4.1.4 - OCD

Question 1

What are the 3 types of characteristics of OCD

Answer 1

• cognitive
• behavioural
• emotional

Question 2

What are the cognitive characteristics

Answer 2

• obsessive thoughts (irrational)
• cognitive coping strategies( performed to temporarily remove anxiety)
• selective attention

Question 3

What are the emotional characteristics

Answer 3

• accompanying depression
• guilt and disgust
• anxiety and distress

Question 4

What are the behavioural characteristics

Answer 4

• avoidance
• compulsive behaviour

Question 5

Describe obsessive thoughts

Answer 5

• for 90% of OCD sufferers, the major feature is obsessive thoughts
• the thoughts are always unpleasant although they differ in nature
• obsessive thoughts recur over and over again

Eg: fear of cross contamination

Question 6

Describe cognitive strategies to deal with obsessions

Answer 6

• cognitive coping strategies are used to reduce the obsessive thoughts. They help to reduce anxiety but makes them appear abnormal and distracts everyday tasks
• eg: religious people tormented by guilt may pray or meditate

Question 7

Describe insight into excessive anxiety

Answer 7

• ocd sufferers are aware that their compulsions and thoughts are irrational (irrationality is part of diagnosis’)
• sufferers have catastrophic thoughts about worse case scenarios that could occur is their anxieties were justified
• sufferers are hyper vigilant, have constant anxiety and focus on potential hazards

Question 8

Describe accompanying depression

Answer 8

• ocd is comorbid with depression so anxiety can be accompanied by low mood and a lack of enjoyment when participating in activities
• compulsive behaviours only provide a temporary relief from the anxiety

Question 9

Describe anxiety and distress

Answer 9

• ocd is regarded as a particularly unpleasant emotional experience because of the powerful anxiety that accompanies both the compulsions and obsessions
• obsessive thoughts are unpleasant and frightening, and the anxiety that goes with these can be overwhelming
• the urge to repeat a behaviour ( a compulsion) is what creates the anxiety

Question 10

Describe guilt and disgust

Answer 10

• ocd can also involve other negative emotions such as irrational guilt over minor moral issues for example
• discuss can also be present which is directed against something external or themselves.

Question 11

Describe compulsive behaviour

Answer 11

• ritualistic behaviours
• compulsions are repetitive: typically sufferers with ocd feel compelled to repeat a behaviour.
• compulsions also reduce anxiety: around 10% of ocd sufferers show compulsive behaviour alone, they would have no obsessions just a general ensue of irrational anxiety
• however the vast majority of compulsive behaviours are performed in an attempt to manage anxiety that is produces by obsessions.

Question 12

Describe avoidance

Answer 12

• behaviour of ocd sufferers may also be characterised by their avoidance as they attempt to reduce anxiety by keeping away from situations that trigger it. (Negative reinforcement)
• this avoidance can lead to ocd sufferers avoiding very ordinary situations, making it more difficult to live a ‘normal’ life.

Question 13

What are the 3 biological explanations of OCD

Answer 13

• genetic (inheritance)
• chemical ( neurotransmitters)
• structural (brain)

Question 14

What is the genetic basis of ocd

Answer 14

• ocd tends to run in families which suggests there may be a genetic link
• ocd may be a disorder that is inherited via the genes across generations in families
• research to support this argument has come from family and twin studies

Question 15

What type of research is used to support genetic arguments

Answer 15

Concordance rate: the % similarity between 2 people for a trait
-the higher the % Concordance rate, the more likely an inherited trait is

Question 16

How do family studies explain ocd

Answer 16

• Lewis(1936) found that the concordance rate of ocd in:
  -> parents and children is 37%
  -> between siblings is 21%

Question 17

Limitation of family studies

Answer 17

Families grow up in the same environment have similar experiences so it is difficult to differentiate between genetic and learnt behaviour

Question 18

How are twin studies used to explain ocd

Answer 18

• you compare MZ and DZ twins for a particular trait
• if ocd is inherited, ten the concordance rate will be higher for MZ twins

Question 19

Why do only some siblings display ocd

Answer 19

The diathesis stress model is used to explain this

Question 20

What is the diathesis stress model

Answer 20

• both siblings share a genetic vulnerability to the ocd gene, however one sibling experiences an environmental trigger that could activate the ocd gene (eg: exams, trauma etc..)

