OCD mindmap

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  • OCD
    • Behavioural characteristics
      • Compulsions
        • They are repetitive. Sufferers feel compelled to repeat behaviours
        • They reduce anxiety. For the vast majority, compulsive behaviours are performed in an attempt to manage the anxiety produced by obsessions.
      • Avoidance
        • The behaviour of OCD sufferers may also be characterised by their avoidance as they attempt to reduce anxiety by keeping away from situations that trigger it
    • Emotional characteristics
      • Anxiety and distress
        • OCD is accompanied by powerful anxiety with the obsessions and compulsions. The urge to repeat a behaviour creates anxiety
      • Accompanying depression
        • OCD is often accompanied by depression, low mood and lack of enjoyment in activities
      • Guilt and disgust
        • OCD sometimes involves negative emotions such as irrational guilt, or disgust, which may be directed against something external like dirt or the self
    • Cognitive characteristics
      • Obsessive thoughts
        • 90% with OCD suffer with obsessive thoughts. These vary from person to person but are always unpleasant.
      • Cognitive strategies to deal with obsessions
        • People respond to the obsessive thoughts by adopting cognitive coping strategies
        • This may help manage anxiety but can make the person appear abnormal to others and can distract them from everyday tasks
      • Insight into excessive anxiety
        • People suffering from OCD are aware that their obsessions and compulsions aren't rational. But they still experience catastrophic thoughts about worst case scenarios
    • Biological approach to explaining OCD
      • Genetic explanations
        • Genes are involved in individual vulnerability to OCD. Lewis discovered that of his OCD patients 37% had parents with OCD and 21% had siblings with OCD. Suggets that OCD runs in families.
        • Candidate genes
          • Researchers have identified genes which create vulnerability for OCD.
          • Some of these genes are involved in regulating the development of the serotonin system.
        • OCD is polygenic
          • OCD is not caused by one single gene but that several genes are involved.
          • Taylor has analysed findings of previous studies and found evidence that up to 230 different genes may be involved in OCD.
        • Different types of OCD
          • One group of genes may cause OCD in one person but a different group of genes may cause OCD in another person. Aetiologically heterogenous
        • Evaluation
          • There is good supporting evidence from a variety of sources for the idea that some people are vulnerable to OCD as a result of their genetic makeup
            • Nestadt found that 68% of MZ twins shared OCD  as opposed to 31% to DZ twins
          • Twin studies are flawed as genetic evidence. They make assumptions that identical twins are only more similar than non-identical twins in terms of their genes, but ignore that they may be more similar in terms of their shared environment.
          • Too many candidate genes. The genetic explanation is unlikely to ever be very useful because it provides little predictive value.
      • Neurological explanations
        • The role of Serotonin
          • Serotonin is believed to regulate mood. NTs are responsible for relaying info from one neuron to another. If a person has low levels of serotonin then normal transmission of mood-relevant information does not take place. Mood and other mental processes are affected
        • Decision making systems
          • Some cases of OCD seem to be associated with impaired decision making. This may be associated with abn functioning of the lateral of the frontal lobes of the brain. These areas are responsible for logical thinking and decision making
        • Evaluation
          • Supporting evidence. Some anti-depressants work purely on the serotonin system. Increasing levels of this NT. These are effective in reducing OCD symptoms
          • Causation
    • Biological approach to treating OCD
      • Drug therapy
        • Aims to increase /decrease levels of NTs in the brain to increase /decrease their activity. According to the bio approach, OCD may be due to low levels of serotonin. Therefore drugs used to increase serotonin levels.
        • SSRIs (selective serotonin reuptake inhibitors)
          • Work on serotonin in the brain. Serotonin is released by the presynaptic neurons and travels across a synapse. The NT chemically conveys the signal from presynaptic to postsynaptic neuron. It is then reabsorbed by the pre SN where it is broken down and re-used.
            • By preventing the re-absorption of serotonin, SSRIs increase its levels in the synapse and continue to stimulate the postsynaptic neuron
        • Alternatives to SSRIs
          • Tricyclics- have the same effect on the serotonin system but can target multiple NTs. More severe side effects, used as a reserve.
          • SNRIs- target serotonin and noradrenaline
        • Evaluation
          • Evidence of effectiveness- Soomro reviewed studies comparing SSRIs to placebos and concluded that all 17 studies showed significantly better results for SSRIs.
          • Drugs can have side effects- these reduce effectiveness of the drug as patients stop taking them before they start to help reduce symptoms.
          • Drugs are cost effective and non-disruptive- cheap compared to psychological treatments. Less time consuming and disruptive.

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