Causes and Diagnosis of Obsessive Compulsive Disorder - Essay Example

? Obsessive-Compulsive Disorder: A Perceptive Analysis Obsessive-compulsive disorder is a neurobehavioral in which people have obsessions and compulsions that are time-consuming, distressing, or interferes with normal routines, relationships with others, or daily functioning. Oftentimes, the process seems to be unreasonable and senseless; however, for the patient with OCD, the compulsion is usually stimulated by anxiety and doing the so-called rituals would help the patient ease the edginess he or she feels. Keywords: obsession, compulsion, anxiety disorder Obsessive-Compulsive Disorder: A Perceptive Analysis Introduction Obsessive-compulsive disorder is a neurobehavioral in which people have obsessions and compulsions that are time-consuming, distressing, or interferes with normal routines, relationships with others, or daily functioning (Hyman & Pedrick, 2006; Nicholas, 2008). Obsessive-compulsive disorder typically develops before the age of thirty but can start at any time (Pedrick & Hyman, 2011). This paper endeavours to tackle obsessive-compulsive disorder and the important facts about this condition specifically its causal factors. The Definition of Obsession Obsessions are persistent impulses, ideas, images or thoughts that intrude into a person’s mind, causing intense anxiety and distress (Pedrick & Hyman, 2011). Rachman and de Silva (2009) stressed that obsessions are experienced as senseless or repugnant. They form against one’s will and the person commonly tries to resist them or get rid of them (Rachman & de Silva, 2009). The person identifies that the obsessions are his own thoughts and such obsessions cause marked anxiety or distress (Rachman & de Silva, 2009). The Definition of Compulsion Compulsions are repetitive behaviours or mental acts performed in an effort to diminish the anxiety and distress brought on by the obsessive thoughts (Pedrick & Hyman, 2011). Conversely, Rachman and de Silva (2009) stressed that such behaviours are carried out because of a strong feeling to do so. The goal of recurrent behaviour is to prevent or decrease anxiety or stress, or to prevent some dreaded event or situation (Rachman & de Silva, 2009). Rachman and de Silva emphasized that compulsions are frequently performed according to certain tenet or in a stereotyped fashion. Pedrick and Hyman (2011) enumerated the examples of mental acts such as praying, counting, repeating words silently, and going over events in one’s mind. Moreover, Pedrick and Hyman (2011) also cited the examples of repetitive behaviours include such things as ordering or putting things in order, repeating actions, checking, cleaning and hand washing. Forms of OCD Many diverse kinds of OCD have been discovered and diagnosed and these include checking, cleaning, counting, touching or repeating which are the most common forms; on the contrary, the other forms consist of praying, arranging and having unwanted thoughts (Rompella, 2009). Two of the most common forms are tackled in this paper. Checking People who are checkers obsess over the thought that they forgot to perform a task, like turning off a light or closing the door; thus, they are then compelled to check to make sure they did (Rompella, 2009). Unfortunately, checking once do not satisfy them so they must check several times just to be sure, checkers feel that something bad will happen if they are unable to perform their task; moreover, they also fear that they may seem irrational with people who do not have OCD (Rompella, 2009). Cleaning Cleaners as described by Rompella (2009), is the most common form of OCD wherein people are obsessed with germs thereby having the compulsion to clean. These people may not want to touch door handles, use public toilets or shake hand with people; this type occurs most often in women than in men (Rompella, 2009). Likewise, they may shower and scrub themselves several times; also, they might spend hours scrubbing floors, door handles and toilets for that they might get sick including the people around them if they are unable to do so (Rompella, 2009). Causative Factors of OCD There is good evidence that biological, psychological and social factors all contribute to the development of OCD (Bernstein et al., 2011). Biological predispositions, distortions in thinking and specific learning experiences appear to be particularly significant (Bernstein et al., 2011). The Serotonin Hypothesis Biologically inclined theorists have proposed that neurochemical and neuroanatomical abnormalities are implicated in the development of OCD (Abramowitz, 2006). The leading neurochemical theory posits that OCD symptoms are caused by abnormalities in the serotonin system (Abramowitz, 2006). Abramowitz (2006) also stressed that OCD may be related to the hypersensitivity of postsynaptic serotonergic receptors and that glutamate-serotonin interactions underlie the disorder. Three lines of evidence are proposed to support the serotonin hypothesis of OCD: medication outcome studies, biological marker studies and challenge studies in which OCD symptoms are evoked using serotonin agonists and antagonists (Abramowitz, 2006). Current research indicates that there might