Obsessive-compulsive disorder: explanations

Psychology A2 · Clinical Psychology. The idea in plain words, the rules to remember, the mistake to avoid and a worked example, written and checked by Mega Lecture.

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The idea

Biological explanations treat OCD as a problem of the body. The biochemical view links it to low serotonin activity (and possibly unusual dopamine activity). The genetic view says risk is inherited: OCD runs in families and is polygenic, but identical twins do not always both have it, so genes are not the whole cause.

Psychological explanations focus on the mind and learning. The cognitive view says a thinking error turns a normal intrusive thought into an obsession. The behavioural view says compulsions are kept going by negative reinforcement. The psychodynamic view says symptoms come from unconscious conflict that began in the anal stage.

Rules to remember

Biochemical: low serotonin activity; supported by SSRIs helping, but a treatment working does not prove the cause.
Genetic: several genes each add a little risk (polygenic); less than 100% concordance in identical twins shows the environment matters too.
Cognitive: thinking errors such as inflated responsibility and thought-action fusion (believing a thought can make an event happen).
Behavioural (operant conditioning): the compulsion removes anxiety, so it is negatively reinforced and repeated.
Psychodynamic: conflict between id impulses and the superego, linked to fixation at the anal stage; defence mechanisms include undoing and reaction formation.
Biological explanations are nature, reductionist and deterministic; learning explanations are nurture.
Operant conditioning explains why compulsions continue, not where obsessions come from.

Common mistake

Calling the relief from a compulsion 'positive reinforcement'. Nothing pleasant is added; an unpleasant feeling (anxiety) is taken away, so it is negative reinforcement.

Worked example

Sana has the thought 'I may have left the gas on'. She believes that if she does not check ten times, a fire will be her fault. Each check calms her, and she checks more every week. Which two explanations fit, and which part does each explain?

Her belief that any harm would be her fault is inflated responsibility, a thinking error.
So the cognitive explanation accounts for why an ordinary thought became an obsession.
Checking removes her anxiety, which is negative reinforcement.
So the behavioural explanation accounts for why the checking continues and increases.

Answer: Cognitive explanation for the obsession (thinking error); behavioural explanation for the compulsion (negative reinforcement).

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