Ocd

Front 1

Psychodynamic- Isolation?

Back 1

People attempt to isolate themselves from, or disown these undesirable wishes and impulses. Sometimes the defence mechanism predominates the id. When the id is dominant, the impulses intrude as obsessional thoughts.

Front 2

Psychodynamic- undoing?

Back 2

When isolation is about to fail, the secondary defence of undoing produce compulsive acts. Someone who compulsively washes their hands may be symbolically undoing their unacceptable id impulses.

Front 3

Psychodynamic- formation?

Back 3

This involves adapting behaviours and character traits that are exactly the opposite of the unacceptable impulses. Compulsive kindness towards others may be way of countering unacceptable aggressive impulses. Observers often see these patterns as highly exaggerated and sometimes quite often inappropriate.

Front 4

Psychodynamic- Regression?

Back 4

Regression is an important mechanism in the formation of OCD symptoms. OCD patients can avoid associated anxiety of genital impulses by partially regressing to an earlier phase of their development when we weren't concerned about controlling bodily to functions.

Front 5

Psychodynamic?

Back 5

This is an approach by Freud. He explains that the id is where all the unconscious thoughts are which our ego suppresses. If the id is only partially suppressed, these unconscious thoughts will occur, which creates anxiety as they are often inappropriate and distressing.

Front 6

Psychodynamic- Apter et al?

Back 6

Assessed suicidal adolescents inpatients admitted for a definite suicide attempt in terms of their ego defence mechanisms. The adolescents scored higher on regression and other defence mechanisms that non-suicidal patients. This suggests a wider academic credibility for the idea that ego defences are associated with self-anger.

Front 7

Psychodynamic- Freud case studies?

Back 7

Because he often used case studies of patients to support his theory, he cannot be seen as reliable, because any of the information collected is not testable or repeatable. Therefore anything he did observe and see is subject to observer bias and interpretation, he could see things the way he wanted to see.

Front 8

Psychodynamic- Scientific?

Back 8

Because his research is unfalsifiable as all his conclusions are not testable, this means his theory has no scientific value. You cannot prove it doesn't exist, but you cannot prove it does exist.

Front 9

Psychodynamic- Deterministic?

Back 9

His explanation is that unconscious thoughts are what cause obsessive and compulsive acts. This would therefore imply that we have little control and involvement in these obsessive and compulsive thoughts. Unconscious psychic conflicts are the cause of these feelings and we have no free will over the behaviour.

Front 10

Psychodynamic? - Adam et al?

Back 10

Evidence of reaction formation. These assessed male participants for homophobia. It was found that 80% of the homophobic were aroused by the videos of male homosexual sex compared to 33% of the non homophobic men.
This suggests that reaction formation does occur, as they are react in the opposite way to which they feel to their 'unacceptable' feelings.

Front 11

Psychodynamic- Salzman- negative effects?

Back 11

It was suggested that psychoanalysis might actually have a negative effect on the recovery from OCD. An alternative is a short psychodynamic therapy. These tend to be more direct and action orientated.

Front 12

Psychodynamic- Rat man?

Back 12

He analysed 'rat man' who had obsessive fears about harm coming to his fiancée and her father, for example that pots of rats were going to be fastened to their buttocks ad then gnaw into their anuses. He tried to fend off these obsessional thoughts with compulsive acts, like jumping in the way of a horse and carriage to remove a rock he thought was in the way.
Freud had two explanations that he had conflicting thoughts about his fiancée and her father and that they stemmed from childhood conflicts.

Front 13

Behavioural- compulsions?

Back 13

These rituals develop so that fear associated obsessions can be neutralised. It reduces anxiety and enables control of the obsessions to be re-established. As a result, ritualistic behaviour is reinforced and will associate the act they have performed with changing the situation. The compulsive rituals are learned because of an association between the anxiety associated obsessions and the reduction of anxiety.

Front 14

Behavioural- Obsessions?

