Essay Example on OCD: Obsession, Compulsion and Cognitive Disorder

Introduction

According to Muller and Roberts (2005), obsessive-compulsive disorder (OCD) is a cognitive disorder that is associated with the obsession and compulsion components. Obsessions can be defined as persistent ideas, impulses, and thoughts experienced repeatedly or inappropriately and result in distress or anxiety. Compulsions are mental actions or repetitive behaviours that are done when individuals are trying to dismiss the discomfort caused by obsessions (American Psychiatric Association, 2016). The major common forms of compulsions are cleaning impulses where people wash their repeatedly and checking compulsions where people check to confirm whether they have completed an activity correctly. According to Morein-Zamir et al. (2013), most individuals suffering from the disorder have no control over their behaviours or actions, but they realize that they are unreasonable. Major common behaviours include checking if the door is locked, hand and body washing, counting items repeatedly. The conditions are associated with anxiety and tics because individuals cannot plan their time.

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According to Goodman et al. (2014), OCD affects approximately 2.3% of individuals at some point in life span. Globally, 1.2% of individuals are affected by the disorder yearly and the symptoms are experienced before the age of 35. Although there have been few cases where symptoms were experienced in early childhood, most begins in late childhood (10 years) or adolescence (American Psychiatric Association, 2016). The rate of women diagnosed is higher than men with a ratio of 1:5 over a lifetime. However, in childhood, more boys are affected by the disorder than girls. A chronic OCD has only 20% have complete recovery (American Psychiatric Association, 2016). OCD diagnosis is performed by a clinical social worker, psychologist, or licensed mental practitioner by the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM test requires patients to demonstrate obsessions and compulsions. Recurrent behaviours are clinically significant when associated with anxiety and distress. Risk factors include genetic component, attention and memory bias, and trauma extremely stressful life events, for instance, sexual abuse, child maltreatment (American Psychiatric Association, 2016). Other mental disorders, such as anxiety and depression have been the leading cause of the condition. Over the last few decades, there have been controversial debates about the correlation between attention and memory loss and OCD. Researchers have conducted numerous studies on attention and memory bias in increasing vulnerability to OCD, but have yielded conflicting results (Amir et al., 2009). The purpose of this essay is to critically evaluate evidence suggesting that attention and memory biases may increase vulnerability to obsessive-compulsive disorder.

Salkovski's Model of OCD

Salkovski's Model highlighted the impact of dysfunctional beliefs in the aetiology and maintenance of the condition. Salkovskis (1985) argued that obsessions are enhanced through stimuli in the environment. The cognitive chain of occurrences will cease when the idea lacks negative ramifications for an individual. However, automatic thoughts occur in the presence of negative ramifications (Beck, 1976). The current mood of an individual is directly associated with automatic thoughts that interact with a set of expectations. Repeated actions action may result from the need to divert the event's responsibility, control thoughts, and self-blame. The compulsions occur when individuals try to dismiss distress resulting from negative thoughts. The model is criticized because the increased beliefs of individual responsibility may change over time. Although the biased assessments of the possibility and severity of harm increased compulsion behaviours, some people may learn to trust actions and cease persistent checking (Aardema et al., 2005). Individuals make errors when viewing things by the fusion of thoughts and actions (TAF), but some evidence indicates that TAF is not specific to OCD because the reaction occurs in other disorders such as anxiety.

Memory biases in OCD

According to Muller and Roberts (2005), OCD patients often report the uncertainty of their actions, and they regularly check to determine whether they performed a task or are mere imagining. The uncertainties result in repetitive behaviours, for example, compulsive checking doors or washing hands. The clinical observation has attracted most researchers to assess the link between memory bias and OCD. According to early research conducted by Sher et al. (1984), individuals with checking symptoms had a moderately impaired memory for complex verbal details. The study involved 49 college students taken randomly from a group that reported checking behaviour. Results demonstrated that compulsive checking was correlated with scores on the Logical Memory subtest. The task tested the ability of the participants to remember information from short passages a few minutes after listening. The study was repeated by two neuropsychological studies and similar results were found (Deckersbach et al., 2000; Zitterl et al., 2001). They found that OCD patients experienced verbal memory impairments.

