Modifying my presentation

I had a meeting with Mrs Bowen today to discuss my presentation tomorrow. To make it more interesting, Mrs Bowen suggested that I use examples of case studies of OCD.

I have decided to include three of them to highlight the differences between OCD and other mental illnesses and also to help explain what is and isn't a symptom of OCD.

Presentation!

My presentation for my EPQ is going to be on Friday this week at lunchtime. For the presentation I am going to make a power point presentation and I will also be giving hand-outs to my audience to help show how the different factors are linked.

A brief outline of my presentation:

• How I chose and refined my question
• What is OCD?
• The biological factors thought to contribute to the development of OCD
• The psychological factors
• The environmental factors
• A conclusion
• Reflecting on my project - what went well and what I could have improved on

My audience will mainly consists of year 13 students.

I now need to discuss this presentation with Mrs Bowen (my supervisor) to ask for her advice so that I can make any additions or changes that I need to make.

Finishing the Bibliography

A few months ago, I talked about a table which I created in order to organise my sources. Using this table I have finally managed to complete the bibliography for my EPQ.

Also, I have completed my report, and so I will be looking to filling in the End of Project Review form, as well as Presentation Record A after discussing my report and presentation with my supervisor.

Conclusion of the Report

I am currently writing the final aspect of the report, the conclusion. In the conclusion I will be answering my question 'To what extent are biological factors responsible for the development of obsessive compulsive disorder in children.'

In more detail, the plan for my conclusion is as follows:

• The extent of my findings - biological factors are very responsible, in particular serotonin, however, psychological factors are also important.
• The weaknesses and limitations of the methodology - there are very few studies looking at OCD in children in particular, moreover, the majority of studies had small sample sizes.
• The recommendations for the future - there are very few sources which looked at environmental factors in particular, this has the potential to be further researched.
• Reflections - what went well in the project, what I have learnt and how I could improve if I were to complete another project.

Evaluating the Significance of Psychological Factors

At the moment, in my report I am evaluating the significance of psychological factors, by looking at the psychodynamic model, the behavioural model and the cognitive model.

Psychotherapy revolves around the psychodynamic model. Due to the failure of psychotherapy in alleviating OCD symptoms,  OCD was actually considered untreatable in the 1960s because there were no alternative treatments. This means that today, it is widely agreed that this theory is out dated and incorrect in terms of explaining a cause of OCD.

In addition to this, I am also writing up my bibliography at the same time. While doing my research, I was very organised and created a table in which I recorded all my sources, therefore, now I just have to transfer this data to another word document to create my bibliography.



An extract from my sources table

Progress Update!

At the moment, I am more than half way through my report. Currently I am evaluating the theory that glutamate is important in the cause of OCD. I am doing this by comparing different studies done by scientists and then evaluating them in order to conclude whether the results from the study are reliable or unreliable, and therefore whether they support the theory.

Source

This is the structure of Riluzole, a drug which I am evaluating in order to make a conclusion on the significance of glutamate in OCD.





A basic overview of my plan for the report:
I have also realised I have only included a very brief outline of the plan for my project, so I have included it here with more detail.

Introduction

• What is the main aim of the project?
• What is paediatric OCD?
• Why have I chosen this question for my EPQ? (The importance of discovering the cause of an illness)

Overview of the theories

• Biological: Brain activity, Serotonin, Glutamate, PANDAS and Genetics
• Psychological: Psychodynamic, Behavioural and Cognitive models
• Environmental: Stress and Parenting Style

Evaluation, Findings and Discussion

• Outline the findings of my research - studies and investigations consulted
• Evaluate each of the different theories' importance in the cause of OCD by discussing results from studies, evaluating the reliability of sources and comparing sources

Conclusion

• Look at the extent of the findings
• Identify any weaknesses or limitations in the project
• Make recommendations for the future
• Reflect on what went well, what was learnt, how to improve in the future

Environmental Theories: Parenting Style

In my report, one of the final theories I discuss is that the style of parenting can affect whether a child develops OCD. This theory explains that the method parents used to bring up their child can affect their personality. If a parent continuously repeats a certain action, their child may 'copy' it and develop OCD.

Environmental factors, although important, are not considered the most important factor by scientists since the majority of patients don't develop OCD as a result of stress, another possible factor, or parenting style. It is more likely that environmental factors can trigger the onset of the disorder in children genetically predisposed to it.

Psychological Theories: Psychodynamic Model

Sigmund Freud
Source

One of the psychological models I explain in my report is the psychodynamic model, which was first proposed by Sigmund Freud. In Freud's opinion, the symptoms of OCD were a result of unconscious discomforts which the child felt earlier on in their life.

