Psychopathology - OCD Flashcards
What is OCD
OCD (Obsessive Compulsive Disorder) = Anxiety disorder and has 2 components:
- Obsessions
- Compulsions
What are Obsessions?
Obsessions are internal, reoccurring and persistent thoughts.
- 70% of OCD sufferers experience combined obsessions and compulsions.
- 20% experience just Obsessions.
What are Compulsions?
Compulsions are external, repetitive behaviours.
- 70% of OCD sufferers experience combined obsessions and compulsions.
- 10% of OCD sufferers experience just compulsions.
Biological Approach to Explaining OCD - Genetic Explanation
Genetic Explanation:
- Suggest OCD is inherited and that individuals inherit specific genes (COMT & SERT) which cause OCD.
- COMT gene regulates neurotransmitter Dopamine as it’s responsible for clearing Dopamine from synapses.
- One variation of COMT results in higher levels of Dopamine and this is related to reward processing in the brain, so increase Dopamine will mean that compulsive behaviours are rewarding which explains the behaviour of people with OCD
- SERT gene regulates Serotonin causing lower levels of Serotonin which is also associated with OCD.
Biological Approach to Explaining OCD - Neural Explanation
Neural Explanation focuses on neurotransmitters + brain structures.
- Abnormal levels of neurotransmitters, in particular Serotonin and Dopamine, are implicated in OCD.
- Particular regions of the brain, in particular Basal Ganglia and Orbitofrontal Cortex, are implicated in OCD.
Neural Explanation: Neurotransmitters
Serotonin regulates mood and is associated with anxiety.
- Lower levels of Serotonin are associated with OCD.
- Higher levels of Dopamine are associated with some of the symptoms of OCD, in particular the compulsive behaviours.
Strength of Neural Explanations for OCD - neurotransmitters
Support:
P - There is evidence to support.
E - Antidepressants increase levels of Serotonin in synapse reduce OCD symptoms, this suggests that Serotonin is involved in OCD.
E - SSRIs block reuptake of Serotonin after it has fired, prolonging its activity and increases availability of Serotonin to excite neighbouring brain cells.
L - Suggests that Neurological processes (especially those involving Serotonin and Dopamine) may be responsible for OCD.
Criticism of Neural Explanations of OCD - neurotransmitters.
Criticism:
P - Relationships between Neurotransmitters and OCD is correlational.
E - Just because antidepressants are effective in reducing OCD symptoms by increasing Serotonin doesn’t 100% mean the symptoms were caused by lack of Serotonin.
E - E.g. Paracetamol can reduce headaches but doesn’t mean that headaches are caused due to lack of Paracetamol.
L - Difficult to establish if imbalance of Neurotransmitters are the cause or effect of OCD.
Neural Explanation: Brain Structure
2 brain regions have been implicated in OCD, Basal Ganglia and Orbitofrontal Cortex.
- The Basal Ganglia is involved in multiple processes (coordination of movements).
Hypersensitivity in the Basal Ganglia is linked to repetitive actions (compulsions).
The Orbitofrontal Cortex, is a region that converts sensory information into thoughts and actions.
Increased activity in the Orbitofrontal Cortex increases the conversion of sensory information to actions (behaviours) which results in compulsions.
Support for Brain Structure
P - There’s support for abnormality in brain structure as the cause of OCD.
E - When Basal Ganglia is disconnected from frontal cortex during surgery, OCD-like symptoms are reduced, providing further support for the role of the Basal Ganglia in OCD.
E - Furthermore, Patients with OCD have higher levels of activity in the Orbital region than patients without OCD as shown in brain scans.
L - These findings support neural explanations for OCD.
Criticism of Brain Structure
Criticism:
P - Findings aren’t completely reliable, there are studies in which no differences in brain structure were found between OCD patients and controls.
E - Research is only correlational between increased brain activity and OCD.
E - Can’t be sure of cause and effect, as it’s not clear whether brain areas cause OCD or are the effects of OCD.
L - There may be a relationship between brain structure and OCD but it may not be direct cause.
Drug Therapy
Anti-depressant drugs - Used to reduce the symptoms (anxiety) associated with OCD.
- Low levels of Serotonin are implicated in OCD.
There are 2 types used with OCD:
- SSRI’s
- TCA
What do SSRI’s and TCAs do in Drug Therapy for OCD?
SSRI’s block the reuptake up Serotonin ONLY, after it has fired, this prolongs its activity and increases the availability of Serotonin to excite neighbouring brain cells.
TCA’s block the reuptake of Serotonin AND Noradrenaline after it has fired, this prolongs its activity and increase the availability of Serotonin and Noradrenaline.
- Only used if SSRI’s don’t work because they have worse side effects.
Appropriateness of Drug Therapy as a Treatment of OCD
P - May not be appropriate due to possible side effects.
E - Evidence suggests that SSRI’s are effective in treating OCD, but some patients experience side effects.
E - Mild side effects include indigestion, but others might experience more serious side effects such as Hallucinations.
L - Therefore, these side effects reduce the effectiveness of drug therapy, as patients may stop taking them due to the side effects.
Effectiveness of Drug Therapy as a Treatment for OCD
P - Research support from randomised drugs trials
E - These trials compare the effectiveness of SSRIs and Placebos (fake drug).
E - Research has found that SSRIs were more effective than Placebos in treating OCD in 17 different trials.
L - This supports the use of Drug Therapy especially SSRIs for treating OCD.
