Basic Psychology, Psychopathology

Obsessive-compulsive disorder (OCD) – Introduction

OCD can be defined as the occurrence of unwanted thoughts or distressing images they are usually accompanied by compulsive behaviors designed to neutralize the obsessive thoughts or images or to prevent some dreaded event or situation .

OBSESSIONS

Repeated uncontrollable, irrational ,unwanted and distressing thoughts or images.

Common symptoms include:

  • Fear of germs or contamination
  • Unwanted forbidden or taboo thoughts involving sex, religion, and harm
  • Aggressive thoughts towards others or self
  • Having things symmetrical or in a perfect order
COMPLUSSIONS

Compulsions can involve either overt repetitive behavior (such as Hand washing) or more covert mental acts (such as counting , praying or saying certain words silently).

Common compulsions include:

  • Excessive cleaning and/or handwashing
  • Ordering and arranging things in a particular, precise way
  • Repeatedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off
  • Compulsive counting
How Does OCD Work?

So, how does OCD actually work? First, to understand OCD, you need to know a little bit about anxiety. Your body uses anxiety as an alarm system to warn you about possible dangers. At a low level of perceived danger, your body might experience stress. At a high level of perceived danger, your body will experience fear. Normally, anxiety helps to keep us alive. It stops us from driving far too fast, and it keeps us alert when we walk down a dark street alone.

With OCD, the anxiety alarm system is triggered far too easily, and its warnings are much more intense than necessary. Minor dangers—or dangers that don’t even exist—might trigger a strong anxiety response.

Imagine that someone with OCD touches a doorknob, and becomes overwhelmed with the fear that their hand will become infected (this is the obsession). They immediately wash their hands, but not for 15 seconds like many people might. Instead, they wash their hands for 10 minutes (this is the compulsion).

The brain takes note of the serious response to touching a doorknob, and confirms to itself that touching doorknobs must be dangerous. Furthermore, the brain notices that the anxiety did in fact diminish after 10 minutes of hand washing, so it must have helped. This creates a negative feedback loop where small sources of anxiety result in extreme responses, which then further reinforce the obsessions and compulsions.

Diagram depicting the cycle of OCD.

During the treatment of OCD, this cycle will be identified and broken.

CAUSES

When it comes to what exactly causes this disorder, the science is still out. Simply put, there’s a lot more research that still needs to be done.

What we do know, however, is that there are a few confirmed risk factors that help us understand what causes different OCD types. They are:

  • Genetics – People with first-degree relatives like parents, siblings, or children that develop OCD as a child or teen are at a significantly higher risk of developing types of OCD.
  • Brain Structure – Scientists have begun narrowing down differences in the frontal cortex between OCD and non-OCD test subjects that might point to specific areas of the brain that are affected.
  • Environment – Experiencing physical, sexual, or emotional abuse at a young age has also been shown to be a risk factor when it comes to developing obsessive compulsive disorder. Various types of OCD may also develop in children following a streptococcal infection.
ASSESSMENT AND DIAGNOSIS - Yale-Brown Obsessive Compulsive Scale (Y-BOCS)

he Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is a 10-item scale designed to measure the severity and type of symptoms in people with obsessive-compulsive disorder (OCD) over the past seven days. The symptoms assessed are obsessions and compulsions. This scale is useful in tracking OCD symptoms at intake and during/after treatment.

Total Y-BOCS scores range from 0 to 40, with higher scores indicating greater severity of OCD symptoms. Scores on the obsession and compulsion subscales range from 0 to 20, but only the total Y-BOCS score is interpreted. Total scores can be split into five categories, based on severity of symptoms. People who have a total Y-BOCS score:

  • Under 7 are likely to be subclinical
  • 8-15 are likely to have a mild case of OCD
  • 16-23 are likely to have a moderate case of OCD
  • 24-31 are likely to have a severe case of OCD
  • 32-40 are likely to have an extreme case of OCD

Here is the  Y-BOCS CheckList to measure your OCD  : Y-BOCS CheckList

 

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