OCD: Anxiety, Unpleasant Thoughts and Repetitive Behaviors - Essay Sample

Introduction

Obsessive compulsory disorder (OCD) refers to a mental illness whereby the individuals who are suffering from the condition exhibit obsessive thoughts that are compulsive leading to repetitive behaviors. Those diagnosed with this condition have no control over their obsessive behaviors and thought. Because OCD is a psychiatric disorder, and that which is relatively common, it has a disabling effect on the patient. It is known for its unpleasant recurrent intrusive thoughts that result in anxiety. Due to obsessions, persons suffering from this disorder tend to feel coerced or driven to perform certain repetitive and concurrent behaviors. For instance, an obsessive thought is to think that someone so dear, like a family member, might be hurt if they fail to dress precisely in a certain way every morning.

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On the other hand, a compulsive tendency might be to thoroughly wash one's hands ten times and dry them after touching anything perceived as dirty. Also, a person might be compulsive and want to clean surfaces every time with the thought that they might be infested with germs whenever someone is in contact with them. The individual suffering from this illness may not want to do or think of doing these things or act that way, but they feel uncontrollable and powerless to stop. Due to the diverse sources of information and explanations that exist concerning the etiology of this condition, there is much to be known about its phenomenology. For the past six decades, only the phobic elements of this condition have been the point of emphasis. However, new information suggests a number of explanatory models and intervention or treatment techniques for this disease. This paper seeks to find the relationship between the explanatory models and treatment approaches of OCD.

Literature Review

Over recent years, an incredible amount of success has been made concerning the psychobiology and phenomenology of obsessive-compulsive disorder. Lochner and Stein (2003) have suggested according to their findings, that OCD is conceptualized as a homogenous neuropsychiatric entity associated with specific universal symptoms. On the other hand, some data bring the impression that it has heterogeneous affiliations too. According to numerous computerized researches on the heterogeneity of OCD, there is a consensus that particular OCD subtypes are valid as well as useful in giving means through which data on neurobiology, symptomatology and treatment techniques can be collated. Huey et al. (2008) have given biological explanatory perspective showing a neuroanatomical and psychological model of OCD. The main organ in focus here is the brain and how certain portions of the organ are altered changing its normal operations. This, in turn, results in the production of OCD symptoms. Similarly, Taylor, Abramowitz, and McKay (2006) presented a new explanatory model showing the cognitive and behavioural elements of obsessive-compulsive disorder. The two approaches that are given by Taylor, Abramowitz, and McKay, (2006) are the general deficit and beliefs and appraisal explanatory models which contain useful insights that will be collated to the treatment techniques. Sun and Wang (2013) then later brought forth from their research, more clarifications on the relationship between OCD and other elements like anxiety disorder and hoarding disorder. With each coming from different theoretical perspectives, the two models presented here will be the primary sources of information upon which this research will be based to identify the relationship between the explanatory approaches and the indicated treatment approaches with reference to OCD as a psychological disorder.

Explanatory Models

The Biological Explanatory Perspective: The psychological and neuroanatomical model by Huey et al. (2008) is presented as the biological perspective to give an insight of the phenomenology, etiology, and symptomatology of obsessive-compulsive disorder. Consistent imaging studies on patients with OCD have recorded abnormality in particular brain areas. The alterations made to these cerebral regions consequentially result in abnormal functioning of the human brain. Huey et al. (2008) have asserted that the process through which certain complex behaviours are completed is associated with some reward signals. This process is always accompanied by abnormalities, some of which are attributed to the symptoms of obsessive-compulsive disorder. With reference to the brain, many of the functional and structural imaging studies covered by the authors indicate differences in the basal ganglia, prefrontal cortex (PFC), the thalamus, or anterior cingulate cortex (ACC) between healthy persons and those suffering from OCD. Through meta-analysis, functional imaging studies on OCD patients and healthy persons were reviewed. It was realized that the head of the caudate and OFC were the only areas of the brain that consistently and significantly registered higher tracer uptake in patients suffering from OCD as compared to the healthy subjects. The brain areas substantially and most consistently involved with imaging studies of OCD are the basal ganglia and the OFC, and that is why the two are the main focus. Because the OFC has a role in reward learning, social behaviours, and emotional responses, any disruption to its normal function gives rise to the occurrence of OCD symptoms such as memory problems and language difficulties. The basal ganglia interact with the OFC in reward learning; hence, it is connected to motor control and actions. This view is supported by surgical, lesion, and imaging studies as well as other theories given by previous researchers of the pathogenesis of the condition. The PFC stores behavioural sequence memories which if initiated results in motivational anxiety, only relieved upon satisfaction. The symptoms of OCD come about when there is a deficit in satisfaction or relief of the motivational anxiety.

