Test on Biological explanations / treatments for OCD

Cognitive Explanation of OCD: A01 People who suffer from OCD have obsessive thoughts so clearly there is a cognitive link There is also evidence that memory systems might be impaired. Sher et al (1989) found that people with OCD had poor memories for their actions, for example, they really could not remember if they had turned the light off. In addition, Trivedi (1996) found people suffering from OCD had low confidence in their memory ability and also their non verbal memory was impaired

Cognitive explanation of OCD: A01 Alternatively, some psychologists suggest that OCD sufferers have a cognitive vulnerability to anxiety (Williams et al 1997). For example a person might show hypervigilance when entering a new environment: They may use rapid eye movements to scan the environment They may attend selectively to threat related stimuli rather than neutral stimuli Rachman (2004) outlines a case study of a patient with OCD which shows a good example of this hypervigilance…

Rachman (2004) Case Study A female patient had a severe fear of diseases, particularly the prospect of encountering other people’s blood. She had catastrophic thoughts about the probability of harm (e.g. contracting AIDS) coming from even a small plaster worn by someone. She over-estimated the seriousness of contact with anyone. When she went to a public place she rapidly scanned the environment and people she encountered on the lookout for evidence of blood, cuts, bandages. Her hypervigilant scanning meant that she could recall in great detail the blood-related items she had encountered over many years.

Evaluation of cognitive explanation of OCD: A02 (-) Cognitive bias (such as hypervigilance) seems to give a good account of individual differences in susceptibility to OCD (+) The treatment of patients with OCD by reducing hypervigilance has shown success, showing that it might be a contributing factor in OCD (-) The cognitive approach concentrates on internal cognitions as an explanation for OCD and tends to ignore the social and biological factors that might be contributing to the condition Remember further evaluation can come from comparison to the other explanations you have covered: biological, behaviourist, psychodynamic With your partner try and think of at least 2 comparisons you can draw with the other explanations which you could use during an explanations essay!

Past paper practise January 2009 (c) (i) Briefly outline a cognitive explanation for obsessive-compulsive disorder. (2 marks) (ii) Suggest one criticism of the cognitive explanation for obsessive-compulsive disorder. (2 marks)

January 2009 (c) (i) Briefly outline a cognitive explanation for obsessive-compulsive disorder. (2 marks) [AO1 = 2] AO1 – Up to 2 marks for description of a cognitive explanation. Possible answers: A cognitive explanation suggests that people with OCD have a cognitive bias so they could have a poor memory for their actions/may be hypersensitive to environmental stimuli. Accept valid answers based on specific researchers such as Cromer’ neutralising hypothesis about OCD or Rachman’s 4-step sequence of catastrophic misinterpretations made by OCD sufferers.

1 mark for criticism, 1 for elaboration of criticism. Possible answer: (ii) Suggest one criticism of the cognitive explanation for obsessive-compulsive disorder. (2 marks) 1 mark for criticism, 1 for elaboration of criticism. Possible answer: The cognitive approach focuses on internal mental processes as an explanation and ignores other possible causes such as social/biological factors.

Cognitive Therapy for OCD: A01 The aim of cognitive therapy is to replace unrealistic and fearful thinking with more realistic mental habits. It teaches patients to identify, challenge and replace counterproductive thoughts with more constructive thinking patterns. Cognitive treatment is used in conjunction with behavioural therapy and this is known as cognitive behavioural therapy. O’Kearney (1993) reports a case study of a woman who had obsessive thoughts about stabbing her mother and sister as well as stabbing her own eyes out:

O’Kearney’s case study O’Kearney asked the woman to record her obsessive thoughts on tape and play them back to herself. This is the ‘exposure’ part of the behavioural treatment. The woman was also helped to identify her catastrophic thoughts and to change these to realistic thoughts. She was taught how to do this in therapy sessions and then asked to practise when listening to the tape of her thoughts. This combined approach reduced the frequency of the obsessive thoughts and the associated compulsive behaviours Q= how would you structure this for this question ‘Outline one study into the treatment of OCD using a cognitive approach. Include why the study was done, method used, results found and conclusions drawn’ (4 marks)

Cognitive therapy for OCD: A02 (+) There is a lot of empirical evidence to support cognitive therapy for anxiety disorders, particularly when combined with behavioural techniques (-) Although changes in patients’ cognitions must take place during cognitive therapy, it is not clear what element of the therapy is most effective. It might be that any cognitive change is a consequence of some other factor (e.g. medication or lifestyle change) and not the intervention by the therapist.

Cognitive therapy for OCD: A02 (COMBINATION) treatments that combine drug therapy with behavioural and / or cognitive therapy have been found to result in improvements that last a number of years (Kordon et al 2005) Remember, other evaluation comes from comparison to other treatments you have covered: biological, behavioural, psychodynamic. With your partner can you think of at least 2 comparisons to the other treatments we have covered?

Plenary: completing essay planning Describe and evaluate two therapies for obsessive-compulsive disorder. (10 marks) If this type of question comes up your A01 must consist of bio and cognitive treatments You can use what we have learnt for A02 as part of the comparison You should bullet point your A01s and A02s for this question now