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KNOCK KNOCK! What is Obsessive Compulsive Disorder?

KNOCK KNOCK! What is Obsessive Compulsive Disorder?

Tor more, He leaves his house and needs to return and check several times if he left the gas keys closed to avoid causing an accident.

ORlivia, he washes his hands 3 or 4 times, every time he arrives from the street because he assumes he can contaminate or contaminate his family.

CIf you need them, you need to count the steps from your home to your office and think that if you don't count one thousand two hundred and fifty-one steps, something bad can happen to him and his parents.

TAdeo, inspect your home before leaving and arriving at it. Nothing can be out of your control. It assumes that if you find something misaligned, dirty or out of place it could be materially the end of the world.

ORsea, he is a very sociable person but he is often tormented to think that he wants to give a blow to his interlocutors while they are talking. They are simply thoughts that come and control your mind and this makes you feel guilty and annoying. He knows he would never harm someone, but this makes him feel very uneasy.

CArolina is a very religious woman, but she often restrains herself when she is in church because she would like to shout obscenities and blasphemies. In the same way he is tormented by the fact of having sexual thoughts that he considers immoral and forbidden.

What do all these characters have in common? They have symptoms of what in Psychology is known as: Tcreep ORbasic Compulsive (TOC).

Content

  • 1. Background
  • 2 What are obsessions and compulsions?
  • 3 Different approaches in the explanation of Obsessive Compulsive Disorder
  • 4 Psychiatric Comorbidity
  • 5 Psychological Approach
  • 6 Diagnostic Criteria, according to the manual: DSM V
  • 7 Treatment

Background

Anxiety - chronic fear that it maintains in the absence of a direct threat - is a habitual psychological correlate of stress. Anxiety is adaptive if it motivates effective coping behaviors; However, when it becomes so severe that it disrupts normal functioning, it is known as anxiety disorder. The five main anxiety disorders are: Generalized Anxiety Disorder, Phobic Anxiety Disorders, Panic Disorders, Post-Traumatic Stress Disorder and Obsessive Compulsive Disorder (Pinel, 2007, p. 512).

It was once thought to be a rare disorder, today it is known to affect between 2% and 3% of the population. The main features are recurring obsessions (persistence of intrusive thoughts, images or impulses that cause anxiety that patients recognize as sensory) and compulsions (repetitive behaviors or rituals that are performed in response to obsessions in an effort to neutralize anxiety, such as excessive: check, wash, count or touch, among others) (Cullari, 1998).

Definition

The Tcreep ORbasic Compulsive, is an anxiety disorder, characterized by recurring obsessions and compulsions what they consume too much time or cause significant discomfort or deterioration (Halgin & Krauss, 2004, p. 603).

For the APA dictionary (2010), obsessive compulsive disorder defines it as: an anxiety disorder characterized by obsessions, recurrent compulsions or both that consume time (more than an hour a day), they generate significant anguish or infer in the functioning of the individual. Obsessions and compulsions are recognized as excessive or unreasonable (APA, 2010, p. 548).

As you can see both definitions share two significant symptoms obsessions and compulsions, in addition to the time that bursts into the brain of those who suffer from them. These elements can occur in intelligent and cultured people, but also in sick subjects.

What are obsessions and compulsions?

  • Obsession, is a persistent thought, idea, image or impulse that is experienced as annoying and inappropriate and that generates a marked anxiety, anguish or discomfort. Among the most common obsessions have persistently thought about pollution, the need to have things in a certain order (symmetry) or sequence, persistent doubts, aggressive or horrific impulses and sexual images. Obsessions are distinguished from excessive worries for everyday incidents in which they are not related to real problems. The response to an obsession is usually an effort to ignore or suppress thought or impulse or neutralize it by compulsion (APA, 2010). Thus, obsessions intrusive, involuntary, absurd, parasitic and recurring acts that generate anxiety and anxiety.
    • Different types of obsessions can be distinguished, namely:
      • Aggressive (fear of harming oneself or others, fear of saying obscenities, fear of causing a great local or world disaster),
      • By contamination (nuisance from sticky waste, concern about contamination or contamination of others due to waste or body secretions or dirt of various categories),
      • Sexual, (prohibitive, perverse, offensive and aggressive thoughts, without really denoting the intention of carrying them out),
      • Accumulators, (they may be related to the accumulation of money or unimportant things, such as objects discarded by others in the garbage or on the street, but that for the accumulator may have a meaning of giving them productive use later),
      • Religious, (related to good and evil, blasphemy, sin or sacrilege),
      • Related to the need for symmetry or accuracy (the symmetric or the spurious calculator, needs to put order to various objects in the house or wherever possible in order not to cause a mess in the outside world),
      • Cleaning related, (wash your hands or body in an excessive and ritualized way),
      • Verification related, (check the closing of doors, stove knobs, turning off the light or any other device or device),
      • Others are related to the need to: touch, hit, count, rub, read or write and many more).
    • Compulsion, type of behavior (e.g., hand washing or review) or a mental act (e.g., tell pray) in which the individual is involved to reduce anxiety or distress. Usually the individual feels driven or forced to perform the compulsion to reduce the anxiety associated with a OBSESSION or to prevent a feared event or situation. Compulsions can also take the form of rigid or stereotyped acts based on idiosyncratic rules that do not have a rational basis (eg, having to perform a task in a certain way. Compulsions do not provide pleasure or gratification and are disproportionate or irrelevant to the feared situation that they must neutralize (APA, 2010). Thus, compulsions such as: counting, praying, checking, ordering, cleaning, remembering meaningless things, drawing letters with the tongue on the palate, crossing oneself, not stepping on the floor lines, repeating sentences, accumulating, having religious or sexual thoughts inappropriate, they are activated in order to neutralize, reduce or reduce the disturbances created by obsessions.

