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Part – 1

Discuss about the Behavioural and Cognitive‐Behavioural Therapy.

Part – 1

Psychological perspective

Key characteristics of the perspective used to explain the cause of obsessive-compulsive disorder (OCD)

Analysis of the perspective to effectively explain the cause of obsessive-compulsive disorder (OCD)

Psychodynamic

The psychodynamic perspective advocated by Freud emphasizes the role of adverse interpersonal relationships on the development of OCD among the predisposed individuals (Stein & Stone, 1997, p. 14). Psychoanalysis models attributing to theories of object relations, interpersonal bonding, classical drive and ego psychology provide the psychodynamic context of the establishment of OCD across the community environment. 

Patients affected with family history of psychosocial conditions and stressful circumstances in life exhibit the potential defects in interpersonal relationships, and their negative thoughts and distressed emotions predispose them towards the development of obsessive-compulsive disorder and its associated manifestations (Mayo-Clinic, 2016). 

Cognitive

The perspective advocated by cognitive theory emphasizes the influence of environmental factors, psychosocial conditions, disrupted behaviour and impaired beliefs on the development of OCD among the predisposed individuals (Matusiewicz, et al., 2011). The gradual and consistent decline in cognitive development of patients elevates the severity of their OCD manifestations that subsequently require the administration of rehabilitative cognitive behavioural interventions by psychologists for remediating the progression of OCD among the affected patients.

The cognitive perspective deals with the thoughts, feelings and behaviour of the individuals that considerably influence the pattern of their intellect and cognition across the community environment. The adverse and intrusive thought processes lead to the development of skewed feelings that resultantly facilitate the development of the pattern of psychosocial stress anxiety and repetitive behaviour among the affected patients (Anon., 2010).  

Genetic

The genetic perspective advocates the considerable influence of genetic factors in the development of OCD across the community environment. Evidence-based research literature recognizes the genetic traits of OCD in terms of familial attributes that transfer from one generation to another and exhibit the pattern of OCD among individuals under the influence of environmental factors (Pauls, 2010).  Furthermore, pre-existing psychosocial conditions also elevate the risk of the affected patients in terms of the development of OCD across the community environment.

The genetic theory indicates that the children of the OCD patients experience greater predisposition towards acquiring the manifestations of OCD in comparison to the children who exhibit no family history of the progression of this disease in their previous generations. The co-morbid states of individuals might also facilitate the development of OCD in the context of a genetic relationship between both morbidities.

Biological

The sustained defect in the caudate nucleus and anterior cingulum of human brain leads to the development of repetitive behavioural pattern, which is indicative of the progression of OCD among the affected patients (Fan & Xiao, 2013). Evidence-based research literature advocates the pattern of hyperactivity in the basal ganglia and orbitofrontal cortex regions of the brain as a significant cause of the development of depression among the OCD patients (Beucke, et al., 2013). Research studies advocate the relationship of various infectious conditions (including influenza, encephalitis and streptococcal infection) and the development of OCD across the community environment (Boileau, 2011). 

The biological perspective relates the pattern of hyperactivity across the brain networks to the development of OCD manifestations among the affected patients. The structural as well as functional defects in the brain circuits might result from the inappropriate administration of therapeutic regimen, environmental factors, genetic predisposition or other miscellaneous causes requiring the organization of prospective clinical studies for delineating the biological basis of OCD development among the affected patients. The development of infectious conditions and their associated manifestations leads to the onset of autoimmune response against basal ganglia resulting in its sustained dysfunction among the affected individuals. The abnormal functioning of the basal ganglia leads to the reciprocal development of abnormal alterations in the activity of the human brain that facilitates the establishment of OCD among the affected patients.

Part – 2

Psychological perspective

Brief description of studies offered to support the perspective’s explanation for OCD

Evaluation of the methods of data gathering used by each perspective

Cognitive

Research by (Cordeiro, et al., 2015) explored the relationship of the symptom dimensions of OCD with the dysfunctional belief pattern. The findings of the research study advocated the pattern of reciprocal relationship between the thought processes related to perfectionism with the symptoms related to symmetry and aggressive dimensions. However, thought processes related to responsibility resulted in the beliefs of religious and sexual dimensions. The study could not track a pattern of linear relationship between the belief domains (including uncertainty tolerance, threat estimation, control and significance of thoughts) and the corresponding symptom manifestations experienced by the patients affected with OCD. However, the findings predicted the influence of cross-cultural variations on the level of cognition of the patients affected with OCD manifestations.

