¶ … dysfunctional behavior that strikes 1 out of 40 or 50 adults and 1 out of 100 children or 2-3% of any population. It can begin at any age, although most commonly in adolescence or early adulthood - from ages 6 to 15 in boys and between 20 and 30 in women -- according to the National Institute for Mental Health. This behavioral affliction is, therefore, more common than schizophrenia or panic disorder and affects people of all ages, gender, race, occupations, religions and socio-economic ranks. Its impact on the mental and emotional states of such numbers in the United States alone has been so strong that it accounts for more than $8 billion worth of social and economic losses - which is 6% of the country's total mental health bill, according to authoritative sources.
As if not depressing enough, these millions afflicted know that something is wrong with how they behave, yet do not know what it is that binds them to perform irrational and uncontrollable acts. What is worse, each of them feels alone and helpless. And ironically, this affliction is treatable with various modern and effective therapies.
This behavioral ailment is called Obsessive-Compulsive Disorder (OCD), a neurobiological mental illness, which is characterized by obsessions and usually followed by compulsions to quiet the obsessions. Obsessions are strong, repetitious, unreasonable, frightening and intruding impulses or images that cause great anxiety in the affected person. Compulsions are odd and ritualistic acts that the person feels must be performed in response to the obsessions. Both the obsessions and the compulsions are senseless, shameful and exasperating to the person, who nevertheless finds the behavior difficult to control or overcome. A person with OCD may have obsessions or compulsions only, but 90% of those affected have both.
Common obsessions are fears of contamination (dirt or germs), harming another person, making a mistake, social misbehavior, a lack of symmetry, sexual thoughts and impulses, doubt, repulsive religious thoughts or images, violent or terrifying thoughts that may occur to a loved one. These obsessive thoughts are then followed by the performance of compulsive acts meant to respond to these thoughts. Common compulsive acts or compulsions include repetitious washing of the hands or cleaning, too frequent showers, checking, reordering, collecting, organizing, counting, touching things. The afflicted person keeps repeating a particular compulsion until he or she feels gratified that his or her fear is gone and things are all right. They are performed rigidly to reduce or eliminate the agony presented by the obsessions, although these acts are not directly connected to the thing feared and, therefore, cannot prevent or minimize it. They are also clearly exaggerated.
This pattern should not be confused with the normal or admirable cautiousness exercised when assuring accuracy as regards measurements and counting; double-checking locks, ovens and electrical or gas equipment for safety; or insuring desirable hygiene and order. The person afflicted with OCD, in time, becomes conscious that his or her pattern of behavior is exaggerated, unreasonable and un-directed at the disturbance. Both his or her obsession and compulsion are distressing, lengthy - at least an hour a day -- and tiresome and disturb normal activities to his or detriment and embarrassment. Obsession over cleanliness, for example, can drive a person to compulsively wash hands, take a shower or perform some other sanitary actions in order to eliminate or avoid getting infections or passing them on. Obsession over order and harmony can impel the person to count repetitiously, keep organizing and reorganizing details, aim at perfect alignment of things in the house or office, testing and retesting exaggeratedly. A child may miss his lessons because he or she is preoccupied with counting the teacher's syllables. Or he may be avoiding pointing instruments for fear of hurting someone.
In the past, psychiatrists believed that OCD developed out of a person's traumatic past, such as the over-emphasis on cleanliness or order in a child by his or her parents. Sigmund Freud theorized that it proceeded from traumatic toilet training. Modern research, however, points to OCD as a neurobiological dysfunction when the difference between the brain neurons of OCD patients and those without OCD: the brain neurons of OCD patients appeared much more sensitive to serotonin, a chemical that sends signals to the brain. Modern psychiatrists assume that the over-communication between the frontal lobe (of the brain) and deeper parts of the brain accounts for the repetitive and excessive behavior (compulsion). This, they see as resulting in a kind of jammed transmission in a car, a condition that may conduce to the development of rigid thinking and repetitious movements. Persons with OCD have abnormal frontal lobes, basal ganglia and cingulum. The basal ganglia are involved in automatic behavior,...
OCD in Childhood Obsessive-Compulsive Disorder (OCD) is a common psychological, anxiety disorder that is characterized by repetitive and intrusive thoughts and stereotypic behaviors frequently associated with dread and compulsion (Walitza). These intrusive thoughts can be scary and the behaviors are often disruptive to the development of social relationships and therefore debilitating especially to children and adolescents. OCD affects approximately 3% of the population and an early age of symptoms onset during
These studies show the importance of confronting feared stimuli for extinguishing anxiety. However, at the same time, other research has found that the cognitive methodology has had equal results to the ERP in OCD treatment. Hackman and McLean report that they have as positive results with thought-stopping as those found with ERP. Once again, however, the number of studies has been very small (Abromowitz). It has only been in the
Here is what is known for now: Patients who are found to have OCD generally display symptoms along the lines of having compulsions, obsessions, doubting, hyper-vigilance and the need to control their environment. No one is completely certain what it is that causes OCD, although there are two trains of thought on the matter. Some people believe that OCD is a psychological disorder and others believe that it is
OCD is in many ways a homogeneous disorder. The disorder has a prevalence of around 2% to 3% of the population, and this prevalence is likely underestimated in many different countries / and descriptions of obsessions and compulsions have been remarkably consistent over time and place. Neurobiological studies have consistently found evidence that cortical-striatal-thalamic-cortical (CTSC) circuits play a crucial role in mediating the disorder and treatment research has invariably demonstrated
Diagnosis in children is sometimes difficult since they often try to mask symptoms. The following questions are a good indicator that the child needs to be evaluated by a professional: Do you have worries, thoughts, images, feelings, or ideas that bother you? Do you have to check things over and over again? Do you have to wash your hands a lot, more than most kids? Do you count to a certain number or
The resulting anxiety then is managed by training children to use strategies that help them work with their anxiety in a more effective and less disruptive way. Anxiety management techniques may include relaxation training, distraction, or imagery. Often, OCD is personified as something that makes the child perform an action. Thus, children learn to assess situations and ask themselves if they really want to do something, as opposed to the
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