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Terms in this set (30)OCD: definition An anxiety disorder, characterised by obsessions (intrusive, unwelcome, persistent thoughts, images, beliefs and impulses that cannot be removed from the mind) and compulsions (an over-whelming need to perform repetitive and ritualistic behaviours in order to prevent imagined dire consequences. Forms of Obsessions - Obsessional thoughts; repeated, intrusive words or phrases which are found distressing or even offensive. Forms of Compulsions - Checking rituals (e.g. checking and rechecking that the front door is locked) Behavioural Explanation: the two-process model Mowrer suggested the two-process model; fear of a specific stimulus is acquired through classical conditioning, leading to anxiety. When the individual learns that this anxiety can be reduced by performing certain behaviours, they are maintained through operant conditioning; the reduction in anxiety is a powerful reinforcer. Behavioural Explanation: social learning theory SLT suggests that we learn OCD behaviours through imitations of models. For example, a child might observe their parent performing repetitive handwashing and adopt this behaviour. Behavioural Explanation: evaluation Rachman found that patients experienced high anxiety in situations triggering their obsessions, and this was rapidly decreased by performing their rituals, supporting the idea that patients produce compulsions to reduce anxiety. Hollon et al also found high, seemingly long-lasting success rates for behavioural therapy (ERP), supporting the behavioural explanation. However, the behavioural explanation fails to take into account genetic factors known to be involved, and do not clearly explain how obsessions arise in the first place. Behavioural Therapy: ERP - summary Clients
are normally offered 15-20 1-2hr sessions, during which they are taken through several steps: Behavioural Therapy: ERP - effectiveness - Between 55-85% of OCD patients improve significantly with ERP and the therapeutic effects to be long-lasting. Eddy et al found in a
meta-analysis that ERP was more effective than cognitive based therapies. Behavioural Therapy: ERP - appropriateness In general, ERP is an appropriate form of therapy for OCD, as it addresses the rituals which most clients are concerned about. In addition, it demonstrates that it is possible to control and reduce the anxiety that they experience. However, it is designed to create high levels of anxiety and so has a high dropout rate, and is also inappropriate for some patients, for example those who are experiencing suicidal thoughts. Cognitive Explanation: summary Views OCD as a product of faulty and irrational thinking, resulting in involuntary and intrusive thoughts that the sufferers cannot dismiss and may blame themselves for. In order to try and ward off the imagined 'dire consequences', people with OCD attempt to neutralise their thoughts using actions or thought suppression. Cognitive Explanation: actions Patients with OCD attempt to neutralise negative thoughts through actions which are intended to reduce any potential threats. For example, those with intrusive thoughts of contamination may repeatedly wash their hands to neutralise those thoughts. This brings a temporary relief in anxiety and so acts to reinforce the behaviour, creating a pattern of repetitive, ritualistic behaviour. Cognitive Explanation: thought suppression People with OCD may attempt to simply suppress their intrusive thoughts. However, this can make them more preoccupied with the irrational thoughts and therefore actually worsen the problem. Cognitive Explanation: evaluation Salkovskis et al found that people with OCD do experience more intrusive thoughts and develop elaborate methods to neutralise these thoughts than controls. Salkovskis and Kirk also found that people with OCD recorded almost twice as many intrusive thoughts when they attempted thought suppression than when they didn't. However, the cognitive explanation could be argued to describe OCD but not fully explain it, and also ignores genetic factors. Cognitive Therapies: summary There are many different forms, but they all focus on changing the underlying irrational thinking, typically over 15-20 1hr sessions. Therapists attempt to inform the client about their misinterpretations of intrusive thoughts and the futility of their 'neutralising acts', challenge their inappropriate thoughts and therefore test the reality of the client's negative expectations, and thought stopping, which involves literally shouting 'stop' when the client experiences inappropriate thoughts and diverting their attention to a pre-prepared image/thought. Clients gradually develop the ability to do this for themselves. Cognitive Therapies: effectiveness Cognitive therapy is rarely used alone which means it can be difficult to measure its effectiveness. Wilhelm et al found a significant improvement in 15 patients who used CT alone over 14 weeks, but it seems that pure CT or ERP alone are not as effective as the two combined (Van Oppen et al). Cottraux et al found that improvement levels at the end of treatment were similar for ERP and CT, but a year later, only those with ERP showed further improvement. Cognitive Therapies: appropriateness Cognitive therapy may be more appropriate than ERP for some patients as it is far less anxiety-provoking. It takes a relatively short length of time and has no side-effects. However, it does require considerable client effort and so may not be suitable for some. Ellis believed that sometimes people who claimed to be following CT may not be putting their revised beliefs into action and the therapy would therefore not be effective. Psychodynamic Explanation: summary Freud believed that OCD stems from a fixation at the anal stage of development (~2yrs). He suggested that children derive pleasure from their bowel movements at this stage, and during toilet training, they must accept the will of the parents to be neat and clean when their natural preference is to be messy and aggressive. This restraint causes the child to feel rage, and also guilty, dirty and ashamed, giving rise to an internal conflict between the id and the superego. This conflict supposedly happens in all children, but if it is particularly strong, development is arrested and issues from this stage reappear in adulthood at an unconscious level, possibly as OCD, which could be them using reaction formation to resist the urge to soil themselves. He also believed that OCD could occur when the ego was disturbed by unacceptable obsessions and compulsions. Psychodynamic Explanation: evaluation Milby and Weber have found no greater incidence of parent-child toilet-training conflicts in people with OCD