Posted at 10.30.2018
Obsessive-compulsive disorder (OCD), can be an panic that traps people in limitless cycles of repetitive thoughts and actions. A person with OCD is plagued with continuing and distressing thoughts and fears that they spend time distressing over (obsessions) that they cannot control. The stress and anxiety created from these thoughts lead to urgent need to execute rituals on a continuous basis (compulsions). The compulsive rituals are performed hoping to try of stopping the obsessive thoughts and make sure they are disappear completely. The ritual might make the anxiety disappear completely for a time, the person then must perform the ritual again when the obsessive thoughts go back. Sometimes this pattern can take time in a person's day that will interfere with "normal" daily activities. A person frequently know their obsessions and compulsions are unrealistic, they can not stop from doing them (Webmd, n. d, . ).
The reason for this job is to provide a extensive five part task on obsessive-compulsive disorder. Part I explaining the disorder, how it became a internal disorder. OCD is labeled as an panic in the DSM-IV and the ways it has been researched. Part II Neurotransmitters that are linked to OCD; then your medications that are approved to a person with OCD. Will give information about how genetics donate to OCD and the area of the brain that is afflicted. Part III the little known environmental affects that triggers a person to be appropriate for OCD. Genetics play more to the disorder than the environment. Part IV Explain the best treatment and most effective treatment in helping a person triumph over OCD. Then will show a treatment arrange for Maria. Part V will explain the best emotional model that best applies in dealing with OCD and the new treatments that are developed and exactly how Maria can have a effective life without obsessive-compulsive disorder.
Maria who's a 38 season old woman, who lives in Pittsburgh, married and has four children. She was raised in a rigorous catholic family and is still specialized in her believes. Maria sometimes doubts if she is dedicated enough and over whether she is accomplishing the rituals perfectly where she started doing rituals that occupies hours and hours of her day. Wit with anxiety she become more obsessed with keeping clean and holly where she became more extreme in cleansing and cleaning, so she will feel clean and 100 % pure. Maria personal habits throughout her life include:, keeping her house clean, tidy, and clear of clutter, brushing her teeth three or times every day, and clean her hands 6 to 8 times each day, until two years ago she became more obsessed with cleanliness and spiritual rituals where she put in six to eight hours cleansing her hands, and cleaning her house that has already been cleaned Her romantic relationship with her man and children are alienated, she refuses to permit them to touch or hug her and insists they clean their hands all the time.
The DSM-IV code for Obsessive-Compulsive Disorder is 300. 03. OCD is considered as an anxiety disorder. The diagnostic criteria are either obsessions or compulsions. Obsessions are continuing and consistent thoughts, impulses, or images that are intrusive that are not only "excessive" worries. A person with OCD tries or attempts to restrain or not pay attention to these thoughts and recognizes that it is only in their brain. Compulsions on the other palm are repetitive conducts. Obsessions and repetition are intended for a person with OCD to prevent or reduce their stress or a frightful situation or event. The individual recognizes their obsessions or compulsions are abnormal and unnecessary and unreasonable. These manners take up someone's time and interfere with a person's daily normal functions (APA, 2002).
Obsessive thoughts can include:
* Persistent fear of harming others or self applied.
* Concern with being contaminated with germs that is unreasonable
* Intrusive faith based, violent or erotic thoughts.
* Need to things perfect which is excessive in doing so.
* Checking gates, stoves, water faucets, and lamps.
* Making lists over and over again.
* Rearranging or realigning things.
* Collecting or hoarding items that are unproductive, such as, outdated newspaper, cheap utensils, or food.
* Doing actions a certain amount of time.
* Rereading or rewriting unnecessarily
* Repeating phrases
* Excessive washing that takes up hours of each day.
(List taken from Rais, 2008 article titles Obsessive Compulsive Disorder).
