The Threat of Obsessive-Compulsive Disorder - Research Paper Example

OCD disorder Obsessive Compulsive Disorder (OCD) is a form of anxiety disorder characterized by an individual’s preoccupation with obsessive thoughts, and the display of compulsive behaviors triggered by anxiety provoking stimuli. The obsessive thoughts and compulsions cause distress within the individual, as they deter normal functioning. The etiology of OCD remains unclear. Data from the International OCD foundation indicates that 1 in every 100 Americans suffers from OCD, with equal distribution of prevalence among both sexes. Research findings infer that biological factors are more likely to predispose the development of OCD compared to environmental factors such as parenting. Introduction Previously classified by the Diagnostic Statistical Manual (DSM-IV-TR) as a form of anxiety disorder, Obsessive Compulsive Disorder (OCD) is classified currently on its own, and it features an individual’s preoccupation with obsessive thoughts and the display of compulsive behaviors triggered by anxiety provoking stimuli. DSM-V outlines the following criteria for the classification of OCD. Criteria A: Either compulsions or obsessions: 1) Intrusive recurrent and persistent impulses, images or thoughts that elevate distress or anxiety levels 2) Recurrent impulses, images or thoughts are not merely worries about everyday problems 3) Individual tries to suppress recurrent, persisting impulses, images or thoughts with another action or thought 4) Individual realizes impulses, images or thoughts are derivatives of the their mind and not externally imposed Criteria B: Eventually, an individual realizes compulsions or obsessions are unreasonable or excessive, not applicable to children. Criteria C: Compulsions or obsessions distress an individual and are time consuming (persist for more than an hour) and disrupt normal routine and relationships. Criteria D: Presence of Axis I disorders do not predominantly cause compulsions or obsessions Criteria E: symptoms do not result directly from physiological effects of a general medical condition or substance (drugs or medications). Historical During the Dark Ages, when religion predominantly governed all facets of human existence, individuals suffering from obsessive thoughts just like those afflicted with blasphemous or sexual thoughts were believed to be possessed by evil spirits. Consequentially, the prescribed treatment entailed exorcising the evil spirits. Religion offered no factual justification for its diagnosis and treatment of OCD; therefore, the probability of recovery among those afflicted with the disorder was slim to none. Scientific advancements during the Enlightenment era offered a different perspective on the causes, diagnosis and possible treatment of OCD. Early physicians attributed the disorder to an imbalance in the body’s humors. According to them, restoring balance to the humors was achievable through bloodletting. These physicians distinguished between different types of compulsions and obsessions; for example, compulsive washing, checking, and sexual obsessions among others. In the early 1900s, scholars discovered a psychological component to the disorder. Psychoanalyst Sigmund Freud posited that obsessive-compulsive thoughts were manifestations of unconscious conflicts. Freud hypothesized that external prohibitions toward specific actions such as touching, failed to abolish one’s desires to pursue those actions, as they resulted in repression. According to him, repressed feelings and thoughts persisting in an individual’s unconsciousness eventually re-surfaced manifesting themselves through peculiar behaviors. Building on advancements made by early scholars, contemporary scholars continue to use highly advanced technology; for example, Magnetic Resonance Imaging (MRI) scans to identify abnormalities in the brain structure that might predispose the development of OCD. Currently, researchers attribute the disorder to genetic and neurotransmitter abnormalities (Starcevic et al., 2011). Cause of the Illness The etiology of OCD remains unclear; however, different researchers allude to a variety of factors. Genes play a predominant role in predisposing the development of OCD whereby, studies indicate a genetic influence of 27-45% in adults, and 45-65% in children. In addition, the concordance in monozygotic twins is higher (80-87%) compared to concordance in dizygotic twins (47-50%). Genetic