compared to controls. The theory is also less relevant to some obsessions and compulsions than others - it is not clear how compulsive checking is relevant to toilet training or sexual constraints. Several factors, including genetics and later life events, are ignored within the psychodynamic approach. Biological Explanations: genetics Pauls et al reported that up to 10% of 1st-degree-relatives with OCD also had the disorder, compared to 2% in the general population, suggesting some degree of genetic contribution. In a review of studies, Lambert and Kinsley found a 53% concordance in MZ twins and 23% in DZ twins. However, these findings could be a result of shared environmental factors rather than genetic ones. Biological Explanations: neuroanatomy OCD may be the result of a dysfunction in the orbito-frontal cortex and the caudate nuclei. These form a circuit which converts sensory information into thoughts and actions. Information from the OFC is passed on to the CN, which filters out irrelevant/unimportant information and passes the rest on to the thalamus, which causes the person to think further and take action. It is believed that if this circuit is damaged, inappropriate information is not suppressed and the individual is overwhelmed by troublesome thoughts and actions. Menzies et al - MRI Scans & OCD Used MRI scans to compare the brains of 31 people with OCD, 31 of their unaffected 1st-degree-relatives and a group of 31 healthy, unrelated controls. During the scan, participants completed a repetitive task until an electronic beep sounded. OCD patients and their relatives were less able to stop the task than the controls, and it was also found that they had less grey matter in the OFC and more grey matter in the cingulated regions associated with control. Biological Explanations: neuroanatomy - evaluation + There is evidence to support the idea that the basal ganglia might be responsible for OCD, as it often occurs in people with disorders where the basal ganglia is known to be involved, such as Parkinson's, Tourette's and Huntington's disease. However, basal ganglia
damage isn't always found in people with OCD. Biological Explanations: biochemistry OCD may be caused by low levels of the neurotransmitter serotonin, based on findings that anti-depressant drugs, especially those which boost serotonin levels, can relieve the symptoms of OCD. OCD also may be caused by a disruption in serotonin levels, which has a knock-on effect on the regulation of other neurotransmitters, including glutamate, GABA and dopamine. Problems with neurotransmitters may also affect the functioning of the brain areas highlighted by the neuroanatomical explanation. Biological Explanations: biochemistry - evaluation + Zohar et al found that drugs which boost serotonin are beneficial for up to 60% of OCD
patients Biological Therapies: drugs - anti-depressants Anti-depressants are usually the first choice of drug for treating OCD. Two types in particular are used: tricyclics (e.g. tofranil), which increase the availability of serotonin, and selective serotonin reuptake inhibitors (e.g. Prozac) which work by increasing the availability of serotonin. Although these drugs are usually used to treat depression, they have been found to reduce the symptoms of OCD. Biological Therapies: drugs - anxiolytics Anxiolytics are used to treat the anxiety that accompanies OCD. Again, two types are used; benzodiazepines. which increase the effectiveness of GABA, which reduces physiological activity, and beta-blockers, which reduce the activity of the ANS by blocking the amount of adrenaline, noradrenaline and cortico-steroids released in the stress response. Biological Therapies: drugs- evaluation - Around 30-50% of people get no benefit from
drug therapies, and the relapse rate is up to 90% when therapy is discontinued. The side-effects can also be very unpleasant and can make drugs inappropriate long-term. Biological Therapies: psychosurgery Psychosurgery is very rare and only used as a last resort. Several procedures are used, including a cingulotomy, where a probe is inserted through the skull and into the cingulated gyrus, a bundle of connections that regulate the corticostriatal circuit, which is hyperactive in those with OCD. The probes' tips are heated and the tissue burned. Other techniques include a capsulotomy and limbic leucotomy. Biological Therapies: psychosurgery - evaluation - Reports on long-term effectiveness have been inconsistent and can vary from 25-70%. OCD: Criteria for Diagnosis - Obsessions, compulsions or both are present on most days for a period of at least two weeks Students also viewedpsych chap 17 therapy60 terms tatum_la Psychology 1103 (Chapter 16)82 terms amandacondreras Exam 1 and missed questions54 terms dani_park Chapter 15 General Psychology82 terms mkruben Sets found in the same folderMedia56 terms juliabaggott Research Methods47 terms juliabaggott AP Psych: personality disorders and Therapy114 terms roverby1 Therapy- Anxiety Disorders84 terms sskordallos Other sets by this creatorWeek One41 terms juliabaggott Frankenstein: Chapters 22-2447 terms juliabaggott Frankenstein: Chapters 19-2131 terms juliabaggott Frankenstein: Chapters 16-1837 terms juliabaggott Verified questionspsychology Emotions are a mix of consciously experienced thoughts, expressive behaviors, and physiological arousal. Which theory emphasized the importance of consciously experienced thoughts? a. Facial feedback theory. b. James-Lange theory. c. Arousal and performance theory. d. Fight-or-flight theory. e. Schachter-Singer two-factor theory. Verified answer psychology Dylan has a BMI of 36. She would best be described as a. Introverted. b. below average on the Buoyant Mood Index. c. normal in Basal Metabolism Index score. d. extroverted. c. obese. Verified answer
psychology What are two relaxation techniques that can be used for coping with stress? How do they work? Verified answer
psychology The section of the brain which strongly influences our personality is called the ___. Verified answer Recommended textbook solutions
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Which of the following is considered a treatment option for patients experiencing OCD?The most effective treatments for OCD are Cognitive Behavior Therapy (CBT) and/or medication.
Which of the following is the most widely used Behavioural treatment for OCD?Cognitive behavioral therapy (CBT), a type of psychotherapy, is effective for many people with OCD .
Which medications are commonly used to treat obsessive compulsive disorder OCD )? Select all that apply?Popular SSRIs to treat OCD include:. Celexa (Citalopram). Lexapro (Escitalopram). Prozac* (Fluoxetine). Luvox* (Fluvoxamine). Paxil/Pexeva* (Paroxetine). Zoloft* (Sertraline). |
