OCD

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OCD

OCD-  (Obsessive compulsive disorder) is a neurotic disorder of the brain where an individual experiences unwanted thoughts and behaviour that does not feel voluntarily controlled.

Obsession-is a persons inability to stop thinking about a certain topic or feeling a certain emotion without a high amount of anxiety.

Compulsion- a repetitive action that is done over and over again associated with the obsession.

Neurotic behaviour- Patient knows behaviour is abnormal

Psychotic behaviour- Patient doesn't know behaviour is abnormal

Compulsions:

  • Repetitive behaviour
  • Hoarding
  • Counting
  • Arranging
  • Sequence of checking

Obsession:

  • Persistant and reoccuring thoughts 
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Biological Explanations of OCD

Biological

  • OCD is in our biology

Genetic Explanation

  • The behaviour is inherited through our genes.
  • Possible predisposition for OCD inherited like other behaviours.
  • OCD should be found in the family members of OCD patients.

Evidence

Pauls et al 1995- found a higher percentage of OCD sufferers in relatives of OCD patients.

Evaluation

  • Takes into consideration biological factors
  • Is reductionist as it doesn't take into account the effect of nurture.
  • It is deterministic as it suggests people with OCD cannot change.
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Biological Explanations of OCD

Biochemical

  • OCD is caused by chemical imbalances in the brain.
  • Drugs, such as anti depressants, that have increased the levels of the neurotransmitter seratonin have decreased OCD symptoms.
  • Therefore low levels of seratonin in the brain causes OCD.

Evidence

Hollander et al- Drugs which reduced seratonin levels increased symptoms.

Piggott et al- anti depressants that increase seratonin levels decrease OCD symptoms.

Evaluation

  • SSRI drugs are not addictive and anyone can tolerate them
  • Drugs cause side effects
  • MAOI's are strong panic blockers, so good for treating people who have anxiety attacks.
  • MAOI'S can cause serious side effects, such as sexual dysfunction
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Biological Explanations of OCD

Neurophysiological

  • OCD could be caused by dysfunctional parts of the brain.
  • Parts of the brain implicated are the basal ganglia and orbital frontal cortex.
  • Basal ganglia is responsible for passing information to enable movement.
  • Individuals with OCD also show increased activity in the orbital frontal corex.
  • Obsessive compulsive sumptoms can also be caused by a loss of tissue in the caudate nuclei. An area of the basal ganglia that filters information coming from the OFC before passing the more important ones to other parts of the brain. The abnormality may also lie in the pathway connecting the frontal lobes with the basal ganglia.

Evidence 

Rapopart and wise 1988- proposed hypersensitivity of the basal ganglia causes repetitive motor behaviours such as those found in OCD sufferers.

Evaluation

  • Evidence which links parts of the brain with OCD
  • Describes the changes which occur but doesn't know why these changes occur.


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Biological Treatments of OCD

Drug Therapy

  • Anti depressants are the main medications for OCD.
  • SSRI's increase seratonin levels by preventing the reabsorption of seratonin at the synapse.
  • MAOI's are the older class of anti depressants used for those who do not benefit from SSRI's.

Evidence

Pigott et al 1995- anti depressants which increase seratonin decrease OCD symptoms.

Evaluation

  • SSRI- easily tolerated
  • Can cause side effects
  • MAOI have a strong panic blocking effect, good for use on those who suffer from panic attacks
  • MAOI have side effects and dietry restrictions
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Cognitive Explanation of OCD

Cognitive

  • People with anxiety disorders feel anxious because they percieve and understand the world in unhelpful ways and behave in ways that maintain these unhelpful perceptions and beliefs.
  • People with OCD misinterpret their intrusive thoughts as being very important, personally significant or having catastrophic consequences. This leads to obsessions. In order for the person to deal with the obsession they engage in compulsive behaviours to resist,block and neutralize the obsession.

Evidence

Sher et al 1989- found that peopel with OCD had poor memory.

Evaluation

  • Focuses on internal cognitions
  • Treatment aimed to reduce hypervigilance in OCD sufferers has been successful
  • Cannot explain social and emotional aspects
  • Doesn't explain why thoughts are faulty 
  • Cannot see what happens in the mind
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Cognitive Treatments of OCD

Cognitive treatments

  • People who suffer from OCD have obsessive thoughts that cause great anxiety.
  • Cognitive bias that can cause hypervigilance to environmental stimuli.
  • Cognitive therapies are based on changing how someone thinks.

Habiutation training

  • Client deliberatly thinks about their obsessive thought, not letting it leave thier mind, until it overwhelmes them and no longer has any effect on them.

Reality testing

  • Client is put into a sitatuion which shows them that their anxious thoughts aren't real in reality.

Evidence

Conttreaux et al 2001- compared cognitive and behaviourist therapy. 60 patients had either cognitive or behavioural therapy for 20 hours over 16 weeks. They found that both therapies reduced symptoms, but cognitive patients did not continue to improve after treatment.

Evaluation

  • Therapy helps patients to control their thoughts and actions
  • Client is tested and so improves
  • The study found flooding therapies more effective than others treating patients.
  • Therapy spread over a long period of time. So people may not be bothered to continue full treatment.
  • The patients irrational fear could accidently be confirmed.
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