INTRODUCTION

Obsessive–Compulsive Disorder (OCD) is a chronic anxiety-related disorder in which a person

experiences persistent, intrusive thoughts (obsessions) and repetitive behaviours or mental acts
(compulsions). These thoughts and behaviours are unwanted, distressing, and difficult to control,
even when the person recognises that they are irrational. OCD affects people across age groups
and cultures and can significantly interfere with daily functioning.

OCD is classified under Obsessive–Compulsive and Related Disorders in the DSM-5. While
anxiety is the core emotion, the disorder is not simply “being neat” or “being particular.” OCD
involves intense psychological distress, a cycle of fear, and repetitive attempts to neutralise that
fear.

Key Features

• Presence of obsessions, compulsions, or both

• Awareness that thoughts/behaviours are unreasonable (in most cases)

• High distress and interference with routine

• Repetitive and time-consuming behaviours

SYMPTOMS AND TYPES OF OCD

OCD symptoms are broadly divided into obsessions and compulsions.

A. Obsessions

Obsessions are unwanted, intrusive thoughts, images, or urges that repeatedly enter a person’s
mind and cause anxiety or discomfort.

Common types of obsessions:

• Contamination fears (germs, dirt, illness)

• Doubting and checking thoughts (“Did I lock the door?”)

• Need for symmetry or exactness

• Aggressive or harmful intrusive thoughts

• Sexual or taboo intrusive thoughts

• Religious obsessions (fear of committing sins, blasphemy)

B. Compulsions

Compulsions are repetitive actions or mental rituals performed to reduce the distress caused by
obsessions.

Common types of compulsions:

• Excessive washing or cleaning

• Repeated checking (locks, appliances, switches)

• Counting rituals

• Arranging and ordering objects

• Mental rituals (praying, repeating phrases, seeking reassurance)

C. OCD Symptom Dimensions

Psychologists commonly group OCD symptoms into 4 clusters:

1. Contamination & Cleaning

2. Symmetry & Ordering

3. Forbidden/Intrusive Thoughts

4. Doubt & Checking

These vary in intensity from person to person.

CAUSES OF OCD

The exact cause of OCD is not fully known, but research shows that it develops due to multiple
interacting factors.

A. Biological Causes

Scientists believe OCD has strong biological origins.

1. Genetic factors

• OCD tends to run in families.

• First-degree relatives of a person with OCD have a higher likelihood of developing it.

2. Brain structure and functioning

 • Overactivity in the orbitofrontal cortex, anterior cingulate cortex, and basal ganglia is
linked with OCD.

• These areas regulate decision-making, emotional processing, and habit formation.

3. Neurochemical factors

• Imbalances in serotonin, a neurotransmitter involved in mood and behaviour regulation,

are commonly found in individuals with OCD.

B. Cognitive Explanations

Cognitive psychologists believe OCD arises from distorted thinking patterns.

Key ideas:

• People with OCD misinterpret normal intrusive thoughts as dangerous.

• They overestimate threat (“If I don’t check the gas stove, the whole house will burn”).

• They believe they must control their thoughts perfectly.

• They engage in compulsions to prevent imagined disasters.

C. Behavioural Causes

Behavioural theories explain OCD through learning processes.

1. Classical conditioning

A neutral item (e.g., doorknob) becomes associated with fear (contamination).

2. Operant conditioning

Compulsions get reinforced because they temporarily reduce anxiety.

Example: Washing hands reduces fear of germs → behaviour repeats.

D. Sociocultural Factors

While not the direct cause, these factors influence severity and expression:

• Stressful life events

• Family expectations and pressure

• Cultural beliefs about cleanliness, morality, or guilt

• Parenting styles (overprotective or highly critical)

 PSYCHOLOGICAL ASSESSMENT OF OCD

Assessment helps understand severity, symptom patterns, and functional impairment.

