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Assignment needs to be a minimum of 300 words. Your answer to the question needs to incorporate and make specific reference to the textbook. The references need to be discussed as to how they apply to your observations in response to the assignment question. Remember to cite your sources—give credit where credit is due.
At the end of your assignment post a question to the class related to the question you have answered. The question needs to be related to the topic—something you might have thought about when you were completing your assignment.
5. According to psychodynamic theorists, behaviorists, and cognitive theorists, what causes obsessive-compulsive disorders? Answer each of the theories separately.
Book to reference is: This is all in the book: Comer, Abnormal Psychology 11 edition
Please reference specific things from the book
Below is whats: written in the book please read:
The Psychodynamic Perspective
As you have seen, psychodynamic theorists believe that an anxiety disorder develops when children come to fear their own id impulses and use ego defense mechanisms to lessen the resulting anxiety. What distinguishes obsessive-compulsive disorder, in their view, is that here the battle between anxiety-provoking id impulses and anxiety-reducing defense mechanisms is not buried in the unconscious but is played out in overt thoughts and actions. The id impulses usually take the form of obsessive thoughts, and the ego defenses appear as counterthoughts or compulsive actions. A woman who keeps imagining her mother lying broken and bleeding, for example, may counter those thoughts with repeated safety checks throughout the house.
Sigmund Freud traced obsessive-compulsive disorder to the anal stage of development (occurring at about 2 years of age). He proposed that during this stage some children experience intense rage and shame as a result of negative toilet-training experiences. Other psychodynamic theorists have argued instead that such early rage reactions are rooted in feelings of insecurity (Erikson, 1963; Sullivan, 1953; Horney, 1937). Either way, these children repeatedly feel the need to express their strong aggressive id impulses while at the same time knowing they should try to restrain and control the impulses. If this conflict between the id and ego continues, it may eventually blossom into obsessive-compulsive disorder. Overall, research has not clearly supported the psychodynamic explanation (Goodman, 2020; Busch et al., 2010).
When treating patients with obsessive-compulsive disorder, psychodynamic therapists try to help the individuals uncover and overcome their underlying conflicts and defenses, using the customary techniques of free association and therapist interpretation. Research has offered little evidence, however, that a traditional psychodynamic approach is of much help (Goodman, 2020; Fonagy, 2015). Thus some psychodynamic therapists now prefer to treat these patients with short-term psychodynamic therapies, which, as you saw in Chapter 3, are more direct and action-oriented than the classical techniques.
The Cognitive-Behavioral Perspective
Cognitive-behavioral theorists begin their explanation of obsessive-compulsive disorder by pointing out that everyone has repetitive, unwanted, and intrusive thoughts. Anyone might have thoughts of harming others or being contaminated by germs, for example, but most people dismiss or ignore them with ease. Those who develop this disorder, however, typically blame themselves for such thoughts and expect that somehow terrible things will happen (Mitchell, Hanna, & Dyer, 2019; Salkovskis, 1999, 1985). To avoid such negative outcomes, they try to neutralize the thoughts — thinking or behaving in ways meant to put matters right or to make amends.
Neutralizing acts might include requesting special reassurance from others, deliberately thinking “good” thoughts, washing one’s hands, or checking for possible sources of danger. When a neutralizing effort brings about a temporary reduction in discomfort, it is reinforced and will likely be repeated (Brock & Hany, 2019). Eventually the neutralizing thought or act is used so often that it becomes, by definition, an obsession or compulsion. At the same time, the individual becomes more and more convinced that their unpleasant intrusive thoughts are dangerous. As the person’s fear of such thoughts increases, the thoughts begin to occur more frequently and they, too, become obsessions.
In support of this explanation, studies have found that people with obsessive-compulsive disorder have intrusive thoughts more often than other people, resort to more elaborate neutralizing strategies, and experience reductions in anxiety after using neutralizing techniques (Mitchell et al., 2019; Salkovskis et al., 2017, 2003).
Although everyone sometimes has undesired thoughts, only some people develop obsessive-compulsive disorder. Why do these individuals find such normal thoughts so disturbing to begin with? Researchers have found that this population tends to (1) have exceptionally high standards of conduct and morality; (2) believe that intrusive negative thoughts are equivalent to actions and capable of causing harm, a point of view called thought–action fusion; and (3) believe that they should have perfect control over all of their thoughts and behaviors in life (Davey, 2019; Simpson, 2019).
Cognitive-behavioral therapists use a combination of techniques to treat clients with obsessive-compulsive disorder (Patel et al., 2020; Abramowitz, 2019). They begin by educating the clients, pointing out how misinterpretations of unwanted thoughts, an excessive sense of responsibility, and neutralizing acts have helped to produce and maintain their symptoms. The therapists then guide the clients to identify and challenge their distorted cognitions. Increasingly, the clients come to appreciate that their obsessive thoughts are inaccurate occurrences rather than valid and dangerous cognitions for which they are responsible. Correspondingly, they recognize their compulsive acts as unnecessary.
With such gains in hand, the clients become willing to subject themselves to the rigors of a distinctly behavioral technique called exposure and response prevention (or exposure and ritual prevention; Patel et al., 2020). In this technique, the clients are repeatedly exposed to objects or situations that produce anxiety, obsessive fears, and compulsive behaviors, but they are told to resist performing the behaviors they usually feel so bound to perform. Because people find it very difficult to resist such behaviors, the therapists may set an example first.
