OCD

• symptoms of ocd

  -the obsessions cant be ignored or supressed and cause anxiety and distress

  -the obsessions are time consuming and cause impairment to daily life

  -the symptoms cant be explained by substance abuse or medical/mental conditions

  -tic disorder history can affect the severity
• features of ocd

  -prevalence of 1.1-1.8%

  -females are more frequent sufferers as adults, and males as children

  -onset is mostly late teens

  -25% of male sufferers develop it before 10

  -culture can affect the nature

  -higher risk if suffered abuse as a child/ biological factors
• lavarenne et al (2013)- use of case studies

  study on sz patients, in a group session before christmas on 6 ppts

  found "fragile" ego boundaries due to reacting to the change in not being able to have the regular session over christmas

  breakdown in the line of real and unreal

  -concerns over memory of researchers

  +insight into behaviour

  +investigation of otherwise immoral research

  -cant generalise
• vallentine et al (2010)- use of interviews

  semi-structured interviews on 43 males in broadmoor with sz that were attending a group session

  aim to help them understand and cope with their illness

  patients valued the insight

  group sessions helped understand their own symptoms

  they got to see other people that were going through the same thing

  increased confidence in dealing with the illness, they saw a better future

  +qualitative data

  +recorded so high inter rater reliability

  -lack of reliability as qs not standardised

  -time consuming
• grounded theory- Glaser and strauss (1960s)

  data gathering where research is conducted to gather data and a theory gradually emerges from the analysed data. the research then changes focus to these themes of interest

  +evidence is intergrated into the theory so is more valid

  -may use a problematic gathering method

  -may be forcing data to fit emerging theory due to selective sampling

  +takes less time than conducting multiple sets of research
• biological explanation of ocd

  due to faulty processing in the orbitofrontal cortex

  caudate nucleus- normally inhibits the action of globus palladius fibres, but is overactive so doesnt

  globus palladius fibres- should act as a braking mechanism controlling activity in the thalamus

  thalamus- hypothetically contains primitive checking and cleaning mechanisms but this is overactive so triggers a compulsion to engage in the behaviour

  cingulate gyrus- connects thalamus and orbitofrontal cortex

  orbitofrontal cortex- alerts the brain to a potential worry in the environment
• positives evaluation of biological explanation of ocd

  +menzies et al 2007- found scans of ocd ppts had differences in amount of grey matter in brain, including orbitofrontal cortex

  +mcguire et al 1994- activity increases in orbitofrontal cortex when ppts are show ocd inducing objects

  +twin studies- typically show a higher concordance in mz twins, showing physiological factors underlie in development, however family studies show sufferers dont have a family history (-)

  +feng et al 2007- bred mice to show symptoms when a targeted gene is missing, however humans only share 97% dna (-)

  +extrapolation- may be unreliable to extrapolate to humans but there is research in humans suggesting theres a genetic marker
• negatives evaluation of biological explanation of ocd

  -extrapolating from brain scans- scanning is imprecise, cant detect decreased metabolic activity and small changes could m=be missed

  -extrapolation to humans is unreliable

  -social learning theory- symptoms of children differed from parents, showing cause is unlikely to be SLT which leads back to a biological cause
• cognitive explanation for ocd

  paul salkovskis

  -faulty info processing=root of disorder

  -perceptions or thoughts we have will trigger an emotional response which triggers behaviour to deal with the emotion

  -changing the perception changes what follows
• early childhood experiences - cog explanation

  -cause a general negative belief system about how the world works

  -these thoughts are misinterpreted and made important causing anxiety -to deal with the anxiety, the person adopts counterproductive behaviour which reinforces
• lack in confidence of memory- cog explanation

  may explain checking behaviours- if a person doesnt have memory for turning off the oven, they dont trust recall and feel compelled to check again

  (woods et al 2002) conducted a meta-analysis of memory related to checking studies and found those with ocd had slightly worse memory for recalling stimuli, but they also felt their memory was inadequate compared to others
• hypervigilance- cog explanation

  -williams et al (1997) constantly scanning for threats and have an attention bias towards potential threats, detection triggers anxiety then compulsions

  -bahman (2004) case study which shows someone with ocd centered on blood could, with hypervigilance, recall all the times she ever came into contact with blood
• evaluation of cognitive explanation

  + validity- therapy based off this explanation is successful

  + van balkom et al (1996)- found it to be just as effective as drug treatment, supports fact ocd lies in faulty cog function. if purely biological then drugs would work

  +POTS (2004) compared treatments and found CBT was more effective than drug

  +quantitative data- Salkovskis and kirk (1997) study, on some days the ppts told to deliberately supress thoughts but on others they had free reign. frequency increased when they tried to supress them

  -face validity- seems to be good explanation but suffers from direction of effect

  -credibility- no evidence that faulty cog function preceeds onset of symptoms
• cognitive behavioural therapy

  asks clients to recall thoughts then examine the meaning. challenge them by exploring why these induce anxiety

  ERPT- exposure and response prevention therapy: behaviourist treatment where person has consistent exposure whilst preventing the compulsion. develop hierachy then gradual exposure
• evaluation of CBT

  -ERPT isnt effective for clients without compulsions. Masellis et al 2003 found 44% only suffer from obsessions and 75% have comorbid depression so reduces effectiveness

  +NICE promote therapy as shown to be effective at reducing symptoms. cost effective and time limited and can be used with drugs

  + ethical- person decides treatment

  -may be uncomfortable for client

  -relies on good interpersonal relationship with therapist and POTS study proved some therapists work better than others
• drug therapy

  medication is aimed at treating the high levels of anxiety

  anxiety is regulated by GABA. it is an amino acid which lowers physiological arousal to return the body to a resting state
• drug therapy- benzodiazepines

  eg valium

  anti-anxiety medication that works to increase GABA effectiveness
• drug therapy- beta blockers 


  relieve the physiological effects of anxiety by blocking stress hormones released by the adrenal glands. these hormones normally have physiological effects such as increased heart rate and respiration

  beta blockers help prevent the physical symptoms and help reduce obsessional thoughts
• drug therapy- antidepressants

  SSRIs (selective serotonin reuptake inhibitors)

  fluoxetine or serataline

  raise serotonin levels by blocking its reuptake from the synapse back into the releasing neuron, so making more serotonin available for longer and thereby increasing activity of serotonergic pathways

  the dosage to treat ocd is higher than depression and takes time to take effect (up to 12 weeks)

  if no benefit is felt the dosage will be changed
• evaluation of drug therapy (pt 1)

  -side effects

  +soomro et al 2007 reviewed 17 studies of controlled trials using antidepressants for ocd showed drugs were more effective than placebo at reducing symptoms

  +koran et al 2002 antidepressents had a long term effect compared to placebo and was better at preventing relapse

  -tricyclic antidepressants sometimes prescribed but have worse side effects

  +drugs and cbt= increased effectiveness

  -goodman et al 1993 prescription needs to match individual differences