Definitions
Obsession:
“A persistent thought, idea, impulse or image that is experienced repeatedly, feels intrusive and causes
anxiety”. (Comer, 2008)
Obsessive thoughts are uncontrollable and often very disturbing. Sexual, aggressive and religious thoughts are the most
common types of obsessive thoughts. They can lead to high levels of panic and anxiety.
Compulsion:
“A repetitive and rigid behaviour or mental act that a person feels driven to perform in order to prevent
or reduce anxiety”.
Also largely uncontrollable - the person feels compelled to act out the certain ‘act’ in a certain way over and over again.
The repetition helps the individual to reduce their high levels of anxiety. The most common forms of compulsions are
washing, showering, checking (lights), and ordering items. Mental compulsive acts include repeating the same phrase,
poem or set of prayers over and over again.
Definition of obsessive-compulsive disorder:
“A disorder where a person has recurrent and unwanted thoughts,
a need to perform repetitive and rigid actions, or both”. (Comer, 2008)
Additionally if the person is prevented for some reason from performing the compulsion, feelings of dread and panic
occur. People with OCD also feel that they should resist the compulsion but are unable to do so. Attempts are made to
resist but end up feeling defeated and so they give in.
The typical symptoms of phobias are:
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Intense and irrational feelings of fear and anxiety, which may be
a severe panic attack
Avoidance behaviour – where the person may engage in extreme
and complicated behaviours In order to avoid the object or
situation that causes the panic attacks
Phobias have a gradual onset or may happen very quickly as a
result of a particular experience
The DSM describes the main symptoms of OCD as:
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Recurrent obsessions and compulsions
Recognition by the individual that the obsessions and compulsions
are excessive and/or unreasonable
That the person is distressed or impaired, and the daily life is
disrupted by the obsessions and compulsions
Some facts
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OCD is equally common in males and females however women more likely to suffer from compulsions of cleanliness
A third who report it say it started in childhood, however, in many cases it goes undetected
Can last a few years to decades
Sufferers can go through intermittent periods of depression
Affects around 1-3% of population (Source: National Institute of Mental Health)
It develops from late adolescence to early adulthood
People can function well in their daily lives by keeping it a secret, or avoiding the actual act
Sometimes they will be unable to hold a job – for example if they need to shower ritualistically they will be
unable to work
Types of OCD
Obsessional Cleanliness
Compulsive Rituals
Obsessional Doubts
Compulsive Checking
Obsessional Ruminations
Obsessional Impulses
obsession with dirt/contamination leads to compulsive behaviours e.g. hand-washing
specific ways/order of doing things, yet have the urge to stop, but cant
usually related to health and safety concerns e.g. locking the house door
follows on from obsessional doubts, will have to keep checking, double-checking things e.g.
the house door…….and never end up leaving
internal debates with self, will present themselves with an issue and debate for and
against it, even over simple things
strong urge to perform an embarrassing, dangerous or violent act.
Task
Read the case studies on the handout provided and decide what obsessional problem the people are suffering from…
Once you have finished that you must do some exam paper questions…
n.b
OCD is an anxiety disorder because the obsessive thoughts cause high levels of anxiety. Compulsive behaviours
and mental acts are carried out in order to reduce the high levels of anxiety.
Family Studies
The research suggests that the closer the family relatives are with OCD the more likely another person will also develop
it. Carey & Gottesman (1981) – reported a prevalence of up to 10% in 1st degree relatives. Lenane (1990) – 30% of
1st degree relatives in their study also had an OCD.
Twin Studies
Hoaker & Schnurr (1980) – found concordance rate of 50-60%, i.e. if one MZ twin suffered from OCD then 60% of the
other twin had it also.
However
The problem with twin studies is that they may not have developed the disorder due to genetics but instead because
they are treated more similarly in their home/societal environments and so this could be the cause.