The things Maria have that are considered typical signs or symptoms of OCD were spending six to eight time cleaning her hands so she would feel clean, undertaking spiritual rituals that occupied time of her day, cleaning an already clean house all night every day, and avoiding pressing her husband and children (case study 1, Kaplan school). Understanding the symptoms and history of OCD is important in determining why Maria got OCD to be able to help her. First we will look at the natural reasons then the environmental reasons that could contribute to someone having obsessive-compulsive disorder.
There are several natural areas of OCD. You can find neurotransmitters that are linked to it, genetic contributors to this disorder, and different brain abnormalities that impact this disorder. Neurotransmitters transmit chemical substance impulses from neurons to neurons. Each neurotransmitter has various functions and different names (Durand, & Barlow, 2007). Serotonin is of the neurotransmitters that impact our action. Serotonin is a substance that requires one messages from one neuron to another (Dryden-Edwards, 2005). When serotonin are too low a person does things they normally wouldn't normally do and have a tendency to overreact doing impulsive actions. A person with low levels of serotonin tend to be quick to do unusual manners. Serotonin is not found to cause the condition (Durand, & Barlow, 2007). The mind appears normal in a person who has OCD. It's been found in the brain of any person with OCD, that there is more activity in the frontal lobe of the cerebral cortex, there are increased activity in other areas of the frontal area and the thalamus. A person with OCD is known as to have a "faulty brain circuit, " due to low degrees of serotonin (Durand, & Barlow, 2007). When the cerebral cortex are under active a person has a hard time managing their OCD behaviours and actions (Dryden-Edwards, 2005).
There is a twin study on monozygotic twins to find if genetic and environment possessed an impact on OCD. Data was collected on the family structure, health of the family, lifestyle of the family, if there have been any issues at the newborns birth, happenings that took place in their life, and other environment factors in their life. The results were more twins (both of them) acquired OCD behaviors later in life if they had parents that were anxious and depressed. This article concludes that genetics played a far more role in OCD then the environment. The writer advised that more studies would have to be conducted to determine the exact mother nature between Genetics and the surroundings factors of OCD (Cath, Truck Grootheest, Sillemsen, Van Oppen, & Boomsma, 2008).
Dr. Wayne Kennedy, a Neurogeneticist, said "a role in a person developing OCD if they have a relative that is damaged with this disorder. " In his article he said that the DNA (5HT1 D Beta) receptor gene is passed with their offspring (Mundo, Richter, Zar, Sam, McBride, Macciardi, & Kennedy, 2002). Durand, & Barlow state that genes are likely involved in certain abnormalities, the environmental causes need to be triggered to be able to activate a disorder such as OCD (2007). After getting an understanding the research that has been done on the natural facet of OCD, Researchers investigated and noticed a strong relationship that genetics play a big role in a person growing OCD, but no factual facts. Researchers have looked into and determine that an environmental factor affects a person having OCD. we can change from what environment performs on someone have this disorder.
In the fourth century OCD was considered to be "melancholia" which really is a Greek word which means dark bile, if a person's OCD behaviors lasted quite a while. In Great britain in the seventeenth century, religious melancholy was founded within an OCD disorder and produced from "overzealous devotion to God" (Allison, 2008). In 1907 Freud explained OCD resembled religious rituals. Rituals are done again and again to get rid of guilt. Religion was the widespread "obsessional neurosis" (Yossifova, & Loewenthal, 1999. p. 145). Freud also thought that obsessive-compulsive manners are caused by issues unconsciously in your brain that manifested in OCD condition. A person struggles between your desire and the activities of their conscious and their unconscious mind. They are really urge to complete the actions with their unconscious brain, to get momentary rest from their high intense anxiety. Their conscious mind recognizes it is ridiculous and bizarre it is to continue to do these actions (Allison, 2008). In Maria's head she experienced she wasn't spiritual enough, where you might get relief from her anxiety she would devote more time when compared to a "normal" religious person would to perform religious rituals time each day.
