Compulsions and Obsessions in OCD, – what comes first?

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Now those of you who are suffering, or who knows of someone who is suffering with OCD or Obsessive Compulsive Disorder, will probably be under the impression that the compulsions associated with OCD are a result of an underlying anxiety and/or fear.

Now new evidence is challenging that view that it is the anxiety that comes first and is suggesting that the behaviours, such as obsessive hand washing, ritual cleaning routines, constant checking and rechecking doors and locks and any number of other repetitive behaviours are actually what come first and the obsessions, or anxiety and fears underpinning them, are just a way for the brain to justify those behaviours.

The study was carried out at the University of Cambridge along with the University of Amsterdam and involved 20 people with Obsessive Compulsive Disorder and 20 control subjects without the disorder.

As part of the research each person was asked to carry out a task which was designed to identify any tendency towards repetitive behaviours, or compulsions as they are often called.

Science Daily reports that they subjects were required to learn simple associations between stimuli, behaviours and outcomes to win points as part of the task.

Interestingly, the researchers found that people with OCD displayed a tendency to carry on with the behaviour regardless of whether the behaviour had a positive outcome or not. In other words they developed the “habit” of repeating the tasks just for the sake of it.

The researchers then made the assumption that the fact that the compulsions continued despite no associated fear or anxiety behind them suggested that the compulsions themselves are the main feature of OCD and not the anxiety or fears associated with them.

“It has long been established that humans have a tendency to ‘fill in the gaps’ when it comes to behaviour that cannot otherwise be logically explained” said Claire Gillan, a PhD student at the University of Cambridge.

“In the case of OCD, the overwhelming urge to senselessly repeat a behaviour might be enough to instil a very real obsessive fear in order to explain it” she said.

The research, which was funded by the Wellcome Trust, has been published in the American Journal of Psychiatry.

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