Interview sessions were conducted with the study subjects in the context of ascertaining the diagnosis of obsessive- compulsive disorder. The pattern of relationship between the symptoms dimensions and the obsessive beliefs evaluated with the deployment of D-YBOCS (Dimensional Yale-Brown Obsessive-Compulsive scale). Impairment scores of patients calculated for determining the severity of their psychosocial symptoms in relation to the established pattern of OCD. Regression analysis of impairment scores (i.e. DYBOCS) executed in the context of evaluating the severity of OCD symptoms and their relationship with the thought processes of the affected patients. The data regarding the co-morbid states attributing to anxiety and depressive states also taken into account in the context of discarding the confounding effect of these conditions on the overall results of the study.

Biological

Case control cross-sectional research study by (Beucke, et al., 2013) evaluated the structural as well as functional alterations in the brain of individuals affected with the pattern of OCD across the community environment. The findings of this research study revealed the level of hyper- connectivity between the basal ganglia and orbitofrontal cortex regions of the brain that is responsible for the psychosocial manifestations experienced by the patients of OCD. The sustained abnormality in the orbitofrontal cortex of human brain disrupts the process of learning as well as decision-making, which becomes the cause of the obsessions experienced by the subjects affected with OCD.    

Demographic data of the non-medicated OCD patients included their age, gender, IQ level, education level, STAI-X1 and X2 traits, OCI-R, BDI, Y-BOCS, MADRS and mean interscan movement. However, the data obtained after interviewing the study subjects by a licensed psychologist and the psychosocial co-morbid states of the patients identified accordingly. The data related to the MRI findings of the selected OCD subjects statistically analyzed for determining the extent and level of the brain dysfunction experienced by the patient affected with OCD pattern.  

Part – 3

Introduction

The presented analysis of the case study attempts to track and identify the attribution of the psychosocial perspectives in the assessment and effective treatment of various states of consciousness, emotional conditions and behavioural patterns experienced by the patients affected with obsessive-compulsive disorder. OCD patients remain affected with intrusive thoughts that compel them to experience the fearful situations leading to the development of states of restlessness and obsession. The manifestations attributing to the disturbed sleep physiology and hyperactivity of brain regions result in the gradual deterioration of the psychosocial profile of the affected individuals.  Treatment interventions like cognitive-behavioural therapy (CBT) proves to be an effective tool in relieving the state of distress experienced by patients affected with OCD across the community environment.

The presented patient scenario describes the fear of 26 years old Diana in stepping on the pavement cracks. This particular behaviour of the patient warrants the configuration of the pattern of therapeutic communication by the healthcare professional in the context of efficiently evaluating the detrimental effects of the disfigured thought process of the patient on her quality of life across the community environment. Indeed, with the utilization of good communication pattern, the healthcare professional attains the privilege of administering tailor-made and culturally appropriate psychosocial interventions in accordance with the individualized requirements and mental care needs of the affected patient (NICE, 2006). The configuration of support groups in the context of motivating the patient for attaining the attribute of self-help proves effective in elevating the wellness outcomes and decreasing the burden of OCD manifestations from the society. The fear of the patient in terms of experiencing adverse events in the absence of execution of a ritual is another indication of the intrusive thoughts experienced by the patient during the course of obsessive-compulsive disorder. Ritual prevention intervention in this particular scenario proves to be advantageous in terms of reducing the state of fear and anxiety of the patient in the absence of the execution of the ritual convention (Foa, 2010). This psychological intervention restrains the patient in practicing the religious custom or ritual, in relation to which he/she experiences the fear of adverse events or disastrous circumstances. The absence of adverse events during the course of ritual prevention makes the patient realize the false implications of his/her intrusive thoughts in relation to the practice of rituals and this resultantly decreases the state of his anxiety, fear and depression of the patient across the community environment.

