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Clinical psychology > OCD (pack 3) > Flashcards

OCD (pack 3) Flashcards

1
Q

What sort of disorder is OCD?

A

anxiety disorder

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2
Q

What is OCD characterised by?

A
  1. Obsessions
  2. compulsions
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3
Q

what are obsessions?

A

persistent, irrational, unwanted thoughts

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4
Q

what are some common obsessions?

A

fear of contamination, fear of not doing an act that could result in harm, afraid of hurting themselves or others

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5
Q

what are compulsions?

A

the tasks that people do to relieve themselves of the obsessions

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6
Q

What are some common compulsions?

A

cleaning and washing, ordering and balancing, repeated checking behaviours.

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7
Q

What is another disorder that some OCD patients may have as well?

A

tic disorder

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8
Q

What are the four stages of the OCD cycle?

A
  1. Obsession
  2. Anxiety
  3. compulsion
  4. Relief
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9
Q

What are the four features of OCD?

A
  1. Onset
  2. prevalence
  3. Prognosis
  4. risk factors
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10
Q

What is onset?

A

When symptoms of OCD begin

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11
Q

What is the age of onset for OCD?

A

late teens early twenties

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12
Q

what is a statistic for onset in men?

A

25% suffer before age of 10

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13
Q

what does prevalence mean?

A

how often or widespread it occurs

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14
Q

what is the prevalence rate?

A

between 1.1 and 1.8 percent of the population

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15
Q

Which gender is OCD more prevalent in adulthood?

A

females

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16
Q

what does prognosis mean?

A

likely course of the disorder

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17
Q

within prognosis, what percentage of people with OCD experience a chronic and life long course?

A

70%

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18
Q

Who estimates that 2% of the population world wide has OCD?

A

Sasson et al (1994)

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19
Q

What are risk-factors?

A

factors that increase the risk of developing or triggering OCD

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20
Q

what are some examples of risk factors?

A

family history
stressful life events

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21
Q

What are the 5 diagnostic criteria for OCD listed by the DSM 5

A
  1. obsessions cannot be ignored or suppressed and cause anxiety
  2. the obsessions/compulsions are time consuming
  3. The symptoms cannot be explained by substance use or another disorder
  4. the clinician must decide if the patient has a fair insight and believes obsessions are untrue or poor insight and does not realise they are untrue
  5. find out if the individual has a current or past history of a tic disorder as this can affect severity
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22
Q

What is the biological explanation for OCD?

A

that the neuro-circuitry in the brain is not working

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23
Q

What is the function of the thalamus?

A

primitive checking and cleaning behaviours, if overacts, it triggers compulsion

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24
Q

What is the function of the orbitofrontal cortex?

A

alerts the brain to potential worries in the environment, if overactive the person would feel anxiety

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25
Q

What is the function of the cingulate gyrus?

A

connects the orbitofrontal cortex to the thalamus

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26
Q

what is the function of the basal ganglia nuclei

A

One of the jobs is to inhibit the thalamus, if NOT working, can’t inhibit, therefore thalamus becomes overactive and causes compulsions

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27
Q

what are the two components of the basal ganglia?

A
  1. The globus pallidus
  2. caudate nucleus
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28
Q

what is the function of the globus pallidus?

A

acts as a breaking system for the thalamus

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29
Q

what is the function of the caudate nucleus?

A

to inhibit the globus pallidus

30
Q

How does brain structure relate to compulsions?

A

if the basal ganglia malfunctions, then the thalamus becomes overactive- therefore cleaning and checking behaviours more likely

31
Q

How does brain structure relate to obsessions?

A

overactive thalamus causes a cascade reaction in the orbitofrontal cortex, leading to the OFC being overactive, the OFC hardwired to alert when brain feels odd, causing anxiety.

32
Q

What are 3 strengths of a biological explanation for OCD?

