OCD

• an disorder characterised by obsessions (intrusive thoughts) and compulsions (repetitive behaviours) either together or alone, they only provide temporary relief.
• Behavioural characteristics of OCD

  Repetitive compulsions such as hand washing as it helps to manage the anxiety. Often irrational and excessive.

  (avoidance) Keeping away from situations that trigger like obsessions with germs and not emptying bins. This interferes with daily life.
• Emotional characteristics

  Unpleasant emotions such as anxiety.

  Having depression and low mood as compulsions bring only temporary relief.

  Experiencing Guilt
• cognitive characteristics

  Having obsessive thoughts that are recurrent and unpleasant, unable to resist

  Cognitive coping strategies like praying, counting or meditating.

  Have an awareness that obsessions are not rational.
• Genetic explanations for OCD

  Candidate genes create vulnerability for OCD. Tukel et al found that lower levels of activity of the COMT gene lead to higher levels of the neurotransmitter dopamine. High levels of dopamine are associated with movements that manifest into compulsions in OCD.
• The SERT gene is linked to the neurotransmitter serotonin and affects the transport of serotonin, causing lower levels of serotonin which is associated with OCD. Ozaki et al found evidence of two unrelated families with mutations of this gene where 6/7 family members had OCD
• OCD is polygenetic. It is not caused by one single gene and involves several genes. Research suggests that that 230 genes may be involved in OCD and relates to be associated with the actions of high dopamine and low serotonin, both neurotransmitters that have a role in regulating mood.
• A strength of the biological explanation is that it comes from family studies. Researchers found that 37% of patients with OCD had parents with the disorder and 21% of siblings who suffered. Research from family studies provides support for genetic explanations for OCD.
• However research from twin studies have shown concordance rates in twin studies are never 100%. This suggests there are also environmental risk factors such as parenting, and OCD does not appear entirely due to genetic origins. For example, Cromer et al found over half of OCD patients had traumatic life events in their past and OCD was more severe in those with more than one trauma. This means genetic vulnerability only provides a partial explanation.
• Neural explanations

  Abnormal brain circuits- There is evidence from PET scans that people with OCD have areas of abnormality within their brains. The orbitofrontal cortex sends signals to the thalamus about potential worries e.g germ alert, usually these minor worries are suppressed by the caudate nucleus. But if it is damaged the worry is not suppressed and the thalamus is alerted and confirms the worry. This creates a worry circuit which leads to obsessive thoughts.
• It is unclear which neural mechanisms are involved in OCD. REsearch has identified that other brain systems that may be involved but no system is clearly identified that plays a role in OCD. This means there is no consistency in which brain system has a role in OCD. Therefore, there is a problem with establishing a cause and effect.
• Anti-anxiety drugs are used to treat symptoms of OCD. BZs enhance the activity of GABA (a neurotransmitter) to reduce anxiety. It tells the neurons to slow down and stop firing. 40% of the neurons in the brain respond to GABA, they also decrease heart and respiration rates which reduce feelings of anxiety. This helps to quieten down the obsessive thoughts.
• Drug therapy is used to reduce chemical imbalances in the brain
• Anti-depressants are another type of drug therapy used to treat OCD, the neurotransmitters target serotonin by raising its levels. Low levels of serotonin cause OCD because the hormone is not absorbed into the receptors which then prevents it from being released into the next neuron. This helps to improve the patients mood and makes them less likely to suffer from obsessive thoughts and compulsions.
• Prozac (SSRI) works by releasing serotonin from the pre-synaptic cell into the synapse, it then would travel into the receptor site in the post-synaptic neuron. It also prevents serotonin that isnt absorbed being reabsorbed. Overall this increases the level of serotonin which improves mood and reduces anxiety.
• drug therapy is also combined with CBT to reduce the emotional symptoms.
• A limitation is that the drugs involved have serious side effects. A small minority dont benefit from the medication and some experience indigestion, blurred vision and loss of sex drive. These side effects are often temporary but can cause distress to the patient. This means that some people have a reduced quality of life as a result of taking drugs and may stop them taking it altogether meaning the drug losses effectiveness.
• There is good evidence that treatment for OCD is effective. Clear evidence to show SSRIs reduce symptom severity and improve the quality of living for people with OCD. Research reviewed 17 studies compared SSRIs to placebos in the treatment. All studies showed better outcomes from SSRIs. This means that drugs appear more helpful for most people with OCD.
• A further strength is that they are cost effective and non disruptive to peoples lives. It is cheaper than psychological treatments because the medication can be manufactured in thousands. Whereas, treatments take time to conduct a session. Using drugs to treat OCD is better value for public health systems like the NHS, also people can simply just take the drug until they feel better. This means that drugs are popular with many people with OCD and their doctors.