Psychological perspective

The patient scenario emphasizes the fear of the patient in terms of harming her own children at bedtime under the influence of disfigured thoughts.  Exposure and response prevention strategy (ERP) proves useful in decreasing the adverse psychosocial manifestations experienced by the patient in relation to the detrimental thought processes (Seibell & Hollander, 2014). Repeated (planned) exposure to the fearful circumstances decreases negative thoughts of the patient in terms of executing homicidal activities across the residential premises. The prevention of the patient’s strangling activity in the present clinical scenario will make her realise and experience the absence of homicidal activity and eventually her fearful attitude and anxiety in relation to the bedtime obsession will decrease considerably. The presented patient scenario describes the lack of confident memory of the OCD patient requiring the administration of psychosocial interventions for elevating the mental health of the affected patient. Evidence-based research literature emphasizes the effectiveness of cognitive behavioural therapy (CBT) in terms of elevating the social functioning of the OCD patient across the community environment (Vandborg, et al., 2016). Improved social functioning might influence the level of confident memory; however, the organization of prospective research studies necessarily warranted for evaluating direct influence of CBT on the memory outcomes of the OCD patient.  The patient scenario displays the familial progression of OCD traits (i.e. the OCD characteristics experienced by Diana’s children in the similar manner that Diana experienced during her childhood). Evidence-based research literature emphasizes the requirement of family based CBT approach for the effective treatment of pediatric patients affected with the pattern of CBT across the community environment. The family based CBT advocates the administration of psychoeducation strategies for effectively reducing the anxiety-provoking cognitive state of pediatric patients affected with OCD manifestations (Marien, et al., 2013). The children and their parents acquire adaptive behaviours following the consistent exposure to CBT across the clinical setting. The healthcare professionals during the course of CBT encourage the pediatric patients in terms of their engagement in extra-curricular activities and modify their external environment in the context of reducing its impact of on their psychosocial behaviour. The parents of affected children require their participation in the educational sessions for elevating their knowledge regarding the manifestations of OCD and their implications on the pattern of mental health of the pediatric patients. The parents resultantly facilitate the execution of CBT while coordinating with the healthcare professionals and assisting in the management of OCD by providing regular feedback of the mental manifestations of their children to the treating physicians. Evidence-based research literature emphasizes the influence of cultural variations and gender differences on the psychosocial manifestations of pediatric patients affected with obsessive-compulsive disorder (Cardwell & Flanagan, 2003, p. 133). Bandura’s social cognitive theory advocates the promotion of self-observation skills among the individuals in the context of modifying the self-response pattern for improving the behavioural outcomes (Cardwell & Flanagan, 2003, p. 146). The incorporation of Bandura’s convention in CBT assists the OCD patients in elevating their self-efficacy pattern, overcoming their fears and improving their response to the administered treatment interventions by the healthcare professionals (Wilhelm, et al., 2015). This indicates the scope of modification in cognitive behavioural strategies in the context of reducing the establishment of emotional complications, detrimental thought processes and disfigured behavioural patterns experienced by the affected patients under the influence of obsessive-compulsive disorder.

Key characteristics of the perspective used to explain the cause of obsessive-compulsive disorder (OCD)

Conclusion

The manifestations of OCD pose several threats to the quality of life of affected patients and their effective mitigation necessarily required in the context of improving the state of wellness and mental health of the patient population. The findings in the evidence-based research literature advocate the requirement of the concomitant administration of pharmacotherapeutic and psychological approaches for the effective treatment of the manifestations of OCD across the community environment. Furthermore, the organization of awareness sessions for the common masses as well as healthcare professionals warranted in the context of administering preventive interventions for reducing the scope of progression of OCD manifestations among the predisposed patients. The determination of the etiology of OCD by the research community highly required in the context of modifying the treatment strategies for improving the state of mind and thought processes of the patients affected with obsessive-compulsive disorder.     

References

Anon., 2010. Behavioural and cognitive‐behavioural therapy for obsessive‐compulsive disorder (OCD) in children and adolescents. Cochrane Dabase of Systematic Reviews.

Beucke, J. C. et al., 2013. Abnormally high degree connectivity of the orbitofrontal cortex in obsessive-compulsive disorder. JAMA Psychiatry, 70(6), pp. 619-629.

