Psychopathology - OCD Flashcards
What is OCD?
An anxiety disorder where sufferers experience persistent and intrusive thoughts occurring as obsessions, compulsions or a combination of the two.
What are obsessions?
Repetitive + intrusive thoughts that are products of the minds (not realistic) and are extremely difficult to dismiss. Patients are aware that the obsessions are unreasonable but they cannot control them.
What are compulsions?
Repetitive + rigid behaviours and are generally carried out due to the obsessions. Patients are driven to perform these acts as they fear dangerous consequences if they don’t.
Describe the OCD cycle.
1) obsessive thought.
2) anxiety
3) compulsive behaviour
4) temporary relief
5) cycle repeats
What is the DSM?
Diagnostic and statistical manual of mental disorder.
What is the DSM’s criteria on OCD?
- recurrent obsessions and compulsions.
- recognition by the individual that obsessions are excessive.
- person is distressed and daily life is disrupted.
What are the behavioural characteristics of OCD?
- repetitive behaviour that disrupt everyday functioning e.g. hand washing.
- compulsions reduce anxiety.
- avoidance. Avoiding certain situations.
- social impairment
What are the emotional characteristics of OCD?
- anxiety and distress.
- depression. Compulsions bring temporary relief.
- guilt and disgust.
What are the cognitive characteristics of OCD?
- recurrent and persistent obsessive thoughts that are intrusive and repetitive.
- uncontrollable urges to perform acts.
- obsessions are unwanted.
- the individual is aware of their excessive + irrational thoughts.
What is OCD in terms of its genetic structure?
It is polygenic meaning more than one gene plays a role in OCD. Up to 230.
What does the ComT gene control?
Controls dopamine regulation, reducing its action.
What does the SERT gene control?
It affects the transport of serotonin.
What does the ComT gene variant cause?
It reduces the production of the enzyme which helps terminate dopamine therefore dopamine is not controlled = too much dopamine.
What does the SERT gene variation cause.
It affects the transport of serotonin. The variation creates lower levels of it because the mutation causes an increase in transporter proteins at the neurones membrane.
Describe the results of 2 twin studies.
MZ concordance rate = 53-87% DZ concordance rate = 22-47%
People with a first degree relative with OCD had a 5x greater risk of having OCD.
What is Diathesis-stress?
Variant genes make people more vulnerable to disorders but stressors affect what condition develops or whether any mental illness develops at all. Therefore, some people could posses the ComT or SERT gene variations but suffer no ill effects.
What parts of the brain are responsible for decision making and logical reasoning?
The lateral (side) bits of the frontal lobe.
Describe how abnormal brain circuits can be involved in OCD?
1) OFC sends ‘worry signals’.
2) these signal usually suppressed by caudate nucleus which filters out irrelevant impulses.
3) more powerful ones are sent to the thalamus for more thinking.
4) for OCD sufferers it is said that the caudate nucleus is damaged so doesn’t suppress the signals.
How can surgery reduce OCD?
If it disconnects the basal ganglia from the frontal cortex the pathway for worrying info is stopped.
What are SSRI’s and how do they help OCD?
It rebalances the low levels of serotonin by blocking the serotonin reuptake, increasing the amount available in the synapse to bind to receptor sites thus increasing overall levels of serotonin in the brain.
What are SNRI’s and how do they help OCD?
They block transporter mechanisms that absorb serotonin and noradrenaline back into the pre-synaptic neurone after it has fired. Therefore leaving more of these neurotransmitters in the synapse, prolonging their activity.
What extreme drugs can be used to treat severe OCD?
BZ’s can be used to reduce severe anxiety. They slow down the nervous system by increasing GABA (a neurotransmitter). However, they are highly addictive.
what are the advantages of drug therapy?
- the drugs are non-addictive.
- Drugs are cost efficient.
- Easy to take.
- They are quick compared to therapy.
- Drug have been proven to be effective in placebo tests.
what are the disadvantages of drug therapy?
- there can be possible side effects. not everyone suffers but people who do may stop taking the drug.
- drugs are not a cure, if u stop taking them you may experience relapse.
- Not everyone responds to drugs.
- there may be better/more ethical treatments out there.