Back 14

This can be explained through operant and classical conditioning.
Fear associated with these stimuli is maintained over time by avoidance- avoiding a feared stimuli leads to positive outcomes and thus reinforced.
Any action which enables someone to avoid a negative event is said to be negatively reinforcing.
In OCD thoughts and obsessions are thought to become aversive through association with some traumatic event.

Front 15

Tracy et al? - Behavioural?

Back 15

Predicts that OCD patients are predisposed to rapid conditioning.
Student participants were divided into an 'OCD like' group and a control group, on the basis of responses to an obsessive compulsive symptom checklist.
In some conditions the OCD-like students were conditioned more rapidly.

Front 16

Tracy et al? - Using a non clinical population?

Back 16

As an 'OCD like' group was used and not real OCD patients it may not be appropriate to generalise data from such studied to understanding clinical cases of OCD. They may react differently, as they are clinically diagnose with OCD, and therefore their mind may react differently to those just 'OCD like'

Front 17

Behavioural approach- Practical applications?

Back 17

Developed his ideas into exposure and prevention therapy, exposure to situations that trigger their obsessions, but are prohibited in engaging in the compulsive response. 90% of adults who use ERP improve, which shows it can improve the quality of peoples lives and therefore the explanation is useful in the treatment.

Front 18

Rachman and Hodgson?

Back 18

Anxiety reducing properties of compulsive acts in OCD. OCD patients were asked to carry out some 'prohibited' activity that would cause a rise in anxiety and an accompanying urge to perform whatever compulsive action was relevant for this feared situation. Patients were then allowed to carry out their compulsive acts, and a consequent reduction in anxiety was noted. If patients were asked to delay the compulsive activity, their anxiety levels were found to persist for a while then gradually decline.

Front 19

Behavioural- Reductionist?

Back 19

It does not consider that biological factors such as genes and neurotransmitters may affect development of OCD, it only looks at classical and operant conditioning. It is over simplistic in considering the cause of OCD, and it ignored other aspects that could contribute to the development.

Front 20

Behavioural- Deterministic?

Back 20

It explains our behaviour as something that is controlled by our environment and our experiences, such as parental punishment, learning these behaviours. This means we have no control over our development of this anxiety disorder as we are unable to control our environment we are brought up in.

Front 21

Behavioural- nature vs. nurture?

Back 21

The behavioural approach only considers the nurture side, as we are supposedly born a blank slate and our behaviour is a product of our learning. It does not consider that a nature side may interact in the development of OCD. Nature and nurture may work together in the formation of OCD, not just one or the other.

Front 22

Gender bias?

Back 22

The description of OCD assume that the disorder has the same origins in men and women. In males it appears that early brain injury may be associated with OCD and Tourette.
Females on the other hand show signs of OCD and trichotillomania after childbirth and pregnancy. This suggests that obsessive compulsive spectrum disorders may have different triggers in men and women.

Front 23

Biological- Abnormal brain structure?

Back 23

The caudate nucleus located in the basal ganglia normally suppresses signals from the orbitofrontal cortex. In turn, the OFC sends signals to the thalamus about things that are worrying. If the caudate nucleus gets damaged, it wont suppress minor worry signals and the thalamus is alerted.

Front 24

Biological - PET scans for abnormal brain structure?

Back 24

PET scans indicate that OCD patients exhibit increased glucose metabolism in the OFC-caudate nuclei loop. When compared with control subjects, people with OCD burn energy more rapidly in this network.

Front 25

PET scan- evaluation?

Back 25

The research will not be subject to any form of bias such as demand characteristics as it was an objective measurement used to obtain these results.

Front 26

Biological- brain abnormalities- Faulty OFC?

Back 26

Just because someone has a faulty OFC doesn't mean they will definitely develop OCD, they may need other factors such as stress which will trigger the OCD.

Front 27

Biological- brain abnormalities- nature vs nurture?

Back 27

Someone with a faulty OFC may be more likely to develop OCD, but may need an environmental stressor to start it.

Front 28

Biological- deterministic?

