Anxiety Sensitivity Accelerates the Temporal Changes in Obsessions and Compulsions During Cognitive Behavioral Therapy
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ORIGINAL ARTICLE
Anxiety Sensitivity Accelerates the Temporal Changes in Obsessions and Compulsions During Cognitive Behavioral Therapy Judith M. Laposa1,2 · Lance L. Hawley2,3 · Kevin J. Grimm4 · Danielle E. Katz3 · Neil A. Rector2,3
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Although obsessive compulsive disorder (OCD) is effectively treated by cognitive behavior therapy (CBT), less is known about mechanisms underlying treatment response. Anxiety sensitivity (AS) may impact symptom change (velocity) and the rate of change in velocity (acceleration) during CBT for OCD. Latent Difference Score (LDS) analysis was used to show path-analytic dynamic modelling of OCD symptom velocity and acceleration during CBT, as a function of baseline AS. Method Eighty-four participants with a principal diagnosis of OCD completed 12 weeks of CBT group therapy, and measures assessing AS at pre-treatment, and obsession and compulsion severity at pre-treatment, sessions 4, 8, and end of treatment. Results LDS velocity models demonstrated that higher levels of baseline AS were associated with subsequent elevations in obsessions throughout treatment, and obsession scores were temporally associated with subsequent changes in compulsion scores. An LDS acceleration model demonstrated that higher levels of baseline AS scores were associated with rapid increases in the severity of obsessions, whereas lower AS scores were associated with rapid decreases in the severity of obsessions. Discussion These results have implications for theoretical and treatment modelling of obsessions and compulsions, as well as AS, in OCD. Conclusion Higher levels of baseline AS negatively impact response to CBT for OCD. Keywords Obsessive compulsive disorder · Cognitive behavior therapy · Anxiety sensitivity · Acceleration
Introduction Obsessive compulsive disorder (OCD) is a chronic disorder that occurs in approximately 2% of the population (Kessler et al. 2012). Individuals with OCD suffer from distressing obsessions and/or compulsive behaviors (APA Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10608-020-10121-4) contains supplementary material, which is available to authorized users. * Judith M. Laposa [email protected] 1
Mood and Anxiety Service, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 100 Stokes St., Toronto, ON M6J 1H4, Canada
2
Department of Psychiatry, University of Toronto, Toronto, ON, Canada
3
Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
4
Department of Psychology, Arizona State University, Tempe, AZ, USA
2013). Olatunji et al.’s (2013) meta-analysis demonstrated the effectiveness of cognitive behavior therapy (CBT) for OCD. However, when examining possible predictors of treatment response, they showed that the effect sizes for CBT did not vary when they considered the pre-treatment severity of depression or OCD sympt
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