In Maria's circumstance she grew-up as a rigorous Catholic, which she prolonged through her life. She concerned that she didn't measure to the objectives to be considered clean or holy. This could have been the reason why she had great levels of guilt that triggered her to do her spiritual obsessions and cleaning compulsions. Durand and Barlow (2007) declare that in every subconscious disorder, both genetics and environment need to be considered. Both are had a need to activate OCD. Research supports that genetics play a significant role in OCD, but need more research on environmentally friendly factors to aid Durand and Barlow theory.
The diathesis -stress model is the best way to make clear that situations in the surroundings along with the biological system will affect OCD behaviors. You can find conducts that are inherited which one is vulnerable to, that can be turned on under stress or an environmental situation (Durand, & Barlow, 2007). As mentioned before, Maria was predisposed to OCD and it was turned on from the surroundings by the petunias at the funeral. After the genetic and environment influences are grasped they can determine the best treatment
In Maria's case her mom exhibited strong OCD tendencies with the her many superstitions (genes). Finding petunias at a funeral (environment) activated the beginning of Maria's obsessive compulsive actions. Maria acquired a hereditary vulnerability for OCD; the environment was one factor in the onset of her illness.
Environment factors that came from a horrible divorce or from traumatic events of erotic mistreatment (Grisham, Anderson, & Sachdev, 2008). Spiritual factors play an enormous environmental effect that is correlated as a risk factor of experiencing OCD (Higgins, 1992). Experts found more regularly the sources of this disorder, is spiritual factors, the explanation for this is a person feel they lack in their faith and feared they haven't prayed enough or hard enough; their habits were sinful; or got contaminated from thought which were impure and sinful. Guilt thrives from these thoughts where they pray over and over again, repeatedly confessing to purge the fear that they are "Doomed to hell" (Higgins, 1992). Maria was apprehensive about her dedication and this she didn't measure up to her spiritual expectations to be considered 100 % pure and holy. This may have affect her to obtain so much guilt which in turn brought on her to do have spiritual obsessions.
February 19, 2009, the meals and Drug Administration (FDA) approved profound brain excitement (DBS) therapy for those who suffer with OCD and other treatments have failed. To qualify for this procedure one has to have had at least three SRIs which may have failed. This product has been an on going study in four Catholic Universities since 1998 (Bates, 2009).
The DBS is surgically implanted in the brain. It delivers electrical power impulses to different regions of the fiber pack in the front of the mind. It is designed by way of a clinician and it is based on an individuals needs (Bates, 2009). This product is not exempt from side effects, One which has been know is cerebral hemorrhage and brain microbe infections, non life threaten have have you been reported. Studies experienced shown that this device has made great improvement in people's life and some has even came back back to work (De Noon, 2009).
A research that was conducted were quasi-experiments designs, which is where researchers manipulate the impartial adjustable (the variable they manipulate) while measuring the dependent adjustable (what is being measured) Durand, Barlow, 2007). They witnessed the relationship between the various medications which were used to treat OCD to see if OCD habit advanced and which psychologically treatment made the most improvement. For example, in this article "Brain Changes Quickly Following Intensive Behavioral Therapy for OCD", the writer concludes there is a strong correlation between your increased brain activity and improvement in OCD symptoms (Douglas, 2008).
Therapy and medications are helpful to help people who have obsessive compulsive disorders. One known therapy that works for OCD is behavioral exposure. This functions by having the person face items, situations, places, and thoughts that the individual doubts and avoids. A person must be exposed repeatedly to the "fearful things" for it to work. Rituals are avoided by not allowing the person to execute their compulsions (Dell' Osso, Altamura, Mundo, Marazziti, Hollander, 2007).
Medications that seem to benefit OCD people are antidepressants, the ones that are serotonin reuptake inhibitors (SRIs). The six that are generally used are fluvoxamine (Luvox), fluoxetine (Prozac), sertraline (Zoloft), paroxetine (paxil), citalopram (celexa), and clomipramine (anafranil). Studies that have been conducted concluded that Anafranil has been the most readily useful in treating OCD. Serotonin reuptake inhibitors work by slowing the reuptake of serotonin and postponing how it is influences the synapse. This serotonin increase produces changes in the receptors in nerve membranes (Korn, 2001). With each one of these medications come possible area results, which do not cause any everlasting damage. The most common side influences are sleepiness, dried out mouth, and nausea. Anafranil has a few harsher aspect effects such as, heart and soul rushing, difficulty in concentrating, slower thinking capacity, and weight gain. Anafranil (Korn, 2001).