Cognitive/Behavioral Explanatory Perspective: Taylor, Abramowitz, and McKay (2006) have given the most suitable perspective that can be utilized as a contemporary explanatory model for OCD. This is because they build on the previous theories and models that have been used before for the same condition. The General Deficit Model and the belief and appraisal models are used by the authors to explain the phenomenology of this disorder. General deficit model suggests that persons with OCD have abnormalities or deficits on a range of numerous tasks which are not related to obsessional or threats concerns. These revelations have demonstrated that activities of executive functioning, inductive reasoning as well as some learning and memory are tasks which, when interfered with, can result in abnormalities or deficits. The authors observed that even after symptomatic treatment, these deficits could persist, meaning that cognitive impairments are never caused by increased anxiety or other symptoms of OCD. Persons with OCD, according to this model, exhibit weakened cognitive inhibition. This refers to a reduced capability to restrain responses, and this applies even to affectively neutral responses. The neuropsychological deficits are not present in all OCD patients as they are mild in some. Some theorists have found that OCD arises from abnormalities general information processing systems. The condition can also come from dysfunctional reasoning processes. The term general is used here because the deficits affect all processed information, including those that relate to an individual's obsessional concerns. The limitations of this model include the fact that it fails to account for heterogeneity in terms of symptoms. It also fails to explain why certain neuropsychological deficits of OCD are similar to those of other conditions. Belief and appraisal model is not emphasized here because of its foundation in dysfunctional beliefs as per its theorists. This has made it difficult to prove and support its relevance empirically.

Clinical Interventions for Each Model

The neuroanatomical knowledge, neural circuitry, and the discovery of the fact that obsessive-compulsive disorder is caused by certain aberrations in some parts of the brain have led to neurosurgery as a treatment intervention for OCD. The use of neurosurgery in treating OCD has been one of the major interventions in the treatment of this condition because the decision was informed by information given by Huey et al. (2008). The areas of interest here involve the cortex, thalamus, and the striatum. At the moment, four lesioning neurosurgical procedures exist in the treatment of refractory OCD. These are capsulotomy, subcaudate tractotomy, cingulotomy, and limbic leucotomy (Shah et al., 2008). A better treatment approach is the Deep Brain Stimulation (DBS) that has added advantages over lesioning (Sedrak, 2013). This therapy involves the implantation of electrodes in targeted areas of the brain with the aim of delivering safe and small impulses that are also programmable. Another intention of the electrodes is to modulate the broad and local neural networks in the brain to restore neural network circuitry. DBS targets the abnormalities found in the loops between the cortex, thalamus, and cortical areas of OCD pathophysiology. The interconnections between the PFC, the ACC, the thalamus and the basal ganglia are targeted by DBS because they are responsible for abnormalities which translate outwardly as signs of OCD. Due to numerous multifarious benefits of this mode of treatment, it will be the suitable mode of intervention that will take of the parts of brains associated with causative symptoms of OCD.

The treatment model suggested that the cognitive-behavioral explanatory model is cognitive-behavioral therapy (CBT). The General Deficit model is highly associated with abnormalities in the cognitive and behavioral functions that also involve reasoning and language difficulties. That means that there is a close connection between the thoughts and behaviors of a person suffering from, as demonstrated by the general deficit model. As treatment therapy for OCD, CBT utilizes two scientific or clinical techniques to change the behavior of an individual and their thoughts. These are cognitive therapy and exposure and response prevention. A cognitive-behavioral therapist is the one responsible for conducting CBT because they are well trained for suchlike activities. While using this intervention method, especially the exposure and response prevention (ERP), the patients get exposed to their obsessions are asked to restrict themselves from compulsions that cause them distress and anxiety. Exposure to fears is the best way to confront such fears and is conducted until the patients get used to conquer their phobias. Cognitive therapy is done to help the patient in recognizing the functioning of the human brain, how it sends messages, and how they can respond to such messages. Cognitive therapy focuses on the meaning people attach to certain experiences. It makes people learn to manage their negative thoughts that can cause negative experiences.

Relative Efficacy and Treatment Outcome

The relative efficacy of the psychological and neuroanatomical technique has been relatively effective with the use of neurosurgery and deep brain simulation. The treatment outcome of DBS is documented. According to finding by Sedrak (2013), the use of DBS has resulted in a massive decrease in cases of OCD and its symptoms. The treatment technique has been declared as safe, adjustable, reversible evidence-based, especially in the treatment of refractory OCD. The technique has significantly contributed to the well-being of many suffering fro...