Clinical Characteristics & Biological Explanations of OCD
1a. Outline the clinical characteristics of OCD. [4]
The DSM-4 states that for one to be diagnosed with OCD, one must have either obsessions, compulsions or both. To be diagnosed with having obsessions, the patient must have recurring, persistent intrusive thoughts that cause marked distress or anxiety, and must have insight into the fact that the thoughts are a product of their own mind. To have compulsions, the patient must feel the need to repeat physical behaviours, which occur as a response to an obsession or in accordance with strictly applied rules, and aim to reduce distress or prevent something that is dreaded. The patient must recognise that the obsessions or compulsions are unreasonable or excessive.
1b. Explain issues with the classification and/or diagnosis of OCD. [10]
There are problems with the reliability of diagnosis of OCD. It is difficult to decide objectively when worrying about something becomes an obsession, or when a physical behaviour or mental act becomes a compulsion. People with eating disorders also experience obsessions and compulsions, meaning they could be misdiagnosed as having OCD. The comorbity rate of OCD is also over 60% (Torres et al 2006). This means that it is difficult to reliably give a diagnosis because it can be hard to tell which symptoms relate to which disorder. A diagnosis cannot be valid if it is not reliable.
There could also be culture bias in the diagnosis of OCD. The reliability and validity of classification systems reflects western culture and therefore cannot necessarily assess people of other cultures. For example, India still upholds a rigid caste system, believing that those with high status exhibit ‘purity’ whereas those with a lower status are ‘polluted’. Within this culture it would not be deemed unusual for a high status individual to feel ‘contaminated’ if they came into contact with a low status individual. Whereas in different cultures this might be a sign of OCD, in this culture it is not
The DSM-4 states that for one to be diagnosed with OCD, one must have either obsessions, compulsions or both. To be diagnosed with having obsessions, the patient must have recurring, persistent intrusive thoughts that cause marked distress or anxiety, and must have insight into the fact that the thoughts are a product of their own mind. To have compulsions, the patient must feel the need to repeat physical behaviours, which occur as a response to an obsession or in accordance with strictly applied rules, and aim to reduce distress or prevent something that is dreaded. The patient must recognise that the obsessions or compulsions are unreasonable or excessive.
1b. Explain issues with the classification and/or diagnosis of OCD. [10]
There are problems with the reliability of diagnosis of OCD. It is difficult to decide objectively when worrying about something becomes an obsession, or when a physical behaviour or mental act becomes a compulsion. People with eating disorders also experience obsessions and compulsions, meaning they could be misdiagnosed as having OCD. The comorbity rate of OCD is also over 60% (Torres et al 2006). This means that it is difficult to reliably give a diagnosis because it can be hard to tell which symptoms relate to which disorder. A diagnosis cannot be valid if it is not reliable.
There could also be culture bias in the diagnosis of OCD. The reliability and validity of classification systems reflects western culture and therefore cannot necessarily assess people of other cultures. For example, India still upholds a rigid caste system, believing that those with high status exhibit ‘purity’ whereas those with a lower status are ‘polluted’. Within this culture it would not be deemed unusual for a high status individual to feel ‘contaminated’ if they came into contact with a low status individual. Whereas in different cultures this might be a sign of OCD, in this culture it is not