[WEB SITE] This could explain why people with OCD can’t overcome their urges – ScienceAlert

People with obsessive-compulsive disorder (OCD) struggle to overcome their repetitious urges due to an inability to learn what kinds of stimuli are actually safe, new research suggests.

OCD is a disorder where people feel compelled to repeatedly perform certain tasks or think particular thoughts. These insistent routines are called ‘rituals’, and scientists think the behaviours persist because those with OCD struggle to learn when situations aren’t threatening.

“Our study suggests that something is going wrong in the brains of people with OCD when they are learning what is safe, and this in turn affects how they perceive threats under updated circumstances,” says neuroscientist Annemieke Apergis-Schoute from the University of Cambridge in the UK.

Apergis-Schoute and her team conducted a learning experiment where they compared the brain activity and anxiety responses of OCD patients with measurements taken from people without the condition.

OCD is estimated to affect around 1 percent of the adult population in the US, with the disorder compelling people to do things like repeatedly wash their hands, or check that doors are locked and appliances are switched off.

“They’re not usually off-the-wall bizarre,” one of the team, Naomi Fineberg from the Hertfordshire Partnership University NHS Foundation Trust in the UK told New Scientist.

“The obsessions are the sorts of things that most people would understand as being rational but exaggerated – for example, the need to wash your hands after going to the toilet.”

While these rituals aren’t necessarily harmful in themselves, they stem from intrusive and unwanted feelings that are usually associated with anxiety, and can have a considerable impact on carrying out day-to-day activities.

One of the ways of treating OCD is called exposure therapy, where people with the condition are made to confront the source of their anxiety – such as touching a dirty object – in an attempt to control their response.

But exposure therapy doesn’t work for every patient, and even in people who do learn to control their anxiety response, the effectiveness can be limited.

To find out why exposure therapy might only have limited success in treating OCD, the researchers recruited 78 people for a learning experiment – 43 of the volunteers had OCD, and 35 acted as a control group.

Each of the participants were asked to lie in a functional magnetic resonance imaging (fMRI) scanner, which measured their brain activity while they were shown one of two faces – a red face or a green face.

In the first experiment, the participants would receive a mild electric shock when shown the green face, but wouldn’t be shocked when viewing the red.

Sensors that measured tiny amounts of sweat produced by the participants showed that the group learned to associate anxiety with the green face (as a result of the electric shocks that came with it), but not with the red face.

But then the researchers swapped the green and red faces around, so that it was the red face that now came with an electric shock.

While the control group successfully learned the new associations – green is now safe, red is bad – the participants with OCD were less able to register that the green face no longer posed a threat.

Measurements of the participants’ brain activity when they were shown the now safe green face indicated that the OCD patients had less activity in the ventromedial prefrontal cortex – which is associated with processing safety signals in the brain, and decision making in relation to perceived risks.

According to the researchers, this could explain why people with OCD have difficulty overcoming their rituals, because their brains may find it significantly harder to unlearn negative associations, even when treatment such as exposure therapy attempts to directly counter them.

“This needs to be taken into consideration when we’re developing future therapies to tackle the disorder,” Apergis-Schoute explains in a press release.

“Current exposure therapies may help the patient take control over their compulsions, but our work suggests that they might never learn that their compulsions are unnecessary and they may return in times of stress.”

It’s worth pointing out that the researchers are drawing their conclusions from a very small sample of participants, so larger studies involving more patients affected by OCD will be needed to confirm the findings.

But if the results can be replicated, it could help explain some of the limitations of exposure therapy, and improve the delivery of the treatment in the future.

“The bit of their brain that should be telling them it’s safe isn’t working,” Fineberg explained to Clare Wilson at New Scientist.

“Now we can say to them this is why [exposure therapy is] taking so long and we should stick with it.”

The findings are reported in PNAS.

Source: This could explain why people with OCD can’t overcome their urges – ScienceAlert

[WEB SITE] OCD OBSESSIVE COMPULSIVE SYNDROME

Obsessive–compulsive disorder (OCD) is a mental disorder where people feel the need to check things repeatedly, perform certain routines repeatedly, or have certain thoughts repeatedly. People are unable to control either the thoughts or the activities. Common activities include hand washing, counting of things, and checking to see if a door is locked. Some may have difficulty throwing things out. These activities occur to such a degree that the person’s daily life is negatively affected.Often they take up more than an hour a day.Most adults realize that the behaviors do not make sense.The condition is associated with tics, anxiety disorder, and an increased risk of suicide.

The cause is unknown. There appears to be some genetic components with both identical twins more often affected than both non-identical twins. Risk factors include a history of child abuse or other stress inducing event. Some cases have been documented to occur following infections. The diagnosis is based on the symptoms and requires ruling out other drug related or medical causes. Rating scales such as the Yale–Brown Obsessive Compulsive Scale can be used to assess the severity.Other disorders with similar symptoms include anxiety disorder, major depressive disorder, eating disorders, tic disorders, and obsessive–compulsive personality disorder.

Treatment for OCD involves the use of behavioral therapy and sometimes selective serotonin reuptake inhibitors (SSRIs). The type of behavior therapy used involves increasing exposure to what causes the problems while not allowing the repetitive behavior to occur. While clomipramine appears to work as well as SSRIs it has greater side effects. Atypical antipsychotics may be useful when used in addition to an SSRI in treatment-resistant cases but are also associated with an increased risk of side effects. Without treatment, the condition often lasts decades.

Obsessive–compulsive disorder affects about 2.3% of people at some point in their life. Rates during a given year are about 1.2% and it occurs worldwide. It is unusual for symptoms to begin after the age of thirty-five and half of people develop problems before twenty. Males and females are affected about equally. In English the phrase obsessive–compulsive is often used in an informal manner unrelated to OCD to describe someone who is excessively meticulous, perfectionistic, absorbed, or otherwise fixated.

Source: OCD

[WEB SITE] O.C.D., a Disorder That Cannot Be Ignored

…But these common habits fall far short of the distressing obsessions and compulsions that are the hallmarks of O.C.D.: intrusive, disturbing thoughts or fears that cannot be ignored and compel the sufferer to engage in ritualistic, irrational behaviors to relieve the resulting anxiety.

An excessive fear of germs may prompt repetitive hand-washing or a refusal to touch doorknobs or use objects handled by another person. But the rituals may be unrelated to the anxieties that trigger them: opening and closing doors an exact number of times, for example, or stepping over every crack or line, or counting to a certain number before performing an activity.

People with O.C.D. know that their thoughts and actions are not realistic, but they cannot stop themselves from behaving as if they were grounded in fact. Performing compulsive rituals does not give them pleasure and only temporarily relieves their anxiety, resulting in a need to re-enact them again and again…

via O.C.D., a Disorder That Cannot Be Ignored – NYTimes.com.

[WEB SITE]: Obsessive-Compulsive Disorder (OCD). Symptoms, Behavior, and Treatment

Symptoms and Treatment of Compulsive Behavior and Obsessive Thoughts

…Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational – but even so, you feel unable to resist them and break free…

via Obsessive-Compulsive Disorder (OCD): Symptoms, Behavior, and Treatment.

[WEB SITE] Family Center – Depression and Bipolar Support Alliance

Welcome to the Family Center

Family support is crucial for those affected by depression or bipolar disorder. If you or someone in your family lives with a mood disorder, the Rebecca’s Dream Family Center is a place of compassion, hope and understanding. It is a central place for a wide variety of family-focused resources and information…

Family Center – Depression and Bipolar Support Alliance.