Controversy Time!

In spite of a range of theories and considerable research, scientists so far take non been able to identify a definitive cause for why a person develops  Obsessive-Compulsive Disorder (OCD).

However, there are enough of theories surrounding the potential causes of OCD, involving one of or a combination of either; neurobiological, genetic, learned behaviours, pregnancy, ecology factors or specific events that trigger the disorder in a specific private at a particular point in time.

We will summarise some of the suggested theories on this page, but before we begin it's of import we make it clear that this is just theory.

There have been many explanations of why people develop OCD. Some have argued that information technology is inherited, whilst others accept said that life events can cause it. Others take suggested that it's caused by a chemical imbalance in the encephalon. Different people, different researchers detect dissimilar explanations more helpful than others. But here's the point, we merely don't know!

So let'south summarise some of those explanations.

Biological Factors

Some mental health researchers have encouraged the states to think of research on encephalon scans and similar  as indicating that OCD is  linked to a genetic or biological cause. This research is often described in terms of chemical imbalances in the brain, faulty brain circuitry or genetic defects.

However, despite the recognition that sure parts of the brain are different in OCD sufferers, when compared with non-sufferers, it is still not known how these differences chronicle to the precise mechanisms of OCD.

Brain imaging studies take consistently demonstrated differing blood menstruation patterns among people with OCD compared with controls, and the cortical and basal ganglia regions are nearly strongly implicated. Withal, subsequent meta-analysis studies establish that differences between people with OCD and salubrious controls were plant consistently just in the orbital gyrus and the head of the caudate nucleus.

So yes, whilst it's true to say that sometimes people with OCD are  establish to have dissimilar encephalon activity, it could be argued this would be expected.

A encephalon scan is sensitive to dissimilar patterns of activity in the brain and can, for example, detect the deviation in terms of the mode the brain reacts between good musicians listening to music and people with no special knowledge of music.

These areas of the brain become relevant and 'switched on' in particular environments where the person is worrying. Information technology is therefore not surprising that there are brain activation differences betwixt people with OCD and those without; this does not mean that OCD is a biological disease.

PANDAS

A 1998 finding implicated the basal ganglia as a central encephalon region in OCD with the discovery that in a sub-group of children with OCD the disorder may have been triggered past infections.

Streptococcal infections trigger an allowed response, which in some individuals generates antibodies that cross-react with the basal ganglia. The caption was that some children begin to exhibit OCD symptoms after a severe strep pharynx infection. It is thought that the trunk's natural response to infection, the product of certain antibodies, when directed to parts of the brain might be linked in some way to Paediatric Autoimmune Northwardeuropsychiatric Disorders associated with Streptococcal Infection (PANDAS).

This machinery may explicate the subgroup of children in whom OCD develops after a streptococcal infection, and worsens with recurrent infections. Notwithstanding, a later on 2004 study found no link betwixt subsequent infections and exacerbation of symptoms.

What we do know is that if OCD results from a strep throat infection the symptoms will start quickly, probably within one or two weeks.

So it could be that PANDAS whilst not a cause for OCD, triggers symptoms in children who are already predisposed to the disorder, perhaps through genetics or other causal explanations.

Genetic Factors

Overall, genetic studies bespeak some tendency towards anxiety that runs in families, although this is probably simply slight.

Some research points to the likelihood that OCD sufferers volition take a family member with OCD or with one of the other disorders in the OCD 'spectrum'. In 2001, a meta-analytic review reported that a person with OCD is iv times more than likely to accept another family member with OCD than a person who does not accept the disorder.

This and other studies accept raised the possibility of familial prevalence of OCD and led to a search to identify specific genetic factors that may be involved. S However, despite a proliferation of studies, and dozens of potential gene candidates suggested, researchers have so far failed to identify a consequent candidate gene responsible for OCD.

It too needs to exist remembered that many sufferers do non identify OCD anywhere else in their family unit, or even other anxiety bug. This theory could be farther questioned based on speaking to identical twins where one will take OCD and the other has no feet problem at all.

What this suggests is that genetics may not be the only cause of OCD (if at all), and  that family prevalence of OCD could be learned behaviours in some cases. And so although we cannot rule genetics out,  information technology's clear that it'south non the whole story and learned or environment factors may play a more significant part.

In summary, in that location is no obvious benefit to offering biological explanations for the cause of OCD, especially if such suggestions pb those who suffer to dismiss existing psychological handling methods.