Back 28

The biological model does not account for free will, simply because someone has a faulty OFC does not mean they will develop OCD.
Therefore this explanation is very deterministic, in the fact it states that if you have this faulty OFC you will develop OCD.

Front 29

Biological- serotonin?

Back 29

OCD has been linked with low levels of serotonin in the brain. When serotonin is released by one cell, it enters the next cell through an area of the cell membrane called the receptor. In OCD some receptors are thought to block the serotonin from entering the cell.

Front 30

Biological- Dopamine?

Back 30

High levels of dopamine and this was seen in an animal study in which high doses of drugs that enhance dopamine, induce stereotyped movements resembling the compulsive behaviours found in OCD patients.

Front 31

Biological- dopamine and serotonin- symptoms not cause?

Back 31

One weakness of drugs therapies is that they treat the symptoms and not the cause. For example one psychologist found that when people were taken off their meds they relapsed within four weeks. This shows that medication and therapy need to be in conjunction with each other to properly treat OCD.

Front 32

Biological- Dopamine and serotonin- real world application?

Back 32

SSRIs have been seen to reduce the symptoms of OCD and therefore are effective in treatment. It was seen in a PET scan that the patients brains looked more like a normal persons brain after treatment with SSRIs and therefore this shows this treatment can improve the quality of peoples lives.

Front 33

Supportive evidence from PET scans- Serotonin and dopamine?

Back 33

Lower levels of serotonin were seen in those with OCD than people without OCD, and therefore shows that the brain is effected by these lower levels. This is an objective measurement and therefore is not subject to any bias.

Front 34

Biological explanation- reductionist?

Back 34

Model reduced the causes down to things such as serotonin, damaged OFC or the COMT gene. It does not however look at psychological factors. It simplifies it down to biological aspects. There could be an interaction between the biological components and psychological issues, that eventually cause the OCD.

Front 35

Nestadt et al- biological explanation- family studies?

Back 35

Conducted a study on 80 patients with OCD, and 343 of their first degree relatives. 73 control patients without mental illness and 300 of their relatives. There was strong familial link for the most common form of this disorder, as well as people with first degree relatives with OCD, having a five times more likely change of having the illness themselves later in life.

Front 36

Biological explanation- further empirical support from Rasmussen and Tsuang?

Back 36

Found a concordance of 53-87% in MZ twins for OCD. Although this shows a reasonably high concordance rate for OCD, it is not 100%.

Front 37

Biological explanation- Rasmussen and Tsuang- conclusion?

Back 37

Although genes may play a role in development of OCD, there must be other factors playing a role such as environmental factors. It is difficult to separate out the influence of nature or nurture, and therefore it means that cause and effect cannot be established. It may be genes, environmental factors, or both working together, there is no clear distinction as to the cause.

Front 38

What is OCD? - Obsession?

Back 38

When a person suffers with obsessions which are intrusive thoughts, impulses or images. These impulsive thoughts, images or impulses are obsessions, and the person Is aware of the obsessional thoughts.

Front 39

What is OCD?- Compulsions?

Back 39

These aim to reduce the anxiety created by obsessions.
They are repetitive behaviours, including both overt behaviours such as hand washing or checking, and mental acts such as praying.
They are not connected in a realistic way to the obsession.

Front 40

OCD -reliability?

Back 40

Reliability refers to the consistency of a measuring instrument, such as a questionnaire or scale to assess how fearful a person about certain experiences. The two tests are inter rater reliability and test retest reliability.

Front 41

OCD- Inter rater reliability?

Back 41

Y-BOCS is the most frequently used to assess OCD and as reasonable scores for reliability. Woody et al assess 54 patients with OCD using Y-BOCS and found good internal consistency, although this was improved if items related to resistance were removed.

Front 42

OCD- Test retest reliability?

Back 42

Over a relatively long period the reliability was .64 for the obsessions subscale and .56 for the compulsions subscale. This is 'lower than desirable' for diagnosing patients.