studies also link serotonergic, glutamatergic and dopaminergic genes to OCD. These researchers assert that impaired intracortical inhibition of particular orbitofrontal-subcortical circuitry fuel symptoms of OCD, as the orbitofrontal-subcortical structures play the role of mediating strong emotions and their subsequent automatic responses (Ota et al., 2013). Treatment via cingulotomy, which a neurosurgical intervention used to treat severe treatment-resistant OCD proves useful in interrupting orbitofrontal-subcortical circuitry; hence, relieve symptoms of OCD. Conversely, research done by Stanford University (School of Medicine), cite abnormalities with serotonin; a neurotransmitter that plays a role in regulating anxiety as a possible cause of OCD. Consequentially, serotonin reuptake inhibitors (SRIs) are used for the treatment of OCD. Other researchers postulate that OCD might result from acute Group A streptococcal diseases. According to them, these infections initiate a Central Nervous System (CNS) autoimmune response, which develop into neuropsychiatric symptoms. However, it is apparent that upbringing and parenting styles have little to no influence in predisposing the development of OCD. In addition, scholars rule out stress as one of the etiological factors, as it only exacerbates the condition. Treatment Common treatment for OCD entails the use of psychotherapeutic or pharmacological interventions. Behavioral and cognitive behavioral therapies are the most common forms of psychotherapy used to treat OCD. Techniques of systemic desensitization are applied during therapy. Systemic desensitization involves slowly but gradually exposing an individual to stimuli that causes anxiety. The therapist also teaches the client relaxation techniques, which include breathing skills aimed at helping the individual cope with anxiety. Saturation is another technique applied during therapy whereby, an individual continually thinks of an anxiety provoking thought over a number of hours or days. Over time, the thoughts become less anxiety provoking for the individual. Finally, thought stopping is another cognitive technique used, which entails a therapist teaching a client verbal and non-verbal techniques of averting compulsive behaviors (Adams et al. 2012). For example, an individual learns how to stop obsessive thoughts by identifying these thoughts and averting them by acting in a way that stops these thoughts. For example, by saying ‘Stop!’ Pharmacotherapy entails the administration of anxiolytics to people suffering from OCD aimed at reducing the symptoms of anxiety; therefore, foster better moods in the individual; for example, serotonin reuptake inhibitors (SRIs). Pharmacotherapy intervention is restricted to patients suffering from severe OCD. However, neurosurgical interventions such as cingulotomy might be recommended for patients suffering from treatment-resistant OCD. It is important to note that psychiatrists use medications concurrently with psychotherapeutic interventions. The latter helps clients maintain their recovery during the tapering off period. Some clients might suffer from withdrawal symptoms after the discontinuation of medication; hence, relapse into a worse state. Prevention There is no agreed upon strategy that will guarantee the prevention of OCD. However, based on findings from different etiological research on OCD, researchers outline possible prevention strategies. Firstly, researchers encourage individuals to seek early intervention at the onset of symptoms. Due to the stigma associated with the disorder, many people avoid seeking health care interventions. As a result, they end up seeking interventions when the symptoms worsen and become unbearable. This undermines the quality of psychotherapeutic treatment, as pharmacological intervention becomes the only viable intervention of managing the obsessions and compulsions. Sensitization of the public aimed at raising awareness about the disorder also helps to encourage people to seek early interventions. Entertainers portray characters suffering from OCD in movies and other genres of entertainment helping to raise awareness about the disorder (Fontenelle et al., 2005). Conversely, some researchers infer that nutrition plays a pivotal role in predisposing the development of OCD. Lakhan et al. (2008) hypothesize that nutritional deficiencies are to blame for causing mental illnesses such as OCD (Fontenelle et al., 2005). In