Obsessive-Compulsive Disorder Analysis

Obsessive-compulsive disorder, otherwise known as OCD is not just and adult disorder, but it also affects children and crosses racial, ethnic and cultural planes, that is the broad perspective. Obsessive-compulsive disorder is defined by two words, obsessive and compulsion. Obsessions according to Nolen-Hoeksema, 2014 are defined as thoughts, images, ideas, or urges (e.g., to harm oneself) that are persistent, that uncontrollably intrude on consciousness, and that usually cause significant anxiety or distress. Nolen-Hoeksema, 2014 also defines compulsion as repetitive behaviors or mental acts that an individual feels he or she must perform. This disorder qualifies as an anxiety disorder which meets criteria for its own classification in

the Diagnostic and Statistical Manual of Mental Disorder 5th edition, (DSM-V). Obsessive-compulsive disorder can be disabling to the person if left untreated. Many research studies have been done on OCD and researchers, counselors and therapists alike know that there are several areas of challenges for this group of people.
One major issue that faces people with OCD is the first part of the disorder itself, obsessive, or the act of being obsessive.

This obsession is not your everyday obsession, but it is the constant, uncontrollable, involuntary and the persistence of thoughts images, ideas, or urges that takes over and invade the privacy or one’s mind and sends that person into a state of anxiety and/or distress. A website called helpguide.org states that, obsessive thoughts may include but not limited to, “fear of being contaminated by germs, intrusive sexually explicit or violent thoughts and images, order and symmetry, and

superstitions”.
Another issue for people with OCD is the second part of this disorder which is compulsion. This type of compulsion is also not your run of the mill compulsion. As described by the authors, Melissa Conrad Stoppler, Md and Barbara K. Hecht, PhD, in the web article, Obsessive-Compulsive Disorder (OCD), More Common Than You Think, compulsion is a result of being obsessive over something and can include washing hands or object and checking behaviors (http://www.medicinenet.com/ocd). This type of compulsion is a progress stopper. It keeps a person in a state of repetition to the point that they cannot move from that space sometimes for several hours. It’s almost describes insanity, where they repeat these behaviors repetitiously, thinking it will change but to no avail. They cannot and will not move forward to the next part of their day, literally, until they can find the next area or object they can be obsessively compulsive with. For example, a person with this disorder may brush their teeth until they bleed because they see images of dirty teeth but they must keep doing it until their gums bleed because they may believe blood to be a cleansing agent.
A possible third issue is a disorder that can accompanies people who suffer from OCD, and that disorder is known as major depressive disorder (RDD). A study done by Hong, Samuels, Bienvenu, III, Cannistraro, Grados, Riddle, Liang, Cullen, Hoehn-Saric, and Nestadt, (2004) stated that with OCD, major depressive disorder is the most frequent partner. For the conclusion of this study researchers indicated that early onset diagnosis and severity of OCD are significantly related with the development of RDD, however, this report in comparison with past studies is inconsistent. This study showed significance in age at onset with and without RDD but previous studies did not. Finally, Hong et al. found that participants with early onset and more severe OCD are at greater risk of developing RDD. Ethnically, European Americans show a higher percentage of having OCD than African Americans and Hispanic Americans living in the United States. In addition, across cultures OCD does not seem to be change in several other countries from the United States to Canada and from Mexico to Egypt with other countries in between. Other descriptions can be seen across cultures where the most common type of OCD are thoughts and images that are associated with aggression, which includes thoughts of hurting someone else. For instance, a person may want to hurt their child, thoughts of sexuality, which would consist of recurrent pornographic images, and/or religion, which would include compulsions to shout obscenities in a house of worship (Nolen-Hoeksema, 2014). Another description and another common type of OCD are those that are driven by symmetry and ordering. Symmetry is where things or objects must be lined or aligned in an exact order or consist of uniformity. Contamination is a third type of OCD. With this one, in particular, comes the compulsion to clean excessively. The person will clean compulsively (parts of their house, hair, teeth or hands, etc.) for fear of being contaminated and overtaken by germs (Nolen-Hoeksem, 2014).
People with OCD are at risk for suffering from other issues or other disorders that may include but not limited to, stress, anxiety, social & generalized anxiety disorder (GAD), and depression (Nolen-Hoeksem, 2014). While there is no known specific cause for OCD, having other family members with the condition and an imbalance of the brain chemical serotonin are thought to increase the likelihood of OCD occurring (http://www.medicinenet.com/obsessive_compulsive_disorder_ocd/article.htm. Research suggest that OCD may be biological. The text written by Nolen-Hoeksem, 2014, states that a circuit in the brain involved in motor behavior, cognition, and emotion may be the culprit. The book also states that this circuit is located in specific areas of the frontal cortex to areas of the basal ganglia (striatum). It shows that people with OCD and have a malfunction with this circuit and causes their brain not to turn off the “primitive urges”, (Nolen-Hoeksem, 2014). Another cause, although rare, is strep infection in children. This is an autoimmune infection that affects the basal ganglia too. A third cause is a person’s genes. Obsessive-compulsive disorder and other anxiety related disorders have found that genetics is a viable part on OCD behaviors. Studies of family history and twin studies show a positive relationship between genes and OCD, according to Nolen-Hoeksem, 2014.
There is a substantial difference between the onset of OCD in women and children. Obsessive-compulsive disorder usually begins in children as young as six years of age, but can range from 6 to 15 years old. Women fall between the ages of 20 to 29 years of age. The other difference between children and women with OCD, children will hide their symptoms which means their OCD goes unnoticed for years, even into adulthood. Obsessive-compulsive disorder is more of a male dominated disease and the onset of males is relatively close to that of the female onset of the disease.
People with both OCD and HD can receive biological and cognitive-behavioral treatments.

