OCD

What are the behavioural characteristics of OCD

- repetitive compulsions

- Avoidance

What are the emotional characteristics of OCD

- accompanying depression

- Anxiety and distress

- Disgust

- Guilt

What are the cognitive characteristics of OCD

- obsessive thoughts

- cognitive coping strategies

- Insight

What is the genetic explanation of OCD?

The disorder can be passed down and inherited from the parents to their offspring.

What are candidate genes?

specific genes which create a vulnerability for OCD

What are the 2 candidate genes for OCD?

COMPT

SERT

What does polygenic genes mean?

multiple genes which are implicated in OCD, as opposed to one OCD gene

How many genes did Taylor predict were involved in OCD?

230 genetic combinations

What does aetiologically heterogeneous mean?

Different variations of OCD have different genetic variations.

Give an example of aetiologically heterogeneous variation

The ordering disorder will have different genes to body dysmorphia disorder

Define concordance rate

similarity between two variables

Define dizygotic twins

Non- identical twins, they share 50% of their genes

Define monozygotic twins

Identical twins, they share 100% of their genes

What does it suggest if monozygotic twins do not always have 100% concordance rate?

There are other factors and alternative explanations such as the environment.

What did Nestadt et al study suggest?

There is a genetic basis

Why does Nestadt et al study support the biological explanation?

monozygotic twins were more 40% likely to both have OCD than dizygotic twins

Do twins only share the same genes?

no

Other than genetics what else do twins share?

environment, parents, clothes, friendships, poverty

What did Cromer find in there study?

over 50% of patients had experienced a traumatic event in their past. OCD was more sever in those with more than one trauma in the sample

What does Cromers study suggest?

there is an alternative explanation for OCD, that the stressful situations (10 ACES) in the environment causes OCD.

Define Diathesis

genetic vulnerability

define stress

childhood truama

What is the diathesis-stress model suggesting?

the interaction between the diathesis and the stress causes mental illness

--> interation between nature and nurture

Why is low predictability as weakness of the genetic explanation of OCD?

There are too many candidate genes as Taylor found over 230 genes involved with OCD. meaning finding a definitive genetic cause to be unlikely. this decreased the usefulness of this explanation, as it has a low predictive validity, meaning we cannot predict who will develop OCD based on their genes.

What is the left parahippocampal gyrus usual function in the brain?

processes unpleasant emotions

What is the left parahippocampal gyrus like in OCD patients?

faulty and prevents the process of unpleasant emotions.

What does faulty left parahippocampal gyrus cause?

Anxiety and disgust

What are the frontal lobes usual functions in the brain?

decision making

What are the fontal lobes like in OCD patients?

faulty and impairs decision making

What does faulty frontal lobes lead to?

compulsions.

What is serotonins usual function in the brain?

mood regulation

What is serotonins levels like in OCD patients?

There is too little serotonin in their synapse

What does little serotonin cause?

low mood and uncomplaining depression

What is dopamines usual function in the brain?

reward pathways

What is dopamines levels like in OCD patients?

too much dopamine in the synapse.

What does too much dopamine lead to?

compulsive behaviours such as checking a mirror every 5 seconds

Why is a weakness of the neurological explanation of OCD because of cause and effect cannot be established?

It could be that changes in the brain are a result of OCD, as opposed to a cause. therefore we have just found another symptom not an explanation. causation cannot be implied as only an association exits decreasing the usefulness and explanatory powers of this theory

Define Comorbidity

Having more than one mental illness at once

How is the correlation between serotonin and comorbidity a weakness for the neurological explanation of OCD?

Most people who suffer from OCD also suffer from depression, which is most likely due to the disruption of serotonin. Therefore, the serotonin OCD link may be due to the depression patients experience along side their OCD rather than the OCD itself. Suggesting serotonin cannot be a sole cause of OCD

What is a real world application to OCD?

Drug therapy

What is the aim of SSRIs?

correcting the imbalance of neurotransmitters in the synapse

How do SSRIs work?

they inhibit the reabsorption at the pre synaptic neurone and breakdown of serotonin in the brain. This increases serotonin levels in the synapse, meaning serotonin continues to stimulate the post synaptic neurone

What are the practicalities to drug therapy and SSRIs?

- Patients have to take a 10mg drug once a day everyday.

- It takes 3-4 months to first show signs of improvement.

- They are usually taken alongside CBT

Give an example of an SSRI

Fluoxetine

Why do we need alternatives to SSRIs?

For patients who don't respond to fluoxetine

What are the SSRI alternatives?

- SNRIs

- Tricyclics

What do SNRIs do?

Increase serotonin and noradrenaline levels.

How do tricyclics work?

They have the same effects on the serotonin system as SSRIs but have more severe effects

What are some side effects of SSRIs?

- indigestion

- sex drive loss

- aggression

- blurred vision

- weight gain

Why are side effects an issue for drug therapy?

If side effects occur people are less willing to take the drug, causing their OCD symptoms to occure reducing the effectiveness of the drugs.

Drug therapy is non disruptive why is this a strength of drug therapy?

They don't interfere with individuals lives, they need to take 10 second out of their day to take a pill then continue with their lives. Which means there is a low effect to maintains drug therapy.

Drug therapy is cost effective why is this a strength of drug therapy?

Drugs are cheap to mass produce causing them to be the NHS first line of defence. There is no need to pay for a therapist, admin to arrange therapy sessions and hire a room out etc. Therefore, this saves the economy money which can be directed towards other societal aspects such as leisure.

Why is drug therapy being cost affective and non-disruptive a positive asspect?

the treatment suits people no matter of their life style, job and situation. This means the drug therapies are accessible to lots of different people.

Why is drug therapy reductionistic?

it reduces the complex phenomena of OCD to low serotonin and high dopamine level, therefore becoming too simplistic

Why is drug therapy deterministic?

assumes if you have low serotonin and high dopamine levels you are destine to have OCD. therefore ignoring the ability of free will to overcome OCD symptoms. Also doesn't align with therapy

why is OCD nature over nurture?

There are alternative explanations as stree in the environment causes OCD (nurture). Croner found 50% of patients had a truamatic life events. Therefore, is not a sole explanation. furthermore, the interactionist approach is the best approach as it combines genetics and the environment.

How many studies did Soomro in 2009 review?

17

What is Soomro find in his SSRI study reviews?

all studies showed better outcomes following SSRIs rather than the placebos. Typically OCD symptoms reduced around 70%. therefore increasing credibility.

What does Soomro study show about SSRIs incomparison to placebos?

SSRIs could be significantly better than placebos at reducing OCD symptoms, strengthening their value as a treatment.

What did Goldacre in 2013 suggest about drug treatment research?

may be biased due to the research being sponsored by drug companies

Why is it a problem if drug treatment research is bias?

researchers may suppress any results that do not support the drug they are marketing. therefore, the results aren't trustworthy and do not give an accurate picture of SSRIs effectiveness.

does OCD always have a biological cause?

No it can be caused via the environment

What did cromer et al. find?

OCD was more sever in patients who has faced truamatic events during childhood

is it right to treat patients whose OCD is caused by trauma or a stressful life events with drug therapy?

no. it isn't the root cause (biological) as it's an environmental factor.