Verified Document

Compulsive Hoarding Due To Childhood Term Paper

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...

Parts of this document are hidden

View Full Document
svg-one

The treatment modules are focused on: (1) assessment, (2) model building, (3) treatment planning, (4) skill building, (5) cognitive therapy, and (6) motivational interviewing. (Boston University School of Social Work, 2007)
The work of Beamish and Hill (2007) entitled: "Treatment Outcomes for Obsessive-Compulsive Disorder: A Critical Review" states that "Behavioral therapy is considered the most effective modality for treating OCD. Behavioral approaches to OCD arrests on the assumptions that compulsions are perpetrated through negative reinforcement. The goals of behavior therapy are to interrupt the association between obsession and subsequent anxiety and to eliminate the connection between completing the compulsion and the reduction of anxiety." (p.1) There are numerous interventions of a behavioral nature used for treatment of OCD. The 'combined treatment of choice is stated to be "exposure and response prevention." (Beamish and Hill, 2007) Other techniques "have not demonstrated such consistent positive outcomes." (Beamish and Hill, 2007) the component of exposure treatment involves clients confronting themselves "with the action, thought, or entity that contributes to their anxiety." (Beamish and Hill, 2007) the component of 'response prevention' involves a delay or minimization of "the compulsion associated with the encountered event, thought, or impulse. Habituation is the process underlying the efficacy of response prevention in that exposure and nonresponding across time result in decreased feelings of anxiety and fear and in habituation to the stimulus. The compulsions will become extinguished as the high level of emotions associated with the obsession disappear and as the reinforcement for engaging in the compulsion is removed." (Beamish and Hill, 2007) Research findings indicate that: "50% to 100% of clients respond positively to exposure and response prevention treatment immediately after treatment and retain the positive response at follow-up assessment at a certain time after treatment." (Beamish and Hill, 2007) There are correlations noted between exposure and response prevention with changes in neurophysiology." (Beamish and Hill, 2007) Behavioral treatments for OCD are stated to be between 72% and 90% effective however making the adjustment of the success rate with considerations of drop-out rates the actual percentage is more likely in the range of 40% to 50%." (Beamish and Hill, 2007)

Group therapy has also been shown to be an intervention that is effective in treating individuals diagnosed with OCD. Beamish and Hill state: "The substantiation of the effectiveness of this approach tends to be theoretical and anecdotal because few empirical studies have explored the impact of group interventions. The general therapeutic benefits of group experiences are well documented in the literature on group dynamics and forces." (2007)

Cognitive Treatment therapy for OCD "rests on the assumption that compulsions are a product of a persistent thought pattern of putting self or others at risk through an action or a failure to act. The thought patterns for clients with OCD tend to include an irrational sense of personal responsibility and irrational perception of threat. Cognitive interventions include challenging excessive responsibility and perfectionist tendencies. Cognitive restructuring also focuses on the specific fear connected with the obsession and the compulsion. Thought-stopping is another cognitive technique during which counselors or clients yell "stop" when the intrusive obsession surfaces in their thinking." (Beamish and Hill, 2007) Little research exists on cognitive therapy's efficacy with clients diagnosed with OCD although some research does indicate a positive change in the thought patterns of an irrational nature however indications are that little difference between behavioral therapy and cognitive…

Sources used in this document:
Bibliography

Beamish, Patricia M. And Hill, Nicole R. (2007) Treatment outcomes for obsessive-compulsive disorder: a critical review.(Private Practices) Journal of Counseling and Development 22 Sept 20077. Online available at http://www.highbeam.com/doc/1G1-170413211.html

Bechtel, Robert B. And Ts'erts'Man, Arzah (2002) Handbook of Environmental Psychology. John Wiley and Sons Ltd.

Boston University School of Social Work (2007) Online available at http://www.bu.edu/ssw/training/pep/programs/workshops/boston/index.shtml

Cromer, Kiara R. (2005) a Pathoplastic Vulnerability Mode: An Association Between Traumatic Stressful Life Events & OCD. Florida State University 2005. Online available at http://etd.lib.fsu.edu/theses/available/etd-11/unrestricted/Cromer_Thesis_Nov_2005.pdf
Saxena, Sanjaya, et al. (2004) Cerebral Glucose Metabolism in Obsessive-Compulsive Hoarding. The American Journal of Psychiatry. 161:1038-1048. June 2004. Online available at http://ajp.psychiatryonline.org/cgi/content/full/161/6/1038
Cite this Document:
Copy Bibliography Citation

Related Documents

Other Cultures Xenophobia and Understanding
Words: 954 Length: 3 Document Type: Essay

The world is more interconnected now than ever before, both with technological tools and also with population migrations that are occurring on an unprecedented scale. People who grow up in pluralistic, heterogeneous societies like the United States, India, or Canada take cultural diversity for granted. However, many people around the world live in homogenous societies with little contact with other cultures other than through what they read about or see

Other Disciplines Relate to Nursing
Words: 726 Length: 3 Document Type: A-Level Outline Answer

Nurse How to gain a comprehensive and well-founded knowledge of nursing as a student? As a student, it is important to keep an open mind when gathering knowledge of this profession. This attitude is most important in my opinion because of the continual changes the medicine world offers on a fairly regular basis. New treatments and new ailments arise consistently and it is up to a nurse's education to guide this process

Other Wind by Ursula K. Le Guin
Words: 1267 Length: 4 Document Type: Term Paper

Wind -- Science Fiction for Adults, a Drama of the Human Heart and Mind rather than Light-Sabers Ursula Le Guin, the Modern Female Conscience of Science Fiction Ursula Le Guin is one of the most highly respected authors of fantasy and science fiction of the 20th century. The award-winning Le Guin has long been praised for combining traditional elements of literary fiction, science fiction; with philosophical and ethical speculations on ways

Media in Other Countries Many
Words: 1295 Length: 4 Document Type: Essay

In the Arab world, it can get that woman killed…literally. That is not to say that is the norm, but it's a commonly discussed and accepted precept with much (but notably not all) of the Arab sphere. Similarly, honor killings are considered acceptable, even with some people that have immigrated to countries that consider it cold-blooded murder. As for whether anything has changed in the recent past that might change

Engagement Phase Examination of Self and Others
Words: 1505 Length: 5 Document Type: Term Paper

Self and Others The term engagement has been defined as being actively involved in, a part of. When applied in a social work context, the same definition holds true. For a client to be engaged it means they must be actively involved in and a part of the process from the beginning until the very end. The National Association of Social Worker's Code of Ethics bespeaks the importance of client

Humanities and Other Modes of Human Inquiry
Words: 1118 Length: 3 Document Type: Essay

Humanities and Other Modes of Human Inquiry and Expression • Define the term humanities Humanities are a term that encompasses many individual study and sciences. There can be a two way classification of all human knowledge. First is the knowledge of the space around us, but not directly linked to humans. For example, the study of physics, botany or astronomy does not involve expressions from human emotion and nor do they reflect

Sign Up for Unlimited Study Help

Our semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.

Get Started Now