In recent years, therapists who conduct exposure and response prevention have often used videoconferencing to go beyond the office and deliver specific instructions to clients directly in their home settings where compulsions cause the most problems (Ferreri et al., 2019; Comer et al., 2017a). At the very least, a number of therapists compose exposure-and-response-prevention exercises that clients must carry out in the form of homework, such as these assignments given to a woman with a cleaning compulsion:
Do not mop the floor of your bathroom for a week. After this, clean it within three minutes, using an ordinary mop. Use this mop for other chores as well without cleaning it.
Buy a fluffy mohair sweater and wear it for a week. When taking it off at night do not remove the bits of fluff. Do not clean your house for a week.
You have to keep shoes on. Do not clean the house for a week.
Drop a cookie on the contaminated floor, pick the cookie up and eat it.
Leave the sheets and blankets on the floor and then put them on the beds. Do not change these for a week.
(Emmelkamp, 1982, pp. 299–300)
Have you ever tried an informal version of exposure and response prevention in order to stop behaving in certain ways?
Eventually this woman was able to set up a reasonable routine for cleaning herself and her house.
Techniques of this kind often help reduce the number and impact of obsessions and compulsions. Overall, between 50 and 70 percent of clients with obsessive-compulsive disorder have been found to improve considerably with cognitive-behavioral therapy, improvements that often continue indefinitely (Patel et al., 2020; Abramowitz, 2019). The effectiveness of this approach suggests that people with the disorder are like the superstitious man in the old joke who keeps snapping his fingers to keep elephants away. When someone points out, “But there aren’t any elephants around here,” the man replies, “See? It works!” One review concludes, “With hindsight, it is possible to see that the [obsessive-compulsive] individual has been snapping his fingers, and unless he stops (response prevention) and takes a look around at the same time (exposure), he isn’t going to learn much of value about elephants” (Berk & Efran, 1983, p. 546).
The Biological Perspective
In recent years, researchers have uncovered direct evidence that biological factors play a key role in obsessive-compulsive disorder. For example, some genetic studies have identified gene abnormalities that characterize individuals with this disorder (Fontenelle & Yücel, 2019). In addition, using brain scan procedures, researchers have identified a brain circuit that helps regulate our primitive impulses such as sexual desires, aggressive instincts, and needs to excrete (Simpson et al., 2020; Shan et al., 2019). The circuit, which brings such impulses to our attention and leads us to act on or disregard them, includes brain structures such as the orbitofrontal cortex (just above each eye), cingulate cortex, striatum (including the caudate nucleus and putamen, two other structures at the back of the striatum), thalamus, and amygdala (see Figure 5-4). Among the most important neurotransmitters at work in this circuit are serotonin, glutamate, and dopamine (Gerez et al., 2016).
Studies indicate that this brain circuit, called the cortico-striato-thalamo-cortical circuit, is hyperactive in people with obsessive-compulsive disorder, making it difficult for them to turn off or dismiss their various impulses, needs, and related thoughts (Park et al., 2020; Zhao et al., 2019). After most people use the bathroom, for example, they have concerns about contamination and they act accordingly by washing their hands. When they perform this behavior, their brain circuit calms their contamination concerns and cleanliness needs. In contrast, because the cortico-striato-thalamo-cortical circuit of people with obsessive-compulsive disorder is hyperactive, these individuals may continue to experience contamination concerns and need to perform cleaning actions — again and again and again.
As you just read, brain scan studies have provided evidence that the cortico-striato-thalamo-cortical circuit is hyperactive in people with obsessive-compulsive disorder. In addition, medical scientists have observed for years that obsessive-compulsive symptoms often arise or subside after the orbitofrontal cortex, striatum, or other structures in the brain circuit are damaged by accident, illness, or surgical procedures (Simpson, 2019; Hofer et al., 2013).
By far, the most widely used biological treatment for obsessive-compulsive disorder is antidepressant drugs, particularly ones that specifically increase activity of the neurotransmitter serotonin. Numerous studies have found that such drugs bring improvement to between 50 and 60 percent of those with obsessive-compulsive disorder. Their obsessions and compulsions do not usually disappear totally, but on average they are cut almost in half (Simpson, 2020; Szechtman et al., 2020).
Given the effectiveness of serotonin-enhancing antidepressant drugs in treating obsessive-compulsive disorder, theorists initially reasoned that the disorder must be caused primarily by low serotonin activity throughout the entire brain. However, most of today’s researchers believe instead that the drugs bring improvement by increasing the activity of serotonin within the cortico-striato-thalamo-cortical circuit, thus helping to correct the brain circuit’s hyperactivity. Consistent with this notion, studies have found that the structures in the circuit interconnect more appropriately after individuals with obsessive-compulsive disorder respond successfully to antidepressant treatment (Shan et al., 2019; Zhao et al., 2019).
While many clients with obsessive-compulsive disorder receive either cognitive-behavioral therapy or antidepressant drug therapy, a growing number are now being treated by a combination of those interventions. According to research, such combinations often yield higher levels of symptom reduction and bring relief to more clients than do each of the approaches alone — improvements that may continue for years (Abramowitz, 2019).