Obsessive Compulsive Disorder Essay Example

constitutes a "good" or "bad" personality. Although every personality psychologist knows very well, in her or her private life, which personalities are "good" and "bad," and although he or she might work very hard to ensure that others regard him or her as having a "good" personality, each will strive to leave these issues at the door when he or she enters the laboratory to undertake research on personality.To do otherwise would be like a chemist judging one atom to be "good" and another "bad" or a physicist judging gravitational forces to be "good" while electrical forces to be "bad. " (Pervin, 2003) Examples of human behaviors, causes, symptoms, treatments Obsessive-compulsive disorder Obsessive-compulsive disorder (OCD) is a psychological dysfunction characterised by several distinct symptoms, often exhibited by strong impulses to carry out actions – obsessions – and the performance of repetitive rituals – compulsions (Gelder et al.

, 1994). Read about early symptoms of a biological attack may appear the same as common illnessesHistorically, this disorder was originally confused with schizophrenia due to some limited similarities between the two in terms of reference, control or possession of the thoughts (who was ‘issuing’ the instructions to the subject), but it was only as recently as the 1970s that the disorder was argued to be separate (Gleitman et al. , 1999).

This was mainly due to the realisation that the impulses were not controlled externally, but were generated internally. The complex nature of OCD and the multifaceted way it is exhibited have made it very difficult to study in

a biological cognitive fashion.The symptoms of OCD can often occur after a stressful incident, but a direct causial link has not been discovered, with the best correlation between the disorder and onset of OCD being between +. 55 and +. 60 (Gleitman et al. , 1999).

In order to describe the clinical features of OCD it is necessary to break the symptoms displayed into the two categories of obsessive and compulsive symptoms. This will allow these separated symptoms to be examined further to see what pharmaceutical and psychiatric measures can be employed to alleviate the symptoms of OCD.It has been argued that in abnormal psychology, often it is not possible or practical to attempt to reverse the effects of a disorder, but educating a patient or subject to reduce the noticeable effects of a malady is often a competent alternative. Looking at obsessions firstly, it can be argued that every patient presents unique symptoms, but that generalisations can be drawn in the manner of the obsession (Carlson, 1995). Obsessional thoughts can often take the form of repeating phrases or even a single word the subject finds difficult not to think about or say.This may well be a blasphemy or swearword, or on a subject the subject finds distressing.

These impulses differ from the Tourette’s form of impulses in that the subject is able to see the irrationality of their actions, and despite having the impulse, is able to suppress it (Simeon et al, 1992). Obsessional doubts are intrusive concerns felt about a recent action the subject has undertaken. An example of this may be the subject doubting whether they did turn the television off, fearing that it

may catch fire if left on unattended; this doubt will lead to the subject returning many times to check their competence in a task.Obsessional ruminations can be described as long, complex thought trains which are often philosophical in nature, but are irritatingly unnecessary and repetitive, often frustrating the subject by their not being able to reach a conclusion on the matter. An example of this is a subject worrying about the end of the world for often weeks on end (Kalat, 1998).

Finally, obsessional impulses are strong desires that the subject desires to carry out, despite their social unacceptability.As with obsessional thoughts, the subject is usually able to recognise the fact that this should not be acted upon, and is able to do so (Carlson, 1995). Moving on to the treatment of OCD, treatment can be based on two separate methods: therapy-based and drug-based. Treating subjects with OCD poses an immediate problem in that often the patient is aware that their actions are illogical, and thus are hidden from their social peers, in the belief that they are suffering from a much more severe slowly-progressive mental illness (Kalat, 1998).In order to reverse the effects of the disorder, this must be tackled firstly, by informing and reassuring the patient of the nature of the malady (Kalat, 1998).

The patient’s social peer group should be informed of the issue, as the very social nature of the disorder means that the subject is ‘cured’, more often than not, in the field, away from the laboratory or hospital setting (Kalat 1998). This can, however, raise the inevitable ethical question of whether to act in the best interests of the patient, if

they do not want their peers to be informed.A successful experiment method employed by Forbes (1978; cited in Gleitman et al. , 1999) is to encourage their peers to aid the subject not to complete the compelled task.

Methods of avoiding situations where the patient feels strong impulses should be raised, as well as methods of dealing with any anxiety that may be felt when not acting on their compulsions. With this method, Forbes’ test group was able to have a 55% success rate of significantly reducing their symptoms when revisited four years later, compared to the control group’s 20%, and a control group – receiving drug therapy – achieving just under 40%.Behaviour therapy can also be employed, through which control techniques are taught to the subjects, but, as will be seen, these are of limited success when tried alone, and can only be really valuable when used in conjunction with drug therapies. There is a further group of subjects who do not show any compulsions, merely strong obsessions (Gleitman et al. , 1999). These patients are often taught negative feedback routines, such as self-inducing a sharp pain when obsessional thought is realised.

Again, this has limited value if not accompanied by the ‘helping hand’ of drug therapy.When considering a drug therapy, all that needs to be considered is that the desired result of the course should be to first do no harm, and then to look to break some aspect of the obsessional compulsive circuit, at any point. Looking at the drug therapies available, it can be seen that there are three distinct categories of drugs which are able to reduce the symptoms of OCD: anxiolytics,

which block anxiety circuits XXX; antidepressants, which allow for increased activity of the serotonergic synapses, hence inhibiting aggressive and compulsive actions (Carlson 1998); and 5HT-uptake blockers, which seek to block the neurotransmitter 5-HT.It is these last class of drugs that shall be focused on first. Neurotransmitters serve “either to activate or prevent the ‘firing’ of downstream neurons” (Berman, Tracy & Coccaro, 1997). 5-HT is a neurotransmitter that is thought to have some influence on compulsive and obsessional behaviour.

