OCD Flashcards
definition of OCD
a long-lasting disorder where a person experiences uncontrollable and recurring thoughts, so engages in compulsive behaviours
what are obsessions
repeated thoughts, urges, or mental images that are intrusive and provoke anxiety
what are compulsions
repetitive behaviours or mental acts that a person performs as a result of their obsession
give 3 examples of obsessions, and the compulsion that could be used to gain temporary relief
obsession - fear of germs
compulsion - excessive hand washing
obsession - fear of being harmed
compulsion - repeatedly checking locks
obsession - need for symmetry
compulsion - arranging items in a specific order
what is the vicious cycle of OCD
obsession, anxiety, compulsion, temporary relief
how to remember the BEC characteristics for OCD
bobby eats cookies
describe how bobby eating cookies links to the BEC characteristics of OCD
BEHAVIOURAL:
- bobby eats the same cookies over and over (compulsions are repetitive)
- bobby eats cookies to calm down (compulsions reduce anxiety)
- bobby doesn’t eat anything but cookies (avoidance)
EMOTIONAL:
- bobby gets anxious if not eating cookies (extreme anxiety and distress)
- bobby feels guilty and disgusted after eating too many cookies (accompanying guilt, depression, and disgust)
COGNITIVE:
- bobby dreams about cookies and can’t stop thinking about them (obsessive recurrent thoughts)
- bobby plans his next eating session to calm down (cognitive coping strategy)
- bobby knows the cookies make him fat, but can’t stop (awareness of irrational behaviours)
what is the first biological approach to explaining OCD
genetics
what supporting evidence shows that OCD might be due to genetics
Lewis (1936) observed that 37% of OCD patients had parents with OCD (2% of the general population has OCD, so this is a big jump), however, it may not be OCD which is genetically passed down, it may be the vulnerability to OCD (Pauls et al. found that the risk of OCD was significantly greater in 1st degree relatives of people with OCD - 10% vs 1.9%)
what is the COMT gene
a candidate gene that can be inherited and increases someone’s vulnerability to OCD
what process is the COMT gene involved in
the production of an enzyme which regulates the production of neurotransmitter dopamine
How does a variation of the COMT gene explain people with OCD
One variation of the COMT gene is more common in OCD patients - this variation produces lower levels of the COMT gene and more dopamine, which explains why people with OCD feel happier after compulsions
what is the SERT gene and what does it affect in regard to OCD
a candidate gene which affects the transport of serotonin (therefore increasing its reuptake), which causes lower levels of activity
what does the diathesis-stress model suggest in regard to the development of OCD
each individual gene creates a vulnerability to OCD, but they do not result in the disorder - other factors like the environment affect the development of OCD
what does polygenic mean
a disorder is not caused by 1 gene but by a combination of genetic variations that can increase vulnerability
what evidence implies that OCD is polygenic
Taylor (2013) analysed findings from previous studies and found that up to 230 genes may be involved in OCD
give 2 pieces of supporting evidence for the genetic approach to OCD
- Ozaki et al (2003) studied 2 different families and found that the 7 people who had a mutation of the SERT gene, 6 went on the develop OCD
- suggests that the SERT gene is credible - Nestadt et al (2010) reported that 68% of identical twins shared OCD compared to 31% of non-identical twins, this highlights that the closer in relation you are to someone, the higher your development chance is (however, if OCD is purely genetic surely identical twins with have a 100% concordance rate?)
give a piece of opposing evidence for the genetic approach to OCD
Grootheest et al (2005) found that OCD originating in childhood was more genetic that OCD originating in adulthood - this suggests that there may be different types and causes of OCD (link to diathesis stress)
what is the second biological approach for explaining OCD
neural explanations (higher levels of dopamine -> more compulsions)
how does an abnormal level of dopamine affect OCD
higher levels of dopamine lead to more compulsions because the brain is more ‘motivated’, after these compulsions are, the brain wants to continue the feeling of temporary relief so compulsions happen again
How does an abnormal level of serotonin affect OCD
lower levels of serotonin which lead to reduced mood and activity levels are associated with OCD - research has shown that antidepressant drugs which increase serotonin help to reduce OCD symptoms
how does the worry circuit work
- the orbitofrontal cortex sends a signal to the thalamus via the caudate nucleus about anything it finds worrying
- the caudate nucleus is supposed to filter/limit messages from the OFC - especially messages which are irrational or not particularly worrying, but this process is damaged in people with OCD
- the thalamus relays strong messaged of confirmed worry back to the OFC, creating a worry loop
give a piece of supporting evidence for the neural explanation of OCD
Zohar et al (1987) gave mCPP (a drug that reduces serotonin levels) to 12 OCD patients and 20 non-OCD patients. The symptoms of OCD were significantly enhanced which suggests that the theory that OCD is associated with low levels of serotonin is credible
give a weakness for the neural explanation of OCD
OCD can also be explained by psychological explanations such as the 2-process model:
germs (UCS) -> anxiety (UCR)
germs (UCS) + dirt (NS) -> anxiety (UCR)
dirt (CS) -> anxiety (CR)
this suggests that neural explanations may be too simplistic
why do neural explanations for OCD often lack internal validity
it is hard to establish the cause and effect of OCD because biological research regarding serotonin, the worry circuit etc., only show a link to OCD, not its true cause
what is the general purpose of drug therapy for OCD
to increase or decrease the levels of certain neurotransmitters in the brain
how do antidepressant drugs (SSRIs) help to treat OCD
These selective serotonin reuptake inhibitors block channels so serotonin cannot get through and must be uptaken. This lower level of serotonin will reduce anxiety by normalising the worry circuit and improving the patient’s mood
how do anti-anxiety drugs (BZs) help to treat OCD
Drugs like benzodiazepines (BZs) lower anxiety levels by enhancing the GABA activity. GABA tells neurons to ‘slow down’ and ‘stop firing’, which results in a quieter brain and, therefore, reduced anxiety, which is experienced as a result of obsessive thoughts
why do drug treatments for OCD usually last between 12-16 weeks
it takes a while for the brain to adjust, therefore some benefits are not noticed until week 12
what supporting evidence shows the strengths of drug treatments for OCD
Soomro et al. (2008) examined the effectiveness of SSRIs and found that they were more effective than placebos in 17 different OCD trials
give 2 strengths of drug treatments for OCD (not supporting evidence)
cost effective: once the drug has been manufactured, it is relatively cheap and easy to distribute and produce (also cheaper because there are fewer doctors appointments needed)
motivation: psychological treatments only work if the patient is motivated enough to do them, which can be unrealistic. drugs, however, do not take any effort so the treatment program is more likely to be successful
give 2 weaknesses of drug treatments for OCD
- The negative side effects - BZs, for example, are known for being highly addictive and causing aggression and memory impairments so patients may be unwilling to complete their trial
- it is reductionist - drug treatments work on the assumption that OCD originates from biological factors, however, it could have other causes such as the environment and traumatic life events
how do drug treatments for OCD benefit the economy
if treatments are effective, workers can go back to work which reduces an employers financial burden due to not needing sick pay or part-time workers
Drug treatments are also cheaper for the NHS because there is no need for ongoing treatments
what is a different treatment for OCD (not drugs)
psychotherapy - exposes patients to the response of their obsessions without the compulsions which helps to reduce anxiety in the long run