Front 43

OCD- validity?

Back 43

Refers to the extent that a diagnosis represents something that is real and distinct from other disorders and the extent that a classification system such as ICD measures what is claims to measure.

Front 44

OCD- Comorbidity?

Back 44

It refers to the extent that two or more conditions co-occur. Rosenfeld et al. found that patients diagnosed with OCD had higher Y-BOCS scores than patients with other anxiety disorders and normal controls.
I.e it does distinguish OCD patients from others.

Front 45

OCD- Internal validity of questions?

Back 45

A key issue that reduces that validity of diagnosis is the extent to which people produce honest answers to questionnaire about their obsessive/compulsive symptoms. This means the questionnaire is not measuring what it intends to measure. For examples, patients may be embarrassed or feel afraid that an interviewer will take symptoms as a sign of deeper psychosis.

Front 46

OCD- reliability- research evidence?

Back 46

Studies have reported good test-retest reliability for Y-BOCS over the shorter term ( 2 weeks) Short terms assessments may be more appropriate when considering reliability because we might expect patients symptoms to change over long periods of time.

Front 47

OCD -reliability- Computerised versions?

Back 47

Y-BOCS have been developed that appear to yield reliability scores similar to interviewer-administered versions. It is useful to know this because such scales have benefits, although face-to-face interviews have other strengths.

Front 48

Validity- Comorbidity- research?

Back 48

Not all research has fund that OCD is a condition distinct from other disorders. Woody et al. found poor discrimination with depression. Patients diagnosed with OCD were often diagnosed with depression. This suggests that the diagnostic category is not very useful.

Front 49

Validity- Using interviews to improve internal validity?

Back 49

OCD patients may be fearful handling questionnaires because they worry the paper is contaminated. This means they may resist answering the questionnaire. It might generally be preferable to interview patients to get fuller answers.

Front 50

Validity- interviews- distinguishing?

Back 50

An experienced clinician can distinguish between obsessions and simple worries that are not pathological. Patients may not be able to distinguish and end up overplaying their obsessions and compulsions.

Front 51

Validity- problems with self-report?

Back 51

Some patients may lack self-awareness of the severity and frequency of their symptoms. This means that the validity of any diagnosis is likely to be improved by interviewing close friends/partners as well as the patient themselves.
On the other hand symptoms of OCD are observable and concrete, and therefore are easier to identify even by a patient.

Front 52

Validity- ICD vs DSM?

Back 52

Steinberger and Schuch considered the diagnosis rates using these two classification systems. Using DSM 95% of their sample of children and adults with OCD symptoms were diagnosed with OCD, whereas only 46% were using ICD. They suggest this is because the criteria used for ICD are less detailed, which challenges the validity of this measure.

Front 53

Validity- Using computer diagnosis to improve internal validity?

Back 53

Computerised scales for assessing OCD may be preferable to interviews because the presence of another person creates fears of negative evaluation. Computerised scales also means there is less influence of interviewer expectations on the patients answers. An interviewer might, for example, steer a patient into overplaying the symptoms in order to make a diagnosis.

Front 54

Cultural bias in evaluating OCD? Symptoms.

Back 54

Incidence of OCD tends to be about the same in most countries/cultures.
Symptoms are often shaped by the patients culture of origin. A patients from a western country may have contamination obsessions that are focused on germs, whereas a patient from India may fear contamination by touching a person from a lower social caste.

Front 55

Cultural bias in evaluating OCD? Diagnosing?

Back 55

Cultural differences may lead to difficulties when using diagnostic scales because the symptom checklist is culturally biased.
Williams et al. demonstrated that there were significant differences between normal populations of black and white Americans in the scores for contamination obsessions. The researchers suggest that black Americans produce higher scores because of for example that they interact less with animals and therefore have a greater concern about contamination from animals.

Front 56

Matsunaga et al?

Back 56

Studied Japanese OCD patients and found symptoms remarkably similar to those in the West, concluding that this disorder transcends cultures.