Chemical Imbalance

It'south mutual to come across and hear mental health professionals describing the cause of OCD in terms of a 'biochemical imbalance'. These approaches have focused on one particular neurotransmitter, serotonin.

Serotonin is the chemical in the brain that sends messages between brain cells and information technology is idea to be involved in regulating everything from anxiety, to memory, to sleep.

Through the accidental discovery in the late sixties of the effectiveness  of the serotonin active tricyclic antidepressant clomipramine, which did not substantially impact on serotonin, led to the serotonin hypothesis.

Initially, it was suggested that at that place was a gross deficit in serotonin; when this was not actually identified, increasingly subtle abnormalities were suggested, with the evidence overall remaining implausible at best.

In more contempo years some researchers have argued that the most robust evidence for the serotonin hypothesis is the specificity of serotonin reuptake inhibitors (SRI) and selective serotonin reuptake inhibitor (SSRI) medication.

However, given that this upshot was the observation that generated the hypothesis, it cannot reasonably be considered every bit evidence for it.

It's worth noting that relapse is oft associated with the withdrawal of SSRI medications in OCD, more than then than in other weather condition, especially where no behavioural therapy is in place, which is yet to exist fully understood. This could mean that serotonin is an important neurotransmitter involved in the maintenance of OCD, if not a specific cause.

Overall, there is a place for SSRIs in the handling of OCD, especially where co-morbidity is present, provided that medication remains part of informed patient selection, and combined with psychological therapy like CBT.

Psychological Theories

Other inquiry has revealed that there may exist a number of other factors that could play a role in the onset of OCD, including behavioural, cognitive, and environmental factors.

For case, according to the Learning Theory, OCD symptoms are a outcome of a person developing learned negative thoughts and behaviour patterns, towards previously neutral situations which can result from life experiences.

Enquiry has revealed a great deal about the psychological factors that maintain OCD, which in turn has led to effective psychological treatment in the course of Cerebral Behavioural Therapy (CBT).

Behavioural Theory – Learned Theory

During the 50s and 60s researchers reported the successful behaviour handling of two cases of chronic obsessional neurosis (a forerunner for the Obsessive-Compulsive Disorder name), followed by a serial of successful case reports.

This discovery and research heralded the awarding of psychological models to obsessions and the development of effective behavioural treatments.

This inquiry later proposed that ritualistic behaviours were a course of learned abstention.

Behaviour therapy for phobias had proved successful in the treatment of phobic avoidance through desensitisation, simply attempts to generalise these methods to compulsions had been unsuccessful.

Researchers argued that it was necessary to tackle abstention behaviours directly by ensuring that compulsions did not take place inside or between treatment sessions. This thinking predictable cognitive approaches in that they emphasised the office of the expectations of impairment in obsessions and the importance of invalidating these expectations during treatment, but this was subsequently regarded as peripheral to the major task of preventing compulsions.

Around the aforementioned time in the early seventies other researchers developed treatment methods in which exposure to feared situations was the central feature. These differing approaches were later incorporated into a highly effective program of behavioural handling incorporating the principles of what we now refer to every bit exposure and response prevention (ERP).

Support for the utilise of this method came from a series of experiments in which it was demonstrated that, when a ritual is provoked, discomfort and the urge to ritualise spontaneously subside when no rituals (compulsions) take place.

These researchers elegantly specified the behavioural theory of OCD, that behavioural treatment of OCD is based on the hypothesis that obsessional thoughts have through conditioning, become associated with feet that has failed to extinguish.

Sufferers accept developed abstention behaviours (such as obsessional checking and washing), which foreclose the extinction of anxiety. This leads directly to the behavioural handling known as ERP, in which the person is: (a) exposed to stimuli that provoke the obsessional response, and (b) helped to prevent abstention and escape (compulsive) responses.

An important contribution to the evolution of ERP was the observation that the occurrence of obsessions leads to an increment in anxiety, and that the compulsions lead to its subsequent attenuation. When the compulsions were delayed or prevented, people with OCD experienced a spontaneous decay in anxiety and the urges to perform compulsions. Continued practice led to the extinction of anxiety. The 'spontaneous decay experiments' that demonstrated this were crucial both for therapists and patients to exist confident that, if they confronted their fears, anxiety and discomfort would diminish and ultimately disappear.

These early behavioural theories and experiments set the phase for later cerebral-behavioural theory and treatment.