Genetics could also be criticized as when OCD runs in families they inherit the general nature of it, but not exactly the
same symptoms (again, suggests that it could be partly genetic and also environment).
Biochemical
The use of PET scans show that people with OCD have two different types of abnormal brain activity - Low levels of the
neurotransmitter serotonin and high levels of activity in the orbital frontal cortex of the brain.
Serotonin is an important neurotransmitter that is responsible for communication between neurons. Drugs that increase
the levels of serotonin in the brain have been found to reduce the symptoms of OCD – these drugs would include Prozacantidepressants.
Also the high levels of glucose metabolism and blood flow have been found in the left frontal cortex of the brain called
the orbital frontal cortex.
EVALUATIONS
Difficult to
identify
whether its
genetics
causes OCD
or the
effects of
the shared
environment
Inconsistent
findings
regarding
serotonin, i.e. is
OCD the cause
of low serotonin
levels or is low
levels of
serotonin a cause
of OCD?
Psychological
therapy is
very good,
due to its
success rates
and so
contradicts
the serotonin
or any
biological
therapy.
Inconsistency
with results
regarding the
orbital cortex
e.g. Aylward
(1996) – found
no difference
between OCD
and non-OCD
sufferers.
Head injuries
and brain
tumours have
been associated
with the
development of
OCD – thus
proving a
biological basis.
Research into brain
structures are still in
their infancy due to
the technological
advancements.
Rappoport (1989) –
About 20% of OCD
patients display
nervous tics, implying
that there is a link
with the anatomy of
the nervous system
What causes
abnormal brain
functions? Answer
may lie in the
diathesis-stress
model which links
the biological basis
with the findings
that the OCD
occurs after a
stressful event .
The cognitive explanation of ocd starts fro the explanation that everyone has an undesirable thought sometimes that
they would not like to admit to others. For example, most of us have at one time worried about touching something that
could have germs on it or forgetting to pull out all the plugs at bed time might start a fire. Cognitive psychologists have
argued people who suffer from OCD suffer from the following characteristics:
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They are more likely to suffer from depression
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They have very high moral standards and standards of conduct
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They believe their thoughts are just like performing the actual behaviour – and so worry their thoughts can be
harmful to others.
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They believe they should have total control over their thoughts and behaviours.
OCD’s are the result of faulty and irrational ways of thinking at an extreme level. It has been suggested that specific
environmental stimuli are paired at some point with an anxiety-provoking thought and then this equals the conditioned
response i.e. if I don’t clean, I’ll get AIDS. Thus the person will avoid the possible threat by undertaking the compulsive
behaviour.
This triggers the obsessional thoughts BUT the compulsive rituals try to counter-balance and neutralise them. Rachman
& Hodges (1987) – Argue that some people are more susceptible to obsessional thoughts due to vulnerability factors e.g.
genetically determined hyper-arousability, depressed mood or poor socialisation experience (as above).
Evaluations
Lack of evidence supporting the view that OCD’s are a result of poor socialisation experiences.
Sher et al (1983) – Patients who scored highly on a measure of compulsive behaviour also showed a memory deficit for
actions recently performed.
Davison & Neale (1994) – Suggest that OCD patients are unable to distinguish between reality and imagination.
Neither biological (specifically medication) nor psychological therapies provide a long term solution to OCD’s. Suggests
that it is a very complex disorder to understand and treat.
The Freudian explanation of ocd disorder is to do with conflict between the id, ego and superego. The conflict is said to
date back to early childhood, especially the anal and phallic stages of psychosexual development.
Id, ego and superego
The id produces obsessive and disturbing thoughts which makes the superego feel guilty and bad. The ego tries to
reduce these feelings by using the following defence mechanisms.
Reaction formation – Behaviour is opposite to that if the obsessive thoughts. For example, thoughts of aggression are
changed to being kind and giving money to charities.