Front 57

Biological treatments- psychosurgery?

Back 57

If damage to areas of the brain is a cause of some of the symptoms of OCD, this means that the removal or deconnection of these areas may be a way to reduce undesirable symptoms.

Front 58

Capuslotomy and cingulotomy?

Back 58

Two operations that are performed for anxiety disorders. Such operations removed the capsule and cingulum respectively. The cingulum links to orbitofrontal cortex to the caudate nucleus. The capsule is part of the limbic system involved with emotion and anxiety.

Front 59

Deep brain stimulation?

Back 59

Involved placing wires in target area of the brain. The wires are connected to a battery in the patients chest. When the current is on, this interrupts the target circuits in the brain, such as the 'worry' circuit.

Front 60

Effectiveness of cingulotomy? Doherty?

Back 60

Found that up to 45% of the patients studied (44) who were previously unresponsive to medication and behavioural treatments for OCD, were at least partly improved after cingulotomy.

Front 61

Effectiveness of cingulotomy? Koran?

Back 61

Suggested that such studies may be biased because they are 'unblinded'. The researchers know the treatment received by patients, and their expectations may influence their judgment.

Front 62

Can psychosurgery be justified- case study?

Back 62

Mrs Zimmerman had suffered for many years with OCD and depression which had not be relieved by drugs or therapies.
She was referred to a clinic which claimed a 70% success rate and 30% of patients unchanged but unharmed.
They performed a cingulotomy and Capuslotomy and afterwards she was unable to walk, stand, eat or use the toilet by herself.

Front 63

Psychosurgery- appropriateness?

Back 63

Psychosurgery is associated with severe side effects ranging from personality changes and seizures to transient mania. There is some research however that these side effects are not long lasting.

Front 64

Psychosurgery- appropriateness- Nyman?

Back 64

Conducted a follow up study of all OCD patients treated with a Capuslotomy at a hospital in Sweden between 1978 and 1990. Their IQ test performance, in general, remained intact. Some functioning has been adversely affected at the time of the operation, but recovery took place over time.

Front 65

Psychosurgery- ethical issues?

Back 65

It is a irreversible process and the effects are not always consistent, so there is no 100% for being treated. Informed consent is therefore an issue.

Front 66

Appropriateness of chemotherapy- lacks lasting effects?

Back 66

Koran et al in a comprehensive review of treatments for OCD suggested that although drug therapy may be more commonly used, psychotherapies such as CBT should be tried first.
Drug therapy may require little effort and also may be relatively effective in the short term but it does not provide a lasting cure, as indicated by the fact that patients relapse within a few weeks if medication is stopped.

Front 67

Appropriateness of chemotherapy - SSRIS side effects?

Back 67

Nausea, headache and insomnia.

Front 68

Appropriateness of chemotherapy- Behavioural therapy and chemotherapy?

Back 68

Even when chemotherapy is a preferred option it may be best to also engage in some kind of psychotherapy to help reduce compulsions. If fact, it has been found that patients who were given response prevention therapy all showed reduce activity in the caudate nucleus, as did those given antidepressants.

Front 69

Effectiveness of chemotherapy- SSRIs?

Back 69

Soomro et al reviewed 17 studies of the use of SSRIs with OCD and found them to be more effective than placebos in reducing the symptoms of OCD as measured with Y-BOCS up to three months after treatment ( Short term). One of the issues regarding the evaluation of treatment is that most treatment studies are only of three to four months duration, and therefore little long term data exists.

Front 70

Effectiveness of chemotherapy- Tricyclic's?

Back 70

Clomipramine, a tricyclic antidepressant, if often regarded as more effective than SSRIs. However tricyclic antidepressants tend to have more side effects than SSRIs so they are more likely to be used as second line treatment.

Front 71

Anti-anxiety drugs- Benzodiazepines?

Back 71

Commonly used to reduce anxiety. They are manufactured under various trade names such as Librium, Xanax and valium. They slow down the activity of the central nervous system by enhancing the activity of GABA.

