Obsessive Compulsive Disorder

Obsessive Compulsive Disorder Sally Lee and Angela Lu

Classification of OCD • Classified as anxiety disorder • ICD-10 classifies it separately • “neurotic, stress-related, somatoform disorder” • Obsessions: plagued by persistent recurring thoughts that reflect exaggerated anxieties or fear • Compulsions: rituals or routines that relieve anxiety

Patient Behavior • Excessive double-checking • Counting, tapping, repeating • Ordering, arranging • Accumulating junk (newspaper, containers..) • Keep on washing, cleaning

Psychological Perspective • Compulsions seen as learned and reinforced responses that help an individual reduce or prevent anxiety • Misinterpretation of intrusive thoughts, causes creation of obsessions and compulsions • Dysfunctional beliefs: inflated responsibility, over-importance of thoughts, control of thoughts, overestimate of threat, perfectionism, intolerance for uncertainty

Biological Perspective • Increased grey matter volumes in bilateral lenticular nuclei • Abnormalities with neurotransmitter serotonin (relatively under-stimulated) and dopamine • Different functioning of circuitry in the striatum region of brain • Hyperactive anterior cingulate cortex (monitors actions, checks for errors)

Genetic Perspective • Mutation in human serotonin gene hSERT • Heritable factor (45-65% of OCD symptoms in children) • Helped ancestors to be extra cautious, just taken to the extreme • May have helped ancestors to be wary of bad things and to be clean

Environmental/Social Perspective • Childhood OCD can be triggered by a specific, often traumatic event (death, divorce, move) • Stress can increase intrusive thought • More negative life events one or two years prior • Onset is not related to family, but maintenance of OCD symptoms are associated with family members (can make things worse if they ‘help’) • Seen as ‘crazy’ socially and so many people try to hide it even though it causes them distress and the condition can worsen

Cultural Perspective • Cultural variation has minimal influence on lifetime prevalence rates • Symptoms take on characteristics of patient’s culture • Muslim culture uses religious connotation of ‘weswas’ (devil and obsession) • Religion can provide a huge part of obsessions

US Frequency • Fourth most common psychiatric disorder • Lifetime prevalence of 2.5% • Similar rates reported across diverse cultures • Tenth most disabling medical disorder • 1 in 100 adults • 1 in 200 children and teens

Treatment & Therapy • As a chronic illness, OCD patients tend to have periods of severe symptoms followed by times of improvement • A completely symptom-free period is uncommon

Psychotherapy • not an effective treatment • Better combined with cognitive-behavioral • Provide effective ways of reducing stress • Reduce anxiety • Resolve inner conflicts

Insight Therapy • Knowing oneself • Also called psychodynamic psychotherapy • Explore inner workings of mind • Understand stuckness -> help move forward

Humanistic Therapy • Work more broadly to examine • Whole approach to life • Previous experiences • Own expectations/relationship with self • become confident • Approach fearful situations in diff. waysanxiety removed/more manageable

Cognitive-Behavioral Therapy • Also called exposure & ritual prevention • Successful 80% of the time • Most effective + well-researched treatment • Focus on how thought triggers anxiety • Expose directly  prevent from performing

Group Therapy • Interaction with other OCD sufferers • Provide support + encouragement • Decrease feelings of isolation • Improve social skills • Face fear  role play activities

Somatic Therapy • Also called experiencing therapy • Talk body sense + mental images • Guide through experience tasks • Help release stored emotions • Shut down within nervous system • After, feel released / free

Psychosurgery • Used in extremely refractory cases of OCD • Over 80% of patients respond favorably

Psychopharmacological Drug Treatments • No ongoing effects once medication stopped • Antidepressants • SRI  TCA, SSRI • SSRI more widely used • Antipsychotic medications • Anxioloytics • Benzodiazepines • Unreliably effective

Works Cited Aanstoos, C. Serlin, I., & Greening, T. (2000). History of Division 32 (Humanistic Psychology) of the American Psychological Association. In D. Dewsbury (Ed.), Unification through Division: Histories of the divisions of the American Psychological Association, Vol. V. Washington, DC: American Psychological Association. Bugental, J.F.T (1964). The Third Force in Psychology. Journal of Humanistic Psychology, Vol. 4, No. 1, pp. 19-25 Kring, A. M., Johnson, S. L., Davison, G. C., & Neale, J. M. (2010). Chapter 5: Anxiety Disorders. In Abnormal Psychology (pp. 119-153). Hoboken, NJ: John Wiley & Sons, Inc. Myers, D. G. (2010). Psychological Disorders. In Psychology (Ninth ed., pp. 593-669). New York, NY: Worth Publishers. Rowan, John (2001). Ordinary ecstasy : the dialectics of humanistic psychology. Hove: Brunner-Routledge

Obsessive Compulsive Disorder