Lecture 5- OCD

Obsessive Compulsive Disorder (OCD) is a type of anxiety disorder characterized by:

1. Obsessions

2. Compulsions

The two are commonly linked but only one is needed for diagnosis.

Obsessions

unwelcome intrusive thought, image or urge that uncontrollably enters the person's mind

Compulsions

repetitive behaviours or acts that a person feels compelled to perform

Not fully understood but many possible triggers:

▪ Genetics (it tends to run in families)

▪ Reduced serotonin

▪ Life events

▪ Personality (some whose more meticulous might be more predisposed to get OCD)

>Likelihood its a mixture of all them

Age of development

Most likely to develop in early adulthood

Common Obsessions

Contamination

Harming others

Sexual thoughts

Order/Symmetry

Violence/Aggression

Religion/Blasphemy

Common Compulsions

Checking (locks, stoves, electricity)

Cleaning

Ordering

Neutralizing thoughts

Observing people (if you thought you have done something bad to someone you might check to make sure you haven’t)

Praying

Avoidance

Describe the OC cycle

You get a negative thought, this causes you to feel sad/distressed, you then check/observe to  make sure you didn’t act out the negative thought, when the person why u may have had the negative thought about doesn’t respond you feel happy. As you feel relief from observing it causes you to not ignore the negative thought and carry on observing.

The obsession is the thought he had and the compulsion is observing.      

Treatment

>Exposure therapy is where you expose someone to somewhere where they are likely to get a negative thought and try and help the change their response to it.

>SSRI = Antidepressant (used when people don’t have time for therapy)

>When OCD is really bad you give them a combination of treatment. This would be at a psychiatrist level not at GP level, the might need multiple antidepressants or other drugs.

>OCD treatment is usually referred to a psychiatrist and not managed at GP level (obviously except from redoing meds).

Cognitive explanation

Interpretation of intrusive thoughts as more meaningful and significant and exaggerated sense of responsibility for preventing harm

Behavioural explanation

Intrusive, distressing thoughts (obsessions) become associated with anxiety through conditioning. Compulsions are then learned to reduce the anxiety associated with these obsessions.

psychodynamic explanation

A manifestation of unconscious conflicts, particularly between unacceptable id impulses (sexual or aggressive) and the demands of the superego (conscience) or reality. Obsessions and compulsions are viewed as attempts to cope with or resolve these internal conflicts, often through maladaptive defence mechanisms

Humanistic explanation

OCD is seen as a manifestation of an existential crisis where individuals struggle to achieve self-actualization due to obsessions and compulsions that hinder their progress. These behaviours are interpreted as an attempt to manage underlying feelings of anxiety and insecurity, potentially stemming from unmet needs or societal pressures.

Biological explanation

It stems from a combination of genetic predispositions and imbalances in brain chemistry, particularly neurotransmitters like serotonin and dopamine. It also highlights the role of specific brain circuits in the development and manifestation of OCD symptoms.