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OCD

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OCD

What is the meaning of OCD? OCD stands for obsessive-compulsive disorder. Like phobias, OCD is an anxiety disorder with two main components: obsession and compulsion. People suffering from this disorder struggle with uncontrollable thoughts of performing specific actions repeatedly.

OCD OCD diagnosis StudySmarter

OCD diagnosis, Flaticon

Obsessions are marked by uncontrollable, recurring, and intrusive thoughts. The main characteristic of obsessions is that they are not grounded in reality.

An OCD patient may believe that germs and bacteria are all around them, which drives up their anxiety levels, making them feel constantly uncomfortable.

Compulsions are the need to perform specific actions to feel better about the obsessive thoughts.

Frequent hand washing because of fear of bacteria and germs. Although the sufferer knows they have washed their hands thoroughly, as soon as they touch something, such as a light switch, they obsess over their hands being dirty and need to rewash them to alleviate this fear.

What are the types of OCD?

Although all OCD have a common basis of symptoms, it can manifest differently. There is no definitive list of types of OCD, but here is the overview of some common symptoms:

  • Contamination: fear of germs or disease causes the patient to avoid touching anything, such as not turning off lights because the light switch may be contaminated.

  • Double-checking: obsessive concern to avoid accidents such as fire leads to compulsive checking, in this case, whether the stove is off.

  • Arranging or ordering: the compulsion to keep everything in the correct order, e.g., placing everything on the desk in exact spots.

  • Intrusive thinking: these can be sexual and violent obsessions; they usually do not involve a compulsion to perform, only intrusive and disturbing thoughts, such as stabbing a loved one.

OCD OCD StudySmarter

OCD, Unsplash

OCD symptoms

Some common OCD symptoms signal abnormal behaviour associated with OCD. These signs of OCD may differ slightly depending on the type of OCD.

  • Fear of contamination.

  • Fear of losing things.

  • Immoral and intrusive sexual thoughts or images.

  • Thoughts of causing violence.

  • Fixation on strict adherence to religious practices.

  • Excessive focus on superstition (judging actions as good or bad luck).

  • Excessive washing and cleaning.

  • Repeated counting to reduce the likelihood of making a mistake.

  • Excessive arranging of things.

  • Engaging in many religious acts to avoid punishment for sins.

  • Double-checking things repeatedly, such as locks.

  • Hoarding things because it is bad luck to throw them away.

OCD can take up many hours of one’s day, intruding and affecting decisions in one’s social and personal life activities.

What causes OCD?

According to the A-level curriculum, you need to understand and focus on genetic and chemical/neural explanations; however, there may be other causes of OCD.

OCD a scientist reading results from genetic studies StudySmarter

OCD – a scientist reading results from a genetic study, Unsplash

Genetic explanation

There is empirical evidence from twin studies (studies conducted on identical and fraternal twins) that if any family member has a history of OCD, the next generation can genetically inherit it. According to a study presented by Lewis (1936), approximately 37% of people with OCD had family members with similar anxiety disorders.

Another twin study by Carey and Gottesman (1981) showed that 87% of identical twins inherited OCD symptoms compared to a rate of 47% in fraternal twins of obsessive symptoms, which is strong evidence for the genetic cause of OCD. However, the genetic component may not be the sole cause of OCD. It is only known to promote susceptibility. There may be other environmental factors that trigger this anxiety disorder.

Chemical/neural explanation

A neural explanation of OCD uses neurotransmitters and brain structures to explain OCD. These neurotransmitters convey messages through the nervous system. Lower levels of serotonin and elevated levels of dopamine may cause OCD. High dopamine levels affect concentration, which explains why it can be difficult for OCD patients to distract themselves from their obsessive thoughts. However, lower serotonin levels are responsible for a bad mood that can cause obsessive thoughts.

The basal ganglia in the brain is responsible for motor movements, cognition and emotions. It is involved in selecting voluntary behavioural movements. The basal ganglia interact with several brain structures, such as the cerebral cortex. According to Rapoport (1990), the basal ganglia picks up some aspects of the stimuli and then releases a stimuli-specific behavioural response. Dysfunction with the basal ganglia and its pathways with the orbitofrontal cortex and the ventroanterior thalamic nuclei and mediodorsal thalamic nuclei is considered responsible for the symptoms of OCD.

Ventroanterior thalamic nuclei relay messages from the basal ganglia to the premotor cortex. It also has a role in planning and starting up movements.

Mediodorsal thalamic nuclei are responsible for executive functions such as planning, cognitive control and decision making.

The brain’s orbitofrontal cortex, a part of the prefrontal cortex (PFC), is thought to be responsible for decision-making and converting information from our senses into thoughts in the brain. People with OCD have an overactive orbitofrontal cortex, which leads to increased conversion of sensory information into thoughts and actions, leading to obsessive compulsions. This increase in orbitofrontal cortex activity also hinders the person from stopping performing the action.

However, it is difficult to establish a confirmed cause-and-effect relationship in this case because it is unclear whether OCD causes this effect on the brain or vice versa.

OCD can worsen if the patient experiences any trauma like the death of a loved one. Too much stress or abuse may increase the patient’s underlying insecurities, worsening the disorder.

OCD treatment


OCD treatments include drug therapy and sometimes cognitive therapy. However, this article will focus on drug therapy, particularly important in your syllabus.

