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OCD
Obsessions
Obsessions are intrusive, distressing thoughts and mental images which repeat over and over. They are ego-dystonic (experienced as unpleasant). Common obsessions:
Dirt and contamination Need for symmetry Hoarding Sexual content Scrupulosity Aggressive content Superstitious fears
Compulsions
Compulsions are behaviors people perform in order to try and reduce or remove the fear and anxiety caused by obsessions. Common compulsions:
Cleaning and washing Arranging until things are just right Hoarding Checking Mental rituals (prayers, counting etc.)
OCPD
Preoccupation with details, orderliness, perfectionism rules and lists, so that the point of the activity is lost
Biological theory
Serotonin Hypothesis
key chemical involved in OCD is called serotonin. key gene for this process is hSERT (hSERT works too fast )
improvement with SSRI (fluoxetin )
NEUROIMMUNOLOGY Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection (PANDAS)
Biological theory
Neuroimaging
circuit >>regulates primitive aspects of our behavior such as aggression, sexuality, and bodily excretions. circuit >>>> relays information from orbitofrontal cortex to the thalamus and the caudate nucleus of the basal ganglia. if circuit is activated, impulses brought to your attention perform a particular behavior that appropriately addresses the impulses
IN OCD
abnormal activity in this brain circuit >>difficulty turning off or ignoring impulses from this circuit Increased activity of the orbitofrontal cortex Increased activity of the cingulate cortex Increased activity in the caudate nucleus Increased activity in the thalamus Dysfunction of cortical/basal ganglia loop
Psychodynamic Theories
obsessions and compulsions >> signs of unconscious conflict (usually related to a sexual or aggressive urge). that you trying to suppress, resolve or cope with
if conflict >>repulsive or distressing>> deal with them indirectly by transferring the conflict to something more manageable such as hand-washing, checking or
ordering.
Psychodynamic Theories
Stress and parenting styles are environmental factors
Psychoanalytic theory
Freud fixation in the anal stage
Child accepts will of parents being neat and clean when their natural preference may be messy.
If preference is too strong and parents are too strict child becomes anally fixated Occurs at an unconscious level sufferer believes there really concerned with keeping clean and tidy. Psychoanalysts believe OCD is most likely to be found in people who show anal personality characteristics e.g. being excessively neat, orderly and punctual. Obsessions can be defence mechanisms which occupy the mind so as to displace more disturbing thoughts. There is conflict between the Id and defence mechanisms