Constans et al. (1995) performed a study to assess memory differences between OCD patients and control groups based on the distress provoking properties of the completed actions against the imagined tasks. The participants were requested to perform six tasks written in a booklet. They were moved into a room and requested to complete or imagine twenty actions. The researchers then asked them to indicate whether they performed or imagined the last task. The ratings were awarded by their vividness, confidence, the desire of vividness, and memory satisfaction. The findings indicated no statistical difference in observing performance across anxiety-provoking stimuli, but a difference was found in the desire for vividness for the OCD sample. The three ratings indicated no statistical difference, but the study involved a small sample size (n=19, OCD=12) (Constans et al., 1995). Another study by Wilhem et al. (1997) demonstrated that OCD patients tend to display impairment in recovering documentary memories, and took a longer period than the healthy sample. The researchers did a further analysis that indicated that these results were caused by comorbid major depression that is often linked to OCD. Therefore, the research indicates that OCD is not directly correlated with memories retrieving impairments, but it results because they also suffer from depression (Wilhem et al., 1997). As Williams, J. M. G. (1992) suggests the cognitive deficits and biases found in other studies were caused by comorbid depression, but the researchers concluded it was OCD because it was the dominant condition in the population.

Attention Bias

Hermans et al. (2003) showed that OCD is observed that OCD is enhanced by memory bias and distrust in attention. In 2007, the researchers conducted another study to replicate and extend the previous results. The latter study demonstrated that OCD patients had less confidence in memory and attention compared with the placebo (Hermans et al., 2003). Moreover, the results indicated that confidence in attention was associated with checking behaviour, and that persistent checking resulted in high levels of attention bias. The memory bias when performing OCD-related tasks extended to both attention and perception (Hermans et al., 2007).

Muller and Robert (2005) conducted a meta-analysis study to investigate deficit and bias in memory associated with OCD. The review found that research relating to memory in verbal information was had found mixed results. However, there was consistent evidence confirming deficiency for non-verbal information, particularly for individual's performed actions and complex visual stimuli (Muller and Robert, 2005). Numerous studies indicated that OCD patients demonstrate less confidence in their decisions on memory recognition. Therefore OCD increased with attention bias of threatening information, and memory distrusts.

Morein-Zamir et al. (2013) conducted a study utilizing a visual search task to examine the effect of attention bias to OC-related sights. Non-depressed, depressed, and controls, patients of OCD rated their personality by choosing positive images amongst their adverse distractors. Although the OCD patients took longer than the controls to select the images, the difference of the magnitude bias was insignificant. The second experiment used a common set of scenes simulated the findings on an extra group of OCD patients. In this case, a large bias to negative OC-relevant pictures without pre-test, and no category variations in attention bias was detected. Nevertheless, the sample of OCD patients consequently rated the images more negatively and slowly than another group, indicating post-attention memory abnormalities. The findings of the study claim against a strong attention bias in patients of OCD, irrespective of their depression condition, and express to generalized impairments separating from undesirable valence incentives. The impairments of post-intentional processing may be due to differences in the emotional procession of patients of OCD (Morein-Zamir et al., 2013).

Another study by Amir et al. (2009) tested the hypothesis that attention bias increases vulnerability to OCD using visual dot-probe action with idiographic name assortment. The results demonstrated that people experiencing symptoms of OC displayed an attention bias towards the selected threatening details during the initial trials. Moreover, the degree of bias was related to the severity of the disorder. The sequential pattern of the attention bias was constant over the entire experiment. Amir et al. (2009) compared their findings with previous studies that demonstrated a reduction of attention bias in OCD patients, indicating habituation to the frightening figures throughout the trial.

Amir et al. (2009) was the first research to assess the chronological pattern of attention bias in OCD patients. The findings suggested that attention bias towards frightening information reduced after the initial set of experiments. On the other hand, there was neither attention bias nor a significant change in bias over the entire trial in the control group. Amir et al. (2009) emphasize that various researches on attention bias in OCD used a different number of experiments, reducing the bias throughout the test. Mcnelly et al. (1990) used an emotional Stroop task to assess the same hypothesis. They found that the reduction of attention bias occurred in respondents who suffered from panic disorders. Likewise, a research Mckenna and Sharma (1995) demonstrate the same result for attention bias towards frightening-associated words in non-clinical college learners. Moreover, the authors also concluded that the reduction was due to the habituation of the threatening content over the process of the test. Cohen et al. (1998) used a visual search action to examine the effect of attention bias on anger-associated hazards and found similar results as Mcnelly et al. (1990). Using a pictorial dot-probe action, Lie et al. also found the same results in anxious college learners. This indicates that the occurrence of reduction of attention bias toward danger is not specific to a clinical group or experimental task (Amir et al., 2009). Additional evidence demonstrates that individuals suffering from OCD display an attentional bias to frightening details (Lavy et al., 1994). Evidence also indicates that the bias is not caused by elements of stimuli, but emotional arousal. Similarly, the cognitive theories of OCD stress reasoning reserve deficits in OCD, deficits in the distribution of attention v...