Obsessive Compulsive Disorder

Question 1

What are the behavioural characteristics of OCD?

Answer 1

1. Compulsions:
   - There are two elements to these compulsions: they are repetitive and reduce anxiety.
2. Avoidance:
   - They attempt to reduce anxiety by keeping away from situations that trigger the anxiety.

Question 2

What are the emotional characteristics of OCD?

Answer 2

1. Anxiety and distress:
   - Obsessive thoughts are unpleasant and frightening.
   - The anxiety experienced can be overwhelming as the urge to repeat a behaviour creates anxiety.
2. Accompanying depression:
   - OCD is often accompanied by depression. This is called co-morbidity.
   - Anxiety is therefore accompanied with low mood and lack of enjoyment in activities.
3. Guilt and disgust:
   - OCD involves negative emotions such as irrational guilt over minor moral issues or disgust which can be directed at something else or the self.

Question 3

What are the cognitive characteristics of OCD?

Answer 3

1. Obsessive thoughts:
   - These thoughts recur over and over again and are always unpleasant.
2. Cognitive strategies to deal with obsessions:
   - People respond to compulsions by adopting cognitive coping strategies e.g. praying.
   - These held to manage anxiety.
3. Insight into excessive anxiety:
   - Sufferers know that their compulsions are not rational.
   - Sufferers experience catastrophic thoughts about worst case scenarios.

Question 4

What is the genetical explanation of OCD?

Answer 4

• One explanation for mental disorders is they are inherited and that individuals inherit specific genes from their parents.
• Taylor found they uo to 230 genes may be involved in OCD. 3 different types of genes are:

1. Candidate genes:
   - The COMT gene regulates the production of dopamine which has been implicated in OCD.
   - It is found that high levels of dopamine are linked to OCD.
   - One form of the COMT gene has been found to be more common in OCD patients.
   - This variation produces lower activity of the COMT gene and higher levels of dopamine.
   - The SERT gene affects the transport of serotonin, another transmitter which is linked to OCD.
2. Polygenic genes:
   - OCD is not caused by a single gene. It is caused by multiple genes, up to 230 as studied by Taylor.
3. Aetiologically heterogeneous genes:
   - One group of genes may cause OCD in one person but a different group of genes will cause it in another person.
   - Different forms of OCD may involve different genes.

Question 5

Evaluate the genetic explanation of OCD.

Answer 5

1. Supporting twin research:
   + Billet et al carried out a meta-analysis of 14 twin studies and found that MZ twins were twice as likely to develop OCD if their own twin has the disorder.
   + This adds validity to the role of genes in OCD.
   — However, it seems that environmental factors can also trigger OCD.
   — Cromer found that over half of OCD patients experienced a traumatic event.
   — This suggests that OCD is not entirely genetic.
2. Family support:
   + Nestadt et al identified 80 patients with OCD and 343 of their first degree relatives and compared them with 73 control patients.
   + They found that people with a first degree relative with OCD had a five times greater risk of developing OCD.
   — However, it is challenging to find all all the genes that are involved in predisposing someone to OCD.
   — Therefore this decreases the prescott validity of the explanation.
3. Animal studies:
   + Some evidence from animal studies show that some genes are associated with repetitive behaviour.
   — However, the human mind is much more complex so it may not be possible to generalise this.

Question 6

What is the neural explanation to OCD?

Answer 6

1. Abnormal levels of neurotransmitters:
   - Dopamine levels are thought to be abnormally high in people with OCD.
   - Lower levels of serotonin are associated with OCD.
   - Antidepressants which increase serotonin activity seem to reduce OCD symptoms.
2. Abnormal brain circuits:
   - In a non OCD brain, the orbitofrontal cortex notices when the something is wrong. It sends a worry signal to the caudate nucleus.
   - Normally, the caudate nucleus suppresses the worry signal sent so the orbitofrontal cortex doesn’t send the signals to the thalamus and the person does not start to obsess or worry.
   - In an OCD brain, the caudate nucleus fails to suppress the signals. These signals are then sent to the thalamus, creating a worry circuit which causes the person to obsess and worry.

Question 7

Evaluate the neural explanation of OCD.

Question 8

What is the biological approach to treating OCD?

Answer 8

1. Antidepressants (SSRIs):
   - Serotonin is released by the presynaptic neuron and travels across the synapse.
   - The neurotransmitter chemically conveys the signal from the presynaptic neuron to the postsynaptic neuron and is then re-absorbed by the presynaptic neuron where it is broken down and reused.
   - SSRIs prevent the re-absorption of serotonin, so they increase the levels in the synapse so they continue to stimulate the postsynaptic neuron.
   - It takes 3 to 4 months of daily use for SSRIs to have an impact on symptoms.
2. Anti-anxiety drugs:
   - Benzodiazepines are commonly used to reduce anxiety of OCD.
   - They slow down the activity of the CNS by inducing the activity of GABA, which has a general quietening effect on many of the neurons in the brain.
   - This is done by reacting with GABA receptors, slowing down the activity and making the person feel more relaxed.

Question 9

Evaluate the biological approach to treating OCD.

Answer 9

1. Effective drugs:
   + There is clear evidence for the effectiveness of SSRIs.
   + Soomro et all found that SSRIs had significantly better results than a placebo on OCD patients.
   — However, drugs can have side effects such as blurred vision, indigestion and loss of sex drive.
   — This can lead to patients not taking the drugs so their OCD isn’t being managed.
2. Cost effective:
   + Drugs cost a lot less than CBT.
   + This means the patient can simply take the drugs until symptoms decline without engaging in hard work of psychological therapy.
   — However, drugs don’t cure OCD, but simply reduce symptoms, so it usually combined with psychological treatments like CBT to be effective.
   — This means that when the drugs are stopped, the symptoms will return requiring a new prescription, creating a revolving door syndrome.
3. Biased evidence:
   — Many studies may be sponsored by drug companies who selectively publish positive outcomes for their drugs.
   — It is difficult to establish how drugs can be.
   - This means that the evidence for the effectiveness of drugs may be misleading.