Psychopathology : OCD

Question 1

What is OCD?

Answer 1

OCD ( obessive compulsive disorder),like phobias, is classified as an anxiety disorder ( fear of losing control) and has two main components , obsessions and compulsions

Question 2

What are the three characteristics of OCD?

Answer 2

Coginitive, behavioural and Emotional

Question 3

What do the coginitive characteristics of OCD contain?

Answer 3

obsessive thoughts are the main coginitive feature of OCD

Intrusive thoughts and impulses.
* Frightening and embarrassing.
* Uncontrollable.

Awareness:
* Sufferers of OCD know that their obsessions and compulsions are irrational.

Question 4

What do the behavioural characteristics of OCD contain?

Answer 4

Compulsive Behaviour
* Repetitive behaviour the sufferer feels compelled to complete.
* Physical or mental.

• Compulsions are used to manage or reduce anxiety.
• But not linked in a realistic way.

Question 5

What are emotional characteristics for OCD consist of?

Answer 5

Anxiety
* Caused by the obsession
Embarrassment & Shame
* Awareness of excessive behaviour
Depression
* Low mood and loss of pleasure caused by the anxiety

Question 6

What are the biological explanations for OCD?

Answer 6

These involve the role of genes, the role of neurotransmitters and the role of brain structures.

Question 7

Explain the role of genes in OCD

Answer 7

Genetic explanations for OCD suggest that the vulnerability to OCD is passed from generation to generation.
Lewis (1936) found that amongst OCD patients 37% had parents with OCD and 21% had siblings with OCD

Question 8

What are canditate genes?

Answer 8

Specific genes involved in a condition.
(specifcally OCD)

Question 9

Give an example of a canditate gene involved in OCD.

Answer 9

One example of a candidate gene is the SERT (5-HTT) gene

• Affects the transport of the neurotransmitter Serotonin.
  → Transportation issues cause lower levels of serotonin to be active within the brain

Ozaki et al. (2003)
Mutation in this gene in two families, where 6 of 7 members had OCD

Question 10

What is meant by a ‘Polygenic condition’ regarding OCD?

Answer 10

OCD is also believd to be a polygenic condition.

• Not caused by one gene, but rather combinations of gene variations.

Question 11

What research supports OCD being a ‘Polygenic condition’?

Answer 11

Taylor (2013) suggests that as many as 230 genes may be involved in the condition
Often ones involved in neurotransmitters such as dopamine and serotonin.

Question 12

What is the Diathesis-Stress Model?

Answer 12

It is highly unlikely that any one gene or combination of genes is solely responsible for the development of OCD.
→ Diathesis-Stress model

Vulnerability + environmental trigger

Question 13

Explain the role of neurotransmitters in OCD

Answer 13

*Both the neurotransmitters serotonin and dopamine are believed to play a role in OCD.

• Serotonin regulates mood and lower levels of serotonin are associated with mood disorders, such as OCD.
• Low serotonin levels → that normal transmission of mood related information doesn’t occur.

Question 14

What research supports the role of neurotransmitters in OCD?

Answer 14

Based on research
* Antidepressants that increase serotonin reduce symptoms Piggott et al. (1990)
* Those that don’t, have no effect. (Jenicke, 1992)

Question 15

Explain the role of brain structures in OCD

Answer 15

Abnormal brain circuits in various regions of the frontal lobes of patients with OCD

• Orbitofrontal cortex
• Caudate Nucleus
• Thalamus
  ‘The worry circuit’

Question 16

Explain the worry circuit regarding brain structures in OCD

Answer 16

Abnormal brain circuits in various regions of the frontal lobes of patients with OCD
* Orbitofrontal cortex
* Relays information about things that are worrying / risky and then converts those emotions into actions.
* Usually stopped by the caudate nucleus

*If broken, that doesn’t happen.

Worry is enhanced

→ Worry circuit.

PET scans showed higher activity in the OFC in patients with OCD when, for example, asked to hold a dirty item i.e. Germ hazard.

Question 17

Explain SSRIs as a biological treatment for OCD

Answer 17

• SSRIs are a type of anti-depressant that aim to increase our levels of serotonin in the brain.
• They are designed to block the reuptake of serotonin, thereby increasing the levels of serotonin in the synapse.
• Resulting in the post-synapse neuron being more likely to fire.

Compensating for the lack of serotonin that would naturally be in the individuals system.

Question 18

Explain combination therapies as a biological treatment for OCD

Answer 18

• Sometimes patients use SSRIs alongside CBT to treat their mental illness.
• What could the point of this be.
• SSRIs help to treat the emotional symptoms (e.g anxiety), which will then help patients to engage with the CBT more fully.

Which type of treatment is most successful depends solely on the patient

Question 19

What are the alternative to SSRIs?

Answer 19

• In 3-4 months, if the SSRIs have not been successful, then the dose can in increased, or a different antidepressant can be used.
• Benzodiazepines can also be used.

Question 20

What do Benzodiazepines do?

Answer 20

Anti-anxiety medication.

• Increases the effect of GABA
• GABA tells neurons in the brain to ‘slow down’ and ‘stop firing’.
• When GABA locks into a receptor site, the flow of chloride ions (CI-) into the neuron is increased.
  The chloride ions make it more difficult for the receiving neuron to be stimulated by further neurotransmitters. Thus the nervous system is slowed down making the patient feel more relaxed.

Question 21

What is a weakness of using biological treatments for OCD?

Answer 21

Drugs have side effects
* Indigestion
* Blurred Vision
* Impaired sex drive
* Erection problems
* Weight gain
* Tremors

Question 22

What is a strength of using biological treatments for OCD?

Answer 22

Strength : Research Support
One strength of biological treatments for OCD comes from research support for their effectiveness.

• Randomised drug trials compare the effectiveness of SSRIs and a drug with no pharmacological value, called a placebo.
• Soomro et al. (2008) conducted a review of research examining the effectiveness of SSRIs and found that they were significantly more effective than placebos in the treatment of OCD, across 17 different trials.
• This supports the use of biological treatments, especially SSRIs, for OCD. However, studies such as this are criticised for only concluding the short‐term effectiveness of drug treatments with long‐term effects still to be investigated empirically.

Question 23

What is a weakness of using biological treatments for OCD?

Answer 23

Weakness : Symptoms not cause
Drug treatments are criticised for treating the symptoms of the disorder and not the cause.

• Although SSRIs work by increasing the levels of serotonin in the brain, which reduces anxiety and alleviates the symptoms of OCD, it does not treat the underlying cause of OCD.
• Furthermore, once a patient stops taking the drug, they are prone to relapse.
• Therefore Koran et al. (2007) suggest that psychological treatments such as CBT may be a more effective long‐term solution to provide a lasting treatment and a potential cure.