Thursday, July 14, 2011

Psychological Disorder: Obsessive Compulsive

Obsessive-compulsive disorder (OCD) is a condition characterized by unwanted repetitive and anxiety-producing thoughts accompanied by the compulsive act of rituals the individual believes will protect them from the anxiety (Hansell & Damour, 2008). The obsessions are thoughts or impulses over which the individual has no control except to apply the ritual for relief, and the compulsions make the individual feel driven to do something - usually the ritualistic practice for the purpose of relieving the anxiety (Hansell & Damour, 2008). Although obsessive-compulsive disorder is more common than traditionally perceived, it seems to have no cultural boundaries. Although its genetic component is well-established, the behavior associated with the disorder is considered abnormal from any cultural perspective.

Human Development and Socialization

According to Shiraev and Levy (2011) human development refers to the physical, psychological, and social behavioral changes that take place over the life span, whereas socialization is the process by which an individual becomes enculturated through experience, observation, and instruction. During the socialization process, individuals learn the values and behavioral norms of their culture. Both human development and socialization are lifelong processes that continue throughout the lifespan (Shiraev & Levy, 2010). Human development consists of continual change and evolution, wherein people alter attitudes, beliefs, and values and acquire new ones. This development takes place within a social construct, usually the native culture, although, for the most part, development takes place similarly in most cultures. Cultural expectations of parents are especially evident during childhood. "In societies that are small, egalitarian, and with little occupational specialization, children are expected to learn “on their own,” whereas in industrialized democratic societies there are explicit expectations about what, with whom, when, and how children should learn" (Levy, 1996, as cited by Shiraev & Levy, 2010, p. 199). Even though fundamental human development takes place mostly without regard to the social construct within which it forms, all of the characteristics of a specific culture precisely determine an individual's socialization, and these characteristics become intrinsic and often unconscious mechanisms within the individual (Shiraev & Levy, 2010).

Affects of Human Development on Obsessive-Compulsive Disorder

Current research supports the prevalence of OCD as affecting 2% to 3% of the world’s population (Hollander, 1997). It is the fourth most common psychiatric illness in the USA (Karno et al., 1988) and is the tenth highest cause of disability in the world (Murray and Lopez, 1996). The prevalence of OCD in the United States, Canada, and Puerto Rico is greater than 2% (Karno et al., 1988). People with OCD are likely to suffer from major depression and other anxiety disorders as co-morbid conditions. This co-morbidity may be due to a dysfunction in the serotonin system in the brain characteristic to depression, anxiety, and obsessive-compulsive disorders (Lundbeck Institute, n.d.). Because the worldwide prevalence varies only slightly from the prevalence in the United States, it is difficult to point to poverty or other developmental complications because of cultural characteristics and suggests an aggregate incidence throughout all populations. However, there is some evidence that associates the prevalence of OCD with higher IQ and in more industrially developed countries where competence is expected at an earlier age (Peterson, Pine, Cohen, & Brook, 2001). Although evidence points to a substantial, although partial genetic component, it is essential to consider the possible environmental factors that interact and affect the inherited predisposition (Pub Med Health, 2010). At this time; however, environmental links are weak.

Affects of Socialization on Obsessive-Compulsive Disorder

          "One must observe the proper rites."

          "What is a rite?" asked the little prince.

          "Those also are actions too often neglected," said the fox. "They are what make one
           day different from other days, one hour from other hours."

           —The Little Prince, by Antoine de Saint-Exup√©ry

Obsessive-compulsive disorder is a common and serious illness whose core symptoms seem to merge more closely with normal human behavior and cultural traditions than those of most other mental illnesses (Hollander, Kim, Khanna, & Pallanti, 2007). Persistent thoughts can be morally or physically abhorrent, and can cause shame in the afflicted individual (Pallanti, 2008). The epidemiology of this disorder is consistent in countries in cross-cultural studies (Pallanti, 2008). Corroborating results from other studies suggest cultural variation has little affect on prevalence. Interestingly, however, symptoms of the disorder often assume characteristics of consequence to the individual's culture. For example, a correlation between compulsive cleansing and religious rituals has been reported among Egyptian Muslims (Okasha et al, 1994). "The religious connotation of obsessive-compulsive disorder in Muslim culture is denoted by the term weswas, which refers to the devil as well as obsession" (Pallanti, 2008, p. 169). The results of current cross-cultural research suggest obsessive-compulsive disorder has a more significant association in neurobiology than in cultural differences (Pallanti, 2008).

Conclusion

Socialization, human development, and enculturation determine the perception, development, treatment, and the full range of emotions associated with psychological disorders. Obsessive-compulsive disorder demonstrates significant prevalence cross-culturally and is neither accepted nor construed as normal from any cultural perspective. Although human development affects individuals without full regard to the social construct within which it forms, socialization determines characteristics of cultural consequence and defines acceptable and expected behaviors, and provides a definition to normal and abnormal behavior.



References

Hansell, J., & Damour, L. (2008). Abnormal psychology. Hoboken, NJ: Wiley.

Hollander E. Obsessive–compulsive disorder: the hidden epidemic. Journal of Clinical Psychiatry 1997; 58: 3–6.

Hollander E, Kim S, Khanna S, Pallanti S. (2007). Obsessive-compulsive disorder and
obsessive-compulsive spectrum disorders: diagnostic and dimensional issues. CNS
Spectrum. (2 Suppl. 3):5-13. PubMed PMID: 17277719.

Karno, M., Golding, K. M., & Sorenson, S. B. (1988). The epidemiology of obsessive– compulsive disorder in five US communities. Archives of General Psychiatry, 45, 1094- 1099.

Lundbeck Institute. (n.d.). Focus on brain disorders: OCD epidemiology. Brain Explorer. Retrieved June 23, 2011, from http://www.brainexplorer.org/ocd/OCD_Epidemiology.shtml

Murray, C. J., & Lopez, A. D. (1996). The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA: Published by the Harvard School of Public Health on behalf of the World Health Organization and the World Bank.

Okasha A, Saad A, Khalil A. H., El Dawla A.S., Yehia N. (1994). Phenomenology of obsessive- compulsive disorder: a transcultural study. Comprehensive Psychiatry 35, 191–197

Pallanti, S. (2008). Transcultural observations of obsessive-compulsive disorder. American Journal of Psychiatry, 165(2), 169-170. doi: 10.1176/appi.ajp.2007.07111815

Peterson, B. S., Pine, D. S., Cohen, P., & Brook, J. S. (2001). Prospective, longitudinal study of tic, obsessive-compulsive, and attention-deficit/hyperactivity disorders in an epidemiological sample. Journal of the American Academy of Child & Adolescent Psychiatry, 40(6), 685-695. doi: 10.1097/00004583-200106000-00014

Pub Med Health. (2010). Obsessive-compulsive disorder. PubMed Health. Retrieved June 23, 2011, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001926/

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