OCD Facts: What Causes OCD
What Causes OCD
OCD is an anxiety disorder that has a neurobiological basis. Using neuroimaging technologies in which pictures are taken of the brain and its functioning, scientists have shown that functioning in some areas of the brain is different in individuals who have OCD.
Research findings suggest that several areas of the brain may be involved with the symptoms of OCD. These are the orbitofrontal cortex, the anterior cingulate cortex (both in the front of the brain), the striatum and thalamus (deeper parts of the brain). The repeated unpleasant thoughts and feelings of OCD may be due to problems in communication among these brain areas. It is not clear what the nature of these problems is, or the cause, but chemicals in the brain (such as serotonin, dopamine, and/or glutamate) may be involved.
Everyone's brain churns out random and strange thoughts. Most children simply dismiss them and move on, but they get "stuck" in the brains of children with OCD. These random thoughts are like the brain's junk mail. Most people have a spam filter and can simply ignore junk mail that comes their way. But having OCD is like having a spam filter that has stopped working -- the junk mail just keeps coming and you cannot make it stop. Soon, the junk mail seriously outnumbers the wanted mail, and you become overwhelmed.
The Gene Connection
A study funded by the National Institutes of Health examined DNA, and the results suggest that OCD and certain related psychiatric disorders may be associated with an uncommon mutation of the human serotonin transporter gene (hSERT). People with severe OCD symptoms may have a second variation in the same gene. Other research also points to a possible genetic component -- about 25% of individuals with OCD have an immediate family member with the disorder.
Although research shows that there could be a genetic component to OCD, genetics does not provide a complete explanation for the disorder. In many cases, a family member has OCD but other members of the family or extended family do not have OCD. Even identical twins are not predictable -- one twin may have OCD and the other may not.
Sudden Onset of OCD Symptoms
Some parents have reported that OCD symptoms occurred almost overnight, “as if a switch were flipped,” or as if their child went to bed as the child they knew and woke up as a stranger. This sudden onset of symptoms may occur in conjunction with a strep infection. However, studies suggest the infection doesn’t actually cause OCD, but rather triggers an autoimmune response that results in OCD and/or tic symptoms in genetically predisposed children. And not all strep infections in children result in this triggering of symptoms. It is believed that a small proportion of OCD that occurs during early childhood and comes on suddenly or gets worse after a child has strep throat involves this autoimmune response.
Researchers have given a name to OCD that is triggered by a strep infection in children. It’s called PANDAS, which is the acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. Research about the causes of OCD is continuing, and researchers expect to learn much more about the PANDAS form of OCD in the future.
Other Factors That May Contribute to OCD
Several other factors may play a role in the onset of OCD. Following is a discussion of behavioral, cognitive, and environmental factors that may contribute to OCD.
Behavioral
Learning theorists suggest that behavioral conditioning may contribute to the development and maintenance of obsessions and compulsions. More specifically, they believe that compulsions are actually learned responses that help an individual reduce or prevent anxiety or discomfort associated with obsessions or urges. A child who experiences an intrusive obsession regarding germs, for example, may engage in hand washing to reduce the anxiety triggered by the obsession. Because this washing ritual temporarily reduces the anxiety, the probability that the child will engage in hand washing when a contamination fear occurs in the future is increased. As a result, compulsive behavior not only persists but actually becomes excessive.
Cognitive
Many cognitive theorists believe that individuals with OCD have faulty or dysfunctional beliefs, and that it is their misinterpretation of intrusive thoughts that leads to the creation of obsessions and compulsions. According to the cognitive model of OCD, everyone experiences intrusive thoughts. People with OCD, however, misinterpret these thoughts as being very important, personally significant, revealing about one’s character, or having catastrophic consequences. The repeated misinterpretation of intrusive thoughts leads to the development of obsessions. Because the obsessions are so distressing, the individual engages in compulsive behavior to try to resist, block, or neutralize them. The Obsessive-Compulsive Cognitions Working Group, an international group of researchers who have proposed that the onset and maintenance of OCD are associated with maladaptive interpretations of cognitive intrusions, has identified six types of dysfunctional beliefs associated with OCD: 1. Inflated responsibility: a belief that one has the ability to cause and/or is responsible for preventing negative outcomes; 2. Overimportance of thoughts (also known as thought-action fusion): the belief that having a bad thought can influence the probability of the occurrence of a negative event or that having a bad thought (e.g., about doing something) is morally equivalent to actually doing it; 3. Control of thoughts: a belief that it is both essential and possible to have total control over one’s own thoughts; 4. Overestimation of threat: a belief that negative events are very probable and that they will be particularly bad; 5. Perfectionism: a belief that one cannot make mistakes and that imperfection is unacceptable; and 6. Intolerance for uncertainty: a belief that it is essential and possible to know, without a doubt, that negative events won’t happen.
Environmental
Environmental factors may also contribute to the onset of OCD. For example, injuries have been associated with the onset of OCD. Research has indicated that within one year after a traumatic brain injury, some children and adolescents experience the onset of new obsessive-compulsive symptoms. This phenomenon provides further evidence of a connection between brain function impairment and OCD.
Summary
In sum, although the definitive cause or causes of OCD have not yet been identified, research continually produces new evidence that hopefully will lead to more answers. It is likely, however, that a delicate interplay between various risk factors over time is responsible for the onset and maintenace of OCD.
What Doesn’t Cause OCD
Uninformed people are sometimes eager to find someone or something to “blame” for a child’s OCD. Find out what doesn’t cause OCD, so you can help put a stop to erroneous information about OCD.