Coccaro asserts that, in general, 5-HT serves to modulate or constrain ongoing behaviour, preventing extreme behaviour, so it follows that a deficiency of 5-HT or a similar substance could increase a subject’s tendency towards extreme behaviours, such as arson, suicide or extreme obsessions.A study by Simeon et al. (1992) showed that the levels of 5-HT in self-mutilating subjects was not particularly different from control subjects. Again, this could be countered by regarding self-mutilation not as an obsessional action, but one of a thousand others, such another, separate aggression circuit. Indeed, Berman, Tracy and Coccaro (1997) pointed out potential flaws with Simeon et al. ’s subject sizes possibly being too limited, their comparison groups not being controlled correctly, and there being methodological issues with the experiments’ systems.

The 5-HT uptake blockers – such as clomipramine, fluvoxamine and fluoxetine – have considerable effectiveness; however, high doses are required, especially in the case of clomipramine, the most common prescribed OCD-treatment drug. This drug, in particular, has several drawbacks: results most often take up to six weeks to start appearing, and remissions are common. To conclude, the best method of treatment is using some method of avoidance of obsessive situations, along with counselling,

and a controlled OCD-drug programme, with the medication dosage being reduced in stages, to allow for increase if remission occurs.Anxiety Anxiety can be crippling. This very unpleasant condition is due to people's concern with their interpersonal evaluation. Generalized anxiety disorder is sometimes difficult to diagnose.

It does not consist of specific, obvious symptoms that set apart other anxiety disorders, such as a panic attack. “To be officially diagnosed as GAD, persistent, disruptive worry must last six months or more and be about at least two distinct life experiences, such as health, money, or career. (Anxiety Disorders Association of America, 2004)The symptoms that most commonly accompany generalized anxiety disorder are: fatigue, trembling, muscle tension, headache, and or nausea. “More woman than men have this illness, and GAD may also run in families. ” (www.

4woman. gov) Panic disorder consists of recurring episodes of extreme fear, and these feelings often occur with out any warning at all. “A patient with panic disorder has repeated, unpredictable, and irrational attacks of fear and anxiety-panic attacks. ”(Antai-Otong, 2003) There are many physical symptoms that accompany the panic disorder.These symptoms consist of: shortness of breath, dizziness or faintness, palpitations, nausea, choking sensation, sweating, flushing, chills, trembling, numbness or tingling, chest pain or discomfort, and fear of dying and or losing control. These symptoms usually max out with in ten minutes, and calm down minutes after the climax.

However experts have reported panic attacks lasting for hours at a time. “Affecting more than five million Americans, social anxiety disorder, also called social phobia, is a persistent and irrational fear of social or performance situations where the patient thinks others will judge him. (Antai-Otong, 2003)This particular

disorder affects men and woman equally, and may also occur in children. A great deal of people are uncomfortable when they give a presentation to their boss, or when they have to speak in front of a class full of peers. People with social anxiety disorder experience these feelings so intensely that they either avoid the situation all together, or it stresses them out so immensely the feelings will eventually evolve into a panic attack.

Individuals with obsessive compulsive disorder are plagued by persistent and recurring thoughts or “obsessions” that they find very disturbing. ” (Anxiety Disorder Association of America, 2004)These individuals have constant thoughts about fears that have no core in reality. Relaxation inhibits any anxiety that might be elicited by the object, as it is difficult to be relaxed and anxious at the same time. After having learnt to relax, the client and therapist construct a hierarchy of the anxiety-producing stimuli.The situations are ranked in order from the one that produces the least anxiety to the one that is most fearful. In systematic desensitisation the client is then asked to relax and imagine each situation in the hierarchy, starting with the one that is least anxiety producing.

As soon as the client can imagine her/himself in the situation without any increase in muscle tension, the therapist will ask him/her to imagine the next situation on the list until the list is completed and the anxiety-provoking situation eradicated.In vivo exposure requires the client to actually experience the anxiety-producing situations. ". In flooding the patient is exposed to the conditioned stimulus that produces fear without the opportunity to escape until the fear subsides. The situation itself may

be preceded by the client listening to a tape recording of an account of their most feared situation.

This is repeatedly played until the client no longer fears the same degree of terror. He is then exposed to the actual situation. Flooding can only be carried out with the full consent of the clients involved.In modeling the client is shown a “model” (in person or on a videotape) that copes well with his own fears and goes through the anxiety-provoking situation without getting hurt. This encourages him/her to replace their maladaptive responses with adaptive behaviour by imitating the models behaviour and applying useful coping strategies. It teaches the client new skills and reduces his/her fears.

(Atkinson et al, 1996) In Behavioural rehearsal the therapist determines the kinds of situations in which the person is passive and then teaches the client more adaptive behaviours and assertive responses by rehearsing and practicing them.This is done by using role-play techniques with the therapist in which the client rehearses effective responses to difficult situations and then gradually applies these in real-life situations (Atkinson et al, 1996). To get better understanding of these techniques, systematic desensitisation and modeling are applied to the anxiety disorder of a person with a bird phobia. For both therapies the first session would consist of the therapist listening to the client to find out what exactly the problem is and where and in which situations anxiety arises.In a systematic desensitisation therapy, the patient would, in the next couple of sessions, be taught to relax.

The client might learn to relax different muscles in a systematic way and will thereby know what muscles feel like when they are totally

relaxed. If the client finds it very hard to relax, hypnotises or drugs might be used to help her/him to relax. The client might be encouraged to practice the learnt relaxation techniques in the sessions and at home until he/she can relax on command.