Abnormal Psychology

310 CHAPTER 7

Key Concepts and Facts About Obsessive-Compulsive Disorder

• OCD is marked by persistent and intrusive preoccupations
  and—in most cases—repetitive, compelled behaviors that usu-
  ally correspond to the obsessions. Although people with OCD
  recognize that their obsessions are irrational, they cannot turn
  off the preoccupying thoughts; they feel driven to engage in the
  compulsive behaviors, which provide only brief respite from the
  obsessions.


• Common obsessions include anxiety about contamination, or-
  der, losing control, doubts, and possible future need. Common
  compulsions include washing, ordering, counting, checking, and
  hoarding or collecting.


• Neurological factors associated with OCD include disruptions
  in the normal activity of the frontal lobes, the thalamus, and
  the basal ganglia; the frontal lobes do not turn off activity of
  the neural loop among these three brain areas, which may lead
  to the persistent obsessions. Lower than normal levels of se-
  rotonin also appear to play a role, although this may be more

directly related to some types of OCD than others. Genes ap-

pear to make some people more vulnerable to anxiety disorders

in general—not necessarily to OCD specifi cally.

• Psychological factors that may underlie OCD include negative
  reinforcement of the compulsive behavior, which temporarily
  relieves the anxiety that arises from the obsession. In addition,
  normal preoccupying thoughts may become obsessions when
  the thoughts are deemed “unacceptable” and hence require
  controlling. In turn, the thoughts lead to anxiety, which is then
  relieved by a mental or behavioral ritual. Like people with other
  anxiety disorders, people with OCD have cognitive biases re-
  lated to their feared stimuli, in this case, regarding the theme of
  their obsessions.


• Social factors related to OCD include socially induced stress,
  which can infl uence the onset and course of the disorder, and
  culture, which can influence the particular content of obses-
  sions and compulsions.

Figure 7.16

7.16 • Feedback Loops in Treating Obsessive-Compulsive Disorder

Treatments Targeting

Neurological Factors

Medication: SSRIs,

clomipramine (TCA)

Changes neural

activity

Treatments Targeting

Psychological Factors

Family therapy or

consultation

Changes family

dynamic regarding

patient’s compulsive

behaviors

Treatments Targeting

Targeting Psychological Factors

CBT: Exposure with

response prevention,

cognitive restructuring

Changes thoughts,

feelings, and

behaviors