Obsessive Compulsive

DisorderSally 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