSM-5 definition of OCD?
OCD is characterized by obsessions (recurrent thoughts, images, etc.) and/or compulsions (repetitive behaviors such as handwashing).
What are obsessions in OCD?
Cognitive processes involving recurrent and persistent thoughts, urges, or images that are intrusive and cause anxiety.
What are compulsions in OCD?
Repetitive behaviors or mental acts performed to reduce anxiety or prevent a feared event.
How do compulsions reduce anxiety in OCD?
Compulsions are performed in response to obsessions to reduce the anxiety associated with them.
What emotional characteristics are common in OCD?
Anxiety, distress, depression, guilt, and disgust.
What is a key cognitive characteristic of OCD?
Obsessive thoughts such as fear of contamination or doubt about locking doors.
What is “insight into excessive anxiety” in OCD?
Awareness that obsessions and compulsions are irrational, but the person still feels compelled to perform them.
What is a common behavioral characteristic of OCD?
Avoidance of situations that might trigger obsessions or compulsions, such as avoiding public places to prevent contamination.
What is the cycle of OCD?
Obsessive thought → Anxiety → Compulsive behavior → Temporary relief → Repeat.
Biological approach
Emphasizes the role of biological processes, including genetics and brain function, in behavior.
Genetic explanations
Focus on the influence of inherited genes on behavior. Genes determine characteristics like serotonin system regulation.
Neural explanations:
Focus on the role of the nervous system, including brain structures and neurotransmitters, in behavior.
How do genetic factors contribute to OCD?
Candidate genes
Polygenic nature
Aetiologically heterogeneous
What are the neural explanations for OCD?
Role of serotonin
Decision-making systems
What research supports the genetic explanation of OCD?
Twin studies:
Nestadt et al. (2010): 68% concordance rate for OCD in MZ twins vs. 31% in DZ twins.
Family studies:
Marini and Stebnicki (2012)
First-degree relatives of OCD patients are more likely to develop OCD.
What are the limitations of genetic explanations of OCD?
Environmental risk factors: Genetic vulnerability is not the sole cause; environmental factors like trauma also play a role (Cromer et al., 2007).
What supports the neural explanation of OCD?
Research support:
Antidepressants targeting serotonin reduce OCD symptoms, showing serotonin’s role.
Neurological disorders like Parkinson’s involve similar biological mechanisms.
Scientific credibility: Evidence from brain imaging and neurotransmitter studies.
What are the criticisms of the neural explanation of OCD?
Correlation vs. causation: Brain abnormalities may result from OCD rather than cause it.
Non-unique neural system: Disruption in serotonin systems occurs in other conditions, questioning its specificity to OCD.
What are candidate genes in OCD?
Genes that create vulnerability, e.g., SERT and 5HT-1 beta, linked to serotonin regulation.
What does “OCD is polygenic” mean?
OCD involves multiple genes, with up to 230 implicated.
What brain regions are linked to OCD in neural explanations?
Lateral frontal lobes (decision-making) and parahippocampal gyrus (emotions).
How does serotonin affect OCD?
Low serotonin impairs mood regulation and increases OCD symptoms.
Define “aetiologically heterogeneous.”
Different genes cause OCD in different individuals, leading to symptom variations.
What is the biological approach to decision-making in OCD?
Dysfunction in the lateral frontal lobes affects logical thinking and decisions.
What is the “diathesis-stress model” in OCD?
Genes predispose individuals to OCD, but stress triggers its onset.
What is drug therapy in the context of OCD treatment?
Treatment involving drugs that affect the functioning of the brain or body system, usually targeting abnormal neurotransmitter levels in psychological disorders such as OCD
What neurotransmitter is primarily targeted in the biological treatment of OCD?
Serotonin.
What is the main type of antidepressant used to treat OCD?
Selective serotonin reuptake inhibitors (SSRIs).
How do SSRIs work in treating OCD?
SSRIs prevent the reabsorption and breakdown of serotonin, increasing its levels in the synapse and continuing to stimulate the postsynaptic neuron.
What are SNRIs, and how do they work?
