OCD - characteristics, explanations and treatments Flashcards
What are obsessions?
(cognitive)
recurrent, persistent, unwanted thoughts
what are compulsions?
(behaviour)
repetitive, ritualised behaviours performed to reduce anxiety
example of obsession and example of compulsion
obsession - thinking you will be contaminated by germs if you touch a door handle
compulsion - washing hands over and over again
Behavioural characteristics of OCD
Compulsive behaviours
Avoidance behaviours - avoiding situations that trigger anxiety
Emotional characteristics of OCD
Anxiety and distress
Accompanying depression
Guilt and dsigust
Cognitive characteristics of OCD
Obsessive thoughts
Cognitive strategies - trying to manage the anxiety to respond to thoughts
Hypervigilance - constant alertness, focus on potential hazards
The biological approach to explaining OCD - genetic explanations (SERT and COMT)
Researchers have identified certain genes which create vulnerability for OCD, these are known as candidate genes
SERT gene - transfer of serotonin - mutated copies of the gene inhibits its ability to properly function causing decreased serotonin
COMT gene - regulated dopamine production - faulty COMT gene causes increased dopamine
The biological approach to explaining OCD - neural explanations
Neural - the view that physical and psychological characteristics are determined by the behaviour of the nervous system - the brain, neurons and neurotransmitters
1 - caudate nucleus - detects threat usually suppressed by serotonin however faulty SERT gene
2 - parahippocampul gyrus - regulates unpleasant emotions eg anxiety
3 - orbito frontal cortex - worry centre responsible for planning and decision making to avoid high anxiety. increased dopamine = abnormal decision making
4 - basal ganglia - this is activated which has high dopamine and causes repetitive motor movement known as compulsion
5 - thalamus - rewards compulsive behaviour causing the feedback loop to the OFC to say the threat has been dealt with. Increasing chance of same action happening again.
EVALUATION - is OCD caused by our genetics?
1 - research support for genetic explanation - Nestadt et al did a meta analysis of twin studies and for identical twins if one twin had OCD then 68% of the time both twins had it compared to 31% for non identical twins - supports as identical twins share 100% of the same DNA which suggests OCD can be explained to genetics due to higher similarity rate - however could also be nurture and environment as identical twins likely to have grown up in the same environment.
2 - weakness - research suggests environmental factors can cause severe OCD - Cromer et al found over half the OCD patients in their sample had a traumatic event in their past and the OCD was more severe in those who had experienced trauma - traumatic event is result of environment and not genetics so this can’t be explained by biological approach - however some people can be more prone to stress from genetics and hormones - genetic and environmental factors go hand in hand
EVALUATION - is OCD caused by our neural correlates (brain connections)
1 - research support for neural explanation - evidence from treatment studies has shown when patients take SSRIs that OCD symptoms decrease, different researchers found an overall 50-80% improvement- suggests low serotonin causes OCD - therefore supports neural explanation as OCD sufferers tend to have a faulty SERT gene that inhibits serotonin production - however this doesn’t work for around half of patients so serotonin can’t be the only factor in causing OCD
2 - further research support for neurochemistry causing OCD - Rapport and Wise used PET scans and found that due to low levels of serotonin, the caudate nucleus is hypersensitive and gives an exaggerated response (therefore increasing repetitive motor behaviours in the OFC) - implies that the caudate nucleus has too little serotonin in people with OCD causing the OfC and basal ganglia to become overactive and create compulsions to reduce anxiety caused by the caudate nucleus - therefore OCD biologically caused by function and structure of the brain - however PET scans do not measure serotonin levels directly so might not be valid.
Biological approach to treating OCD - SSRIs
Effectiveness - 50-80% improvement, 3-4 months to work
Side effects - agitated, shaky, sickness, indigestion, weight loss, dizziness, loss of appetite
Biological approach to treating OCD - tricylclics and MAOIs
Effectiveness - 56-60% responded well to treatment, little difference to SSRIs
Side effects - dry mouth, nausea, headache, drowsiness, can cause fatal increase in blood pressure when mixed with some foods
Biological approach to treating OCD - SNRIs
Effectiveness - meta analytical studies suggest a small superiority over SSRIs
Side effects - fewer side effects and better tolerability - tiredness, insomnia
EVALUATION of biological treatments of OCD
1 - research to suggest that SSRIs and the biological treatment are effective in reducing symptoms of OCD - Julien found a 50-80% improvement in OCD symptoms with SSRIs and another meta analysis found when comparing SSRIs to placebo all 17 studies found a 70% reduction in OCD for SSRIs - therefore clear robust evidence from multiple studies - however drugs only treat the symptoms and not the cause and a study found 90% relapse rate when patients stopped taking SSRIs - only effective when taken consistently and can produce side effects that make the patient worse
LINK
2 - SSRIs produce side effects such as sickness, indigestion, weight loss, dizziness, infertility and anxiousness - this is a limitation compared to other psychological therapies that have no side effects as they can clearly effect the quality of life for adults and can result in the patient not wanting to engage in treatment - however psychological therapies are more time consuming and require commitment - therefore drug therapies may be practically better for treating OCD