In peer examined article, "Cognitive action remedy and medications in the treating obsessive compulsive disorder, " the researcher's examined to determine what treatment would best help a person suffering from this disorder. Within their research they wished to determine whether cognitive behavior therapy (CBT) will be the best remedy, or Cognitive patterns remedy and medication, or just medication, or just a sugar tablet known as a placebo. They concluded that CBT plus medication experienced the greatest outcomes. It was interesting the analysis showed no visible difference among those that took medication and the ones that got placebo, but when the individual added remedy with the medication they made major improvement. Medications that seemed to work the best were those that are serotonin reuptake inhibitors (SRI), Serotonin reuptake inhibitors revealed more improvement in their moods to where they could finally focus on their OCD behaviours. Combining CBT and medication has been known to be effective in treating OCD (O'Connor, Aardema, Robillard, Pelissier, & Todorov, 2006). Another remedy that may be beneficial and make significant changes in their brain activity after four weeks is an extensive cognitive behavior remedy program. The program consisted of a 90-minute individual therapy session, and four time of research five days weekly. The PET scans revealed changes in normalized regional sugar metabolism and bilateral decreases in normalized thalamic metabolism. YOUR PET scores also showed a rise in a person's right dorsal anterior anterior cingulated cortex activity along with improvement in their OCD symptoms (Douglas, 2008).
Durand & Barlow (2006) stated that the most typical psychosocial treatment that is employed to take care of a person with OCD is coverage and ritual elimination (ERP). That's where a person is exposed to a threaten situations they dread or think are invasive. For instance, if a person has a fear that their hands being polluted, the therapist will encourage the client touch the object they fear and trip it through to the end without cleaning their hands, such as door knobs (Durand, & Barlow 2007).
When it comes to insurance firms or other third party reimbursement such as Medicaid fast result are essential. They expect therapists to provide written paperwork to justify the procedure and expected length of the client's treatment (Hill, & Beamish, 2007).
Maria treatment plan would consist of cognitive behavior therapy (CBT), medication and family guidance. I think Maria will require spiritual counseling, first because of her religious Catholic backdrop that has put a great deal on her behalf; she does not feel she can surpass those goals where she spends many hours a day executing rituals in order to feel clean and genuine. I would start by having her speak to her priest to get an understanding that she actually is clean, God allows her, and she does not have to pray time a day in order to feel accepted and considered clean. I feel spiritual counseling is necessary first because if she can feel accepted by God she can get started working on the other OCD manners. It would be supportive for Maria to begin on some medication to help decrease her nervousness when she begins cognitive behavior therapy.
A arrange for therapy would be then to get started with cognitive therapy to change Maria's old thinking patterns concerning worries of contamination, plus to find various ways to take care of stress and change her powerful fears (Owens, 2009). The counselor could have Maria touch thing that she anxieties are contaminated rather than be allowed to wash her side afterwards. She will need to find ways to handle her anxiety and stress when she's to reframe from cleansing her hands. Maria would be put on an idea that only lets her clean her tooth a few time's day and limited to just how many times she can clean and straighten her house, eventually she would have to omit a day in cleaning her house. Maria need realize nothing at all bad will happen if she does not have a clean house. Maria will also be restricted to the full total of spiritual rituals she could do. It might be important to be involved in her trust, but must limit the amount enough time on religious rituals such as praying. The target is always to change the full total number of time she spends in praying right down to five minutes only two times every day.
