Download Suri Project 4: Research Proposal Research Proposal: OCD

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Project 4: Research Proposal
Research Proposal: OCD Treatments
Varun Suri
ENG 3010-010
Wayne State University
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Project 4: Research Proposal
Background on Topic:
Obsessive compulsive disorder (OCD) is one of the most common psychological
disorders in the world among diagnosed anxiety disorders. OCD is characterized with obsessive
thoughts and compulsions to drive that particular thought away (Lara, F., Allison, W., Ella, M., &
Thomas, O). However, after the compulsion the thought keeps returning and the cycle is
unbreakable. The most common type of OCD is fear of germs also known as Mysophobia; the
person has an irrational fear of germs, which makes them believe they are contaminated
utmost of the time. This leads them to take showers and wash hands compulsively throughout
the day (March, P., & Schub, T., 2012).
This image above explains the cycle of an OCD attack
Moreover, OCD is a chronic illness which negatively impacts an individual’s life (PR, N
2012). For example, people cannot go to school if their mind is so occupied with obsession and
compulsions. Similarly, they have to let go many friends because they do not have time to meet
them. Likewise, family life is also disrupted and many times ended because of this disease
(Stewart, S., Hu, Y., Hezel, D. M., Proujansky, R., Lamstein, A., Walsh, C., & ... Pauls, D. L, 2011).
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Obsessive compulsive disorder can show up in a person in many different ways and can
be portrayed differently varying from individual to individual. A person can have an obsession
with: washing hands, germs, checking, counting, wetting, sex, furniture, clothing, or whispering.
However, for the purpose of this research proposal the focus is on germs and hand washing.
The chart below shows that people with the hand washing/germs OCD have to wash their
hands multiple times throughout the day—which interferes in their day to day activities. Their
lifestyle differs from the average person because they fear everything is contaminated and they
tend to wash their hands about 30 times a day. The chart bellows compares OCD victims to
surgeons, fast food employees and everyone else. Clearly, you can see the OCD victims have to
wash their hands almost three times more than a normal person.
Scholars have pondered about treatments for many years and discovered some valuable
options. Yet treating a patient still remains a trial and error method. This can be frustrating for
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the patient as they could get tired of not seeing any improvements and stop going to a
psychologist or psychiatrist.
There many forms of therapy that have been introduced over the last century:
cognitive-behavioral therapy, client centered therapy, exposure therapy, and drug therapy.
Cognitive behavioral therapy is the approach taken to change the thinking of an individual that
is causing a certain type of behavior (Haddock, G., Lobban, F., Hatton, C., & Carson, R., 2004).
For example, an obsessive compulsive disorder (OCD) patient might wash his hands often
because he fears the fact that his hands are contaminated by germs. Now, with a cognitive
behavioral therapy, the psychologist would change this individuals thinking by telling him/her
that not everything is contaminated. The psychologist would try approaches to change their
cognitive ways of processing that not everything is contaminated. This would result in a
behavioral change of less hand washing (McGrandles, A., & Duffy, T. 2012).
Client centered therapy approach should be used by every psychologist because the
psychologist gives unconditional love to their client. This means that they are very accepting
and not judging of anything the client does or says. Therefore, if the client is saying that they
are afraid of a certain thing (germs), the psychologist must accept that instead of laughing at
them or judging them. This would help because people respond to unconditional love better
than they would to someone who is judging them, the individual would feel more comfortable
in sharing his/her feelings.
Exposure therapy is when a psychologist works closely with their clients/patient
exposing them to a certain object, situation, or place that is the cause of their anxiety. For
example, a patient with OCD might be handled well with exposure therapy. The psychologists
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will slowly exposure this patient with germs, one meeting session at a time. Slowly, the client
will accept that germs a natural part of life and feel better. However, the relapse rate is
extremely high for exposure therapy with patients with OCD. Individuals at many times cannot
accept that germs exist in their life. They want to avoid germs and at times form a safe-haven at
their house in which they will not move because everything else outside that area is
contaminated.
Another form of therapy is drug therapy. This is common with almost any psychological
disorder: depression, OCD, schizophrenia, anxiety, panic disorder, and many more. The most
basic thing about drug therapy is that this is used when a psychologist believes that the cause
of a disorder is purely biological (McGettigan P, Kelly A, Carvahlo M, & Feely J., 2000). For
example, a person diagnosed with OCD would be said to have less serotonin in his/her body.
Serotonin is a happiness neurotransmitter, when there is not enough of it present in the bod,
things go wrong. These clients would be given an antidepressant such as Prozac, Lexapro or
Zoloft. The medications help increase the neurotransmitter serotonin in the human body.
Almost all psychological disorders are caused by a combination of anxiety and stress therefore,
drug therapy is very successful and positive if one is expecting quick results (2-3 weeks).
However, due to the side effects and long term effects of using anti-depressants and other
medications to treat psychological disorders people want to eventually wean off of these
medications. That is why they need to eventually learn to overcome their disease with other
therapy techniques (Wang, Y., Mathews, C., Li, Y., Lin, Z., & Xiao, Z. 2011).
Another aspect of psychology is that most psychological disorders are not diagnosed
alone. For example, each person who is diagnosed with a psychological disorder has more than
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one. For example, depression and eating disorder, depression and OCD, or depression and
panic disorder (Waugaman, R. M., & Korn, M. 2012).
This image shows that OCD is
commonly diagnosed with
schizophrenia.
Although many forms of therapy have been invented besides these therapy techniques,
these remain the most common while dealing with OCD. Psychologists have always tried a trial
and error method, which leads to many patients getting annoyed from not seeing any results
within themselves.
Literature Review/Scholarship Review:
The biggest shift in the field of psychology occurred when scholars started to study the
biological aspect of psychology leading to the discovery of neurotransmitters and how they
affect a person’s mood and behavior (March, P., & Schub, T., 2012). In the case of OCD, the
neurotransmitter serotonin is involved; there is not enough of it in the body causing chemical
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changes in the brain which leads to behavior changes. This is what scholars know about some
causes of OCD.
This led to many different drugs to be used in therapy to treat OCD during the 1950s, which
later became known as drug therapy. Most of these drugs were tranquilizers (a type of
benzodiazepines), which started to surface the psychology field in the 1950s; however, it was
not until the 1980s that these medications became extremely popular (Sarika, K., Rodolfo E., C.,
& Suraj, V). Tranquiller are believed to relieve anxiety reduce the tension in the muscles. This
relates to OCD because the patient with OCD has very tensed muscles because of the fear of
something or someone, relieving this physical tension leads to lower anxiety levels.
Today in 2012, therapist are using the client centered therapy approach in which they do
what is best for the client. A prime example of this would be cognitive therapy. They combined
many different forms of therapies. For example, a psychologist might combine exposure
therapy for obsessive compulsive disorder with benzodiazepines like Lexapro or Zoloft or in
other words, drug therapy. A person diagnosed with depression per say would use Lexapro
because it increases the activity of the neurotransmitter serotonin while receiving cognitive
therapy from a psychologist. Furthermore, psychologists are questioning the old ideas of
treating patients and trying to come up with the best options (Waugaman, R. M., & Korn, M,
2012).
Thus far in the field of psychology, it has been discovered that OCD is all about being in
control (Hawke, L. D., & Provencher, M. D. 2011). Being who are helpless will take control
through OCD, keeping germs off of them, counting the cracks in inside or praying all the time. It
is known that treatment is hard and OCD can never be fully cured. It can have episode at
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different times of a person’s life; it can be better and worse at times in a person’s life. It is also
known to be heighted in a stressful environment (Anholt GE; Aderka IM; van Balkom AJ; Smit
JH; Hermesh H; de Haan E; van Oppen, P 2011). The treatment for OCD is therapy, all different
forms as mentioned above. However, the field of psychology is still stuck on the trial and error
method since there is not one best treatment, the field of psychology does not know what the
most effective treatment for OCD is; this is the gap in the knowledge of the scholars in the field
of psychology.
Research Question:
 Which therapy technique is MOST effective in treating obsessive compulsive disorder
(OCD)?
Proposed Research Method:
o
Definition of Key Terms:

