Paper Two Revision: OCD

13D

Key Question Describe Explain Discuss Evaluate

To what extent does neurotransmitter functioning provide an explanation for SZ?

Assess the usefulness of quantitative and qualitative research in interviews and case studies from Clinical Psychology

13E

Basal Ganglia Prefrontal Orbital Cortex Cingulate Gryus

Biological Explanation Basil Ganglia: movement, plays an important role in addictive behaviors and habit formation **** patients with OCD appear to have different levels of brain activity in this area Prefrontal Orbital Cortex: decisions about appropriate social behaviour occurs here *****more brain activity in this area, which leads to feelings of worry and concern Cingulate gyrus: part of the limbic system that helps to regulate emotion, drives the body’s conscious responses to unpleasant experiences, orients the body away from negative stimuli ** different levels of brain activity

Loop of Circuit

This circuit regulates primitive aspects of our behaviour such as aggression, sexuality, and bodily excretions. When this circuit is activated, these impulses are brought to your attention and cause you to perform a particular behaviour that appropriately addresses the impulse. For example, after a visit to the bathroom, you may begin to wash your hands to remove any harmful germs you may have encountered. Once you have performed the appropriate behaviour — in this case, washing your hands — the impulse from this brain circuit diminishes and you stop washing your hands and go about your day. It has been suggested that if you have OCD, your brain has difficulty turning off or ignoring impulses from this circuit. This, in turn means the obsessions and compulsions continue, leading you to wash your hands again and again

Serotonin Abnormalities, or an imbalance in the neurotransmitter, or brain chemical, serotonin, may also help explain OCD. Serotonin is the chemical in the brain that sends messages between brain cells and it is thought to be involved in regulating everything from anxiety, to memory, to sleep. Medications known as Selective Serotonin Re-uptake Inhibitors (SSRIs) are often used to treat OCD Studies have shown that OCD patients tend to have lower levels of this neurotransmitter (NT). Because serotonin is essential for nerve cell communication, it has been proposed that the dysfunction of the “worry circuit/loop” may be caused by the imbalance of serotonin. Baxter et al. (1992) proposed that the 3 brain parts involved in the "worry circuit" can become unlinked with Prozac (SSRI). Evidence for the breakup of the "worry circuit" comes from PET scans which show less activity in the right caudate nucleus after effective pharmacological or psychological therapy.

SZ: Treatment Drug Therapy: Typical Atypical

How do they work? Social control? Ethics? Helps to reduce the level of dopamine in areas of the brain associated with the symptoms Primary mechanism of action: blocking the dopamine receptors Prevents dopamine binding to receptors Depolarises neurons Mainly block D2 receptors Atypical Do not bind to receptors as tightly as typical psychotics They also block 5GT2a (serotonin receptors) This difference in action is thought to reduce side effects (Seeman, 2002) Less risk of movement disorders (uncontrollable movements) Tablet form Or injections (especially when there is a risk that a patient will not comply with the treatment regimen themselves Social control? Ethics?

CBT for schizophrenia Symptoms are focused on rationally, accepting them and their experience of them Focus on the individual One to one sessions (weekly for weeks or longer) Focus on therapist being supportive and non-threatening Collaboration between patient and therapist is required

Process of CBT for schizophrenia – following an acute phase Belief modification Focusing and reattribution Normalising Cognitive therapy

OCD: Treatment Drug Therapy: Altering chemicals in the brain SSRIs (serotonin involved in the brain circuit) Blocking the reuptake of serotonin by the presynaptic neuron, leaving more in the post synaptic Evidence to suggest that serotonin levels are low.

CBT: * Focusing on obsessive thoughts and what is going on at the time. Look at page 85 of textbook ERP is actual exposure to fear and compulsion

Key Question Describe Explain Discuss Evaluate

Assess the usefulness of quantitative and qualitative research in interviews and case studies from Clinical Psychology