Family remedy would be, not to allow Maria to put huge demands on her children and spouse to remain clean by not presenting into her by firmly taking a shower when they come home and not washing their hands every time she needs. Maria's family will hold the opportunity to exhibit that they feel and question her love because she will not touch or get near them so she comprehends how her disorder impacts them. It might be good to have a doctor explain OCD to her family. I'd give Maria assignments each week to help Maria get started to be comfortable touching and hugging her children and husband. How this will be done is after leaning relaxation techniques she'll be told to do the weekly assignments in a tranquil express. On week one she'll touch each family member on the shoulder and if it is fearful to do deep breathing techniques, then on weeks to come get her to comfortable hug her children without the need to showering. By heading to family remedy will help change the dynamics in Maria's family.
In conclusion, there has been research done that suggest that genetics is the key factor in producing OCD. More research must be conducted on the environmental reasons a person has obsessive compulsive disorder to preserve that the mixture of hereditary and environmental factors a person conclude having psychological disorders. Through agreeing to the natural and environmental factors of the disorder, specialists can comprehend the reason why of Obsessive Compulsive Disorder to raised provide better healing treatment so that it might be reduced in the foreseeable future. I fully think that Maria can change through hard work if she has religious and family counseling along with cognitive behavioral therapy and medication to get over her compulsive habits that have used many years of her life and rejoin her family in a healthy romance. After, learning what studies consider the best treatment are and discussion a treatment plan I believe will help Maria, we will discover the different therapeutic ideas and new medication that are being devised. I will determine the ultimate outcome of Maria's disorder through the use of these techniques.
To determine which mental model that would best help a person with obsessive compulsive disorder it is important to understand the essential concept of each.
Psychoanalysis is a verbal remedy to help a person receive freedom from their mental pain. This model allows the view of Freud's that the unconscious motives are manufactured from some sexual motive (Fine, 2007).
Cognitive model suggested our thoughts influences patterns. This remedy was pioneered by Albert Ellis in 1950 and workes to get visitors to change their attitudes. This therapy is known as talk remedy and targets thoughts and emotions that lead to behaviors (Schonbeck, 2005).
Psychodynamics model uses expressive or supportive solutions to treat a problem. Expressive attempts to relieve symptoms through understanding their thought and feelings that possible they might not be familiar with. Expressive is that adults problems are created in childhood where they don't really have the maturity at that point to make appropriate selections because the way they coped with their problems as a child halted working as a grown-up. This therapy demonstrates to the person to learn new ways to resolve problems to relieve stress and cope in more appropriate ways (Fine, 2007).
Behavior remedy model handles changing and reducing behaviors that are frustrating. This remedy was pioneered by Joseph Wolpe which includes assertiveness training, operant fitness, and desensitization (Schonbeck, 2005) Wolpe reported great success with the stigmatic desensitization for people that have phobias (Durand, & Barlow, 2001).
Humanistic Psychology emphasizes a person to regulate their mental health. It shows that environment factors impact a person's behaviours. It eliminates the stigma that individuals think "therapy" is and allows the given individual to determine their own care and attention on mental health (Wagner, 2009), it is just a person-centered therapy, where in fact the therapist is passive in the customers care and attempts to avoid interpretations (Durand & Barlow, 2001).
I would choose a combo of the cognitive and behavioral models in order to take care of OCD. The rationale for this is research shows cognitive behavioral therapy (CBT) to be the very best method to the treatment of this disorder. The cognitive model works on the idea procedures, and the behavioral model works in changing undesirable manners (Schonbeck, 2005).
The latest medication that is approved for OCD is Luvox CR in January 2007. Luvox CR can be an prolonged release from of Luvox SSRI. People are paying more attention to this method of having more beneficial results (Jeffery, 2008).
Now we know and understand the various treatments and medication in assisting a person with OCD, I really believe there is a strong possibility that Maria can beat her OCD behaviors that she's. If Maria desires it and puts her whole heart into her treatment solution, she can have a smart gratifying future. Once one is able to get their OCD under control and is able to cope with the surroundings affects (stressors) in their life they may or might not exactly need to continue medication. A person can be free from the issues of OCD and live a "normal" life. Maria can have this; it will be hard work but worth the purchase price she's to pay to be free from this disorder that has presented her hostage for so many years.