Psychological Disorders: also known as a mental disorder is a pattern of
behavioral or psychological symptoms that impact multiple life areas and/or
create distress for the person experiencing these symptoms (WebMD, 2012).

Obsessive Compulsive Disorder: Obsessive-compulsive disorder (OCD) is a
type of mental illness that causes repeated unwanted thoughts. To get rid of
the thoughts, a person does the same tasks over and over. For example, you
may fear that everything you touch has germs on it. So to ease that fear, you
wash your hands over and over again (WebMD, 2012).

Anxiety Disorders: Are characterized by very strong fears that may be caused
by physical or psychological stress (WebMD, 2012).
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
Comorbidity: Where two or more psychological disorder exists in a person
(WebMD, 2011).

Cognitive Behavioral Therapy: an assumption that a person's mood is directly
related to his or her patterns of thought (WebMD, 2012).

Exposure Therapy: Exposure therapy reduces the physical or emotional
distress you experience when confronted with a particular object, situation,
or distressing thought or memory (WebMD, 2012).

Drug Therapy: Using various drugs/medications to treat a particular disease
(WebMD, 2012).

Benzodiazepines: are types of medication known as tranquilizers. Familiar
names include Valium and Xanax. They are some of the most commonly
prescribed medications in the United States. When people
without prescriptions take these drugs for their sedating effects, then use
turns into abuse (WebMD, 2012).

