13) Most of studies in this area investigation the association between SLEs and OCD have held limitations of: (1) small sample sizes; and (2) difficulty of establishing retrospectively the temporal relationship between onset and SLEs; and (3) a limited scope with regard to the effect of SLEs on OCD. (2005; p.13) Cromer relates that "mounting evidence suggests that early life-stress, in particular may preferentially incline individuals to develop adult psychiatric disorders." (2005; p.13) McCauley et al. (1997) states evidence from a large epidemiological investigation that childhood abuse "was related to a large range of physical and psychosocial difficulties." (Cromer, 2005; p. 14) the work of Nemeroff et al. (2004)states findings that there is an association between experiences in childhood and "increased adult psychopathology" which can be explained by the "profound effect early-life experiences have on the developing brain...research indicates that changes in the brain can lead to life-long psychiatric sequelae." (Nemeroff, 2004; as cited in Cromer, 2005; p.14) Nemeroff et al. along with other researchers state implications from both preclinical and clinical investigations that "neurobiological systems, relating the corticotropic releasing factor (CRF) system in the etiology of mood and anxiety disorders." (Cromer, 2005; p. 14) Related is: "In conjunction with the hypothalamic-pituitary-adrenal (HPA) axis, this system represents the major mammalian neuroendocrine stress response system Hypothalamic CRF is released by an organism in response to stress that leads to the stimulation of the HPA axis, which in turn results in the secretion of the adrenocorticotropic hormone (ACTH). ACTH stimulates the secretion of other neuropeptides, which ultimately releases cortisol (Dallman et al., 1994). Through a number of well-executed analogue Nemeroff and colleagues have proposed a neurochemical hypothesis that would explain how early life-stress antecedes psychological disorders, such as anxiety disorders. It is hypothesized that particularly early life-stress leads to neuronal changes that result in the induction of persistently-elevated neuronal releases of CRF. The net effect is an increased responsiveness to stress Several investigations have shown that this increased responsiveness then renders individuals more susceptible to psychopathology in adulthood (Heim & Nemeroff, 2002; as cited in Cromer, 2005; p. 14).Cromer relates the 'biopsychosocial model of psychopathology which is illustrated in the following figure.
Biopsychosocial Model of Psychopathology
Source: Cromer (2005)
The findings of Cromer (2005) include those relating that the experience of SLEs "would be more strongly associated with specific OC symptom dimensions (hoarding and obsessions/checking) as SLEs were "significantly correlated with the obsessions/checking and symmetry/ordering symptoms dimensions, as well as the SI-R hoarding dimensions." (p. 27) Cromer relates that the total number of "comorbid disorders was not significantly associated with SLEs" which indicates that the SLEs are closer related to mood and anxiety disorder comorbidty as compared with other comorbid disorders.(p. 28; paraphrased) Cromer states that "alternatively, it may be that SLEs act through a common vulnerability pathway that leads to a comorbidity phenotype of OCD." (2005 p. 28) the third stated possibility is that OCD in combination with SLE "acts as a trigger for the expression of comorbid disorders." (2005; p.29) Cromer relates that the work conducted by Hasler et al. (2005) relates that "neither hoarding, nor the contamination/cleaning symptom dimensions were strongly associated with mood and/or anxiety disorders." (as cited in Cromer, 2005; p.29) Cromer additionally relates that when comparing individuals experiencing SLE in childhood or adulthood that these individuals "differed significantly from those who reported no SLEs in mood and anxiety disorder comorbidity." (p. 29) These findings partially corroborate evidence from neurobiological investigations relating to hyperactivation of the CRF system nd the HPA axis" (Cromer, 2005; p. 30) in the work of Memeroff (2004).
The work of Bechtel and Ts'erts'man entitled: "The Handbook of Environmental Psychology" states the fact that hoarding behavior is not related to material deprivation with researchers making suggestion of a model that conceptualizes hoarding as an "avoidance behavior tied to indecision and perfectionism." (Bechtel and Ts'erts'man, 2002) Furthermore, sexual abuse "whether it occurs in childhood or adulthood has been a major source of post-traumatic stress disorder and has the focus of an extensive body of research..." which relate that "disassociation occurs both peritraumatically - at the time of the event - and posttraumatically - as a long-term consequence of traumatic exposure." (Bechtel and Ts'erts'man, 2002) Symptoms of disassociation that arises from childhood abuse include: "...depersonalization, derealization, dissociative amnesia, fragmentation of identity and posttraumatic re-experiencing phenomena...
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