Front 72

How do benzodiazepines work?

Back 72

GABA when released has a general quietening effect on many of the neurons in the brain as it is a neurotransmitter.
It does this by reacting with special sites on the outside of receiving neurons. When GABA locks into these receptors it opens a channel which increases the flow of chloride ions into the neuron. Chloride ions made it harder for the neuron to be stimulated.

Front 73

SSRIs?

Back 73

Work in the same as tricyclic's but instead of blocking the uptake of different neurotransmitters, they the block the re uptake of serotonin and so increase the quantity available to excite neighbouring brain cells, thus reducing the symptoms of depression and anxiety.

Front 74

Tricyclic?

Back 74

Antidepressant tricyclic clomipramine was the first antidepressant used for OCD and today is primarily used in the treatment of OCD rather than depression. They block the transporter mechanism that re absorbs both serotonin and noradrenaline into the pre-synaptic cell after it has fired. More of the neurotransmitters are left in the synapse, prolonging their activity and easing transmission of the next impulse.

Front 75

Biological treatment- ethics?

Back 75

There is an issue related to studying the effectiveness of drugs. A fundamental requirement of research ethics is that if effective treatments exist, they should be used as controls when new treatments are tested. Substituting a placebo for an effective treatment does not satisfy this duty as it exposes individual to a treatment known to be inferior.

Front 76

Exposure and prevention therapy? Exposure?

Back 76

Patient is repeatedly presented with the feared stimulus until anxiety subsides. Exposures may be at first imagined and later experienced in vivo. Exposures may move gradually from least to most threatening in a manner similar to SD.
The patient is forced to experience the stimulus and learn through association with relaxation, that it no longer produces anxiety.

Front 77

Exposure and prevention therapy? Prevention?

Back 77

The patient is prohibited from engaging in the usual compulsive response. This is important in order for the patient to recognise that anxiety can be reduced without the compulsive ritual.

Front 78

Exposure and prevention therapy? Mode of action?

Back 78

At the beginning of therapy the psychiatrist can identify a list of target symptoms, including obsessions and compulsions, using Y-BOCS. A list of items can then be ranked by the patient from least to most anxiety provoking. ERP consists of 13-20 weekly sessions, and then when enough progress has been made they can continue the therapy themselves.

Front 79

Effectiveness of ERP- success rates?

Back 79

Albucher et al. report than between 60 and 90% of adults with OCD have improved considerably using ERP. Research has found that the effectiveness of ERP was improved when integrated with discussions of feared consequences and dysfunctional beliefs i.e cognitive therapy.

Front 80

Effectiveness of ERP- Combined with drug treatments?

Back 80

ERP is often combined with drug treatment although this may or many not improve effectiveness. In one review of research ERP alone was found to be as effective as ERP with medication.
In both conditions patients were doing equally well at a two year follow up. However some more recent studies have found the evidence for effectiveness of ERP combined with drug therapy.

Front 81

Foa et al.?

Back 81

Found that a combination of clomipramine and ERP was more effective than either alone.

Front 82

Effectiveness of ERP- Self-directed ERP?

Back 82

For people with mild OCD, self-directed ERP may be a reasonably effective alternative to therapist led ERP. One computer based program, BT STEPs, was found to be more effective than relaxation training along, but less effective than therapist guide ERP.

Front 83

Appropriateness of ERP?

Back 83

Not all patients are helped by this therapy. ERP alone is not successful with patients who are severely depressed, nor with patients who have certain typed of OCD such as severe hoarding behaviour.
ERP success depends on the effort made by the patient e.g their willingness to do their 'homework' not all patients are willing to commit to this kind of effort. This leads to a substantial refusal rate that may artificially elevate the apparent success of therapy because only those patients who are willing to be helped agree to participate.

Front 84

Psychological treatment- Ethical issues in research?

Back 84

In some studied the effectiveness of ERP is determined by comparing symptom reduction in patients give therapy with that in patients on waiting list who have not yet received therapy.

