SEMINARINTRODUCTION:Obsessive compulsive Disorder is a clinical diagnosis for a diverse, heterogeneous and a generally long term mental disorder that is categorised under anxiety disorders.It is further divided into two parts:Obsessions: These refer those thoughts, ideas, drives, or feeling which are continuous, consistent and unwanted and consume an individual’s way of thinking and cognition to an unbearable extent. These obsessive thoughts lead the individual to feel afraid, shameful, disgusted, helpless etc. These are often very time consuming and come in the way of normal day to day functioning of an individual.
Compulsions: these refer to those actions that an individual feels forced to do again and again in order to get rid of his/her obsessive thoughts. Even though performing such actions might give the person temporary relief from her/his anxiety provoking thoughts but they do not provide a permanent solution.OCD is said to affect all kinds of the demographic population irrespective of their gender, caste, race, ethnicity, geographical surroundings etc.
The age at which OCD is said to start developing, varies, and is generally divided into two categories: 1.) from 8-10 years of age and, 2.) in the late teens or early adult life. Despite this it’s usually difficult to determine when exactly the onset of the disorder will begin. Usually those patients diagnosed with an early onset of OCD tend to had more intense, long lasting, and unstable symptoms as well as behavioural defects resulting in an equally intense treatment plan.CAUSES:Obsessive compulsive disorder is a heterogeneous disorder with its roots in various causes. Some of them are:BRAIN DISORDER:OCD is believed to be caused due to insufficient transmission of information and communication between the front of the brain and more complex and deeper parts of the brain. This is most likely due to abnormal amounts of serotonin (a neurotransmitter) in the brain. The levels of serotonin in the brain can be controlled through medication and maintained through cognitive and behavioural therapy.GENE STRUCTURE:Another explanation to understand the reasons for the onset of OCD is that an individual might have inherited such genes through her/his family. Even though genes of an individual are partially responsible for the development of this disorder, other factors such as an infection, injury, exposure to stress, vulnerability due to predisposition of the individual towards the disorder are also taken into account.Despite the amount of theories, researches and explanations regarding the genesis of this disorder, mental health professional continue to stress on further researches and breakthroughs in this field to help narrow down to one or two causes for OCD.DIAGNOSIS:An accurate diagnosis for Obsessive Compulsive Disorder can be done by a psychiatrist or a mental health professional. The signs and symptoms that the psychologist will look for are:Presence of obsessive and persistent thought patternsPerforming repetitive and compulsive actions/behaviour to get rid of the thoughtsInability of the individual to adapt to normal, day to day activities due to behavioural and cognitive problems that he/she can’t get rid of.Once an individual displays these symptoms over a certain period of time he/she is diagnosed with OCD and a treatment plan is devised for him/her.TREATMENT:The two most widely utilised treatment methods for OCD are medication and a specific Cognitive behaviour therapy method.Medication: As discussed above, OCD is caused due to abnormal serotonin levels in the brain, which can be controlled through adequate and regular medication in most of the cases. The medication can be prescribed by a psychiatrist after he/she makes a proper diagnosis.Exposure and Response Prevention (ERP): This is a form of CBT in which is further divided into two phases. Phase 1 includes exposing the patient to his/her anxiety inducing thoughts, feelings, and situations etc which trigger the obsessions of the particular individual. Phase 2 includes consciously resisting one’s compulsions and/or not performing the repetitive actions that the patient feels forced to do, under the supervision of a professional or therapist. In due time the patient will be able to perform ERP on his/her own and would be able to have some form of control over the symptoms.ROLSProf Jonathan S Abramowitz et al (2009), published a theoretical and multidimensional research of obsessive compulsive disorder and the various models that have been proposed to explain the disorder. According to the study, the onset of OCD is usuallu observed in late teens and early adults. a mixture of models are used to explained OCD, some of them focus on the biological aspects while others prpound that its the way an individual thinks and acts that leads to OCD. Some of these models have a stronger empirical database than others, while some are accepted aand studied more than others. In the end, it is stated that both biological as well as CBT models are used together to create a treatment method and administer medications.David Mataix-Cols et al (2005), studied a multidimensional structure of OCD for better understanding of the diverse disorder and its various aspects. For this, various literatures and past researches/ experiments were studied and reviewed closely. The studies