be a communication problem between the frontal lobe of the brain and the inner part of the brain; these areas of the brain utilize serotonin to communicate, this chemical carries messages between brain cells (Giddens, 2009). In people suffering from obsessive-compulsive disorder or OCD, there are lower levels of serotonin; low levels of serotonin may cause obsessions and compulsions (Giddens, 2009). Giddens (2009) pointed out that sometimes, by raising the serotonin levels through medication, there can be an improvement in OCD symptoms. Streptococcal Infection OCD symptoms appear or are worsened during cases of strep throat experienced by some children (Giddens, 2009). It is probable that the antibodies that are attempting to combat the streptococcal infection may also attack nerve tissues in the basal ganglia, which is situated in the central part of the brain; thus, this lead to OCD and the likelihood of acquiring tic symptoms (Giddens, 2009). Fortunately, anti-streptococcal medications or antibiotics have exhibited some progress in the symptoms (Giddens, 2009). Infectious Diseases It has long been noticed that Obsessive-Compulsive symptoms can arise from brain-injuring agents such as particular infectious diseases; for instance, there are patients who developed Obsessive-Compulsive disorder or OCD as a result of encephalitis such as post-encephalitic syndrome (Houts & Abramowitz, 2005). More recently, attention has been directed to the probability that several form of OCD, specifically early onset OCD, may be an outcome of specific conditions that frequently strikes during childhood (Houts & Abramowitz, 2005). It was also noted that Sydenham’s chorea, a well-recognized manifestation of rheumatic fever is typically correlated with OC symptoms (Houts & Abramowitz, 2005). Genetics Giddens (2009) emphasized that a person’s risk of acquiring Obsessive-compulsive disorder is higher if one or more of the individual’s parents or family members are already suffering from this condition. Moreover, in the case of identical twins, the frequency of OCD occurring in each twin is two times greater than OCD occurring in two non-identical twins; however, there is no definite evidence to prove that there is a certain set of genes responsible for this disorder (Giddens, 2009). Other Possible Biological Factors In the brain-imaging studies that have been performed, the results revealed that people with Obsessive-compulsive disorder or OCD show abnormal neurochemical activity in regions known to play a role in specific neurological disorders and these findings imply that these areas may be crucial in the origins of OCD (Giddens, 2009). Furthermore, obsessive-compulsive disorder or OCD had considerably less white matter in their brains, which is accountable for transmitting information (Giddens, 2009). Psychological Factors and Experiential Causes of OCD Giddens (2009) cited that in a study at the University of California, Los Angeles or UCLA, thirty percent of the individuals with long-term OCD had been victims of sexual, physical or psychological trauma. Osborn (2008) cited that according to Freud, obsessive thoughts represent a perfect model for the psychological conflicts he presumed were raging in his patient’s minds. Freud, the great psychoanalyst, speculated that obsessive-compulsive disorder started in childhood, when a boy or a girl instinctively wanted to behave in a sexual or aggressive manner but was averted by a parent from doing so (Osborn, 2008). Thus, the consequent parent-child conflict, if not agreeably resolved will result to repression of the conflict into the unconscious; this conflict necessitating to be discharged was released later in life in altered forms through the development of obsessions and compulsions (Osborn, 2008). On the contrary, if the contemporary scientific understanding of obsessive-compulsive disorder is to be taken into consideration, it was given emphasis that obsessions are fleeting; irrational thoughts that have no basis at all in actual desire (Osborn, 2008).Osborn (2008) stressed that extensive research has been unable to establish any connection between obsessions and conflicts carried from childhood. On the other hand, studies unleashed that obsessive-compulsive disorder or OCD sufferers tend to come from families that are relatively stable and free of conflict; likewise, psychotherapies that target unconscious conflicts, such as psychotherapies, have proven ineffective in the treatment of obsessions and compulsions (Osborn, 2008). Pharmacological Treatment for OCD The well-established finding that patients with obsessive-compulsive disorder or OCD respond to a particular group of drugs—serotonin reuptake inhibitors or SRIs—which have a specific effect on the activity of the serotonergic neurotransmitter system, has changed the outlook for OCD sufferers (Maj & Zohar, 2002). Clomipramine or CMI was the first effective drug treatment reported for OCD; it had clearly shown it effectiveness in comparison with a placebo wherein in a study conducted, after 10 weeks of treatment, 58% patients treated with CMI rated themselves as much or very much improved in contrast with only 3% of placebo-treated patients (Maj & Zohar, 2002). Equally, as