Anti-Depressants: used to treat depression and conditions that have
depression as a component of the disease, such as bipolar disorder (WebMD,
2012).

Case Study: A detailed analysis of a person or group, especially as a model of
medical, psychiatric, psychological, or social phenomena (WebMD, 2012).
o
Materials/Tools:

100 individuals diagnosed with Obsessive Compulsive Disorder by a
psychologist using the diagnostic statistics manual—DSM IV (The book that
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has all the diagnostic criteria for various psychological disorders), (
Brian P., B., Scott L., R., J. Eric, J., & Harrison G. Pope, J. r.). The more patients
we have with OCD, the better the results will be as stated in previously
designed studies.

Ten psychologists to meet these individuals weekly over a two to five year
period.

Psychology Clinic: This is where meetings and testing will be done. With OCD
patients (Brian P., B., Scott L., R., J. Eric, J., & Harrison G. Pope, J. r.). A place
to conduct the research is the most important part of the research
organization.

Psychiatrist: To prescribe medications, if and when needed by the
psychologist for their patient.

Nurse: To take vital signs over the client/patients visit.
o
Nurses would need:

Blood Pressure Instrument: To take blood pressure

Thermometer: Take temperature of the individual when they
come for the bi-monthly or weekly appointment.

Clip board/Pen: To record vital sings and take other notes, if
necessary.

MRI Scanner: To see which part of the brain responds to the anxiety causes
of the OCD type (germs, counting, cracks, prayers, anxiety, mess,
organization).
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
Research Assistants: Undergraduate students to help carry out procedures, if
they want to gain research experience.
o
Budget:

100,000 for the building and construction of the psychology clinic where the
study would take place.

10,000 for supplies and tools.

100,000+ for paying the psychologist, psychiatrists and nurses for working in
the research study.

