OCD is a fairly well known but also a very misunderstood mental health condition often people who are exceptionally organized and tidy or like to do things in a certain way will say oh I'm a bit OCD well that's simply not true that kind of comment minimizes how badly people with obsessive compulsive disorder suffer from their illness repetitive and intrusive thoughts dominate the internal mental world of some of OCD causing constant and crippling anxiety and the need to repeat the same behavioral compulsions again and again and again leaves little time for the rest of their lives in this video we'll discuss the biological approach to explaining and treating OCD of course if you want to brush up on biological terminology you can check out my biological psychology video in the approaches unit but I will cover everything you need for this section from areas of the brain to candidate genes and drug treatments as well as evaluations right here psychboost.com over 170 videos to help you with your qualification and Patron supporters can access bonus resources tutorial videos and the Discord Channel the biological approach to explaining and treating OCD there are a wide range of explanations for why people develop OCD but in this video we need to focus on the biological including genetic and neural explanations you likely remember what obsessive-compulsive disorder is from my characteristics video but as a quick reminder OCD is a common mental health condition affecting around 150 people these individuals have obsessive thoughts and compulsive behaviors the repetitive and unpleasant obsessive thoughts on mental images worries and urges that cause anxiety compulsions of the behaviors that the individual feels they need to act out in order to relieve the discomfort caused by the obsessive thoughts unfortunately this relief is only temporary and the obsessive thoughts in return obsessions around dur and contagion are common leading to repetitive cleaning there are obsessions about burglary leading to repetitive checking of locks and there are obsessions about causing a fire leading to repetitive checking of power switches these are just some of the more common symptoms but there are many many other obsessions and compulsions the biological approach to explaining OCD the genetic explanation the genetic explanation suggests that a vulnerability or predisposition to OCD is inherited from our parents well there certainly isn't one single OCD Gene that causes OCD there are some individual genes called candidate genes that are found more frequently in those people who have OCD these include G9 comp Gene cert Gene and 5 ht1d beta Gene however in total there are as many as 230 separate genes that could be involved in some way in the development of OCD this means OCD is polygenetic family studies also indicate a genetic origin to OCD the prevalence rate of OCD in the general population is two percent however if an individual has OCD the likelihood that their first two relatives have OCD known as the concordance rate Rises to 10 percent this increased risk is arguably due to Shear genetics with first degree relatives sharing 50 of their genes identical twins who share 100 of their genetic makeup also known as monozygotic twins have been shown to have a 68 concordance rate for OCD well non-identical or dizygotic twins have a 31 concordantry the presence of genes isn't the whole story because those genes have functions the role of your genes is to code for aspects of your biology unexport those candidate genes might influence the functioning of certain neural systems in your brain especially the serotonin system the biological approach to explaining OCD the neural explanation neural exclamation through OCD include both biochemical causes this is an imbalance of neurotransmitters chemicals that communicate information between neurons and the large structures in the brain that are made of many neurons serotonin is the neurotransmitter most associated with OCD low levels of Serotonin are thought to cause obsessive thoughts and the low level of Serotonin is likely due to it being removed too quickly from the synapse before it's been able to transmit signal if you haven't studied neurons and synapses yet that probably sounded like a pretty weird sentence when it comes to the synapse and synaptic transmission I'm going to tell you what you need to know for OCD in this video but I did make an entire video on synapses you might want to watch serotonin other neurotransmitters are chemical Messengers presynaptic neurons release neurotransmitters which are detected through receptors on the postsynaptic neural if the signal is strong enough then the message is passed on and the neurotransmitters detach from receptors are not taken back into the presynaptic neuron through a process called reuptake it seems like this process happens too quickly in people with OCD leading to reduced levels of serotonin in the synapse the cert Gene mentioned in the previous section is the gene responsible for serotonin transport in the synapse looking at larger structures in the brain the communication between a set of brain structures term the worry circuit is overactive in people of OCD leading to an inability to filter out small worries the structures that form the worry circuit are the Orbiter from the cortex the part of the brain responsible for rational decision making the basal gangla system in particular part called the claudic nucleus and the thalamus in normal functioning the basal gangla filters out minor worries coming from the Octo frontal cortex but if this area is hyperactive even small worries get to the thalamus which is then passed back to the orbital frontal cortex forming a loop this is the recurring obsessive faults this abnormal brain activity is ultimately responsible for the repetitive motor functions the compulsions these are an attempt to break this Loop while carrying out the compulsion may give temporary relief the hyperactive basal ganglia will soon resume the worry circuit there is another brain area that's linked to OCD called the parahippocampal gyrus it's an area of Cortex on the underside of the brain close to the hippocampus it's responsible for regulating and processing unpleasant emotions and has been seen to function abnormally in cases of OCD the biological approach to explaining OCD are valuations the fact that there's a high concordance rate between close family members shown by the data provided by nostan suggests that there's a genetic origin to a CD close relations share more DNA and have a higher concordance rate this is because if you share more DNA you have a higher chance of sharing the parts of DNA that cause the OCD both monozygotic and dizygotic twins grow up sharing very similar environments like food upbringing and education unlife events like