OCD

• What does OCD stand for?

  Obsessive compulsive disorder
• What is OCD?

  Chronic long lasting disorder characterised by uncontrollable reoccurring thoughts and/or behaviours that they feel the urge to repeat over and over
• DSM-5 categories of OCD

  • Trichotillomania
  • Hoarding Disorder
  • Excoriation Disorder
• What is trichotillomania?


  • A compulsive hair-pulling disorder
  • May pull out the hair on her head or in other places such as eyebrows and eyelashes
• What is hoarding disorder?

  The compulsive gathering of possessions and the inability to part with anything, regardless of its value
• Excoriation disorder?

  • A compulsive skin-picking disorder which leads to areas of swollen or broken skin
  • Also called dermatillomania
• 3 categories of characteristics of OCD

  • Emotional
  • Behavioural
  • Cognitive
• Behavioural characteristics of OCD

  • Compulsions
  • Avoidance
• 2 elements of compulsions in OCD


  • Repetitive
  • Reduce anxiety
• How are OCD compulsions repetitive?

  • People with OCD feel compelled to repeat a behaviour.
  • Examples are handwashing, counting, praying, tidying/ordering objects
• How do OCD compulsions reduce anxiety?

  • Compulsive behaviours are performed to try and manage the anxiety produced by obsessions
  • For example, compulsive handwashing is carried out as a response to an obsessive fear of germs
• Percentage of people with OCD who show compulsive behaviour alone and they have no obsessions


  Around 10%
• Avoidance in OCD

  • Attempt to reduce their anxiety by keeping away from situations that trigger it
  • This avoidance can lead people to avoid very ordinary day-to-day situations that can interfere with leading a regular life
• 3 emotional characteristics of OCD

  • Anxiety and Distress
  • Accompanying
  • Depression
  • Guilt and Disgust
• Anxiety and distress in OCD

  • Powerful anxiety that accompanies both obsessions and compulsions
  • The urge to repeat a behaviour (a compulsion) can create anxiety
  • Compulsive behaviour tends to bring some relief from anxiety but this is only temporary
• Accompanying depression in OCD

  OCD is often accompanied by depression,Low mood and lack of enjoyment in activities
• Guilt and disgust in OCD

  Irrational guilt, such as over minor moral issues Disgust at something external (e.g. germs) or internal (e.g. the self)
• 3 Cognitive characteristics of OCD

  • Obsessive thoughts
  • Cognitive coping strategies
  • Insight into excessive anxiety
• Obsessive thoughts (Cognitive characteristics of OCD)


  Thoughts that recur over and over again These vary from person to person but are always unpleasant
• Obsessive thoughts (Cognitive characteristics of OCD) Examples


  Impulse to hurt someoneThe door has been left unlocked, intruders will enter
• Cognitive coping strategies (Cognitive characteristics of OCD)

  People can also respond to OCD by adapting cognitive coping strategies to deal with the obsessions
• Cognitive coping strategies (Cognitive characteristics of OCD) Example


  A religious person tormented by obsessive guilt may respond by meditating
• Insight into excessive anxiety (Cognitive characteristics of OCD)

  • People with OCD are aware their obsessions and compulsions are not rational
  • This is necessary for an OCD diagnosis
  • Despite this they may experience catastrophic thoughts and be hypervigilant/maintaining constant alertness
• Two biological explanations for OCD

  • Genetic
  • Neural
• What are genes?

  A small section of DNA which carries the information which determines your traits
• What did Lewis find about genetics and OCD?

  Of his OCD patients, 37% had parents with OCD and 21% had siblings with OCD
• What do Lewis's results suggest?

  These results suggest that genetics may play a role in OCD However, it can't just be genetics involved or the percentages would be much higher
• What model explains genetic factors in OCD?

  Stress-diathesis
• What does the stress-diathesis model suggest?

  People have a genetic vulnerability to mental health issues and stress causes the trigger of the gene
• Candidate genes in OCD

  Genes which create vulnerability for OCD

  Some of these genes are involved in regulating the development of the serotonin system - 5HT1-D beta
• What is meant my OCD is polygenetic?

  not caused by a combination of genetic variations which together increase vulnerability
• How many genes did Taylor et al implicate in OCD?

  Around 230
• Different genes causing OCD

  • Aetiologically heterogeneous - One group of genes may cause OCD in one person but a different group of genes may cause the disorder in another person
  • Different types of OCD may result from different genetic variations
• Aetiology meaning

  Origins
• Heterogeneous meaning

  Genes vary from person to person
• Strength of the genetic explanation of OCD


  A strong evidence base
• Why is "a strong evidence base" a strength of the genetic explanation of OCD?

  • Nestadt et al (2010): 68% MZ and 31% DZ share OCD
  • Must be environmental factors - Higher % for MZ twins - genetic component
  • Marini and Stebnicki, 2012 - Those with family diagnosed with OCD are 4 times as likely to develop it
  • Suggest that there must be a genetic influence on the development of OCD
• Limitation of the genetic explanation of OCD

  There are also environmental risk factors
• Why is "there are also environmental risk factors" a limitation of the genetic explanation of OCD?

  • While there is evidence for genetic explanations affecting an individuals vulnerability to OCD, it is not entirely genetic and environmental factors can also increase the risk of OCD
  • Cromer et al (2007) found that over half of the OCD clients in their sample had experienced a traumatic event in their past, OCD was also more severe in those with one or traumas
  • Genetic vulnerability only provides a partial explanation for OCD
• 2 parts of the neural explanations for OCD

  Role of serotonin Decision-making systems