were selected on the basis of their relative importance and contribution to the field of mental health. Studies using factor analysis in their approach and involving around 2,000 subjects/patients were considered that displayed the four major dimensions of the disorder consistently. The conclusion of this multifaceted and scientific presentation of obsessive compulsive disorder was that OCD can be condensed down to a few symptoms that are consistent and stable over time.Gail S. Steketee et al (2001), conducted a research to devise a treatment plan for Obsessive Compulsive Disorder to act as a tool used by mental health professionals. The method collaborates with a book that is self help and is divided into four distinct parts. The first part speaks about the nature of the disorder, the second talks about the way to asses the symptoms of OCD through a person’s behaviour, the third elaborates on the ERP (Exposure and Response Prevention) treatment measure and the final part of the book deals with follow up issues such as relapse and how to prevent complex symptoms and maintain the learning from the treatment.James F. Leckman et al (2000), conducted a research to establish correlation between various symptoms experienced by patients diagnosed with obsessive compulsive disorder. Since this disorder has symptoms that impact a person’s various psychological aspects such as emotion, cognition, information perception, attention and social capabilities the researchers decided to use the Yale-Brown OCD checklist as it has various categories to organise the symptoms. The results came out almost identical. They concluded that obsessive compulsive disorder is a diverse and vast domain of mixed symptoms and causes and has various dimensions under one huge umbrella.Gerald Nestadt et al (2000), proposed that there could be a role of genes, passed down along the generations, in the occurrence and development of obsessive compulsive disorder in individuals. To confirm this hypothesis, 80 family subtypes were identified and selected from clinics specialising in OCD as well as through randomisation. The patients and their close relatives participated in the study as subjects. The results of the study helped reach the conclusion that OCD can be a common disorder within a family but various other factors such as onset age and prevalence of symptoms also makes a difference.Randy O. Frost et al (2000), compared the levels of perfectionism among people who were diagnosed with OCD and those who were not including people diagnosed with PDA (panic disorder with agoraphobia). The level of perfectionism in people with obsessive compulsive disorder was clearly more that normal people but was more or less similar to people with PDA when measure on various parameters.Hans C. Breiter et al (1999), used functional magnetic resonance imaging (FMRI) to observe if there were any biological, especially, neurological changes in patients diagnosed with OCD as compared to normal subjects. During the scans the 10 patients with OCD were exposed to provoked conditions to trigger their symptoms. The statistical imaging and mapping of the subjects and patients showed that those diagnosed with OCD showed activation of various brain region under provoked conditions whereas the normal subjects showed no activation of any brain region or area under any condition. This provided the conclusion that obsessive compulsive disorder has its roots in various neurological causes as well as they do in the psyche of the individual.Gunnar Skoog et al (1999), performed a study to observe, analyse and determine the symptoms and effects of OCD in the long term. The patients admitted in a psychiatric hospital in Sweden were observed through a semi structured interview process over 40 years. The researchers recorded that there was improvement in about 80% of the cases, some of which recovered completely and others had residual symptoms left. Some patients showed a change in their symptoms but overall conclusion of the study was that most of the patients diagnosed with OCD continued to display symptoms and behavioural problems.Paul M. Salkovskis et al (1999), attempted to understand and then devise a treatment plan for obsessive compulsive disorder under behaviour therapy as well as CBT. He stated that the recent developments in cognitive therapy, such as negative statement interpretation and refusal as well as negative emotions and thoughts of the client etc, could be the answer that professionals need to treat OCD. He also proposed various treatment strategies that could be used to reduce the occurrence of obsessive thought patterns which would in turn reduce the compulsive behaviours performed by the individual.Steven A Rasmussen et al (1999), used the data from a previously conducted study to understand the increased occurrence and control of OCD. They stated that OCD was two times as widespread as schizophrenia or other anxiety disorders and equally frequent. The researcher and his associates concluded that the reason for overlooking such high statistics in the past was due to several factors such as the stigma attached to the symptoms and the disorder, inaccurate diagnosis and screening of the disorder by professionals, lack of awareness and skills to identify the heterogeneity in the symptoms of obsessive compulsive disorder.