bereavement or parental divorce but there's a significant difference in concordance rate 68 of monothygotic and 31 in dizygotic suggesting the additional shared DNA is what's responsible for the increased Concordance but as you can imagine there are issues of assuming it's the DNA that results in the high concordance rates closer family members also share similar environments and even when it comes to twins who do have similar experiences it could be argued that identical monozygotic twins are treated more similarly on the basis that they look identical compared to dizygotic non-idential twins also the concordance rate even for identical twins is at 68 not 100 the level we'd expect for a feature that was entirely genetically determined so there's likely a role for the environment this means of the diaphysis stress model might be a more valid explanation than biology alone individuals inherit a genetic vulnerability to OCD a diaphysis however the disorder does not develop unless there's a stressor an environmental Factor such as a traumatic life experience this is supported by research from chroma who showed 54 of 265 participants with OCD reported at least one traumatic life event and those with traumatic life events reported increased severity of OCD symptoms this demonstrates an environmental aspect to OCD many neural Imaging studies using pet scanners have shown hyperactivity in the orbital frontal cortex and the chlordate nucleus in people with OCD both while scanning the brain at rest and when symptoms are stimulated but there is a problem with this neural evidence it's correlational research can be sure if the hyperactivity in these areas cause OCD or are just a consequence of having OCD we can evaluate the biological University based on the effectiveness of drug treatments a matter analysis by samaro demonstrates ssris are more effective than placebos suggesting there's a biological aspect to OCD however despite altering levels of serotonin in the synapse within hours these drugs take weeks to reduce symptoms and 40 to 60 of patients show no or just partial symptom Improvement these findings suggest low levels of Serotonin have a role to play in OCD but not the sole cause of OCD but biological approach to treating OCD drug therapy the main type of drug used to control the symptoms of OCD is a group of antidepressant drugs known as ssris one example is fluoxetine also known as Prozac I think these ssris are well named because the name explains exactly what this class of drugs do in the brain they are selective serotonin meaning they only influence serotonin in the brain reuptake Inhibitors meaning they inhibit they slow down the process of reuptake in the synapse this means that serotonin continues to stimulate the postsynaptic neuron this decreases anxiety by normalizing the activity of the worry circuit going back to this image we can see the process of reuptake ssris by blocking the reuptake of Serotonin keep serotonin in the synapse for longer increasing its effectiveness it can take three to four months for ssris to impact symptoms however some patients ssris are not effective the dosage can be increased but there are other treatment options anti-anxiety drugs like benzodiazepines enhancing your transmitical Gaba slowing the central nervous system resulting in general relaxation tricilics and S nris work by increasing serotonin and neuroadrenaline these drugs can be effective when ssris fail but because they work on multiple neurotransmitters they tend to have more intense side effects evaluations of biological treatments for OCD as I've already mentioned there is research evidence by Samara that compared assets rise to placebos placebos are sugar pills that make the patient think they're receiving drug therapy Samara combined the data from 17 studies including 3000 and 97 participants into a meta-analysis the results showed the ssris significantly reduced the symptoms of OCD compared to placebos between 6 and 17 weeks post-treatment this suggests drug therapy is effective at least in the short term there are criticisms that this type of research may not be as reliable as it appears goldacre points out that the vast majority of the research duties and drug therapies are conducted by the pharmaceutical companies who created them this means they have a financial interest in showing their effective this along with a file draw problem fact that many negative results stay unpublished means that the drug therapies may not be as effective as drug companies claim they are on a related Point Dr Ben goldacre has two books about science and bad Pharma they're interesting and well written any student considering medicine or just interested in how scientists conducted poorly and misrepresent in the media should probably read them an advantage of drug therapy is it's a relatively inexpensive treatment as well as potentially more convenient for the patient this is in comparison to psychological therapies like CBT which require multiple sessions of a trained therapist as CBT is much more expensive from an economic perspective Health Services like the NHS are more likely to provide drug therapy before CBT a disadvantage of drug therapy is it's not the preferred treatment plan for many patients with many preferring a course of Cong to behavioral therapy this is because drug therapy can have a range of potential side effects in the Samara meta-analysis nausea headache and insomnia or the most common side effects for each drug tested there are other reasons drug therapy is not preferred by patients the desired effects of the drugs the symptom reduction can take up to three to four months and patients can ultimately become dependent on the drugs and finally drug therapies may be only treating the symptoms of OCD not the cause serotonin imbalance could be due to other biological processes or the origin of OCD may not be biological at all but due to a traumatic experience remember research by crime measured 54 of 256 participants with OCD reported at least one traumatic life event and those with traumatic life events reported increased severity of OCD symptoms this suggests jug therapy may only be a temporary solution and psychological therapy might be a more effective long-term treatment I want to thank everyone over on patreon for supporting the channel because of you I've been able to teach part-time meaning I can make site boost on YouTube for everyone and a special thank you to cat posnick and Ahmad Romani for supporting at the developer level I do have extra resources that are exclusive to my patrons so if you decide to sign up you can grab those over my website and these include over a hundred exam question tutorial videos of course including questions on the psychic pathology unit I hope this was helpful and I'll see you in the next site Boost video foreign