Obsessive-compulsive disorder (OCD) consists of two behaviors that happen simultaneously, which are obsession and compulsion. One of the most vivid examples of OCD is David Sedaris’s case, who had felt the need to “press his nose to the hood of a particular car, lick a certain mailbox, or touch a specific leaf that demanded his attention” (Garrett, & Hough, 2018, p. 622). OCD patients demonstrate increased activity in the orbitofrontal cortex (Garrett, & Hough, 2018). At the same time, OCD occurs with diseases that damage the basal ganglia, and some researchers believe that the condition is associated with the high serotonergic activity (Garrett, & Hough, 2018). Even though OCD affects some parts of the brain, it cannot be diagnosed based on physiological changes.
According to DSM-5 criteria, an OCD patient needs to demonstrate several conditions. First, a patient should have both obsession and compulsion that significantly impact their daily life (Gluck, 2019). Second, the obsession is described as intrusive, repetitive and persistent thoughts, urges, or images that cause distress, and do not focus on the real problems of one’s life (Gluck, 2019). A person should have tried and failed to suppress these thoughts (Gluck, 2019). Third, compulsion should be seen as a ritualistic behavior that a person must feel to perform to avoid adverse events (Gluck, 2019). These rituals should take more than an hour od one’s day, and they should relieve the pressure associated with the obsession (Gluck, 2019). The DSM-5 criteria correlate with the definition of OCD provided by Garrett and Hough (2018) and provide specific details about how obsession and compulsion are described.
Considering the physiological changes caused by OCD, it is vital to include an additional criterion for DSM-5. I believe that inclusion of increased activity in the orbitofrontal cortex with particular attention paid to the left orbital gyrus. The addition of this criterion to DSM-5 should improve the reliability of screening and decrease the number of false-positive results. I believe that the criterion is not yet included in DSM-5 is because it may be associated with different psychological disorders. At the same time, the amount of evidence may not be sufficient to diagnose OCD based on imaging. However, I believe that imaging used together with screening using DSM-5 criteria will be beneficial for all stakeholders.
Garrett, B., & Hough, G. (2018). Brain and behavior: An introduction to behavioral neuroscience (5th ed.). Los Angeles, CA: SAGE Publications, Inc.
Gluck, S. (2019). OCD Diagnosis: OCD criteria and characteristics in DSM 5. Web.