OCD (PSYCHOPATHOLOGY 4/4) Flashcards
OCD definition
obsessive compulsive disorder is an anxiety disorder where suffers experience persistent and intrusive thoughts (obsessions), compulsions or a combination of both
most realise obsessive ideas and compulsions are excessive and inappropriate but cannot consciously control them, resulting in high levels of anxiety
symptoms can overlap with other conditions (autism, Tourettes), question whether it exists as a separate disorder
can become very time consuming, interfering with ability to conduct everyday activities
obsessions
things people think about
recurrent and persistent thoughts, urges or images that are inappropriate and aren’t based in reality
lead to extreme anxiety
compulsions
results of obsessions
repetitive behaviours or mental acts which are intense and uncontrollable
attempt to reduce distress or prevent feared events, even though there is little chance of them happening or being reduced by compulsions
can reduce compulsions but are only temporary solutions, but rely on them as a short-term solution as there is no other way of coping
e.g. avoiding situations that trigger obsessive ideas or images
prevalence
2% of UK population
no real gender difference
preoccupations with contaminations and cleaning are more common in females
males focus more on religious and sexual obsessions
more common among male children - earlier, gradual onset
females generally have later, sudden onset with fewer severe symptoms
behavioural characteristics
REPETITIVE COMPULSIONS - compulsions to repeat a behaviour, commonly hand washing, praying, tidying or ordering objects
ANXIETY-REDUCING COMPULSIONS - 10% of sufferers have compulsive behaviours alone, no obsessions, just a general sense of irrational anxiety, performed to manage anxiety e.g. hand-washing in response to fear of germs
AVOIDANCE - attempt to reduce anxiety by avoiding situations that trigger it, can interfere with leading an ordinary life
emotional characteristics
EXTREME ANXIETY AND DISTRESS - anxiety accompanies both obsessions and compulsions, obsessive thoughts are unpleasant and frightening, anxiety overwhelming, urge to repeat a behaviour creates anxiety
ACCOMPANYING DEPRESSION - low mood and lack of enjoyment, compulsive behaviours bring some relief from anxiety but is only temporary
GUILT AND DISGUST - involves other negative emotions such as irrational guilt (e.g. over moral issues) or disgust directed at something external or at self
cognitive characteristics
OBSESSIVE/RECURRENT THOUGHTS - 90% of sufferers experience obsessive thoughts as major cognitive feature, vary but always unpleasant e.g. contaminated by dirt, certainty a door in unlocked, impulses to hurt someone
COGNITIVE COPING STRATEGIES - respond to obsessions by adopting coping strategies, religious person tormented by excessive guilt may respond by praying or meditating, may help manage anxiety but can make them appear abnormal and distract from everyday tasks
INSIGHT/AWARENESS OF IRRATIONAL BEHAVIOURS AND ANXIETY - aware of irrationality of obsessions and compulsions, necessary for diagnosis, experience catastrophic thoughts about worst-case scenarios, tend to be hypervigilant (maintain constant alertness and keep attention focused on potential hazards)
explaining OCD - genetics
evidence that OCD is inherited
those with disorder inherited specific genes related to onset
concordance rates
COMT gene
SERT gene
diathesis-stress model
OCD is polygenic
concordance rates
2% of UK population at risk
Lewis observed 37% of OCD patients had parents with OCD, 21% with siblings with OCD, suggesting that it runs in families
may be a vulnerability passed on, not absolutely certainty
Pauls found that risk was greater in first-degree relatives of OCD patients compared to relatives of controls without OCD (10% vs 1.9%)
COMT gene
catechol-o-methyltransferase
candidate gene that can be inherited and increase vulnerability to OCD
involved in production of an enzyme regulating production of neurotransmitter dopamine
one form is more common in OCD patients - lower activity and higher dopamine (rewards - positive reinforcement)
SERT gene
candidate gene
affects transport and take-up of serotonin (causes anxiety, resulting in compulsions performed to reduce anxiety)
lower levels and activity of serotonin implicated in OCD
diathesis-stress model
genes interact with environment to bring about development of OCD
suggests that individual genes cause vulnerability for OCD (diathesis)
other factors affect development (stressors)
some possess genes but never suffer
genetics play part in development, but interaction with environment is key
OCD is polygenic
caused by combination of genetic variations that increase vulnerability
Taylor analysed findings and found that up to 230 genes may be involved
genetic explanation of OCD strengths (supporting evidence)
supporting evidence
Ozaki found mutation of SERT gene in two unrelated families, where 6/7 family members had OCD
supports idea that SERT gene increases risk of developing OCD, caused by genetics
supporting evidence
Nestadt reviewed twin studies and reported that 68% of identical twins shared OCD as opposed to 31% of non-identical twins
supports idea of inheritance - share 100% of DNA so if one has OCD, the other’s risk of developing OCD is higher
proves inheritance and affected by genetics
genetic explanation of OCD weaknesses
cannot rule out environmental influence
living in similar environments may affect OCD development
social learning theory - if one family member has OCD, others may view behaviour as normal and learn from each other, increasing likelihood of development
concordance rates
not purely genetic - in twins the risk should be 100% as they share same DNA
