Psychopathology - OCD

Question 1

What are the behavioural characteristics of OCD (action)?

Answer 1

• compulsive behaviours
• hinder everyday functioning
• social impairment
• repetitive
• avoidance

Question 2

What are the emotional characteristics of OCD (feelings)?

Answer 2

• anxiety and distress
• accompanying depression
• guilt and disgust

Question 3

What are the cognitive characteristics of OCD (thinking)?

Answer 3

• obsessions
• recognised as self generating
• realisation of inappropriateness
• attention bias

Question 4

What are the biological approaches to explaining OCD?

Answer 4

• genetic
• neural

Question 5

What are the genetic causes of OCD?

Answer 5

• COMT gene
  
  • regulates the production of dopamine (high levels associated with OCD)
  • high levels of dopamine = drive, motivation, aggression
  • this gene is more common in OCD patients than those without the illness
• SERT gene
  
  • affects transportation of serotonin (low levels result in low mood/depressive symptoms)
  • present on chromosome 17, a mutation on this gene can cause OCD
  • Ozaki (2003) found that 6/7 of family members with OCD had a mutation of the SERT gene

Question 6

What are the strengths of the genetic causes of OCD?

Answer 6

• research support
  
  • Nestadt (2000) found that those who had a first degree relative with OCD were five times more likely to get the illness
  • Blillett (1998) conducted a meta-analysis of 14 twin OCD studies and found that it is twice more likely to be concordant in MZ twins than in DZ twins

Question 7

What are the weaknesses of the genetic causes of OCD?

Answer 7

• there are other factors
  
  • the concordance rate (genetics) for OCD is not 100%
  • this explanation does not take into account the psychological/environmental factors causing OCD

Question 8

What research did Beckman and Cath (2005) conduct into genetics and OCD?

Answer 8

• conducted a meta-analysis of twin studies and OCD
• MZ (identical) twins were compared to DZ (non-identical) twins

Question 9

What are the strengths of Beekman and Cath’s research?

Answer 9

• used a large sample (more representative results)
• used a meta-analysis making the findings more accurate/and minimises bias as there is research support

Question 10

What are the weaknesses of Beekman and Cath’s research?

Answer 10

• not in controlled conditions
  
  • the data is not very scientific/objective and may not be valid/reliable
• gene mapping not taken into consideration
  
  • this would look closely at the DNA of the twins that had OCD and would compare it to twins that do not have OCD
  • a comparison would need to be made to increase the validity of the results

Question 11

What are the neural explanations of OCD?

Answer 11

• dopamine (high levels)
  
  • neurotransmitter that affects mood (linked to frontal lobes)
  • research conducted on animals has shown that high levels of dopamine can induce repetitive/compulsive behaviour (similar to what OCD suffers would experience)
  • also linked to over activity in the basal ganglia
• serotonin (low levels)
  
  • neurotransmitter that affects mood (linked to frontal lobes)
  • plays a key role in the caudate nucleus and low levels of it can cause it to malfunction
  • the caudate nucleus helps to work cognitive memory, cognitive function, and emotions

Question 12

What are the strengths of the neural explanations of OCD?

Answer 12

• research support
  
  • evidence that anti-depressant drugs will increase serotonin levels in OCD patients (led to a decrease in symptoms)
  • Ciccerone (2000) found that giving OCD patients low doses of Risperidone lowered dopamine levels/alleviated some OCD symptoms
  • shows that high levels of dopamine may be a biological cause for OCD
  • Menzies (2007) studied MRI scans of OCD patients and their family members (compared them with healthy controls)
  • results showed that OCD patients/their families had reduced grey matter in key regions of the brain/had an unusual neuroanatomy
  • so OCD can be caused by abnormal brain structure which could be inherited via genes

Question 13

What are the weaknesses of the neural explanations of OCD?

Answer 13

• cause and effect
  
  • dopamine and serotonin might not necessarily cause OCD
  • low levels of serotonin and high levels of dopamine might be the effect of OCD
  • OCD exists alongside depression
  • so it is not clear whether low levels of serotonin cause OCD or depression or both
• role of dopamine
  
  • high levels of dopamine can also cause other psychological illnesses and not just OCD
  • e.g. high dopamine can cause bipolar depression/schizophrenia.
  • there is not enough research evidence to show that high levels of dopamine causes OCD

Question 14

What research did Jenike and Rauch conduct on neuroanatomy?

