Psychological Explanations of Obsessive-Compulsive and Related Disorders (OCRDs)
Simply having a biological predisposition is not enough to develop an obsessive-compulsive or related disorder (OCRD). As previously mentioned, a person is more likely to develop an obsessive-compulsive disorder if they also possess a psychological vulnerability to developing such a disorder. Research has identified several variables that may contribute to a psychological vulnerability. These variables include: 1) perceived control, 2) cognitive appraisals, and 3) cognitive beliefs and distortions.
We previously mentioned that people could develop psychological vulnerabilities for mental disorders due to early life experiences. One such vulnerability is the lack of "perceived control" over stressful life circumstances.
Children and their families experience varying degrees of distress. The presence of these stressors may set the stage for the development of an obsessive-compulsive or related disorder (OCRD). However, researchers have learned it is not just the stressors themselves that create psychological vulnerabilities. The way the people learn to cope with these stressors is also important. Resilient people believe they can control, or at least influence, what happens to them. This is called perceived control. It is important to note this sense of control may, or may not be accurate. Instead, it is the person's perception about their degree of control that is important.
People's perceptions of control are influenced by childhood experiences. When children repeatedly experience a lack of control over the events in their lives, they may come to view the world as unpredictable and dangerous. This worldview may lead to feelings of helplessness. These children come to expect negative outcomes, and feel they are helpless to prevent them. Examples of early life experiences that may influence a person's perception of control include: 1) family dynamics such as parenting style (i.e., overprotective parenting style, and its opposite, under-protective, low-care style); 2) significant life stressors such as loss of, or separation from, primary caregivers; and, 3) traumatic experiences such as childhood abuse (physical, emotional, and/or sexual).
This is not to say that our psychological trajectory is fixed in childhood and that nothing can be done to change it. It simply means that early life experiences can contribute to the development of psychological vulnerability. This helps us to understand why some people develop psychological problems, while others do not.
Another psychological vulnerability results from the way we interpret our environment. The term "cognitive appraisal" refers to the way we think about, and assess, a particular event or situation. Cognitive appraisal is a key concept in understanding one's susceptibility to stress and anxiety. According to Lazarus and Folkman (1984), cognitive appraisal is traditionally broken down into two separate types. Primary appraisal refers to an individual's subjective evaluation of a situation. In this appraisal, a person evaluates whether or not a situation is relevant to their well-being. Secondary appraisal refers to an individual's evaluation of their ability to cope with that situation. Therefore, whether an individual experiences a situation as anxiety-producing is determined by their own unique appraisals. As with perceived control, these appraisals may, nor may not be accurate. Overtime, people develop a habitual style of appraisal. When people habitually think they are in danger, and believe they lack the ability to cope with those threats, it makes them more vulnerable to developing an OCRD.
Cognitive Beliefs and Distortions:
A third type of psychological vulnerability is our core beliefs. Core beliefs refer to organizing principles we use to understand and interpret the world around us. Our beliefs about a particular situation, and our beliefs about our ability to cope with it, are not necessarily haphazard. Instead, our core beliefs influence our understanding of a particular situation.
Although these core beliefs fundamentally influence our appraisal of an event, we are often unaware of these beliefs. Therefore, we do not realize their impact on our everyday lives. Unfortunately, these core beliefs may not always represent an accurate portrayal of the situation at hand. As such, our core beliefs may cause us to experience undue emotional distress.
According to Beck and Emery (1985), people are prone to making certain types of cognitive "errors" in their appraisals across various situations in their lives. These thinking errors are called cognitive distortions. While there are many different types of cognitive distortions, two types are particularly common with obsessive-compulsive and related disorders (OCRDs): 1) the overestimation of threat and 2) the underestimation of one's ability to cope with that threat. The overestimation of threat refers to a person's beliefs about the probability, or certainty, that an event will occur. A good example of this type of distortion is called "fortune-telling." For instance, a person with obsessive-compulsive disorder may believe, "I will get sick if I touch that doorknob." Catastrophic prediction is another type of cognitive distortion that refers to a heightened or exaggerated sense of perceived harm. A good example of this type is called "catastrophizing." For example, someone may believe, "It will horrible if I get sick," or "I could not stand being sick."