A
  1. Brain scans show differences in structure between people who have OCD and healthy controls. For example, Menzies found that those with OCD had more grey matter in OFC
  2. Salloway and Duffy found PET scans of OCD patients had increased activity in PFC
  3. Brain scans showed different functioning between people who have OCD and healthy controls. Patients with OCD have structures still active when sleeping whereas healthy people do not.
33
Q

What are three weaknesses of the biological explanation for OCD?

A
  1. difficult to show cause and effect using this model because differences in those with OCD may be a symptom, rather than the cause
  2. Brain activity and thoughts are related, so it’s not easy to say whether the brain activity altered the thoughts, or thoughts altered activity.
  3. support for bio link comes from genetic link as it suggests physiological factors underlie the development of the disorder (twin studies)
34
Q

what does the cognitive explanation for OCD look at?

A

The role that thoughts play in the disorder and suggests it is the thought processes rather than structure

35
Q

What are the 3 ways in which the cognitive explanation explains OCD?

A
  1. False beliefs
  2. memory problems
  3. hypervigilance
36
Q

how do false beliefs explain OCD?

A

people with OCD misinterpret their thoughts, due to false beliefs learned in earlier life

37
Q

How does cognitive theory suggest false beliefs uphold OCD?

A

as long as they interpret the intrusive thoughts as catastrophic, they will continue to be distressed and practice rituals.

38
Q

what are three false beliefs that researchers believe develop and maintain obsessions?

A
  1. exaggerated responsibility
  2. belief that certain thoughts are important and should be controlled
  3. the tendency to overestimate the likelihood of danger
39
Q

What did sher et al find that involves memory problems and OCD?

A

people with OCD had poor memories for their actions. For example, they really couldn’t remember if they had turned the light on or off.

40
Q

What did Trivedi (1996) find that involves memory problems and OCD?

A

people suffering from OCD had low confidence in their memory ability and non-verbal memory impaired

41
Q

What does hypervigilance mean?

A

they have attentional bias which makes them overly sensitive to threat.

42
Q

What are three strengths of the cognitive explanation for OCD?

A
  1. Backed up by supporting evidence (sher et al)
  2. therapy based on cognitive explanation and has been successful for treatment of OCD. E.G- Van Balkom found that it is as effective as drug treatment
  3. Cognitive bias such as hypervigilance seem to give a good account of individual differences in susceptibility to OCD
43
Q

What are two limitations of the cognitive explanation for OCD?

A
  1. Does not prove a cause and effect link, does not show that the faulty cognitions are the CAUSE of the OCD
  2. reductionist- ignores the role of biology and ignores the role of learning in the development of faulty cognitions
44
Q

What are the 3 types of drug treatments used for OCD?

A
  1. Anti-depressants
  2. Anti-anxiety
  3. Beta- Blockers
45
Q

what is the most common drug treatment for OCD?

A

Antidepressants

46
Q

How do anti-depressants work?

A

drugs such as sertraline are used to raise serotonin levels by blocking it’s reuptake from synapse back into releasing neuron, more serotonin available

47
Q

how do anti-anxiety drugs work to treat OCD?

A

increasing the effectiveness of GABA in regulating anxiety

48
Q

How do beta blockers work to treat OCD?

A

for example propranolol, these work by blocking the stress hormone which are released into the blood stream by the adrenal glands
therefore if they feel less physiological stress, they may have less obsessional thoughts

49
Q

Three strengths of using drug treatment for OCD?

A
  1. useful as it can be used to treat cases of OCD where they have not responded to CBT
  2. empirical evidence to show drug treatment is effective (soomro et al 2007) found anti-depressants were more effective in reducing symptoms…scientific cred.
  3. Drug treatment combined with CBT and has been shown to raise the effectiveness of CBT (POTS)
50
Q

Three weaknesses of using drug treatment for OCD?

A
  1. it may cause side effects such as nausea and headaches, side effects may limit usefulness of drugs because people do not want to take them
  2. rare cases, medications may increase anxiety rather than decrease it
  3. Drug therapy for OCD usually needs to last for 12 months before medication can be reduced or discontinued
51
Q

How long does a course of CBT usually run for?

A

3 months

52
Q

How does CBT begin?