In this way we can distinguish different types of compulsive obsessives where obsessions are accompanied by compulsions just to neutralize the obsession or at least intern reduce it:

OBSESSIONSCOMPULSIONS
ComputersOriented to achieve symmetry, organization, reorganization by size, shape and color.
Cleaners / WashersThey will seek not to stain, not store, dust, wear gloves, have everything with a hospital cleaning.
CheckersThey will check the appliances, devices or locks in your home or work.
Perfectionists / Self-criticsNothing will be fine, but they do it themselves and as the name implies, they are their main critics and especially the most destructive of themselves. Analyze, analyze and analyze and become paralyzed, not performing their activities.
RepeatersThey will repeat phrases of all kinds (ecolalia), simple or complex, positive or negative.
AccountantsAs the name implies, lovers of figures and counting productive and non-productive things.
RitualizersThey will not be able to do their routine activities, if they are not mediated by a series of simple or complex rituals, which may be aggravated and becoming increasingly sophisticated and paralyzing and disabling.
Sexual / ReligiousThey will have prohibitive, blasphemous and sinful thoughts.
Collectors or accumulatorsThey can collect all kinds of generally unusable items.

Different approaches in the explanation of Obsessive Compulsive Disorder

There are different approaches to explain OCD, and all of them obey different approaches or that present a certain degree of disorganization in their systems, but that meet in the presence of the disorder. Therefore, I present different ways of explanation in order to have a self-organized criticality approach (different disorganized systems that meet in a single event, in this case the person suffering from the disorder), namely:

The Cognitive Neuroscience of OCD

Alterations in the prefrontal cortex produce a wide range of symptoms. The frontal lobe is widely connected with the rest of the brain, so damage to the rest of the brain will alter the prefrontal cortex and vice versa. This produces prefrontal syndromes and are quite common among the disorders: neurological, psychiatric and neurodevelopmental.

Therefore, dysfunctions known as "frontal syndromes" do not always imply a direct lesion in the frontal lobe. On the contrary, they can be produced by remote effect of lesions in distant regions. Either morphological or biochemical alterations, which connect the frontal lobe with other structures such as the basal ganglia or the brain stem. Many of the symptoms associated with different frontal syndromes are also observed in psychiatric disorders, such as: attention deficit hyperactivity disorder, schizophrenia and severe depression (Redolar, 2015, p. 735). It is also the case of Obsessive Compulsive Disorder which presents as much mental rigidity and constancy in their thoughts and actions.

Genetic biological approach

Some authors (Jonnal, 2000; Pato, 2001) consider it a genetic disorder, which reflects abnormalities in the basal ganglia, which are subcortical areas of the brain involved in the control of motor movements. In these cases, systems involving glutamate, dopamine, serotonin and acetylcholine may be involved, affecting the functioning of the prefrontal cortex. They also have high levels of activity in the brain centers of motor control of the basal ganglia and frontal lobes. These brain structures have hyperactivity as if they were working overtime all the time.

Abnormal serotonin levels are also associated with a wide spectrum of disorders such as, in addition to OCD: somatization, hypochondria, eating disorders, gambling, borderline personality disorder and disorders that include uncontrollable impulses such as tearing off the hair (trichotillomania), scratching the face or compulsive shopping disorder.

Psychiatric Comorbidity

Due to the similarity of some behaviors, such as the uncontrolled impulse to shout obscenities in inappropriate places, it has also been associated with the presence of Tourette Syndrome.

