Longitudinal Relations of Obsessive Beliefs, Obsessions, and Compulsions During Treatment for Obsessive Compulsive Disor
- PDF / 1,004,586 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 67 Downloads / 175 Views
ORIGINAL ARTICLE
Longitudinal Relations of Obsessive Beliefs, Obsessions, and Compulsions During Treatment for Obsessive Compulsive Disorder Martha J. Falkenstein1 · Meghan Schreck1 · Sriramya Potluri1 · Jacob A. Nota1 · Kara N. Kelley1 · Courtney Beard1 · Jason A. Elias1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background This study examined the temporal relations between obsessive beliefs, obsessions, and compulsions during treatment. Gaining a better understanding of these relations may inform targets for improving treatment response. We hypothesized that our results would support the goal-directed model of OCD whereby obsessive beliefs at time t, predict obsessions at time t + 1, which then predict compulsions at time t + 2. Methods Participants were adults receiving intensive/residential treatment (IRT) for OCD (N = 446). Time points examined were admission, weeks 2 and 4, and discharge, utilizing a random intercepts cross-lagged panel model. Results Results supported the reciprocal model of OCD, wherein both the goal-directed and habit-driven models coexist. Most of the significant paths between OCD symptoms were found early in treatment between weeks 2 and 4. Conclusions These findings offer unique information regarding the temporal precedence of these relations, and they are consistent with prior cognitive models of OCD. The importance of targeting both obsessive beliefs and compulsions is highlighted by these findings. Future research would benefit from investigating moderators of OCD models. Keywords Obsessive–compulsive disorder · Cognitive processes · Cognitive model · Obsessive beliefs · Exposure and response prevention Obsessive–compulsive disorder (OCD), a highly disabling and often relapsing disorder, affects 1–3% of the United States population (Karno et al. 1988; American Psychiatric Association 2013). Exposure and response prevention (ERP; Foa and Kozak 1996) is considered the gold standard treatment for OCD (i.e., National Institute for Health and Clinical Excellence 2006). Randomized controlled trials indicate that patients receiving ERP show an average reduction of 49% in OCD symptoms after treatment (Öst et al. 2015); yet 40–50% of patients with OCD do not recover following treatment (Fisher and Wells 2005). Gaining a better understanding of the temporal relations between OCD symptoms during treatment may inform targets for improving and augmenting ERP. Despite a widespread emphasis * Martha J. Falkenstein [email protected] 1
McLean Hospital/Harvard Medical School, Belmont, MA, USA
on the relations between obsessions and compulsions and the conceptualization that obsessions precede compulsions, only one study has explored the temporal relations of OCD symptoms (Laposa et al. 2019). However, the analyses in this prior study did not include obsessive beliefs, an integral part of cognitive-behavioral models of OCD.
The Importance of Obsessive Beliefs in the Development and Maintenance of OCD Obsessive beliefs are hypothesized to pl
Data Loading...