Moreover, this model explains that a symbolic meaning could be attributed to the symptoms of OCD, such as what is deemed to be most important, or most feared, by an individual with OCD.

This theory is now believed to be outdated, and other models, such as the cognitive and behavioural models are believed to be better suited to explaining OCD. The reason for many to believe this model is inaccurate is because the therapy revolving around this theory rarely benefits patients. Due to the therapy's failure, until the 1960's, OCD was believed to be untreatable, since it was the only therapy available at that time.

Biological Theories: Brain Activity

ABNORMAL BRAIN ACTIVITY:

When writing my report, one of the first theories of the cause of OCD I wrote about is abnormal brain activity.

Source

This diagram shows the different lobes of the brain. Scientists have revealed that patients with OCD can have hyperactivity in the orbital frontal cortex, found in the frontal love, and the anterior cingulate cortex.

Both these regions are believed to be responsible for personality and behaviour, therefore, it makes sense to infer that an abnormality in these regions leads to a problem with the patient's personality or behaviour, consequently leading to the expression of the symptoms of OCD.

Dr Rapoport's answers!

After receiving my email, Dr Rapoport responded quickly to my questions. Through this, I have learnt more about the similarities and differences between childhood onset OCD and adult OCD.

Firstly, Dr Rapoport has found that symptoms for both are very similar, although children can have more motor rituals, for example specific movements with their hands, than obsessions. Also, children have a similar reaction, generally, to CBT (Cognitive Behavioural Therapy), however, parents may also have to help during CBT.

In addition to this, the doctor replied that she believes environmental factors aren't likely to cause OCD. However, in response to a traumatic event, for example a break in, people can sometimes develop a single compulsion, such as checking the locks.

I will use Dr Rapoport's replies in my report where suitable in order to support different ideas, along with examples from her book.

Questions for Dr Judith Rapoport

In order to support my project, I have emailed Dr Judith Rapoport a few questions. I have asked her what she thinks the main differences are between OCD in adults and children.
Also, I have asked her if she believes that parenting style or stress (environmental factors) could be the cause of OCD.
I have asked her if it could be possible for her to explain how antibodies to Group A beta haemolytic streptococcus could lead to the development of OCD.
Lastly, I asked her which factors she thinks are most significant in the development of OCD.

Hopefully she will be able to answer some of my questions and will reply as soon as possible!

The Boy Who Couldn't Stop Washing

I have just finished reading this book, and I have found its content extremely useful.

Dr Rapoport presented many fascinating cases, such as a lady who had compulsions to sprinkle her entire flat in sugar. Many of the cases were extremely bizarre, however, they also highlighted to me the variable nature of the symptoms expressed from those with OCD. Furthermore, this book emphasised that the public view on OCD as being a disorder simple about 'neatness' is completely false.

I have also emailed Dr Rapoport asking whether she would still be free to answer a few of my questions via email. Hopefully, she will agree to answering some questions so I intend to write these questions within the next few days. The questions will be primarily based on childhood OCD and the differences present between adult and paediatric OCD. Furthermore, I will ask Dr Rapoport her views on the theories that currently exist to explain the cause of paediatric OCD.

Mid-Project Review

I had another meeting with my supervisor today in order to discuss my findings, as well the next stages of my project.

The successes of my project so far includes that an expert, Dr Rapoport, has agreed to answer a few of my questions via email after reading her book. Also, the table of sources I have produced seems to be very useful too!

My proposed plan for the rest of the project:

I will first finish off the research, most importantly, many sources have claimed that environmental factors are less important than biological factors, however, I haven't found any reliable evidence for this yet.

I will publish another post describing the outline of my project in more detail, but at the moment the simple outline is:

• Introduction - introducing my project and explaining OCD
• Explaining each of the different factors
• Evaluating the evidence I have found in order to determine the significance of each of the different factors
• Conclusion - summarising my project and my findings

A source's reliability is a very important thing to take into account, therefore, when writing my report, I will remember to take this into account.

A Brief Description of The Theories

My research has shown that there are various biological based theories detailing why paediatric OCD develops. These include heightened brain activity in the areas of the frontal lobes and orbital cortex, decreased levels of serotonin, a neurotransmitter and increased levels of glutamate, another neurotransmitter. Another interesting theory is that OCD can be triggered by an infection, and is one of the Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection (PANDAS).

