ocd

• Obsessive-Compulsive Disorder (OCD)


  An anxiety disorder characterised by experiencing persistent and intrusive thoughts which occur as obsessions, compulsions or sometimes both
• Obsessions


  • Cognitive internal intrusive thoughts e.g. there are germs everywhere and they could harm me
• Compulsions


  • Behavioural external repetitive behaviours e.g. I need to wash my hands each time I touch something to avoid the germs and getting ill
• The DSM-5 recognises OCD, and a range of disorders related to it, which also have obsessive thinking and repetitive behaviours as characteristics
• OCD


  Characterised either by compulsions (repetitive behaviours, E.g. turning the lights off and on a particular amount of times before leaving the room) and/or obsessions (reoccurring thoughts: If I don't turn the lights off 5 times then something bad will happen)
• Excoriation


  Compulsive skin-picking
• Trichotillomania


  Compulsive hair-pulling
• Symptoms of OCD can be characterised by three areas

  • Behavioural characteristics
  • Emotional characteristics
  • Cognitive characteristics
• Behavioural characteristics


  • Compulsions: repetitive and time-consuming, can stop the person suffering from OCD from continuing their daily life
  • Compulsions reduce anxiety and the repetitive behaviour is often performed to reduce the anxiety of the person suffering from OCD
  • Avoidance: the person suffering from OCD is likely to try and avoid situations that would cause them to show their compulsions
• Emotional characteristics


  • Extreme anxiety: The person suffering from OCD is likely to suffer from extreme levels of anxiety, obsessive thoughts (which are often frightening and overwhelming) and the compulsions that cause the sufferer anxiety and distress
  • Guilt: 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: Often those suffering from OCD, can also suffer from depression and experience low mood plus a lack of enjoyment of activities, brought on by the compulsions and obsessions
• Cognitive characteristics


  • 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
  • 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
• Biological approach


  The medical model that explains all behaviour through our biology, seeing OCD and other abnormalities in the same way it sees a physical illness, explaining it by abnormal biological processes
• Genetic explanations


  • Hereditary influences transmitted from parent to offspring by genetic transmission
  • Researchers have identified Candidate genes as genes that create vulnerability to OCD
  • OCD seems to be polygenic; this means OCD is not caused by one single gene but by a combination of genetic variations that together cause significantly increased vulnerability
  • Genes studied in relation to OCD include those involved in the action of dopamine and serotonin and both neurotransmitters are believed to have a role in regulating mood
• Variation of the COMT gene

  May contribute to OCD as it is more common in patients who suffer from OCD than in those that do not, producing higher levels of dopamine and lower activity of the COMT gene
• The 5-HTT gene


  Has also been linked with OCD as it affects the levels of serotonin, making them less and these lower levels of the neurotransmitter are linked with OCD
• Evaluation of genetic explanations

  • Strengths: Strong evidence base of research, especially within twin studies

  Limitations: Ignores environmental factors, not enough understanding about the actual genetic mechanisms causing OCD, genetic link stronger in children than adults
• Neural explanations


  • OCD can be explained through neural connections and the imbalance or damage these can have

  Serotonin plays a role in regulating mood, if a person has low levels of serotonin, the person can have low moods and other mental processes are often affected

  Dopamine levels are thought to be abnormally high in people who suffer from OCD

  Abnormal brain circuits: The orbital Frontal Cortex (OFC) is overactive, the thalamus is not suppressing the worry, and the caudate nucleus is not completing its job of normalising the worry
• Evaluation of neural connections

  • Strengths: Antidepressants such as SSRIs, which are used to control levels of serotonin, are seen to be effective in reducing OCD symptoms

  Limitations: Not all OCD sufferers respond positively to antidepressants, environmental triggers can play a large role in triggering OCD
• SSRIs (Selective Serotonin Reuptake Inhibitors)


  Drug therapy that works solely on the neurotransmitter serotonin which is associated with OCD, inhibiting the re-uptake/ absorption of serotonin to effectively increase levels of serotonin in the synapse
• SNRI's (Serotonin-Noradrenaline Reuptake Inhibitors)


  Drug therapy that works in a similar way to SSRIs, but as well as increasing levels of serotonin, they also increase another neurotransmitter called noradrenaline
• Tricyclics


  An older antidepressant drug therapy reserved for those that SSRIs do not work for, with more severe side effects than SSRIs
• Evaluation of biological treatments of OCD


  • Strengths: Evidence of effectiveness, cost-effective, non-disruptive to people's lives

  Limitations: Side effects, high relapse rates, publication bias