generals, minerals and vitamins enhance mental functioning by providing brain structures with adequate nutrition. As a result, the release of hormones and neurotransmitters occurs without disruptions, which might impede optimal mental functioning. Cross Cultural Data from the International OCD foundation indicates that one in every 100 Americans suffers from OCD. This translates to 2 to 3 million adults in the USA suffering from OCD. Prevalence rates of OCD among men and women are equally distributed between both sexes. Onset of symptoms pertaining to the disorder manifests during childhood, and worsen over time if appropriate health care intervention is not sought early enough (Subramaniam et al., 2012). Research is still ongoing with regard to racial, cultural and ethnic differences in influencing the prevalence of the disorder. Current findings infer that racial diversity minimally influences the prevalence of OCD. However, research findings indicate that cultural differences play a role in influencing prevalence of OCD. Culture predetermines cognitive appraisals among individuals whereby, people from diverse cultural backgrounds handle anxiety in different ways. In addition, research findings also identify religion as one of the factors that influence the prevalence of OCD (Subramaniam et al., 2012). For example, prevalence is higher among individuals who ascribe to Judaism religion. Biblical Worldview The Bible views OCD as a form of anxiety disorder, which results in excessive worrying. The main source of anxiety is the state of incongruence created by disobedience and inadequate trust in God’s power to mitigate one’s problems. According to the Bible, finding peace and learning how to trust in God fully helps to alleviate worry and fear that trigger symptoms of OCD. Various Bible verses such as Matthew 6:34, 2 Timothy 1:7 and 1 Peter 5:7 among others address the issue of anxiety, and further issue directives on how to handle one’s anxiousness. The Bible lobbies for sanctification, which encompasses the acceptance of Jesus Christ as one’s personal savior. This is achievable through confessing one’s sins and accepting God’s forgiveness. As a result, the new convert learns how to depend on God and to commit all their problems to God; hence, avoid excessive worrying that might trigger anxiousness, and in turn OCD. The Bible advocates for individuals to stay clear of sinful acts, which might predispose the development of mental disorders such as OCD. Conclusion In conclusion, when OCD remains untreated, obsessions and compulsions may worsen resulting in the deterioration of a person’s general health. Symptoms of OCD include preoccupation with obsessive thoughts and the display of compulsive behaviors. The recurrent, persistent nature of obsessive thoughts intrudes on an individual’s functioning resulting in heightened distress. Obsessions are ego dystonic; meaning, they are ‘alien’ and not within an individual’s control. In a bid to suppress obsessive thoughts, the individual engages in actions or behaviors that will neutralize the obsessions. However, receiving early treatment helps in the mitigation of symptoms. References Adams, T. G., Reiman, B. C., Wetterneck, C. T., & Cisler, J. M. (2012). Obsessive Beliefs Predict Cognitive Behavior Therapy Outcome for Obsessive Compulsive Disorder. Cognitive Behavior Therapy, 41(3), 203-211. doi:10.1080/16506073.2011.621969 Fontenelle, L. F., Mendlowicz, M. V., & Versiani, M. (2005). Impulse control disorders in Patients with obsessive-compulsive disorder. Psychiatry & Clinical Neurosciences, 59(1), 30-37. doi:10.1111/j.1440-1819.2005.01328.x Ota, T., Lida, J., Sawada, M., Suehiro, Y., Yamamuro, K., Matsuura, H., &…Kishimoto, T. (2013). Reduced Prefrontal Hemodynamic Response in Pediatric Obsessive-Compulsive Disorder as Measured by Near-Infrared Spectroscopy. Child Psychiatry & Human Development, 44(2), 265-277. doi:10. 1007/s10578-012-0323-0 Starcevic, V., Berle, D., Brakoulias, V., Sammut, P., Moses, K., Miliceric, D., & Hannan, A. (2011). Functions of compulsions in obsessive-compulsive disorder. Australian & New Zealand Journal of Psychiatry, 45(6), 449-457. doi:10.3109/00048674.2011.567243 Subramaniam, M., Abdin, E., Vaingankar, J., & Chong, S. (2012). Obsessive-compulsive disorder: prevalence, correlates, help seeking and quality of life in a multiracial Asian population. Social Psychiatric Epidemology, 47(12), 2035-2043.doi:10.1007/s00127-012-0508-8 Read More