OCD

• OCD


  A condition characterised by obsessions/ compulsive behaviour
• Obsessions

  Recurring thoughts, images, etc
• Compulsions

  Repetitive behaviours eg handwashing
• Conditions

  • Trichotillomania- compulsive hair pulling
  • Hoarding disorder- compulsive gathering of possessions and the inability to part with anything regardless of value
  • Excoriation disorder- compulsive skin picking
• Behavioural characteristics of OCD

  • Repetitive compulsions: people feel compelled to repeat a behaviour eg handwashing, counting, tidying
  • Reducing anxiety: 10% of people show compulsive behaviour alone- they have no obsessions, just a general sense of irrational anxiety. For the vast ast majority, compulsive behaviours are performed in an attempt to manage the anxiety produced by obsessions. (eg compulsive handwashing as a response to an obsessive fear of germs)
  • Avoidance: people with OCD may try to manage their OCD by avoiding situations that trigger anxiety/ compulsive thoughts. However, it can lead to people avoiding ordinary situations, interfering with their life (e.g. avoiding walking outside in order to not step on cracks)
• Emotional characteristics of OCD

  • Guilt and disgust: often those suffering from OCD, can also have other negative emotions against themselves, such as feeling guilt over a situation or being disgusted with themselves
  • Depression: due to the constant compulsion to carry out compulsive/repetitive behaviours, which often interfere with day to day functioning and relationships
  • Anxiety: associated with the acknowledgement that the obsessive thoughts are irrational, but despair at the fact that they will always lead to compulsive behaviours
• Cognitive characteristics of OCD

  • Obsessive thoughts: The majority of people suffering from OCD have obsessive thoughts This is when they have thoughts that reoccur over and over again and are often intrusive (E.g. if I do not wash my hands 7 times, I will die from the germs on my hands)
  • Obsessive actions: The person suffering from OCD will often have to perform these obsessive actions to allow them to continue with their day
  • Excessive anxiety: The sufferer of OCD understands that these thoughts and actions are irrational but they cannot stop them, however, even though they understand they are irrational. They may experience catastrophic thoughts about what could happen, in their worst-case scenario, if their anxieties came true
• Genetic explanation of OCD

  Some mental disorders have a stronger biological component than others such as OCD. Genes are involved in individual vulnerability to OCD. Diathesis-stress model suggests that certain genes leave some people more likely to develop a mental disorder but is not certain
• Genetic evidence for OCD

  • Twin studies showed that 68% of MZ twins shared OCD as opposed to 31% of DZ twins. Family studies- if one person in the family is diagnosed with OCD then a family member is four times more likely to develop it than someone without a diagnosed family member. Shows there is genetic influence on the development of OCD
• OCD is Polygenic: means that OCD is not caused by one gene but instead a combination of genetic variations that together significantly increase vulnerability
• Steven Taylor (study) found evidence that 230 different genes are involved in OCD
• Neural explanation of OCD

  The view that physical and psychological characteristics are determined by the behaviour of the nervous system (particularly the brain and individual neurons)
• Neural explanations of OCD

  • Role of serotonin: helps regulate mood. Responsible for relaying information from one neuron to another. If a person has low levels of serotonin then the normal transmission of mood- relevant information does not take place and a person may experience low moods. Some cases of OCD may be explained by a reduction in the functioning of the serotonin system in the brain.
  • Decision-making systems: OCD and especially hoarding can be associated with impaired decision making. Associated with abnormal functioning of the frontal lobes and the left parahippocampal gyrus, a brain region that processes negative emotions. The left parahippocampal gyrus is associated with processing unpleasant emotions, and in OCD, it appears to function abnormally. These neural explanations indicate that OCD may be caused by dysfunctional decision-making and emotional processing in specific brain areas.
• Antidepressants that work purely on serotonin are effective in reducing OCD symptoms
• Many people with OCD also experience clinical depression, a comorbidity that may not be linked to serotonin function
• Drug therapy for OCD

  Aims to increase or decrease levels of neurotransmitters. SSRIs (Selective Serotonin Reuptake Inhibitors) work by inhibiting the reuptake/ absorption of serotonin, which happens too fast in people with OCD. This effectively increases levels of serotonin in the synapse, which results in the neurotransmitter remaining active in influencing the postsynaptic neuron. The average time for SSRIs to take effect is 4 months, before they impact on symptoms. Used alongside cognitive behaviour therapy to treat OCD.
• Drugs used to treat OCD

  • Prozac (fluoxetine)
  • SNRI's (Serotonin-Noradrenaline Reuptake Inhibitors)
  • Tricyclics
• Strengths of drug therapy for OCD

  • Cost-effective as they are cheaper than other psychological treatments
  • Although drug therapy doesn't 'cure' OCD, it allows for a significant improvement in the suffering life, reducing OCD behaviours
• Limitations of drug therapy for OCD

  • Potentially serious side effects: With SSRIs, these side effects can include; blurred vision, loss of sexual appetite, irritability, indigestion, and sleep pattern disruption