OCD- Psychopathology Revision

Characteristics
1. Behavioural
  1. Compulsions
    1. Repetitive behaviours which reduce anxiety
    2. Response to obsessions
  2. Avoidance
    1. Avoiding situations that may trigger anxiety
2. Emotional
  1. Anxiety/distress
    1. Obsessions are unpleasant and frightening
    2. The urge to repeat a behaviour creates anxiety
  2. Co-morbid with depression
    1. Low mood
  3. Disgust
    1. For self or for other things
3. Cognitive
  1. Obsessions
    1. Recurrent unpleasant thoughts
    2. Awareness
      1. Sufferers know their thoughts are irrational
Explanations
1. Genes
  1. 230 Candidate genes
    1. Polygenic
    2. Create vulnerability to OCD
  2. Aetiologically heterogenous
    1. Different genes cause OCD in different people
  3. Evaluation
    1. Supporting evidence
      1. Twin studies
        68% concordance in MZ
        31% concordance in DZ
    2. Too many candidate genes
      1. Little predictive value
      2. Difficult to treat
    3. Ignores role of environment
      1. MZ twins often have very similar environments compared to DZ
      2. Not solely genetic
2. Neural
  1. Serotonin
    1. Low levels
      1. Lower mood
  2. Abnormal functioning of frontal lobes
    1. Impaired decision making
  3. Abnormal functioning of parahippocampal gyrus
    1. Deal with negative emotions
  4. Evaluation
    1. Supporting evidence
      1. Antidepressants which increase serotonin levels help treat OCD
        Suggests serotonin does play role in onset/maintenance of OCD
    2. The neural abnormalities may be the result of OCD, not the cause
    3. Serotonin-OCD link may be due to co-morbidity with depression
Treatment
1. Drug therapy
  1. SSRIs
    1. Prevents serotonin re-uptake
      1. Serotonin continues to stimulate post-synaptic neuron
    2. Increases levels of serotonin
    3. Takes 3 months for it to take effect
    4. Often combined with CBT
  2. Alternatives
    1. Tricyclics
      1. Same effect on serotonin system
      2. More severe side effects
    2. SNRIs
      1. Also increase levels of noradrenaline
  3. Evaluation
    1. It is effective
      1. Reduces severity of symptoms
      2. Improves quality of life
      3. Works for 70% of patients
    2. Cheap and non-disruptive
    3. Negative side effects
      1. Tremors
      2. Weight gain
      3. People stop taking the drugs
    4. Drug companies over-reemphasis effectiveness
    5. Doesn't account for reactive OCD

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OCD- Psychopathology Revision

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	Created by Grace Fawcitt about 7 years ago