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Obsessive Compulsive Disorder (OCD).

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Obsessive Compulsive Disorder (OCD) What is Obsessive Compulsive Disorder? In order to understand what OCD is, we need to identify and distinguish between what is meant by an 'obsession' and what is meant by a 'compulsion' Obsession are recurrent, unwanted thoughts and images which seem involuntary and are intensely distressing. These obsessions are usually aggressive, sexual or blasphemous Compulsions are actions of which the victim/patient feel compelled to carry out over and over again, perhaps learnt through rituals or rules. Obsession and compulsions are often inter-related and that compulsions can be used to try and counteract obsessions. For example, compulsive hand washing may be an attempt to eradicate the obsessive preoccupation of having germs and dirt on the hands. A person may however have only obsessive thoughts without their expression as compulsive behaviour. Failure to complete the compulsion often results in severe anxiety or panic - but continuing to try to live with the rituals often also leads to anxiety or depression. Examples of compulsions include excessive hand washing, cleaning, counting, checking, touching, arranging, hoarding, measuring, excessive neatness, and repeating tasks or actions. Examples of obsessions are worrying excessively about germs, contamination, dirt, fearing having harmed others, intrusive sexual thoughts or urges, death and illness. People with OCD are aware that their compulsions and obsessions are irrational or excessive. ...read more.


Clomipramine, a tricyclic antidepressant (TCA) used to be the usual treatment, this worked well. However TCAs have more side effects than the newer Selective Serotonin reuptake inhibitors (SSRI's). Therefore initially in most cases now, SSRI's are prescribed because of the improved safety, tolerability, and equivalent effectiveness. However, no SSRIs except fluoxetine (Prozac) should be prescribed to children and adolescents under the age of 18, due to increased risks. Medications will usually relieve the symptoms of OCD, but often, if the medication is discontinued, relapse will follow. Medication usually works within 4 weeks but may take up to 10 weeks to work fully. If successful, it is usual to take medication for at least a year. The doses needed to treat OCD are sometimes higher than those needed to treat depression. Symptoms can improve by up to 60% with medication. Cognitive Behavioural Therapy (CBT) CBT involves exploring the nature of anxiety and stress responses. The therapist will then gradually expose the individual to the feared object or idea, either directly or by imagination, and then discourages or prevents them from carrying out the usual compulsive response. The aim is for the individual to gradually experience less anxiety from the obsessive thoughts and become able to forgo the compulsive actions for extended periods of time. ...read more.


Therefore the pigeons may have associated the chance of getting food and reinforcing the movement they displayed, once food was given, which allowed them to compulsively move idiosyncratically. Perhaps the pigeons believed that if they moved like that, they were more likely to get food. This superstition hypothesis can also be explained with soccer players, when they only wear a particular pair of boots because they 'were lucky last time'. There are compulsively wearing the same boots on the chance that the same reinforcement of winning will be given. With respect to the cognitive approach (Beck 1976) This approach assumes that people with OCD overestimate the likelihood of harm and therefore tend to avoid the 'source of harm' (unnecessarily) One theory by Rachman (1993) suggested the 'though-action fusion model'. This involved estimating the likelihood of intrusive thoughts as equivalent actions. For example, if a man had said he had seen an image of his dog lying dead, then it was as if he was 'tempting fate' and 'increasing the chances that the dog would actually die. The model of 'thought-action fusion; comprises 2 components: Likelihood TAF believes that thinking about an unacceptable or disturbing event, makes it more likely that it will actually happen. Moral TAF The person believes that the thoughts they had were (almost) as bad as the actual event itself. This lead psychologists to believe that people with OCD find it hard to distinguish thoughts from actions, which leads to compulsively repeating obsessive behaviour. ...read more.

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