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OCD Explanation and Treatment - Coggle Diagram
OCD Explanation and Treatment
What is OCD?
A condition characterised by obsessions and compulsive behaviours to deal with the anxiety created by obsessions
Behavioural Characteristics
Compulsions are external components of OCD. They comprise of repetitive behaviours that try to relieve the anxiety created by obsessions.
Behaviours hinder everyday functioning.
Create social impairment and avoidant behaviours
Emotional Symptoms
Anxiety and distress from obsessions
Depression (high comorbidity of OCD)
Guilt and disgust at the trigger or themselves
Cognitive Characteristics
Obsessions are the internal component of OCD. They comprise of inappropriate thoughts that recur and cause anxiety.
Realisation of inappropriateness
Attentional bias
Explanations of OCD
Genetic Explanation
People with OCD have a higher concordance rate
Miguel et al found that twins have a concordance rate of 53-87%
Nedstadt et al found that first degree relatives have an 11.7% chance of developing OCD compared to 2.7% of controls
COMT gene regulates dopamine and SERT regulates serotonin
OCD is assumed to be polygenic
Neural Explanations of OCD
Brain structure
Basal ganglia associated with OCD
Max et al argued that surgery disconnecting the basal ganglia and frontal cortex reduced OCD symptoms. Head injuries can cause OCD symptoms
Ursu and Carter argued impairment of the orbitofrontal cortex may cause some compulsive behaviours seen in OCD. PET scans found higher activity in orbitofrontal cortex in OCD patients
Neurotransmitters
Serotonin (regulates mood and involved in task repetition) is too low (too much is reabsorbed and not taken up by receptors)
Too much dopamine is taken in at receptor sites which makes thought regulation difficult.
Evaluation
Thoren et al found increased levels of serotonin metabolite in spinal fluid of OCD patients.
Neurotransmitter explanation has led to positive application in SSRIs and benzodiazepines.
Brain scanning evidence is limited as the research is correlational.
OCD-serotonin link may be comorbidity with depression that affects the serotonin system.
Genetic explanations have little application due to polygenity.
Diathesis stress - Cromer et al
Biological reductionism
Treatment of OCD
Drug therapies alter levels of neurotransmitters in the brain
SSRIs are the main type of drug used to treat OCD. They increase levels of serotonin by reducing the reabsorption in the presynaptic neuron which increases stimulation as receptors have longer to detect.
Increase in serotonin helps normalise the 'worry circuit in the brain.
Other treatments such as tricyclics or benzodiazepines may be used to treat OCD. Benzodiazepines are anti-anxiety and can slow activity of the CNS by enhancing activity of HABA preventing sensory overload.
Evaluation
Shown to be effective - Soomro + placebos
Long term effects of drug therapies unknown
Drug therapy is cheap and non-disruptive
Drugs have side effects. Therapy more effective. Simpson et al 12% relapse 45%.
Research biased from drug companies