Cognitive therapy

Test on Biological explanations /
treatments for OCD
Cognitive Explanation of OCD: A01
 People who suffer from OCD have obsessive
thoughts so clearly there is a cognitive link
 There is also evidence that memory systems
might be impaired. Sher et al (1989) found that
people with OCD had poor memories for their
actions, for example, they really could not
remember if they had turned the light off.
 In addition, Trivedi (1996) found people suffering
from OCD had low confidence in their memory
ability and also their non verbal memory was
Cognitive explanation of OCD: A01
 Alternatively, some psychologists suggest that
OCD sufferers have a cognitive vulnerability to
anxiety (Williams et al 1997). For example a
person might show hypervigilance when
entering a new environment:
They may use rapid eye movements to scan the
They may attend selectively to threat related stimuli
rather than neutral stimuli
 Rachman (2004) outlines a case study of a
patient with OCD which shows a good example
of this hypervigilance…
Rachman (2004) Case Study
 A female patient had a severe fear of
diseases, particularly the prospect of
encountering other people’s blood.
She had catastrophic thoughts about
the probability of harm (e.g.
contracting AIDS) coming from even
a small plaster worn by someone.
She over-estimated the seriousness
of contact with anyone. When she
went to a public place she rapidly
scanned the environment and people
she encountered on the lookout for
evidence of blood, cuts, bandages.
Her hypervigilant scanning meant
that she could recall in great detail
the blood-related items she had
encountered over many years.
Evaluation of cognitive explanation of
OCD: A02
 (-) Cognitive bias (such as hypervigilance) seems to give
a good account of individual differences in susceptibility
to OCD
 (+) The treatment of patients with OCD by reducing
hypervigilance has shown success, showing that it might
be a contributing factor in OCD
 (-) The cognitive approach concentrates on internal
cognitions as an explanation for OCD and tends to
ignore the social and biological factors that might be
contributing to the condition
 Remember further evaluation can come from
comparison to the other explanations you have covered:
biological, behaviourist, psychodynamic
 With your partner try and think of at least 2 comparisons
you can draw with the other explanations which you
could use during an explanations essay!
Past paper practise
January 2009 (c)
(i) Briefly outline a cognitive explanation
for obsessive-compulsive disorder. (2
(ii) Suggest one criticism of the cognitive
explanation for obsessive-compulsive
disorder. (2 marks)
January 2009 (c) (i) Briefly outline a cognitive
explanation for obsessive-compulsive disorder. (2
 [AO1 = 2]
 AO1 – Up to 2 marks for description of a cognitive
 Possible answers:
 A cognitive explanation suggests that people with OCD
have a cognitive bias so they could have a poor memory
for their actions/may be hypersensitive to environmental
 Accept valid answers based on specific researchers
such as Cromer’ neutralising hypothesis
 about OCD or Rachman’s 4-step sequence of
catastrophic misinterpretations made by OCD
 sufferers.
(ii) Suggest one criticism of the cognitive
explanation for obsessive-compulsive
disorder. (2 marks)
1 mark for criticism, 1 for elaboration of
Possible answer:
The cognitive approach focuses on
internal mental processes as an
explanation and ignores other possible
causes such as social/biological factors.
Cognitive Therapy for OCD: A01
 Cognitive therapy
 The aim of cognitive therapy is to replace unrealistic and
fearful thinking with more realistic mental habits.
 It teaches patients to identify, challenge and replace
counterproductive thoughts with more constructive
thinking patterns.
 Cognitive treatment is used in conjunction with
behavioural therapy and this is known as cognitive
behavioural therapy.
 O’Kearney (1993) reports a case study of a woman who
had obsessive thoughts about stabbing her mother and
sister as well as stabbing her own eyes out:
O’Kearney’s case study
 O’Kearney asked the woman to record her obsessive
thoughts on tape and play them back to herself. This is
the ‘exposure’ part of the behavioural treatment. The
woman was also helped to identify her catastrophic
thoughts and to change these to realistic thoughts. She
was taught how to do this in therapy sessions and then
asked to practise when listening to the tape of her
thoughts. This combined approach reduced the
frequency of the obsessive thoughts and the associated
compulsive behaviours
 Q= how would you structure this for this question ‘Outline
one study into the treatment of OCD using a cognitive
approach. Include why the study was done, method
used, results found and conclusions drawn’ (4 marks)
Cognitive therapy for OCD: A02
 (+) There is a lot of empirical evidence to
support cognitive therapy for anxiety disorders,
particularly when combined with behavioural
 (-) Although changes in patients’ cognitions must
take place during cognitive therapy, it is not clear
what element of the therapy is most effective. It
might be that any cognitive change is a
consequence of some other factor (e.g.
medication or lifestyle change) and not the
intervention by the therapist.
Cognitive therapy for OCD: A02
 (COMBINATION) treatments that combine drug
therapy with behavioural and / or cognitive
therapy have been found to result in
improvements that last a number of years
(Kordon et al 2005)
 Remember, other evaluation comes from
comparison to other treatments you have
covered: biological, behavioural,
 With your partner can you think of at least 2
comparisons to the other treatments we have
Plenary: completing essay planning
 Describe and evaluate two therapies for
obsessive-compulsive disorder. (10 marks)
 If this type of question comes up your A01 must
consist of bio and cognitive treatments
 You can use what we have learnt for A02 as part
of the comparison
 You should bullet point your A01s and A02s for
this question now