Budget is not finalized at the time, however a vague idea is presented above
for consideration.
o
Method of Evaluation:
A study designed with many different research participants would help to see how OCD
is treated with what therapeutic technique. Case studies over a period of two to five years can
give results to see what treatment has helped an individual. This has to be long term, which is
why a case study is the superlative method. Case study has been used in many different studies
regarding psychological disorders and it is a sensible and trusted research method according to
the American Psychiatric Association. However, everything else designed in this proposal is
fairly new and upcoming.
Ten psychologists would maintain records with individuals who agree to participate in
the study. Diagnosed individuals would meet with the psychologist weekly, over a two to five
year period to see what treatment best responds to the OCD they have been diagnosed with.
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This would help psychologist see what treatment should help a person diagnosed with OCD
based on their symptoms and type of OCD (germs, organization etc.).
Nurses will be present at the psychology clinic to take vital signs of patients over their
visits through the years. People with anxiety tend to have a higher blood pressure level and
higher heart rate. With therapy and medications their heart rate and blood pressure should
decrease and reach a normal level (Brian P., B., Scott L., R., J. Eric, J., & Harrison G. Pope, J. r.). If
medication is needed a psychiatrist will also be available at the psychology clinic to prescribe
medication as decided by the psychiatrist and psychologist team.
The research team would also use an MRI machine to see which part of the brain is
being triggered when the patient has an OCD attack (Rakhee, K., Saumya, U., Cilna Mariam, G.,
Keshav J., K., Biju, V., Thennarasu, K., & ... Y.C. Janardhan, R). This would show us ways to help
treat the disorder with either medication or surgical procedures.
From this the field of psychology would be able to see how the patients that are
diagnosed with OCD are treated better with what treatment. Most patients done research on
will be showing signs of “fear of germs” OCD since that is the most common. This shall show us
how to treat those individuals most effectively.
Hypothesis/Expectations:
This experiment should concur that OCD is treated with a combination of approaches at
once. It should involve cognitive behavioral therapy, exposure therapy and drug therapy. This
should be able to help relieve OCD symptoms. Not one therapy at once but all different ones
together should help an individual with their OCD diagnosis. The psychologists should not use
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trial and error and go from one approach to the time. Instead, they should use many
approaches at once. This will help the patient physiologically and psychologically.
Concluding Remarks:
Research in this proposal is about treating psychological disorders, it is a common
concern in the field of psychology. There are many treatment options and plans. However, this
experiment will set out to see which one is the most effective and the best one for obsessive
compulsive disorder. Is one method better than the other? Is there a combination of methods
that will work to treat someone better? Basically, we need people who are diagnosed with
psychological disorders, such as OCD, to go back to living a normal and fulfilling life which can
be done only if we have a treatment that is effective. There are so many options when
someone is diagnosed with a physiological disorder but when they are with a psychological
disorder, options are limited. Overtime, with this study: our goal is to make sure that victims of
OCD also have enough choices and get treated as soon as possible. Getting them back to their
normal routine and helping them to act normal around people and in certain situations.
This study aims to explain which treatments are better for a person with a certain
psychological disorder, OCD, and/or a comorbidity of psychological disorders. As mentioned
before, there are many options but the trial and error method psychologist try on people leads
to people quitting therapy because they are not seeing results. If psychologists have a better
understanding of what therapy/technique is better for a person then they can help the
individual achieve results faster and avoid the hassle the trial and error methods presents. This
question is worth asking because the number of people with psychological disorders in the
United States is increasing every day. OCD is the most commonly diagnosed disorder along with
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some type of depression. Some of these people don’t know how it feels to live a normal life
anymore. This question is worth answering because these individuals need help and it is the job
of psychologists to help them. With results from such a study, psychologists can help their
patients more efficiently.
A study conducted in 2000, clearly shows that mental disorders cases are 24% of all cases in the medical society.
Therefore, we need treatments and most effective options.
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Bibliography
Anholt GE; Aderka IM; van Balkom AJ; Smit JH; Hermesh H; de Haan E; van Oppen, P.
(2011). The impact of depression on the treatment of obsessive-compulsive disorder: results
from a 5-year follow-up. Journal Of Affective Disorders, 135(1-3), 201-207.
Brian P., B., Scott L., R., J. Eric, J., & Harrison G. Pope, J. r. (n.d). Review: A critical review
of magnetic resonance spectroscopy studies of obsessive-compulsive disorder. Biological
Psychiatry, 73(Structural and Functional Activity with Stress and Anxiety), 24-31.
doi:10.1016/j.biopsych.2012.06.023
Lara, F., Allison, W., Ella, M., & Thomas, O. (n.d). Comorbidity and treatment response in
pediatric OCD: A pilot study of group cognitive-behavioral treatment. Psychiatry Research,
doi:10.1016/j.psychres.2012.04.035
March, P., & Schub, T. (2012). Obsessive-compulsive disorder.
PR, N. (2012, May 29). Obsessive compulsive disorder (OCD) therapeutics - pipeline
assessment and market forecasts to 2019. PR Newswire US.
Haddock, G., Lobban, F., Hatton, C., & Carson, R. (2004). Cognitive-behaviour therapy for
people with psychosis and mild intellectual disabilities: A case series. Clinical Psychology and
Psychotherapy, 11(4), 282-298. Retrieved from
http://search.proquest.com.proxy.lib.wayne.edu/docview/213890837?accountid=14925
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Hawke, L. D., & Provencher, M. D. (2011). Schema theory and schema therapy in mood
and anxiety disorders: A review. Journal of cognitive psychotherapy, 25(4), 257-276.
doi:10.1891/0889-8391.25.4.257
McGrandles, A., & Duffy, T. (2012). Assessment and treatment of patients with anxiety.
Nursing standard, 26(35), 48-56.
McGettigan P, Kelly A, Carvahlo M, & Feely J. (2000). Anti-depressants in primary care:
Analysis of treatment discontinuations. Pharmacoepidemiology and Drug Safety. 9(6), 521-8.
doi: 10.1002/1099-1557(200011)9:6<521::AID-PDS525>3.0.CO;2-K
Rakhee, K., Saumya, U., Cilna Mariam, G., Keshav J., K., Biju, V., Thennarasu, K., & ... Y.C.
Janardhan, R. (n.d). Neuropsychological performance in OCD: A study in medication-naïve
patients. Progress In Neuropsychopharmacology & Biological Psychiatry, 351969-1976.
doi:10.1016/j.pnpbp.2011.09.009
Sarika, K., Rodolfo E., C., & Suraj, V. (n.d). JAAD online: Escitalopram oxalate (Lexapro)induced acneiform eruption. Journal of the American academy of dermatology, 67e261-e263.
doi:10.1016/j.jaad.2012.03.032
Stewart, S., Hu, Y., Hezel, D. M., Proujansky, R., Lamstein, A., Walsh, C., & ... Pauls, D. L.
(2011). Development and psychometric properties of the OCD family functioning (OFF) Scale.
Journal Of Family Psychology, 25(3), 434-443. doi:10.1037/a0023735
Study methods . (n.d.). Retrieved from www.apa.org
Wang, Y., Mathews, C., Li, Y., Lin, Z., & Xiao, Z. (2011). Brain-derived neurotrophic factor
(BDNF) plasma levels in drug-naïve OCD patients are lower than those in healthy people, but
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are not lower than those in drug-treated OCD patients. Journal Of Affective Disorders, 133(1-2),
305-310. doi:10.1016/j.jad.2011.04.002
Waugaman, R. M., & Korn, M. (2012). Review of 'Understanding and treating
dissociative identity disorder: A relational approach'. Journal of the American psychoanalytic
association, 60(3), 626-631. doi:10.1177/0003065112447105
Webmd . (2012 ). Retrieved from WebMD.com