Gilles de la Tourette Syndrome (Tourette Syndrome or ST) is a neurological disorder that manifests first in childhood or adolescence, before the age of 18. Tourette's syndrome is characterized by many motor and phonic tics that last for more than a year. Usually, the first symptoms are involuntary movements (tics) of the face, arms, limbs or trunk. These tics are frequent, repetitive and fast. The first most common symptom is a facial tic (blinking, contraction of the nose, grimaces). Other tics of the neck, trunk and limbs may be added. Also, there are vocal tics. These vocal tics (vocalizations) generally occur along with the movements. Vocalisations can include grunts, throat clearing, screaming and barking. They can also be expressed as coprolalia (the involuntary use of obscene words or inappropriate words and phrases in the social context) or copropraxia (obscene gestures) (Tourette Association of America, 2019).

Psychological Approach

They will depend on the psychological approach where they come from.

  • Behavioral approach, considers the current behavior as a product of particular features of the previous behavior (stimulus-organism-response). It is claimed that OCD symptoms are established from a conditioning process, in which their behaviors are associated with momentary relief of anxiety.
  • The cognitive behavioral approach, he associates them with thought patterns related to cognitive distortions of reality, which contribute to the development and maintenance of symptoms. They are established through cognitive distortions (Obsession: ideas of being contaminated) and anxiety is relieved with other cognitive distortions (Compulsion: repeatedly washing hands).
  • The cognitive approach does not have a unique paradigm. Structures are analyzed (specific brain areas), processes (all information exchange and processing at the molecular level; that is, all chemical messengers and electrical activity at the brain and body level) and products (the behavior itself). Only one example of the memory analysis is mentioned for reasons of space where different types of short and long term memories are associated with behaviors, thoughts and emotions and to neutralize those obsessive thoughts, other behavioral, iconic, semantic or sequential memories are presented. compulsions to neutralize the former.

Diagnostic Criteria, according to the manual: DSM V

The diagnostic criteria are presented below, in summary form:

Obsessions are defined according to the following two aspects:

  • Thoughts, impulses or mental images that are constantly repeated. These thoughts, impulses or mental images are unwanted and cause a lot of anxiety or stress.
  • The person who has these thoughts, impulses or mental images tries to ignore them or make them disappear.

Compulsions are defined according to the following two aspects:

  • Behaviors (for example, washing your hands, placing things in a specific order or checking something over and over again like when you constantly check if a door is closed) or thoughts (for example, pray, count numbers or repeat words silently) that are repeated over and over again or according to certain rules that must be strictly followed so that the obsession disappears.
  • The person feels that the purpose of these behaviors or thoughts is to prevent or reduce distress, or avoid a feared situation or event. However, these behaviors or thoughts have no relation to reality or are clearly exaggerated.

In addition, the following conditions must be met:

  • Obsessions or compulsions consume a lot of time (more than an hour per day), or cause intense distress or significantly interfere with the person's daily activities.
  • The symptoms are not due to the use of medications or other drugs or another condition.
  • If the person suffers from another disorder at the same time, obsessions or compulsions cannot be related only to the symptoms of the additional disorder. For example, to receive the diagnosis of OCD, a person suffering from an eating disorder must also have obsessions or compulsions that are not related alone with food

Treatment

Generally a combined model is used that integrates:…

  • Cognitive behavioral psychotherapy, where it is about neutralizing the affections and emotions of patients with new associations that free them from their anxiety states.
  • The low frequency pulsed electromagnetic field technology, which balances the electrical charges of the body at the cellular level and allows a self-balancing, relaxation and self-healing process at the molecular level.
  • The use of antidepressants, anxiolytics, antidepressants and some serotonin reuptake inhibitor medications.

Bibliography

American Psychiatric Association Diagnostic and statistical manual of mental disorders, fifth edition: DSM-5. Washington, DC: 2013.

APA (2010) Concise Dictionary of Psychology, Mexico: Editorial Manual Moderno.

Cullari S. (1998) Foundations of Clinical Psychology, United States of America, Edited by Salvatore Cullari.

Halgin R. & Krauss S. (2004) Psychology of the abnormality, Mexico, McGraw Hill Editorial.

Jonnal A. H., Gardner C.O. Presscott C. A. & Kendler, K.S. (2000) Obsessive and compulsive symptoms in a general population sample of female twins. American Journal of Medical Genetics, 96, 791-796.

Pinel J. (2007) Biopsychology, Madrid Spain, Pearson Editorial.

Redolar D. (2015) Cognitive Neuroscience, Madrid, Editorial Panamericana Médica.

Pato M. T., Schindler K. M. & Pato C. N. (2001) The genetics of obsessive-compulsive disorder, Current Psychiatry Reports, 3, 163-168.

Tourette Association of America (2019) What is Tourette syndrome? accessed on September 7, 2019, online: //tourette.org/about-tourette/overview/espanol/medicos/que-es-el-sindrome-de-tourette/

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