Drug therapy

According to empirical studies, antidepressants such as SSRIs (selective serotonin reuptake inhibitors) and SRIs (serotonin reuptake inhibitors) effectively treat OCD symptoms. These two categories of OCD medication increase serotonin levels, supporting the neural explanation of OCD. However, any medication that regulates neurotransmitters other than serotonin has not had significant results.

According to Kotapati et al., 2019 in a systematic article review, cognitive behavioural therapy was more effective in reducing OCD patients with the help of SSRI. Soomro et al. (2008) examined 17 studies comparing SSRI to placebo. They concluded that SSRIs reduce OCD symptoms better than placebo.

OCD - Key takeaways

  • OCD is an anxiety disorder that consists of two main components: obsession and compulsion. Obsessions are uncontrollable, recurring, and intrusive thoughts; they are not grounded in reality. Compulsions are the need to perform specific actions to feel better about the obsessive thoughts.
  • There are various types of OCD, but they all share some common symptoms: contamination, intrusive thoughts, double-checking, and arranging or ordering things.
  • There are two main explanations for OCD: genetic and neural.
  • Neural explanations focus on the roles of serotonin and dopamine. Also, certain brain structures are the basal ganglia and orbitofrontal cortex.
  • SSRIs have been empirically proven to reduce OCD symptoms.

Frequently Asked Questions about OCD

OCD can worsen if the patient experiences any trauma like the death of a loved one. Too much stress or abuse may increase the patient’s underlying insecurities, worsening the disorder.

Obsessive symptoms:

  • Fear of contamination by bacteria or germs.
  • Fear of losing something.
  • Having immoral and intrusive sexual thoughts or images.

Compulsive symptoms

  • Excessive washing and cleaning.
  • Repeatedly counting to avoid mistakes.
  • Excessively arranging things.

Genetic, environmental, and neural factors can cause OCD.

OCD stands for obsessive-compulsive disorder.

OCD can take up many hours of one’s day, intruding and affecting decisions in one’s social and personal life activities.

Final OCD Quiz

Question

List one characteristic of OCD.

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Answer

OCD includes repetitive intrusive thoughts and behaviours. 

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Question

Alia has obsessive thoughts about slicing her elder brother’s arm with a knife. 

Which OCD type does Alia have?

Show answer

Answer

Intrusive thoughts.

Show question

Question

Which levels of dopamine are related to OCD symptoms?

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Answer

Higher levels.

Show question

Question

What do SSRIs stand for?

Show answer

Answer

Selective serotonin reuptake inhibitors.


Show question

Question

What is the neural explanation of obsessive-compulsive disorder?

Show answer

Answer

A neural explanation of OCD uses neurons and neurotransmitters to explain OCD. These neurotransmitters convey messages through the nervous system. Lower levels of serotonin and elevated levels of dopamine may cause OCD.

Show question

Question

What were the findings of Soomro et al.’s study on drug therapy for OCD?

Show answer

Answer

Soomro et al.’s study showed that SSRIs reduce OCD symptoms better than placebo. They used 17 trials compared to placebo medicine to show the effects of SSRIs.

Show question

Question

What does PFC stand for?

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Answer

Prefrontal cortex.

Show question

Question

What is the function of PFC?


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Answer

The PFC in the forehead region of the brain is thought to be responsible for decision-making and converting information from our senses into thoughts in the brain.

Show question

Question

How are high dopamine levels related to OCD?

Show answer

Answer

High dopamine levels affect concentration, which explains why it can be difficult for OCD patients to distract themselves from their obsessive thoughts.

Show question

Question

Give an example of how an overactivated PFC can cause OCD.

Show answer

Answer

People naturally need to wash their hands after going to the toilet to avoid illness. Once they make the appropriate decision to wash their hands, their activity in the prefrontal cortex decreases. However, OCD patients will repeatedly decide to wash their hands due to an overactivated PFC.

Show question

Question

Which study came out in support of the genetic explanation?

Show answer

Answer

A twin study by Carey and Gottesman (1981) showed that 87% of identical twins inherited OCD symptoms compared to a rate of 47% in fraternal twins of obsessive symptoms, which is strong evidence for the genetic cause of OCD.

Show question

Question

Is the genetic component a sole explanation for OCD?

Show answer

Answer

No, the genetic component may not be the sole cause of OCD. It is only known to promote susceptibility. There may be other environmental factors that trigger this anxiety disorder.

Show question

Question

What are the obsessive symptoms of obsessive-compulsive disorder?

Show answer

Answer

  • Fear of contamination.
  • Fear of losing things.
  • Immoral and intrusive sexual thoughts or images.
  • Thoughts of causing violence.
  • Fixation on strict adherence to religious practices.
  • Excessive focus on superstition (judging actions as good or bad luck).

Show question

Question

What are the compulsive symptoms of obsessive-compulsive disorder?

Show answer

Answer

  • Excessive washing and cleaning.
  • Repeated counting to reduce the likelihood of making a mistake.
  • Excessive arranging of things.
  • Engaging in many religious acts to avoid punishment for sins.
  • Double-checking things repeatedly, such as locks.
  • Hoarding things because it is bad luck to throw them away.

Show question

Question

Define obsessions and compulsions.

Show answer

Answer

Obsessions are marked by uncontrollable, recurring, and intrusive thoughts. The main characteristic of obsessions is that they are not grounded in reality.


Compulsions are the need to perform specific actions to feel better about the obsessive thoughts.

Show question

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