Front 85

Ethical issues in psychological treatment- O'Kearney?

Back 85

Examined four studies where CBT was compared to either a placebo therapy or not treatment. Two of the studied found no lessening in symptoms as a result of the therapy. A fundamental requirement of research ethics is that if effective treatments exist, they should be used as control conditions when new treatments are tested.
Exposes patients to inferior treatments.

Front 86

ERP vs CT?

Back 86

Koran et al. point out that in many instances ERP inevitably involves some informal cognitive techniques. In fact in most therapeutic studies It is not possible to be sure of the extent to which a therapist has adhered to treatment protocols. This means that it is difficult to state whether any one particular therapeutic approach is more effective. He concluded that ERP combined with CT probably gets the best results.

Front 87

Cognitive therapy?

Back 87

Focus on changing thoughts in contrast to behavioural therapies which focus on changing behaviour. CT aims to identify, challenge and modify dysfunctional beliefs.

Front 88

Cognitive therapy- Obsessions?

Back 88

The therapist questions how patients interpret their beliefs, including why they think they are true and why they think the obsessions developed.

Front 89

Cognitive therapy- Compulsions?

Back 89

A CT therapist also questions patients about the value of their compulsive behaviour. When a belief is challenged and confronted as false, it can help control the behaviour.

Front 90

Cognitive therapy- thought records?

Back 90

Used to help patients consider their dysfunctional beliefs about obsessions and compulsions. Patients are required to keep a daily record of their intrusive thoughts. This might include details of where they were when they had the thought. details of what that meant to them and they did in response to the intrusive thought.

Front 91

Appropriateness of CT- not suitable for all?

Back 91

It requires considerable patient effort and therefore is not suitable for all. Ellis believed that sometimes people who claimed to be following the principles of CT were not putting their revised beliefs into action, and therefore the therapy was not effective. Some people simply do not want the direct sort of advice that CT practioners tend to dispense, they prefer to talk with a therapist.

Front 92

Effectiveness of CT?

Back 92

CT is rarely used on its own, although a few studies have looked at the effectiveness of CT alone. For example, Wilhelm et al found a significant improvement in 15 patients who used CT alone over 14 weeks, as measured on Y-BOCS. Jones and Menzies found a 20% improvement im symptoms from group CT over eight sessions.

Front 93

Appropriateness of CT- theoretical basis?

Back 93

People who hold irrational beliefs tend to produce thoughts that are more dysfunctional than those formed by people who hold rational beliefs.
One the other hand it may be that irrational beliefs are counterproductive but realistic. Alloy and Abrahmson found that depressed people gave more accurate estimates of the likelihood of a disaster than 'normal' controls.

Front 94

Cognitive- intrusive thoughts?

Back 94

Cognitive explanations of OCD stress that everybody has unwanted or intrusive thoughts from time to time, but these thoughts can ignored or dismissed fairly easily. For some people, however, these thoughts are misinterpreted and lead to self-blame and the expectation that terrible things will happen. These thoughts continue because the person cannot stop or ignore them easily.

Front 95

Cognitive- neutralising anxiety?

Back 95

In order to avoid the anticipated consequence of these thoughts, the individual must 'neutralise' them. Such behaviours only provide temporary relief and then anxiety builds up again. Every time a neutralising thought or action if repeated it becomes harder to resist because of the temporary relief it provides.

Front 96

Cognitive eval- intrusive thoughts?

Back 96

People with OCD appear to have different patterns of thinking, such as believing that they can and should have total control over their world.
This can explain why an individual who is vulnerable to developing an anxiety or mood disorder might end up with OCD. It is because they react to their obsessions and anxieties with maladaptive thought patterns.

Front 97

Cognitive eval- Neutralising anxiety?

Back 97

The evidence from Rachman and Hodgson demonstrated that compulsive acts can reduce or neutralised anxiety, which supports cognitive explanations because it suggests that compulsive acts may well develop as a means of neutralising anxiety.