The cognitive approach assumes that OCD is a consequence of faulty and irrational ways of thinking taken to an extreme. Patients with OCD have different thinking patterns and more intrusive thoughts. The cognitive explanation stresses that everyone has unwanted thoughts from time to time, but OCD sufferers cannot ignore these thoughts and they are often misinterpreted, leading to self-blame and the obsessive symptoms of OCD. So that the negative thoughts and concerns associated with a particular anxiety do not come to pass, compulsions arise in an attempt to ‘neutralise’ the anxiety. The sufferer becomes more wary of having intrusive thoughts and their fear of them increases. As these ideas are constantly thought about, they become obsessive and a pattern of ritualistic, repetitive behaviour begins.
A strength of this theory is that there is supporting evidence. For example, Wegner found that a group of students asked not to think of a white bear were more likely to do so than a group allowed to think about it. Salkoius found that when asking participants to suppress thoughts and on other days not to, the participants kept a diary of more intrusive thoughts when they had to be suppressed these findings support the idea that a deliberate attempt to suppress thoughts leads to an increase in these thoughts; supporting the main ideas of the approach. This is a strength because the two studies have found similar findings and are therefore externally reliable. This makes the cognitive approach reliable as a whole because it can be checked and verified and the theory has sound foundations for further research.
However, a weakness of this theory is that there are problems with the evidence. For example, Salkoius used self-report methodologies in order to measure the thoughts of the participants. This means that the results may have been subjected to social desirability bias. For example, the amount of intrusive thoughts may not have all been recorded in the diaries in order to please the experimenter; they may not want them to know how bad their symptoms are due to feelings of embarrassment. This is an issue because it means the study lacks internal validity; the intrusive thoughts in the diary are not caused solely by supressing them, but there are other extraneous variables such as embarrassment. We therefore cannot prove cause and effect to show that suppressing thoughts lead to symptoms in OCD, so there are other factors the cognitive approach needs to consider in order to offer a causal explanation.
However, although there are issues with self-report methodologies, they can provide a greater insight into the participant’s thoughts and a greater level of detail. They are allowing the participants to describe their own experiences rather than inferring this from observing participants. It therefore provides access to a high level of quantitative data.
The behavioural approach assumes OCD is a result of a learnt association between a stimulus and anxiety. Firstly, a neutral stimulus becomes associated with a particular learned response and whenever the stimulus is present, the individual carries out the response. For example, dirty objects became associated with anxiety and this is called classical conditioning. This response is furthered by avoidance of the stimulus, so positive outcomes are achieved. The anxiety is maintained over time by negative reinforcement which leads to the obsessions and the compulsive behaviours are then developed as the person believes that by performing them, the anxiety will decrease.
A strength of this theory is that there are also supporting evidence. For example, Tracy used an eye-blink task; when a puff of air is blown in the eye the unconditioned response is to blink if a bell is rung along with the puff. A person therefore acquires a conditioned response of blinking to the sound of the bell. OCD-like participants were conditioned more rapidly. This is a strength because it improves the internal validity of the theory, because it shows that those with OCD are more prone to develop conditioned responses which can provide an explanation for the compulsions.
Similarly, a weakness of the behavioural theory is that there are problems with the evidence. For example, the participants used in Tracy’s study are OCD-like; they haven’t been diagnosed with OCD but have more obsessions and/or compulsions than ‘normal’ people. This is an issue because any conclusions may not be appropriate to generalise to understand the causes of OCD, as the participants used do not reflect the behaviour of an individual who truly does have OCD, so the study lacks population validity, weakening the ability for the behavioural approach to make applications to others.
Despite this, the fact that the study used participants who haven’t been diagnosed OCD means that ethical guidelines haven’t been breached, particularly protection of psychological harm. Causing such participants to suppress thoughts could worsen their symptoms of OCD, whereas participants without the disorder will be less affected. These approaches sit on the reductionist side of the debate. For example, the behavioural approach only focuses on environmental factors and doesn’t take into account cognitions, biological factors such as biochemistry, genetics and brain dysfunction and psychodynamic factors.
The cognitive approach draws attention to cognitions, ignoring behavioural, psychodynamic and biological factors. This is a strength because the reductionist nature of the approach means a higher level of detail is given because only one idea is taken into consideration. These approaches also only focus on one variable in an attempt to establish causal relationships, as opposed to looking at a variety of variables. However, this could also be seen as a weakness of the approach, because it leads to a limited theory overall and therefore, any treatments developed from the assumptions of these approaches solely may not treat the whole of the OCD sufferer, and there may not be a correct diagnosis.