Cognitive theory

Many cognitive theorists believe that individuals with OCD take faulty beliefs, and that information technology is their misinterpretation of intrusive thoughts that leads to OCD.

According to the cognitive model of OCD, everyone experiences intrusive thoughts from time-to-time. All the same, people with OCD often have an inflated sense of responsibility and misinterpret these thoughts equally being very important and meaning which could lead to catastrophic consequences.

The repeated misinterpretation of intrusive thoughts leads to the development of the obsessions and because the thoughts are then deplorable, the private engages in compulsive behaviour to try to resist, cake, or neutralise the obsessive thoughts.

The cognitive-behavioural theory developed following a focus on the meaning attributed to internal (or external) events.  The cognitive-behavioural theory builds on behavioural theory every bit it begins with an identical proffer that obsessional thinking has its origins in normal intrusive cognitions. However, in the cerebral theory the difference betwixt normal intrusive cognitions and obsessional intrusive cognitions lies not in the occurrence or even the (un)controllability of the intrusions themselves, only rather in the interpretation made by people with OCD about the occurrence and/or content of the intrusions.

If the appraisal is focused  on harm or danger, then the emotional reaction is likely to exist anxiety. Such evaluations of intrusive cognitions and consequent mood changes may get part of a mood-appraisal negative spiral merely would not exist expected to result in compulsive behaviour. Cognitive-behavioural models therefore suggest that normal obsessions get problematic when either their occurrence or content are interpreted equally existence personally meaningful and threatening, and it is this interpretation which mediates the distress acquired.

Thus, according to the cognitive hypothesis, researchers have hypothesised that OCD would occur if intrusive cognitions were interpreted as an indication that the person may be, may have been, or may come up to be, responsible for harm or its prevention.

Fundamental to how threatening this appraisement is the idea of non only how likely the event is, but how 'awful' this is to the individual. Furthermore, this is set against the individual'south sense of how they might cope in these circumstances.

Co-ordinate to cerebral models, the interpretation of an intrusive thought results in a number of voluntary and involuntary reactions which each in their turn can have an affect on the strength of belief in the original interpretation. Negative appraisals can therefore act every bit both causal and maintenance agents in OCD.

Some researchers believe that this theory questions the biological theory because people may exist born with a biological predisposition to OCD but never develop the full disorder, while others are built-in with the aforementioned predisposition just, when subject to sufficient learning experiences, develop OCD.

Psychoanalytic Theory

Ordinarily accepted in the past, simply present increasingly disregarded, the psychoanalytic theory suggests that OCD develops because of a person's fixation arising from unconscious conflicts or discomfort they experienced during infancy or childhood, or the way a person interacted with his or her parents during childhood. This theory is now quite rightly disregarded due to the failure of psychoanalytic therapy to treat OCD.

Stress

Stress and parenting styles are ecology factors that have been blamed for causing OCD, simply no bear witness is yet to show that. Stress does non really cause OCD, merely major stresses or traumatic life events may precipitate the onset of OCD. Nevertheless, these are not thought to cause OCD, but rather trigger information technology in someone already predisposed to the disorder.

If left untreated, everyday anxiety and stress in a person's life will worsen symptoms in OCD. Problems at school or piece of work, university exam pressures and normal everyday issues that relationships tin bring are all contributory factors to increasing the frequency and severity of a person's OCD.

Low

Depression is also sometimes thought to cause OCD, although without question depression will brand OCD symptoms worse, the majority of experts believe that depression is often a consequence of OCD rather than a cause.

SUMMARY

As you lot tin can encounter at that place is a range of factors accept been identified equally contributing to the crusade of OCD, and there is still a keen deal of theoretical contention surrounding the definitive cause.

However, despite most of the above theories offering compelling and highly informative insights, it'southward a possibility that a combination of the theories may eventually be identified as the bodily crusade of OCD and that information technology is likely that for any given person a number of factors are involved.

Whilst the crusade is currently however being debated, sometimes vigorously by the scientists, what is not in contention is the fact that Obsessive-Compulsive Disorder is indeed a chronic (at times), but every bit very treatable medical condition.

Information technology's also important that nosotros don't get fixated on what causes our OCD at the expense of fighting and tackling it.  Even if we think we take identified  a cause, it won't necessarily help us overcome OCD , so our focus must remain on tackling the trouble nosotros have correct now, today, in the hither and now.

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