Isolation – the ego tries not to respond emotionally to the obsessive thoughts and so someone may act in a highly
intellectual and aloof way
Undoing – the person behaves in ways to undo thoughts – for example hand washing will und the unacceptable dirty sexual
thoughts.
THE EGO DOES NOT GET RID OF THE ANXIETY/CONFLICT – IT SIMPLY USES DEFENCE MECHANISMS TO
COPE AND SO YOU HAVE OCD
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.
Evaluations
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Hard to experimentally test the idea of the unconscious motivation
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Gross (1996) – Reports that studies that examine the potty training of anal personality types (who are not as
severe as OCD) find no difference from the potty training of other personality types.
Suggests that OCD is an extreme form of ‘learned avoidance’ behaviour:
The behavioural explanation uses classical conditioning to show how compulsive behaviours develop. Behaviourists claim
it occurs by chance.
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A person who has a high level of anxiety or is extremely fearful happens by chance to wash their hands or
organise something into alphabetical order. This then reduces their feelings of anxiety.
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This behaviour is then performed again when the person is anxious and after performing the same action many
times when anxious and then finding that the level of anxiety is reduced, the behaviour becomes a learned
response. The reduction in anxiety is positively reinforced and so the behaviour is repeated.
Compulsive behaviour or mental acts are the result of many pairings of the behaviour with the lowering of anxiety.
Having learned this they will engage in the compulsion to prevent the high level of anxiety developing in the first place.
Hodson and Rachman (1972) conducted a study to show that compulsive behaviours reduced the high levels of anxiety
they were experiencing. P’s with washing their hand compulsions were put in a room with objects they believed to be
dirty or contaminated. P’s showed ritual hand washing behaviour and reported this reduced their anxiety. Proof that
ritualistic behaviours reduces anxiety.
Evaluations
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Symptoms of OCD e.g. avoidance behaviour, themselves create anxiety
so it is hard to argue/believe that people learn these responses in
order to reduce their anxiety.
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Behavioural therapies are very effective → Baxter et al (1992) and
Schwartz et al (1996) both found that behavioural therapies not only
reduces the symptoms but also brings about changes in biochemical
activity e.g. athletes ‘psych themselves up’ before an event, to suppress
self-defeating thoughts.
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An OCD patient will use strategies to reduce the negative thoughts, but
the effort they put in to trying to inhibit the thoughts ends up inducing
a preoccupation with it.
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The behavioural approach has focused on the compulsion but has not
adequately been able to explain the origins of the disorder.
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It also cannot explain why people have obsessions – not just the
compulsions
Positive or negative?
Exam questions for revision
Briefly discuss a biological explanation for phobias.(4 marks)
Briefly discuss a biological treatment for phobias.(4 marks)
NB. Do the same for all the explanations/phobias….
Katy constantly worries about germs. Each time she touches a door handle she becomes extremely anxious and starts to
panic. Her doctor thinks that katy is suffering from obsessive-compulsive disorder and says she needs to see a
specialist With reference to Katy, explain what is meant by obsessions and compulsions. (4 marks)
1.
2.
3.
4.
5.
6.
7.
8.
Define OCD (2 marks)
Give at least three diagnostic criteria for OCD using the DSM IV. (3 marks)
Discuss one biological explanation for OCD. (3 marks)
Describe one other biological explanation for OCD different to the one mentioned in question 3. (4 marks)
Give two strengths and 2 weaknesses of the biological explanations of OCD. (4 marks)
How is positive reinforcement related to the development of OCD? (5 marks)
Give two criticisms of the behavioural explanations of OCD. (2 marks)
From a cognitive point of view, psychologists argue that people who suffer from OCD are also more likely to show
what characteristics? (3 marks)
9. Give one strength of the cognitive explanation of OCD. (2 marks)
10. Describe from a psychoanalytical perspective how someone might develop OCD (4 marks)
Describe and discuss at least one treatment for phobias. Refer to empirical evidence in your answer. (10 marks)