Question 21

How are gene mapping studies used to explain ocd

Answer 21

• Genetic material from ocd sufferers is compared to genetic material from non-ocd sufferers
• gene mapping studies indicates a genetic link between particular genes that make some people more vulnerable to developing ocd

Question 22

What type of genes cause ocd

Answer 22

• ocd is polygenic, so has multiple genes that are linked to ocd
• it is likely to be a combination of several genes rather than just a single gene alone

Taylor (2013)
- found that there are up to 230 genes that are linked to ocd
- However this is a simple explanation for a complex biological and potentially psychological concept - REDUCTIONIST

Question 23

What’s are the candidate genes that are known to be linked to ocd

Answer 23

• SERT (serotonin transmission)
• 5HT1-Dbeta
• COMT (dopamine transmission)

Question 24

What do neurotransmitters do

Answer 24

• neurotransmitters carry, boost and regulate signals between euros and other cells in the body. They are linked to mood

Question 25

What is serotonin and how does it link to ocd

Answer 25

- a neurotransmitter linked to ocd that regulates mood - if a person has low levels of serotonin then normal transmission of mood-relevant information cannot take place - meaning that mood and mental processes can be affected. - low serotonin levels are linked to ocd

Question 26

How are serotonin levels increased

Answer 26

- take SSRI’s which stop the re absorption of serotonin they block the serotonin from returning back into the pre -synaptic neuron - the serotonin diffuses though the synapse and is forced to enter the receptor sites in the post synaptic neuron - a higher volume of serotonin is in the body because more is absorbed into the post synaptic neuron - this will improved the mood and reduce the anxiety experienced by ocd sufferers

Question 27

How does brain structure explain ocd

Answer 27

People with ocd have a different brain structures

Question 28

What are the 3 areas of the brain involved with ocd

Answer 28

- orbital frontal cortex - thalamus - caudate nucleus

Question 29

How do non-ocd brain respond to a problem

Answer 29

- the orbital frontal cortex notices that there is a problem - it sends a signal to the thalamus to take action - once the resolution has been carried out, the caudate nucleus will cut this communication.

Question 30

How does an ocd brain respond to a problem

Answer 30

- the orbital frontal cortex notices the problem - it sends a signal to the thalamus to action a resolution - once the solution has occurred the thalamus sends a dog Lam back to the ofc - this communication isn’t interrupted by the caudate nucleus - meaning the ofc continues to tell the thalamus to action a resolution ( signals rebound) which causes repetitive obsessions

Question 31

What are the 3 drug therapies used to treat ocd

Answer 31

- ssris - tricyclics - benzodiazepines

Question 32

Are drug therapies effective

Answer 32

- they are the most common treatments for ocd in the uk - 70% of sufferers symptoms are effectively reduced by drug therapies

Question 33

What are the side effects of SSRIs

Answer 33

- nausea - headaches - insomnia Although these side effects aren’t severe, they could lead to disruptions in how people ca live their everyday lives

Question 34

How are tryclilics used to reduce ocd symptoms

Answer 34

- they were the first antidepressants to be used to treat ocd. They are now more commonly used to treat ocd compared to depression. - they work by blocking the transporter mechanism that reabsorbs both serotonin and noradrenaline into the pre synaptic cells - therefore neurotransmitters are eft in the synapse that prolonged their activity

Question 35

What are the side effects on tricyclics

Answer 35

- blurring of vision - constipation - dizziness - weight gain - excessive sweating

Question 36

Why are tricyclics not as commonly used than SSRIs

Answer 36

Due to the side effects of tricyclics being more severe than the side effects of SSRIs, it is usually the second-line treatment for ocd sufferers - this is done to avoid the patients from experiencing serene side effects that have potential possibilities to severely effect their everyday lives - therefore they are only used to treat patients when SSRIs are not effective

Question 37

How do benzodiazepines treat ocd

Answer 37

- BZs work by enhancing the action of the neurotransmitter GABA - GABA tells the neurons in the brain to “slow down” and “stop firing”. This reduces the the number of thoughts and heightened emotions that are experienced at one time - 40% of the neurons in the brain are responsive to this drug, so there is an overall questioning influence on the brain which reduces overall anxiety caused by the obsessive thoughts

Question 38

Wat are the side effects of benzodiazepines

Answer 38

- highly addictive - increased aggression - long-term memory impairments Due to these side effects, BZ is the only prescribed for the short term, so cannot be used as a permanent treatment option

Question 39

Why should drug therapies to be used

Answer 39

- drug therapies use little input from the patient and therefore require minimal effort and are also very time effective - drug therapies are cheaper than other methods of treatment, so are more economical for he health service - patients don’t have to be motivated Mike in CBT, so is an easy option if patients lack motivation or suffer from severe anxiety or depression ( more manageable)

Question 40

What are some alternative treatment options

Answer 40

Talking therapies are very effective, but are time consuming and expensive: - CBT is often used alongside exposure and response prevention (ERP)

Question 41

How is CBT used to reduce symptoms on ocd

Answer 41

- treatment involves working with therapists to discuss the problems that are due to the patients ocd in separate parts: these parts include thoughts, feelings, actions etc.. - in order for this method to be effective patients must be motivated and willing to be fully truthful - people with mild ocd usually require yurt o 10 hours of therapist treatments to notice significant improvements of their symptoms