OCD

Question 1

What are the DSM-5 categories of OCD

Answer 1

Characterised by either obsessions (recurring thoughts, images etc) and for compulsions (repetitive behaviours such as hand washing)

Question 2

Name 3 types of OCD

Answer 2

Trichotillomania - compulsive hair pulling
Hoarding disorder - compulsive gathering of possessions and the inability to part with anything regardless of value
Excoriation disorder - compulsive skin-picking

Question 3

Name 3 behavioural characteristics of OCD

Answer 3

compulsions are repetitive- feel compelled to repeat compulsions
compulsions reduce anxiety - 90% say that their compulsions help reduce anxiety from their obsessions
Avoidance - avoid situations that trigger their anxiety

Question 4

Name 3 Emotional characteristics of OCD

Answer 4

Anxiety and distress
Accompanying depression
Guilt and Disgust - can cause irrational guilt over minor moral issues or disgust which may be directed to something external like dirt

Question 5

Name 3 cognitive characteristics of OCD

Answer 5

Obsessive thoughts - For 90% this is the main cognitive feature
Cognitive coping strategies - a religious person tormented by obsessive guilt may pray often. Helps manage anxiety from the obsession
insight into excessive anxiety - They are aware that their O and C are irrational but they think about the worst case scenario that might result if their anxieties are justified.

Question 6

Describe the biological approach

Answer 6

A perspective that emphasises the importance of physical processes in the body such as genetic inheritance or individual neurons.

Question 7

Describe the family study done on OCD (Who, when, findings and suggestions)

Answer 7

Aubrey Lewis (1936) observed his OCD patients 37 % had parents with OCD and 21% had siblings with OCD. Suggests OCD runs in the family but genetic vulnerability is passed on not the certainty of OCD

Question 8

What is the diathesis-stress model

Answer 8

It states certain genes leave some people more likely to develop a mental disorder but is not certain. some environmental stress is necessary trigger the condition.

Question 9

What are candidate genes

Answer 9

These genes create a vulnerability for OCD. Some are involved in regulating the development of the serotonin system

Question 10

What is the Sert gene

Answer 10

This gene is implicated in transport of serotonin across the synapse (also called 5HT1-D beta)

Question 11

What does OCD is polygenic mean

Answer 11

This means that OCD is not caused by one single gene but by a combination of genetic variations that increase vulnerability.

Question 12

Describe one study on OCD being polygenic (Who, when, findings)

Answer 12

Steven Taylor (2013) Analysed findings of previous studies and found that 230 genes may be involved in OCD. Genes involved to OCD are associated with dopamine as well as serotonin (both regulate mood)

Question 13

What does aetiologically heterogenous mean in OCD

Answer 13

This term means that one group of genes may cause OCD in one person but a different group og genes may cause the disorder in another person.

Question 14

Describe one twin study on genetic explanation (Who, when, findings)

Answer 14

Gerald Nestadt Et Al (2010) reviewed twin studies and found 68% of identical twins shard OCD but only 31% of non identical twins

Question 15

Explain the study for the chances of getting OCD if you have a family member with one

Answer 15

Marini and Stebnicki (2012) found a person with a family member is 4 times as likely to develop it someone without

Question 16

One limitation of genetic explanation for OCD

Answer 16

Kiara Cromer Et Al (2007) found over half of their OCD clients experienced a traumatic event in the past. OCD was more severe in clients with more than 1 trauma

Question 17

What is meant by the term neural explanation

Answer 17

The view thst physical and psychological characteristics are determined by the behaviour of the nervous system, in particular the brain as well as individual neurons

Question 18

Explain the role of serotonin in explain OCD

Answer 18

The neurotransmitter Serotonin is believed to help regulate mood. The role of neurotransmitters is to relay information from one neuron to another. If there are low levels of Serotonin then normal transmission of mood relevant information does not take place

Question 19

Explain how the decision making systems can cause OCD

Answer 19

some cases of OCD is associated with impaired decision making. This may be linked with abnormal functioning of the lateral of the frontal brain

Question 20

Explain the frontal lobe.

Answer 20

The frontal lobe is the front part of the brain that is responsible for logical thinking and making decisions.

Question 21

What area of the brain functions abnormally and may cause OCD

Answer 21

Evidence to suggest that an area called the left parahippocampal gyrus (associated with processing unpleasant emotions)

Question 22

What is the comt gene

Answer 22

(catechol - o -methyl transferase) regulates the neurotransmitter dopamine.

Question 23

one strength of the neural explanation for OCD

Answer 23

antidepressants that work purely on serotonin are effective in reducing OCD symptoms and that suggests that serotonin may be involved in OCD.

Question 24

one limitation of the neural explanation for OCD

Answer 24

Many people with OCD have comorbidity and experience depression. Depression probably involves the action of serotonin. So we are left with a logical problem.

Question 25

Describe drug therapy

Answer 25

Drug therapy for mental disorders aims to increase or decrease levels of neurotransmitters in the brain. For example with OCD it tries to increase levels of serotonin.

Question 26

Describe an SSRI.

Answer 26

This is the standard treatment for OCD an antidepressant drug called an selective serotonin reuptake inhibitor.

Question 27

How does an SSRI work

Answer 27

serotonin is released by certain neurons in the brain. In particular, presynaptic neurons. The neurotransmitter chemically conveys the signal from the presynaptic neuron to the postsynaptic neuron and then it is reabsorbed by the presynaptic neuron where it is broken down and reused. By preventing the reabsorption and breakdown SSRI effectively increases levels of serotonin and continues to stimulate the postsynaptic neuron

Question 28

What is the normal dose of fluoxetine? and explain how it works.

Answer 28

A typical dose of fluoxetine is 20 mg but this can be increased if not benefitting the patient. Normally given in tablets or liquid. takes 3-4 months of daily use for symptoms to decrease.

Question 29

What is used along side SSRI's

Answer 29

CBT is often used along side drugs. The drug reduces a persons emotional symptoms, this means the user can engage more effectively with CBT. In practice some respond to CBT and some to drugs.

Question 30

What is one alternative to SSRI's

Answer 30

Tricyclics (an older antidepressant) are sometimes used such as clomipramine. This acts on many systems including the serotonin system. However has more severe side effects

Question 31

What is an SNRI

Answer 31

(selective noradrenaline reuptake inhibitor) used more recently to treat OCD. Increases serotonin and noradrenaline.

Question 32

Explain one study showing evidence of effectiveness of SSRI's

Answer 32

G. Mustafa Soomro et al (2009) reviewed 17 studies that compared SSRI's to placebos in treatment. All studies showed better outcomes from SSRI than placebo. 70% of all symptoms reduced, in other 30% combination with CBT or other drugs helped.

Question 33

Explain one strength of drug treatment for OCD

Answer 33

Cost effective and non disruptive. A tablet is a lot cheaper to make. Many 1000s of tablets can be made in 1 therapy session. Therefor for the public health system like the NHS it is good value. It also doesn't take much time out of the patients life.

Question 34

One limitation of drug therapy in treating OCD