Biological treatments consist of the use of antidepressant. Per Nolen-Hoeksem, 2014, antidepressants drugs were found to have affecting levels of serotonin which helps relieve symptoms of OCD. The first drug was called Clomipramine then came the selective serotonin reuptake inhibitors (SSRI’s), which included Prozac, Paxil, Zoloft, and Luvox. These have been proven effective, up to 80 percent in patients with OCD, to decrease a person’s obsessive and compulsive behaviors. There are 30 to 40 percent of people with OCD that stop taking the medication, and may relapse. Along with relapse there are side effects of these types of medications which include drowsiness, constipation, and loss of sexual interest (Nolen-Hoeksem, 2014). Cognitive-behavioral treatments are therapies which include a clinician/therapist. For OCD and other compulsive behaviors, it is believed that the use of exposure and response prevention can help a person recover completely. This type of therapy, per Nolemn-Hoeksem, 2014, exposes the client to the focus of the obsession and prevents compulsive responses to the resulting anxiety. This type of therapy also challenges the client’s moral thoughts and excessive sense of responsibility. Cognitive-behavioral therapy has a higher rate of success than the medication. There is a 60 to 90 percent improvement rate in both the obsession and compulsive

behavior.
Obsessive-compulsion disorder can have great outcome for patients who seek out therapy and commit to the process. Although, everyone is different and will respond differently to medications and or therapy, the prognosis can still be very positive. The key to a successful and positive prognosis is to get the proper diagnosis as soon as possible and then receive the proper treatment and plan. One patient may respond well to only medication, another may respond better with only cognitive-behavioral therapy, and another patient may need both types of treatments. These solutions are contingent upon the person, how severe their disorder is, and which is the best course of action (as far as the type of therapy) for them. The prognosis for OCD may also have so negative outcomes. As previously stated, we know according to Nolen-Hoeksem, 2014, that although both types of treatments work, both treatments have a relapse rate. This still leaves patients with a positive prognosis because the relapse rates are less than 50 percent.