Summary
Summary PSYCHOLOGY AND ABNORMALITY NOTES
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OCDCharacteristics of OCD
OCD: an anxiety disorder in which people have unwanted and repeated thoughts, feelings,
images, and sensations (obsessions) and engage in behaviours (compulsions) or acts in
response to these thoughts or obsessions.
Obsession: recurring and persistent thoughts that interfere with normal behaviour
Compulsion: is a recurring action a person is forced to enact
The DSM-V describes the main symptoms of OCD as :
● recurrent obsessions and/or compulsions
● recognition by the individual that the obsessions and compulsions are excessive and/or
unreasonable
● that the person is distressed or impaired, and daily life is disrupted by the obsessions
and compulsions
Hoarding: when an individual experiences great difficulty getting rid of possessions. They collect
so many possessions, their homes may be unsafe, due to access or hygiene.
● homes may be difficult to clean
● individuals experience distress associated with discarding possessions, which can then
impact their ability to live with their families, have visitors'
● hoarding can include any item, regardless of value
Body Dysmorphic Disorder: Obsessive thoughts regarding perceived faults in one’s physical
appearance. These faults are likely to be slight or not at all obvious to others.
● anxiety caused by these intrusive thoughts leads to compulsive, repetitive behaviours
such as frequent mirror-checking or excessive grooming and constantly comparing one’s
appearance with others.
Case studies
Naomi the ballet dancer
● OCD started in high school
● nearly stopped her from dancing
● obsessions experienced: Naomi had thoughts of leaving her curling iron on, not locking
the door could harm her family
, ● compulsions: 5-6 hours checking her kitchen and bathroom
● was offered medication and psychological therapy
● she was able to go back to school and ballet dancing
Charles by Rappaport
● obsession was that he had something sticky on his skin that had to be washed off
● case study of a 14-year-old boy, Charles, with OCD.
● spent three hours or more each day showering, plus at least another two hours getting
dressed
● he had elaborate, repetitive routines for holding soap in one hand, putting it under water,
switching hands and so on.
● his mother contacted Rappaport after this behaviour had been going on for two years.
● charles had to leave school because his washing rituals were making it impossible for
him to attend. He had been in and out of hospital for his condition and had already
received standard treatments of medication, behavioural therapy and psychotherapy
● his mother helped him clean his room and kept things he touched clean by rubbing
alcohol. He had only one friend because his rituals left him little time to leave the house.
● he underwent a drug trial for an antidepressant, which gave effective relief of his
symptoms, and he was able to pour honey. Yet after a year, he developed a tolerance for
his medication. Charles relapsed and returned to ritualistic washing and dressing.
Jason by Lehmkuhl
Jason is a 12-year-old boy who had both OCD and autism. Jason had high-functioning autism
and contamination fear (obsession), excessive hand washing, counting and checking
(compulsions)
He would spend several hours each day engaged in compulsive behaviour and reported
significant anxiety when prevented from completing his rituals.
He attended 10x50 minute CBT sessions over 16 weeks, which involved identifying his feelings,
learning coping statements and exposure to stimuli he feared contaminated.
After completing therapy his score on the YBOCs dropped from 18 to 3. 3 months later his score
stayed low and he had improvements in both his OCD and participating in school and social
activities.
, Measurement Tools
MOCI
A psychometric test to assess OCD. It is a self-report questionnaire using a forced-choice true
or false format.
It has 30 questions/items with four sub-scales.
Total score out of 30
Assesses symptoms related to checking, washing, slowness and doubting.
Slowness- I do not take a long time to dress in the morning. True/False
Checking- my major problem is repeated checking. True/False
Y-BOCS
Measures the nature and severity of OCD.
Semi-structured interview, 30 minutes, checklist of different obsessions and compulsions with a
ten-item severity scale. The scale allows individuals to rate the time they spend on obsessions,
how hard they are to resist and how much distress they cause.
The checklist is used to measure progress or to inform a treatment plan
Scores range from 0-40. Those above 16 considered in the clinical range
Explanations of OCD
1. Biomedical (genetic, biochemical and neurological)
Genetic – Genes (such as PTPRD and SLITRK3) have been found to have a possible role in
OCD-type symptoms. Mattheisen et al. (2015) did a large-scale study of 1406 patients with OCD
and other members of the general population to analyse and identify genes that may be linked
to OCD symptoms. The gene PTPRD was implicated along with SLITRK3, both of which
interact to regulate particular synapses in the brain.
Taj et al (2013) researched another candidate gene called DRD4 (dopamine D4 receptor).
173 OCD participants compared to 201 healthy controls completed a range of questionnaires
that measured OCD and mental health. All were genotyped for the DRD4 gene and variants.
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