Issues concerning the classification and diagnosis of OCD

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Validity is concerned with the suitability of the classification categories. A valid diagnosis should be representative of what the patient is suffering from and subsequently, an effective treatment should be given, this is known as predictive validity. 

Everyone at some point in their lives suffers from thoughts that are unwanted, or habitually behave in a ritualistic manner. This suggests that compulsive behaviours that are mild are a common occurrence in the population. Symptoms of OCD, similarly with other anxiety disorders, exist on a spectrum of severity so people should only be diagnosed if their obsessions/compulsions are so overwhelming and disruptive that they cannot function adequately in their life. The issue raised here is the subjectivity, when exactly does normal behaviour become abnormal consequently there are risks of medicalizing normal behaviour. 

There is much variance in the obsessions and compulsions that individuals suffer thus it has been suggested that there are several subtypes of OCD. Jakes [1996] states that patients can be classed in subgroups according to the nature of their compulsions i.e. Some experience checking rituals, others experience cleaning rituals etc. Jakes believes that these subgroups may originate differently and consequently require different treatments. On the other hand, patients with OCD suffer a mixture of obsessions and compulsions and these can change. Rasmussen and Eisen [1991] found factors that are present in the majority of diagnosed cases of OCD:

  • Anxiety is the dominant and overwhelming emotion that patients experience 
  • Patients all experience a fear that they believe is inevitable
  • Patients believe that their compulsions give them temporary relief. 

Another issue when obtaining a valid diagnosis of OCD is that it is the regular occurrence of co-morbidity. Studies illustrate that 67% of…


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