OCD Flashcards
What is obsessive compulsive disorder?
• OCD - ANXIETY disorder (differs from Schizophrenia, which is a PSYCHOTIC disorder).
• OCD - characterized by OBSESSIONS (thoughts) and/or COMPULSIONS
(behaviours)
What are obsessions?
Persistent, unwanted, irrational thoughts.
Might include:
• Being contaminated or contaminating others,
• Fear of not having completed a ritual or specific act
• Hurting people
• Unwanted sexual thoughts, images, urges
What are compulsions?
Compulsions are the tasks that people do to relieve themselves of the obsessions. Compulsions can be mental or physical. Common compulsions include cleaning and/or washing;
Describe the OCD cycle
1) Obsession
Constant thoughts
2) Anxiety
Strong, uncomfortable feelings
3) Compulsion
Behaviour to relieve anxiety
4) Relief
From anxiety. Obsession response has been strengthened for future
Summaries the 5 diagnostic criteria for OCD listed by the DSM 5.
1) The obsessions cannot be ignored or suppressed and cause anxiety and/or distress.
2) The obsessions and/ or compulsions are time-consuming (take up more than one hour a day) and/ or cause clinically significant distress to daily life.
3) The symptoms cannot be explained by substance use or another medical condition or other mental disorders.
4) The clinician must determine if individual has fair insight the order or not and recognises that their beliefs are probably not true or if they have no inside and are definitely true.
5) Find out if the individual has a current or past history of attack disorder as this can affect the severity of the disorder
What is the onset of OCD when describing the features
For most people, the age of onset is late teens and early twenties, although it can start earlier or later - in 25% of male sufferers, before the age of 10. The symptoms usually develop
gradually, though occasionally there is a sudden, acute onset.
What is the prevalence of OCD when describing the features
Prevalence means how often or how widespread it occurs. The prevalence rate is between 1.1 and 1.8 percent of the population. In adults, OCD is more common in females than in males. However, in children, it is more common in males than females.
What is the prognosis of OCD when describing the features?
Prognosis is the likely course of the disorder. Although treatment can reduce symptoms, about 70% of people experience a chronic and lifelong course, with worsening and
improving symptoms.
The factors associated with a good prognosis include the following:
•Milder symptoms
•Brief duration of symptoms
•Good functioning before full onset
What is the risk factors of OCD when describing the features
• Family history. Having parents or other family members with the disorder can increase the risk of developing OCD.
• Stressful lite events People who have experienced traumatic or stressful events or who tend to react strongly to stress may have an increased risk of getting OCD.
What is the difference between symptoms features of a disorder
Symptoms of how a disorder shows itself in a patient. Features refer to the general information about the disorder
Describe the main features of OCD
The age of onset for OCD is late teens and early twenties, although it can start earlier or later - in 25% of male sufferers, before the age of 10.
Good prognosis for OCD is associated with milder and brief duration of symptoms and good functioning before onset.
The prevalence rate for OCD is between 1.1 and 1.8 percent of the population.
Risk factors for OCD include Family history. Having parents or other family members with the disorder can
increase the risk of developing OCD.
Stressful lite events People who have experienced traumatic or stressful events or who tend to react strongly to stress may have an increased risk of getting OCD.
Name one difference between OCD and schizophrenia
OCD is an ANXIETY disorder this is different to Schizophrenia, which is a PSYCHOTIC disorder
List the areas of the brain thought to be involved in OCD
•Thalamus
•Orbitofrontal Cortex
•Cingulate Gyrus
•Basal ganglia (which consists of the following two structures)
-Globus pallidus
-Caudate nucleus
Describe the role of the thalamus
The thalamus contains primitive checking and cleaning behaviours hardwired in the brain. If this is
overactive, it triggers a compulsion to engage in these behaviours.
Describe the role of the orbitofrontal cortex
The orbitofrontal cortex alerts the brain to potential worries in the environment. If overactive, the person would experience anxiety.
Describe the role of the cingulate gyrus
Connects orbitofrontal cortex to thalamus
Describe the role of the globus pallidus
• Part of BASAL GANGLIA
• Acts as a braking mechanism, controlling activity in thalamus
(“calming” Thalamus)
Describe the role of the caudate nucleus
• Part of Basal Ganglia
Inhibits action of globus pallidus fibres. If caudate nucleus is overactive, it over inhibits the globus pallidus fibres. This means the Globus pallidus can’t do its job of calming the Thalamus and it therefore becomes over reactive.
How can malfunction of different areas of the brain relate to OCD?
In OCD, the Basal Ganglia can malfunction. This means that the thalamus is overactive - therefore
cleaning and checking behaviours are more likely. These would be the compulsions found in OCD.
The overactive thalamus causes a cascade reaction in the orbitofrontal cortex, leading to the orbitofrontal cortex becoming overactive. The orbitofrontal cortex is hardwired to alert the brain when something seems odd, causing anxiety. This would lead the obsessions found in OCD.
Describe the feedback loop theory of OCD
An overactive caudate nucleus means that the globus pallidus does not perform its braking mechanism of inhibiting activity in the thalamus.
This means that the thalamus (which controls primitive checking and cleaning behaviours hardwired in the brain) is overactive. The overactive thalamus in turn causes over-activity in the orbitofrontal cortex. The overactive thalamus explains the compulsions found in OCD because it is responsible for primitive checking and cleaning behaviours. The overactive orbitofrontal cortex explains the obsessions found in OCD, because it is hardwired to alert the brain when something seem odd, causing anxiety.
strengths of a biological explanation for OCD (brain structure and functioning) evidence to support
There is a lot of supporting evidence for the idea that brain structure and functioning explains OCD.
•Brain scans show differences in brain structure between people who have OCD and healthy controls.