In terms of environmental theories, these seem to be less significant. An environmental factor believed to possible influence the development of  OCD is the style of parenting; certain rituals performed by the parent may be 'picked up' by their child. However, this is not believed to be an important factor since many children with OCD don't have parents expressing similar symptoms.

Psychological factors are also believed by many to be significant. These are the psychodynamic model, the cognitive model and the behavioural model. The cognitive and behavioural models seem, to an extent, to be true due to the success of Cognitive-Behavioural Therapy (CBT).

Towards the end of my research...

After initial research, I realised that there were different types of OCD, such as childhood-onset OCD, pre-natal OCD and post-natal OCD. I have therefore decided to modify my question slightly so that I am now investigating the significance of biological factors in the development of OCD in childhood-onset OCD in order to further focus my question.

After emailing many experts in this field, I finally received one reply from Dr Judith Rapoport, a expert in Child Psychiatry. In this reply she replied that she would be happy to answer my questions, however, she advised me to first consult her book, 'The Boy Who Couldn't Stop Washing'. I have ordered this book, and when I have finished reading it, I will then ask Dr Rapoport if she would be happy to answer a few questions.

An Update on Progress

In order to organise the sources I have used, I have created a table listing all the details needed for referencing that type of source which I hope will make citing and referencing in my report easier.

Through initial research I have discovered that OCD is the fourth most common mental disorder, therefore, it is necessary to determine how it is caused to ensure a relevant, successful treatment can be used. Furthermore, I have begun to research various theories which are grouped into: biological, genetic, environmental, cognitive and behavioural theories.

I have also email the libraries of the University of Sussex and the University of Brighton asking whether it would be possible to visit their libraries to consult the resources there. I have also emailed three consultants who have specialised in Psychiatry and have a specific interest in OCD. Hopefully, at least one will agree to answer a few of my questions, either in person or via email, after I have completed the bulk of my research in the university libraries.

Plan for research

I intend to begin my research next week, after my work experience placement. After the referencing and citation taught element with our librarian, I have also decided to create a spread sheet to record all the sources that I use.

The first elements that I will focus research on will be present theories on the development of OCD, focusing on biological, environmental and psychological. After researching this, I will begin to investigate which is the most significant factor using investigations and experiments carried out by researchers.

An update on everything I have done so far...

Firstly, after initial research, I learnt that successful treatments of OCD can be used to produce theories on the causes of OCD. I have decided to alter the focus of my question to the causes of OCD.

The cause of OCD is not known, however, scientists speculate that people with OCD have a different brain activity pattern, moreover, deficiency of serotonin, a neurotransmitter, could lead to the development of OCD. These biological factors could be to blame, however, environmental (e.g. stress) and psychological factors could also be significant. I have decided that my question will be 'to what extent are biological factors responsible for the development of OCD?'

I have also completed Project Proposal Part A and my supervisor has completed Part B. After this, I completed the Planning Review.

Meeting with my supervisor

Last Wednesday (18th June) I had the first meeting with my supervisor.

My supervisors main comments and advice:
Through my initial research, I discovered that the last reported use of Neurosurgery for Mental Disorder (NMD) for treating a mental illness in the UK was in 2010 at Frenchay Hospital in Bristol. Due to the infrequent use of NMD, my supervisor commented that researching NMD adequately could prove to be difficult, and so therefore, would restrict my EPQ due to the limited number of secondary sources available.

In addition to this, my supervisor advised me to research a single mental illness, such as Obsessive Compulsive Disorder, in contrast to many different illnesses, so that my project question can be more specific.

The changes I have made as a result of the discussion:
In order to ensure my EPQ isn't limited, I will research all available treatments specifically for Obsessive Compulsive Disorder (OCD). In addition to researching treatments available today, I would like to research the history of the treatment of OCD. Furthermore, I would like to investigate any future developments in treating OCD.

This method of approach to my project will allow me to develop it further since it will enable me to explore how the treatment of OCD has evolved over time, and how it will continue to change in the future.

The initial ideas for my EPQ

Welcome to my blog, I will be using this to record the stages of my EPQ.

My initial idea for my EPQ was to research Neurosurgery for Mental Disorder (NMD), and to determine how effective a treatment this is, as well as how viable an option it is for treating various mental illnesses, such as OCD and severe depression.

In order to develop this project, my initial ideas were to research the various types of NMD, using secondary sources such as text books and articles, and to compare the effectiveness of this to other available treatments. Also, I wanted to research how often this treatment is used in the UK and whether its usage is varied in different countries. Another idea I had was to interview a psychiatrist in order to find out their opinion on NMD.