A. DSM-5 Diagnostic Criteria (Simplified)

To be diagnosed with OCD:

• Presence of obsessions, compulsions, or both

• The behaviours are time-consuming (more than 1 hour/day)

• Symptoms cause distress or interfere with routine

• The person tries to resist or ignore the thoughts

• The symptoms are not due to substances or another disorder

B. Psychological Tests Used in OCD

1. Yale–Brown Obsessive Compulsive Scale (Y-BOCS)

• Gold-standard tool

• Measures severity of obsessions and compulsions

• Scores range from mild to extreme OCD

2. Maudsley Obsessive-Compulsive Inventory (MOCI)

• Self-report questionnaire

• Focuses on checking, washing, slowness, and doubting

3. Obsessive–Compulsive Inventory – Revised (OCI-R)

• Measures frequency of OCD symptoms

• Used in research and clinical settings

C. Clinical Observation Points

During assessment, psychologists observe:

• Repetitive actions
 • Avoidance behaviour

• Level of anxiety

• Distress during interruptions

• Overall functioning at home/school

D. Case Study Format (for your file)

• Identifying information

• Presenting complaint

• History of problem

• Symptoms observed

• Assessment tools used

• Interpretation of results

• Conclusion

TREATMENTS FOR OCD

OCD treatment focuses on reducing symptoms, breaking the obsessive–compulsive cycle, and
improving daily functioning.

A. Cognitive Behaviour Therapy (CBT)

CBT helps a person understand how their thoughts influence their behaviours.
For OCD, it mainly focuses on:

CBT Techniques

• Identifying irrational thoughts

• Challenging catastrophic thinking

• Reducing the need for reassurance

• Developing healthier coping behaviours

CBT is one of the most effective therapies for OCD.

B. Exposure and Response Prevention (ERP)

ERP is considered the gold-standard treatment for OCD.

How ERP works:

1. The person is gradually exposed to the feared situation (e.g., touching a doorknob).

2. They are prevented from performing the compulsion (e.g., washing hands).

3. Anxiety naturally decreases over repeated sessions.

4. The brain learns that nothing dangerous happens without the ritual.

ERP helps break the reinforcement cycle that maintains OCD.

C. Medication (Simple Explanation)

Common medications:

• SSRIs (Selective Serotonin Reuptake Inhibitors)

o Increase serotonin availability

o Help reduce obsessional thinking and compulsive urges

Medications are often prescribed when:

• OCD is moderate to severe

• Therapy alone is not enough

• The person cannot fully participate in ERP

D. Combined Therapy Approach

For many people, CBT + ERP + medication works best.

This approach gives:

• Cognitive tools

• Behavioural change

• Biological support

E. Self-Help & Coping Strategies

 • Practising mindfulness

• Delaying compulsions

• Keeping a thought journal

• Stress-management techniques

• Avoiding reassurance-seeking

• Family education and support

CASE STUDY

INTRODUCTION:

Name: Ankita Kundu

Age: 21

Educational Qualification: BF 3rd Year

HISTORY:

1. 2017- Saw her dad’s death at a very young age

2. Suicidal thoughts, attempts at suicide- first attempt in 8th grade due to ragging in school,
and no support from teachers.
3. Started taking sleeping pills
4. Dad’s friend sexually harassed her
5. Beloved pet died in 2023. She started getting panic attacks after this
6. She was stalked multiple times by her peers
7. Suppressed grief of her dad’s death

SYMPTOMS:

1. Nightmares, flashbacks of traumatic experiences (dad’s death, harassment) – signs of

PTSD which probably caused OCD
2. Repeated hand washing, excessively doing other things
3. Palpitations
 4. Blood vomit
5. Chest pain
6. Asthma attacks, breathing issues
7. Dizziness, drowsiness
8. Blurry vision
9. Disturbed sleep
10. Reduced appetite (been going on for 6 months)
11. Manic episodes- Panic attacks one moment, excited the next
12. Irritated mood
13. Has a phobia of blood
14. OCD- Does everything 3 TIMES; Checking doors, handwashing etc. If she does not do it
thrice then she thinks something bad will happen to her or the ones she loves
15. These things only happen at home, not outside
16. Loss in interest
17. Has germophobia
18. Very emotional
19. Feelings of intense guilt

HOBBIES:

1. Reading
2. Pottery
3. Gathering knowledge about our culture
4. Mythology
5. Research about religion

STUDENT LIFE:

1. Good at studies
2. Will take a corporate job
3. Hope for a good future

MOTHER:

1. Leaves for work in the morning, comes back late

2. She slipped into depression after her husband’s death

MEDICATION:

1. Sleeping pills
 2. Panic attack medicine

RELATIONSHIP:

1. Supportive
2. Good & healthy
3. Her conditions have bettered since the start of the relationship