Answer 14

• investigated the relationship between OCD and brain damage
• brain damage may cause a problem in the short term memory (results in repetitive behaviour)
• OCD patients (cleaning obsession) were studied using PET scans and were shown something dirty/unclean
• the scans showed that the frontal lobes and the basal ganglia (over active) were the most active parts of the brain

Question 15

What are the strengths of Jenike and Rauch’s study?

Answer 15

• research support
  
  • Rapoport (1990) reviewed an epidemic that occurred in Europe between 1916-18 (widespread viral brain infections)
  • he found that there was a major rise in the number of OCD cases reported
  • this may be because the viral infection caused damage or brain abnormality
• PET scanning
  
  • can highlight/investigate abnormalities and cleary view the areas that are working properly
  • shows that this explanation is based on scientific/objective data

Question 16

What are the weaknesses of Jenike and Rauch’s study?

Answer 16

• cause and effect
  
  • brain damage may cause OCD but OCD could also cause brain damage
• reductionist
  
  • it reduces the brain into simple components malfunctioning despite it being a very complex part of the body
  • different parts of the brain may need to malfunction to cause OCD

Question 17

What are the biological approaches to treating OCD?

Answer 17

• SSRI drugs
• BZ drugs

Question 18

What are SSRI drugs?

Answer 18

• selective serotonin re-uptake inhibitors
• it prevents the re-uptake of serotonin levels and prolongs its activity in the synapse (reduces anxiety levels)
• low serotonin levels are associated with damage to the caudate nucleus where the brain fails to suppress minor worry signals
• message is sent to the orbital frontal cortex (this worsens anxiety levels)
• it helps to stabilise moods/emotions and improves memory (reduces compulsive p behaviour/checking)
• prescribed for 12-16 weeks

Question 19

What are the strengths of SSRI drugs?

Answer 19

• research support
  
  • Soomro (2009) reviewed 17 studies that compared SSRIs to placebo drugs
  • found that all 17 studies showed that SSRI drugs were more effective than placebos, especially when combined with CBT
• relatively effective (70% of patients experienced a decline in OCD symptoms)
• cost effective
  
  • relatively cheap in comparison to psychological therapies (CBT), counselling/family therapy
  • using SSRI drugs to treat OCD is good value for money for the NHS/is economical compared to other treatments

Question 20

What are the weaknesses of SSRI drugs?

Answer 20

• limited treatment
  
  • they do not work for all OCD patients
  • for some patients, SSRI drugs will not alleviate their OCD symptoms so they will have to take an alternative drug instead (may be more effective for them)
• they have terrible side effects (indigestion, blurred vision, loss of sex drive)
• not effective in the long term
  
  • Koran (2007) stated that drug therapy may be a popular treatment, but CBT should be tried first to reduce OCD symptoms
  • drug therapy requires little effort/may be effective short term, but it does not provide a lasting cure for OCD (relapse is possible)

Question 21

What are BZ drugs?

Answer 21

• benzodiazepines
• reduce anxiety and control action of neurotransmitters
• reduce the activity in the central nervous system and reduce brain arousal
• increase GABA (slows down the firing of neurons which makes them less anxious)
• neurons in the brain become less active and the person feels calmer
• BZ also decreases serotonin levels in the brain (more likely to get depressed)

Question 22

What are the strengths of BZ drugs?

Answer 22

• very effective at reducing anxiety/OCD symptoms
• used by millions of people worldwide (very good at reducing anxiety and OCD on a global basis)
• work very quickly and effectively
  
  • faster compared to other psychological treatments (CBT).
  • BZ drugs can begin to reduce anxiety levels/OCD symptoms in a short period of time (immediate benefits of relief)
• minimum side effects (short term use)
  
  • can be used for short periods of time and they will produce hardly any real serious side effects unlike other drugs

Question 23

What are the weaknesses of BZ drugs?

Answer 23

• several unwanted side effects can appear (long term)
  
  • e.g. drowsiness, depression and unpredictable interactions with alcohol
  • patients have a high chance of being involved in accidents
  • so BZ drugs should not be used as a long term treatment for OCD
• long term use can be dangerous
  
  • Ashton (1997) found that long term users of BZ became very dependent on the drug
  • a sudden withdrawal of the drug leads to a return of high levels of anxiety/OCD symptoms
  • this also causes a problem of tolerance/drug escalation where patients need to take very large doses of the drug in order to reduce their OCD symptoms
• impairment in speed and processing of verbal learning
  
  • Stewart (2005) carried out a Meta analysis and found evidence that long term use of BZ leads to cognitive impairments
  • but cognitive ability seems to improve once the BZ drugs are withdrawn (it is still below that of control patients who have never taken BZ)