• Evidence for this: Menzies (2007) found people suffering from OCD had different amounts of grey matter in the orbitofrontal cortex.
• High in Scientific credibility - brain scans are objective and many studies have come up with similar results
strengths of a biological explanation for OCD (brain structure and functioning) applications
Surgical lesioning of the cingulate gyrus (the area that connects the thalamus with the orbitofrontal cortex has been used successfully as a treatment for OCD. This would suggest that the idea that OCD results from a faulty feedback loop between the thalamus and the orbitofrontal cortex is correct, since breaking the loop can cure OCD. However, Some people respond to surgery on the cingulate gyrus, some
don’t
Limitations of a biological explanation for OCD (brain structure and functioning)
• However, sometimes this surgery does not work; this might mean that OCD is more complex than this theory suggests. For example, Kireev et al (2013) suggest that the functions usually performed by the cingulate gyrus can be taken over by other areas of the brain. Therefore, a weakness of this explanation is that it is reductionist: it does not fully explain OCD.
• A further weakness is that is difficult to show cause and effect using this model. The differences
in brain activity in people with OCD may be a symptom of their OCD, rather than the cause.
• Brain activity & thoughts are related, so it is not easy to say whether the brain activity altered the thoughts, or the thoughts altered the brain activity, as they cannot be separated.
Describe one piece of supporting evidence for brain functioning as a biological explanation of OCD
When people with OCD are shown objects that bring on their symptoms, such as a dirty piece of clothing with someone who hates dirt & has a cleaning compulsion, there is an increase in the activity in the orbitofrontal cortex & the caudate nucleus
(McGuire et al. 1994)
Explain how surgical lesioning of the cingulate gyrus both
- Supports the theory
- Argues against the theory
•Supports: Surgical lesioning of the cingulate gyrus (the area that connects the thalamus with the orbitofrontal cortex has been used successfully as a treatment for OCD. This would suggest that the idea for OCD results from a faulty feedback loop between the thalamus & the orbitofrontal cortex is correct, since breaking the loop can cure OCD.
•However sometimes this surgery does NOT work; this might mean that OCD is more complex. KIREEV et al. (2013) suggest that the functions usually performed by the cingulate gyrus can be overtaken by other areas of the brain
According to the cognitive explanation what are the causes of obsessive thoughts in OCD
False beliefs learned in childhood
Memory problems
Hypervigilance (attentional problem)
Explain how false believes in the cognitive approach can explain OCD
People misinterpret their thoughts due to false beliefs (learned in earlier life)
Most people have intrusive thoughts but can shrug them off. People with OCD tend attach importance to them
Respond as if thought were a threat - leading to high anxiety and negative emotions (shame, guilt)
Tend to interpret thoughts as catastrophic, leading to anxiety and then the practicing of avoidance or ritual behaviours
List the five beliefs that researchers suggest may be important in the development and maintenance of obsessions.
- Exaggerated responsibility that one is responsible for preventing harm to others
- Belief - certain thoughts are important & should be controlled
- Somehow having a thought/ urge will increase the chances of it happening
- tendency to overestimate the likelihood of danger
- belief that one should always be perfect & mistakes are unacceptable
Explain how the faulty beliefs can lead to obsessive behaviours found in OCD
People who fear their own thoughts usually attempt to neutralize feelings that arise from their thoughts.
They might avoid situations which may spark such thoughts. Another way is by engaging in rituals, such as washing or praying. The anxiety produced by the thoughts lead to the compulsive behaviours seen in OCD.
Give a piece of research evidence that shows cognitive psychology can explain OCD as being due to memory problems.
Sher et al (1989) found that people with OCD had poor memories for their actions, for example, they really could not remember if they had turned the light off.
Describe hypervigilant explain OCD
Hypervigilance means that they
have an attentional bias which means that are overly sensitive to threat.
This is seen where they may use rapid eye movements to scan the environment, and they may attend selectively to threat related stimuli rather than neutral stimuli. This means that they feel very anxious. The threats that are perceived therefore become the basis of their obsessions. The compulsive behaviours are designed to reduce their anxiety.
Provide one argument AGAINST the cognitive explanation for OCD in terms of C&E
Cognitive theories do not really provide a cause & effect explanation of OCD. It does not show that faulty thinking is because of OCD; it could well be that faulty thinking is a symptom of OCD (with the underlying cause being something else e.g. brain structure/ functioning)
What is a biological treatment for OCD
Drug treatment
What are the three types of drug treatments used for OCD
1) antidepressants
2) anti-anxiety drugs
3) beta blockers
Describe how antidepressants work by treating OCD
Antidepressants such as sertraline are used to raise serotonin levels. They do this by blocking its reuptake from the pre-synaptic neuron. This means that more serotonin is available for a longer period.
dosage used to treat OCD is higher than that used to treat depression.
It may take up to 12 weeks for the drugs to take effect.
Some people do not respond to medication.
Describe how anti-anxiety drugs work by treating OCD
Anti-anxiety drugs called such as valium work by increasing the effectiveness of GABA in regulating anxiety. GABA is an amino acid that acts to lower physiological arousal and return the body to a resting state.
Describe how beta blockers work by treating OCD
work by blocking the stress hormones which are released into the blood stream by the adrenal glands. These stress hormones create symptoms of anxiety such as increased heart rate and respiration; beta blockers prevent this physiological response from occurring. Because the person feels less physiological stress, they may have fewer obsessional thoughts and therefore (because the obsessional thoughts lead to compulsive behavior) less compulsive behaviour.
Give a strength of drug treatments for OCD to do with alternative treatments
One strength of drug treatment is that is useful, because it can be used to treat cases of OCD which have not responded to cognitive behaviour therapy.
