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Psychology Paper 2 > Psychopathology - Biological approach to OCD > Flashcards

Psychopathology - Biological approach to OCD Flashcards

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1
Q

What are the general assumptions of the biological approach to OCD?
(NAGI)

A
  • OCD is caused by neural abnormalities in the
    structure or function of the brain
  • OCD may be partly caused by genes
  • OCD is assumed to be an illness which can
    be treated medically

(Neural Abnormalities Genes Illness)

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2
Q

How is OCD thought to be linked to neural abnormalities in the brain?

A
  • evidence that OCD is linked to abnormalities in brain circuits that are involved in detecting & responding to potential danger
  • in OCD it is thought that abnormal activity in
    these circuits may trigger obsessions &
    compulsions
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3
Q

How is are the Basal Ganglia & Orbito Frontal Cortex thought to be involved in OCD?

A
  • The two areas of the brain connect in a circuit
    which is responsible for detecting &
    responding to threats
  • Abnormalities in this circuit may mean that
    there is overactivity of primitive, protective
    behaviours
  • over activity of direct pathway triggering
    concern about danger, harm & hygiene
  • under activity of indirect pathway which
    inhibits compulsive behaviour (behaviour
    becomes repetitive)
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4
Q

Evidence for neural abnormalities & OCD

A
  • brain scanning studies of patients with OCD
    has revealed abnormalities in basal ganglia
    (but NOT all OCD patients)
  • symptoms of OCD can be reduced by altering
    the activity between the O.F.Cortex & BG
    (deep brain stimulation)

Damian Denys
- DBS effective in 60% of OCD patients

Polak: Case Study
- man who suffered damage to BG after heart
attack showed compulsive whistling
behaviour

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5
Q

Weaknesses of using neural abnormalities to explain OCD

A
  • we cannot be certain of cause & effect from
    brain scanning studies
    (abnormalities may be a result of OCD)
  • Scanning studies have not found
    abnormalities in brain function in every
    patient with OCD
    > other explanations are needed
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6
Q

What are neurotransmitters & how are neurotransmitters thought to be involved in OCD?

A
  • Chemicals in the brain that allow messages
    to be sent between brain cells
  • Serotonin = involved in mood regulation
  • one theory is that OCD is related to reduced
    activity of serotonin in the brain
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7
Q

Evidence for mutations in neurotransmitters & OCD

A
  • mutations in a gene linked to serotonin
    activities have been found in brain scanning
    studies comparing patients with & without
    OCD
  • considerable evidence for medications that
    increase Serotonin activity being effective in
    reducing OCD symptoms
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8
Q

Weaknesses of neurotransmitter abnormalities explaining OCD

A
  • The brain uses a complex range of
    neurotransmitters which interact with each
    other. It is unwise to focus on the role of one
  • Drug effectiveness does not prove a cause -
    may be treating symptom
  • Improvements in OCD patients have been
    found in those treated with SSRIs &
    psychologically (Baxter)
    > brain abnormality may be a consequence
    not cause of OCD
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9
Q

Why are genes thought to be involved in OCD?

A
  • evidence that OCD ‘runs in families’
  • we may inherit a vulnerability to OCD
  • twin studies support the idea of a genetic
    component
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10
Q

What does polygenic mean?

A

linked to many genes NOT a single gene

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11
Q

Evidence for role of genes in OCD

A

Nestadt:
- review of evidence from twin studies found a
concordance rate of 68% for identical (MZ) &
31% for non-identical (DZ)
- Identical twins more genetically similar so
suggests genetic component of OCD

Van Grootheest:
- review of twin studies found that OCD has a
stronger genetic component if people
develop it in childhood
- suggests environmental triggers may cause
some adults to develop OCD without genetic
vulnerability

Gene mapping (NIMH America)
- OCD linked to serotonin transporter gene
(SERT) which is important in how serotonin in
transported across synapses

Zohar
- drugs that reduce serotonin levels cause an
increase in OCD symptoms
- drugs that increase ser. levels have been
found to reduce symptoms

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12
Q

Weaknesses of the use of genes to explain OCD

A
  • NO twin study of OCD has found 100%
    concordance rate
  • although MZ & DZ twins raised together,
    upbringing of MZ twins may be more similar
  • The mechanisms by which genes make
    someone more vulnerable to OCD aren’t
    currently fully understood
  • role of genes so complex that we are unlikely
    to find a clear treatment
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13
Q

What are examples of biological treatments of OCD?

A
  • drugs (SSRIs = Serotonin re-uptake inhibitors)

- surgery (Deep Brain Stimulation (DBS))

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14
Q

How are SSRIs used in the treatment of depression & how do they work?

A
  • 20mg a day
  • 3-4 month course of treatment
  • prescribed
  • drugs reduce the re-uptake of serotonin,
    making more available in the synapse
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15
Q

What are some side effects of SSRIs?

A
  • tiredness
  • sleep disturbance
  • headaches
  • suicidal thinking
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16
Q

Evidence for the effectiveness of SSRIs

A

Soomro:
- review found that SSRIs were better at
treating OCD and were moderately effective
at reducing symptoms in adults
- estimated around 70% of patients show
significant reduction in symptoms
(BUT be wary of drug company bias)

Koran: combining SSRIs with other medication
- patients varied in how well they responded to
SSRIs combined with olanzapine
- there appeared to be benefits of trying
combination with patients who didn’t respond
to SSRIs alone but considerable weight gain

17
Q

Why might SSRIs be seen as an appropriate OCD treatment?

A
  • reduction in symptoms can reduce distress &
    improve wellbeing
  • benefits the economy if people can return to
    work (no sick leave)
  • relatively ‘cost effective’ - tablets cheaper to
    NHS than cognitive therapy sessions & no
    time off work needed
  • tablets can be taken easily
18
Q

Why might SSRIs be seen as an inappropriate OCD treatment?

A
  • can have unpleasant side effects - people
    may drop out of treatments needing
    alternative therapy
  • people’s symptoms may return if they stop
    taking the medication - some people take
    medication for many months or years (may be
    more effective to combine medication with
    cognitive therapy to help)
  • Fluoxetine is not appropriate for young
    children as it’s use has been associated with
    thoughts of self harm or suicide
19
Q

What is deep brain stimulation (DBS)?

A
  • surgery involving inserting an electrode into
    the area of the brain thought to be
    malfunctioning
  • the electrode sends impulses to these areas
    & remains in the brain
20
Q

Evidence for DBS as a treatment for OCD

A

Damian Denys:
- 60% of 50 patients treated with DBS to basal
ganglia area found improvements in OCD
symptoms

21
Q

Problems with DBS as an OCD treatment

A
  • 40% Denys’ patients didn’t significantly
    improve
  • complex & dangerous - high risk of internal
    bleeding
  • used in intractable cases of OCD (last resort)

Psychology Paper 2 (12 decks)

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