A

starting with thoughts that are least anxiety provoking, client then encouraged to test beliefs until thoughts no longer generate anxiety

53
Q

what does CBT aim to prevent?

A

a cognitive distortion of catastrophising

54
Q

What is an additional technique used in CBT?

A

habituation training

55
Q

What is habituation training?

A

asked to think repeatedly about obsessive thoughts, by deliberately thinking about them, they will become less anxiety provoking, therefore compulsions not needed to relieve anxiety.

56
Q

What is the most common behavioural therapy used as part of CBT for OCD called?

A

exposure and response prevention therapy

57
Q

what does exposure and response prevention therapy focus on?

A

compulsions

58
Q

what are the four steps involved in exposure and response prevention therapy?

A
  1. informing client about exposure and response prevention and what therapy will include
  2. exposure hierarchy (least anxiety provoking to high anxiety provocation)
  3. repeated exposure to situations that cause anxiety, until it reduces
  4. getting client to resist and refrain from performing compulsions
59
Q

what researcher found that between 55 and 75% show improvement after ERPT and it lasts for 5-6 years?

A

Franklin et al

60
Q

What are three strengths of CBT as a treatment for OCD?

A
  1. The use of CBT is supported by evidence which shows that it is effective in reducing the symptoms of OCD and is endorsed by NICE 2006
  2. CBT does not have any side effects (unlike medication for OCD)
  3. CBT has lower relapse rates that medication when discontinued
61
Q

what are three weaknesses of CBT as an explanation for OCD?

A
  1. It is difficult to disentangle which of the benefits from CBT are due to a cognitive component and which are due to behavioural component
  2. Found 70% respond well to CBT, there are still some where it is ineffective (individual differences)
  3. ERPT not effective for those without compulsions
    MASELLIS found up to 44% only suffer from depression
62
Q

What was the aim of the POTS study?

A

to compare the following treatments
1) CBT on it’s own
2) An SSRI on it’s own
3) CBT and sertraline combined
in order to see which is most effective in treating young people with OCD

63
Q

what was the sample in POTS study?

A

volunteer, 112 children, 7-17 y/o
severity of symptoms measured using yale brown obsessive compulsive scale

64
Q

what was the baseline condition of the POTS study?

A

children with ADHD were on stimulant medication so that interaction affects didn’t effect treatment

None of the children were on anti-obsession medication prior

65
Q

what were the four conditions in the POTS study?

A

drugs
placebo
CBT only
combo of CBT & drugs

all children interviewed and baseline measure taken using Y-BOCS

66
Q

Some procedure of POTS study?

A

study lasted 12 weeks and each child had special psychiatrist to measure their progress

DRUG condition and PLACEBO required children to attend weekly for first 6 weeks of study and then very other week

parents kept a medication diary, assessing changes

participants were assessed at 4,8 and 12 weeks

67
Q

what were some results of the POTS study?

A

entering remission was when children went below 10 on CY-bocs scale

39.3% of CBT alone group did this
21.4% of drug condition
both together showed sig drop

68
Q

POTS study conclusion?

A

concluded that the combination of drug therapy and CBT led to greatest reduction in symptoms

69
Q

three strengths to evaluate the POTS study?

A
  1. high inter-rater reliability , evaluators were carefully trained and supervised
  2. cause and effect can be established as the participants were not on any medication before
  3. generalisable as large and representative sample of 112 children aged between 7-17 y/o done across 3 centres
70
Q

three weaknesses to evaluate the POTS study?

A
  1. conducted over 3 centres, 1 had better results on CBT only, may be due to the effectiveness of therapist
  2. the ethical considerations as the p’s in placebo condition were deceived and put through stress of no medication
  3. All American and 92% white, ethno-centric, low cross- cultural generalisability and excluded children co-morbid with other disorders , therefore can’t generalise to these people
71
Q

what are some applications for the POTS study?

A

provides strong evidence about most effective treatment for OCD in children and young people

effectiveness of CBT and sertraline combined

Clinical psychology (6 decks)

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