Serotonin-noradrenaline reuptake inhibitors (SNRIs) increase serotonin levels and another neurotransmitter, noradrenaline. They are used for people who don’t respond to SSRIs.
What is the role of serotonin in treating OCD?
It regulates mood, and low levels are associated with OCD symptoms. Drug treatments increase serotonin to alleviate symptoms.
What are alternatives to SSRIs if they are not effective after three to four months?
Alternatives include increasing the SSRI dose, combining with other drugs, or using different types of antidepressants like tricyclics or SNRIs.
What is a tricyclic antidepressant, and why is it used less frequently?
Tricyclics affect the serotonin system like SSRIs but have more severe side effects, so they are reserved for those who don’t respond to SSRIs.
What is drug therapy in the context of OCD treatment?
Drug therapy involves using chemicals, such as antidepressants, that affect neurotransmitter levels in the brain to increase or decrease their activity. It targets abnormal neurotransmitter levels associated with OCD.
What are SSRIs, and how do they work in treating OCD?
type of antidepressant that work by preventing the reabsorption and breakdown of serotonin in the brain
increases serotonin levels in the synapse, helping to stimulate the postsynaptic neuron and correct serotonin imbalances.
How is serotonin released and reabsorbed in the brain?
released by presynaptic neurons into the synapse, where it travels to receptor sites on postsynaptic neurons. After conveying its signal, serotonin is reabsorbed by the presynaptic neuron, where it is broken down and reused.
What happens when SSRIs block the reabsorption of serotonin?
ensure that more serotonin remains active in the synapse, increasing its availability to stimulate postsynaptic neurons and compensating for serotonin deficiencies in OCD.
What is one strength of drug treatment for OCD in terms of effectiveness?
There is clear evidence that SSRIs reduce symptom severity and improve quality of life. Studies show significantly better outcomes for SSRIs compared to placebos, with around 70% of patients benefiting from SSRIs.
What happens to the remaining 30% of people for whom SSRIs are not effective?
For these patients, symptoms may be managed through alternative drugs or combinations of drugs with psychological therapies.
What is a counterpoint to the evidence of effectiveness for drug treatments for OCD?
Some studies, such as Petros Skapinakis et al. (2016), suggest that cognitive and behavioral (exposure) therapies are more effective than SSRIs, indicating that drugs may not be the best treatment for all patients.
Why are drug treatments for OCD considered cost-effective?
Drugs like SSRIs are cheaper to produce than psychological treatments, making them a good value for public healthcare systems such as the NHS. They also require fewer resources compared to therapy sessions.
How are drug treatments less disruptive to people’s lives compared to psychological therapies?
Patients can simply take drugs until symptoms decline without needing to spend time attending therapy sessions, making them convenient for most individuals.
What is one limitation of drug treatments for OCD?
Drugs can cause serious side effects, such as indigestion, blurred vision, and loss of sex drive. These side effects are usually temporary but can still be distressing for patients.
What impact can serious side effects have on a patient’s treatment?
Patients may stop taking the drugs altogether if side effects are severe, reducing the effectiveness of the treatment and potentially worsening their quality of life.
Why are drugs popular among many patients and doctors despite their limitations?
Drugs are effective, cost-efficient, and less disruptive than psychological therapies, making them a preferred choice for many patients and healthcare providers.
What evidence supports the effectiveness of SSRIs in treating OCD?
G. Mustafa Soomro et al. (2009) reviewed 17 studies comparing SSRIs to placebos and found significantly better outcomes for SSRIs. Around 70% of patients benefited from SSRIs, reducing symptom severity and improving quality of life.
What is a counterpoint to the effectiveness of drug treatments like SSRIs for OCD?
Petros Skapinakis et al. (2016) found that cognitive and behavioral (exposure) therapies were more effective than SSRIs, suggesting that drug treatments may not be the most effective option.
Why might cognitive and behavioral therapies be preferred over SSRIs for treating OCD?
These therapies address the underlying thought patterns and behaviors contributing to OCD, providing longer-term benefits without the side effects associated with drugs.