serotonin seems to perform a significant role in OCD, SSRIs or Selective Serotonin Reuptake Inhibitors are an apparent treatment option and for the reason that SSRIs lack vital pharmacological activity on other neurotransmitter systems and thus provide effective and well-tolerated therapy that is generally acceptable to patients (Maj & Zohar, 2002). The examples of SSRIs proven efficient in the treatment of OCD are fluoxetine, fluvoxamine, sertraline, paroxetine and citalopram (Maj & Zohar, 2002). Cognitive-Behaviour Therapy The other established treatment of OCD as cited by Foa and Kozak (1997) is a form of cognitive-behaviour therapy known as Exposure Therapy. Cognitive Behaviour therapy is founded on the idea that obsessive intrusions, distress and rituals are habitual means of reacting and for the reason that they are habits; they could be weakened (Foa & Kozak, 1997). Exposure therapy as illustrated by Foa and Kozak (1997) is a learning-based therapy that encompasses a sequence of exercises created to weaken particular thinking habits, feeling habits and overt habits; these exercises are termed as prolonged exposure and response prevention, which truly means abstaining from rituals. Exposure as given emphasis by Foa and Kozak (1997) means that an individual intentionally face circumstances that provoke obsessions, distress and urges to ritualize and that a person stay in that situation for a long period of time until the symptoms lessen instinctively. Abstaining from rituals deemed that a person gives up utilizing rituals as a mode of diminishing obsessions and stress (Foa and Kozak, 1997). Outstanding findings have been derived with an intensive cognitive-behaviour therapy program that involves a daily 90-minute sessions for a month, consisting of guided exposure practice with the therapist at the home of the patient with OCD; this is presumed crucial for the reason that OCD habits are frequently strong in the home (Foa & Kozak, 1997). Foa and Kozak (1997) tackled a number of clear advantages from exposure therapy; it has been discovered that it was more beneficial in comparison with medications for those individuals who completed the sessions. Moreover, about 75% of patients who accomplished cognitive-behaviour therapy performed well instantaneously after treatment and in the long run, exhibiting lasting improvement of about 65% fewer symptoms on average (Foa & Kozak, 1997). Likewise, an individual with OCD planning to undergo such treatment should not worry with medication side effects from exposure therapy (Foa and Kozak, 1997). Nonetheless, Foa and Kozak (1997) also enumerated the drawbacks that could be experienced while undergoing cognitive-behaviour therapy. First and foremost, there is no guarantee of improvement according to Foa and Kozak (1997), for not all individuals who received it benefited from the treatment though they pointed out that somehow, it made a difference in their experience; however, it does not promise that the client will be symptom-free after undergoing therapy. Second, cognitive-behaviour therapy presents an unpleasant side effect that is, the distress that a client suffers when confronting situations that stimulate your obsessions (Foa & Kozak, 1997). Lastly, a substantial effort is mandated on the client’s part for it to be successful; the client must devote enough time and energy to be able to complete the tasks required by the treatment (Foa & Kozak, 1997). Conclusion Understanding the details regarding OCD which is a type of anxiety disorder will be valuable not only for the individuals suffering from this condition but also for the people around them to understand what they are going through. Treatment options can be optimized if a thorough analysis of the disorder’s causative factors is taken into consideration. References Abramowitz, J.S. (2006). Understanding and treating Obsessive-Compulsive Disorder: a Cognitive-Behavioral Approach. New Jersey: Mayo Foundation for Medical Education and Research. Bernstein, D., Penner, L.A., Stewart, A.C. & Roy, E.J. (2011). Psychology. [n.p.]: Cengage Learning. Foa, E.B. & Kozak, M.J. (1997). Mastery of Obsessive-Compulsive Disorder: a Cognitive-Behavioral Approach. New York: Oxford University Press. Giddens, S. (2009). Obsessive-Compulsive Disorder. New York: The Rosen Publishing Group, Inc. Houts, A.C. & Abramowitz, J.S. (2005). Concepts and Controversies in Obsessive-Compulsive Disorder. United States of America: Springer Science + Business Media, Inc. Hyman, B.M. & Pedrick, C. (2006). Anxiety Disorders. Minnesota: Twenty-First Century Books. Maj, M. & Zohar, J. (2002). Obsessive-Compulsive Disorder. West Sussex: John Wiley & Sons Ltd. Nicholas, L. (2008). Introduction to Psychology. Cape Town: UCT Press. Osborn, I. (2008). Can Christianity cure Obsessive-Compulsive Disorder?: a Psychiatrist explores the Role of Faith in Treatment. United States of America: Brazos Press. Pedrick, C. & Hyman, B.M. (2011). Obsessive-Compulsive Disorder. Minnesota: Twenty-First Century Books. Rachman, S. & de Silva, P. (2009). Obsessive-Compulsive Disorder. New York: Oxford University Press. Rompella, N. (2009). Obsessive-Compulsive Disorder: the Ultimate Teen Guide. Maryland: Scarecrow Press, Inc. Read More