Boileau, B., 2011. A review of obsessive-compulsive disorder in children and adolescents. Dialogues in Clinical Neuroscience, 13(4), pp. 401-411.

Cardwell, M. & Flanagan, C., 2003. Psychology A2: The Complete Companion. USA: Nelson Thornes.

Cordeiro, T., Sharma, M. P., Thennarasu, K. & Reddy, Y. C. J., 2015. Symptom Dimensions in Obsessive-Compulsive Disorder and Obsessive Beliefs. Indian Journal of Psychological Medicine, 37(4), pp. 403-408.

Fan, Q. & Xiao, Z., 2013. Neuroimaging studies in patients with obsessive-compulsive disorder in China. Shanghai Archives of Psychiatry, 25(2), pp. 81-90.

Foa, E. B., 2010. Cognitive behavioral therapy of obsessive-compulsive disorder. Dialogues in Clinical Neuroscience, 12(2), pp. 199-207.

Marien, W. E., Storch, E. A., Geffken, G. R. & Murphy, T. K., 2013. Intensive Family-Based Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder: Applications for Treatment of Medication Partial- or Nonresponders. Cognitive and Behavioral Practice, 16(3).

Matusiewicz, A. K., Hopwood, C. J., Banducci, A. N. & Lejuez, C. W., 2011. The Effectiveness of Cognitive Behavioral Therapy for Personality Disorders. Psychiatric Clinics of North America, 33(3), pp. 657-685.

Mayo-Clinic, 2016. Diseases and Conditions - OCD. [Online]
Available at: https://www.mayoclinic.org/diseases-conditions/ocd/basics/risk-factors/con-20027827
[Accessed 07 09 2016].

NICE, 2006. The experience of people withOCD and BDD and their families and carers. In: bsessive-Compulsive Disorder: Core Interventions in the Treatment of Obsessive-Compulsive Disorder and Body Dysmorphic Disorder. UK: British Psychological Society.

Pauls, D. L., 2010. The genetics of obsessive-compulsive disorder: a review. Dialogues in Clinical Neuroscience, 12(2), pp. 149-163.

Seibell, P. J. & Hollander, E., 2014. Management of Obsessive-Compulsive Disorder. F1000Prime Reports, 6(68).

Stein, D. J. & Stone, M. H., 1997. Essential Papers on Obsessive-compulsive Disorder. New York: New York University Press.

Vandborg, S. K. et al., 2016. Can memory and executive functions in patients with obsessive-compulsive disorder predict outcome of cognitive behavioural therapy?. Nordic Journal of Psychiatry, 70(3), pp. 183-189.

Wilhelm, S. et al., 2015. Mechanisms of Change in Cognitive Therapy for Obsessive Compulsive Disorder: Role of Maladaptive Beliefs and Schemas. Behaviour Research and Therapy, pp. 51-10.

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"Behavioural And Cognitive‐Behavioural Therapy: Exploring Psychological Perspectives For Understanding And Treating Obsessive-Compulsive Disorder." My Assignment Help, 2017, https://myassignmenthelp.com/free-samples/behavioural-and-cognitivebehavioural-therapy.

My Assignment Help (2017) Behavioural And Cognitive‐Behavioural Therapy: Exploring Psychological Perspectives For Understanding And Treating Obsessive-Compulsive Disorder [Online]. Available from: https://myassignmenthelp.com/free-samples/behavioural-and-cognitivebehavioural-therapy
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My Assignment Help. 'Behavioural And Cognitive‐Behavioural Therapy: Exploring Psychological Perspectives For Understanding And Treating Obsessive-Compulsive Disorder' (My Assignment Help, 2017) <https://myassignmenthelp.com/free-samples/behavioural-and-cognitivebehavioural-therapy> accessed 21 June 2024.

My Assignment Help. Behavioural And Cognitive‐Behavioural Therapy: Exploring Psychological Perspectives For Understanding And Treating Obsessive-Compulsive Disorder [Internet]. My Assignment Help. 2017 [cited 21 June 2024]. Available from: https://myassignmenthelp.com/free-samples/behavioural-and-cognitivebehavioural-therapy.

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