OCD

• What is OCD?

  A mental health condition where a person has obsessive thoughts and compulsive activities
• What are Behavioural characteristics of OCD?

  • Repetitive behaviours are preformed to reduce anxiety, these are external actions which can be observed
  • Avoidance of situations that might trigger anxiety
• What are Emotional characteristics of OCD?

  • Anxiety and distress are created by both the obsessive thoughts and compulsive behaviours
  • Shame and embarrassment over the excessive nature of their behaviour
• What are Cognitive characteristics of OCD?

  • Recurrent, intrusive and uncontrollable thoughts
  • Irrational and distorted beliefs
  • Obsessions are recognised at some point as being irrational excessive
• What does the biological approach assume about OCD?

  That it is caused by problems within the body or brain and that mental illness has a physical cause
• What factors that mental illness according to biological approach?

  • Genes
  • Neuroanatomy
  • Neurotransmitters
• What is the genetic explanation of OCD?

  OCD is passed from parent to child through genetic inheritance, geneticists have been trying to isolate a candidate gene for OCD, they have identified 2
• What are the two genes they have identified?

  COMT and SERT gene
• How is the COMT gene associated with OCD?

  It is involved in the production of an enzyme (COMT)that regulates the production of dopamine, one form leads to lower activity of the enzyme and therefore higher levels of dopamine, this form is commonly found in individuals with OCD
• How is the SERT gene linked to OCD?

  It is involved in the production of a protein that removes serotonin from the synapse between neurons, a mutation leads to higher activity of this protein and therefore lower levels of serotonin, this is found in families where many members have OCD
• What is a strength of the genetic argument?

  There is research to support the genetic argument, Nestadt (2010) reviewed twin studies and found 68% of identical twins (MZ) showed concordance for OCD compared to 31% in non identical twins (DZ)
• What are weaknesses of the genetic argument?

  • Difficult to draw firm conclusions about influences of genes from twin studies alone
  • No studies show 100% concordance in MZ twins showing must be another factor
  • Too many candidate genes have been identified, OCD seems to be polygenetic meaning caused by many genes
• What is the Neural explanation?

  Genes that are associated with OCD are likely to affect the levels of neurotransmitters as well as the structures of the brain, neural explanation says that OCD can be caused by abnormal levels of neurotransmitters such as serotonin and certain structures within the brain like the areas that make up the worry circuit
• How may serotonin cause OCD?

  By a disruption of serotonin levels which has a knock on affect on regulating the levels of other neurotransmitters such as GABA and dopamine, Individuals who take pills to increase serotonin have a reduction in symptoms of OCD
• What 3 areas in the brain form the worry circuit?

  • The orbital frontal cortex (OFC)
  • The caudate nucleus
  • The thalamus
• What is another neural argument of OCD?

  The symptoms arise from structural damage to the brain, it is argued that there are impairments in an area of the brain called the basal ganglia, specifically the caudate nucleus
• What is the OFC responsible for?

  Sending worry signals to the thalamus when we are concerned or anxious
• What happens to the signals?

  They are usually supressed by the caudate nucleus , but if damaged the caudate nucleus fails to block the signal and the thalamus is alerted
• What happens if the thalamus is alerted?

  It sends signals back to the OFC creating a circuit, the OFC regulates the transmission of information regarding worrying events between the thalamus and the OFC, but in OCD the caudate nucleus is impaired and therefore incorrectly regulates the worrying information, this makes it difficult for the individual with OCD to pay attention to anything other than the worrying event
• What is a strength of the Neural argument?

  There is research to support the role of serotonin in OCD, Zohar et al (1996) found that drugs which increase serotonin have been beneficial for up to 60% of patients with OCD
• What is a strength of the biological approach to explaining OCD

  Very useful in providing practical applications to treat OCD, drug therapies attempt to correct faults in the brain by rebalancing the chemical that are thought to be causing OCD, requires little effort and commitment
• What are weaknesses of the biological approach?

  • very difficult to determine cause and effect between an individuals biology and mental illness
  • Heavily focused on the nature side of the nature nurture debate, it ignores the impact our experiences have
• What does SSRI's stand for?

  Selective serotonin reuptake inhibitors
• What do SSRI's do?

  They prevent the serotonin that flows from one neurone to the next from being reabsorbed or removed from the system leaving greater amounts in the synapse reducing symptoms of OCD
• What other anti depressants have been used?

  Tricyclics
• How do Tricyclic work?

  They block the transporter mechanism that reabsorbs both serotonin and noradrenaline into the presynaptic cell after it has fired
• What do benzodiazepines (BZ) do?

  They help to control feelings of extreme anxiety by reducing the level of brain activity and brining about feelings of being calm
• How do BZ work?

  BZ act on chemicals within the brain and slow down activity within the CNS, they enhance the action of neurotransmitter GABA
• What is GABA?

  The bodies natural form of anxiety relief, it has a calming effect and is an inhibitory neurotransmitter
• What happens during synaptic transmission?

  GABA binds with GABA-A receptors on the post synaptic neuron, this opens a channel that increases the flow of cl ions into the post synaptic neuron making it more difficult for the neuron to be stimulated by other neurotransmitters, signals are less likely to be passed from one neuron to the next
• What are strengths of the effectiveness of drug therapy?

  • Smooro (2009) conducted a meta analysis of 17 studies of OCD patients being treated with SSRI's found all 17 studies SSRI were more effective at reducing symptoms
  • Zohar found 60% clients clinically significant improvement
  • BZ more effective than placebo , it makes people feel even better than when they just had the fake
• What is a weakness of the effectiveness of drug therapy?

  Zohar found 60% of clients improved with the drugs that increased serotonin and 40% didn't
• What are weaknesses of the appropriateness of drug therapies?

  • They do not cure OCD, when they stop taking the drugs the symptoms return
  • Negative side effects to taking drugs e.g. nausea, headaches, insomnia
• What is a strength of the appropriateness of drug therapy?

  They are relatively fast acting and require little effort, good for people who lack insight into their OCD