Cognitive Mediation of Symptom Change in Exposure and Response Prevention for Obsessive Compulsive Disorder

Abstract This study examined cognitive mediators of symptom change during exposure and response prevention (EX/RP) for obsessive compulsive disorder (OCD). Based on cognitive models of OCD, obsessive beliefs were hypothesized as a mediator of symptom change. Participants were 70 patients with primar...

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Bibliographic Details
Published in:Behavior therapy 2016-07, Vol.47 (4), p.474-486
Main Authors: Su, Yi-Jen, Carpenter, Joseph K, Zandberg, Laurie J, Simpson, Helen Blair, Foa, Edna B
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Behavior Therapy - methods
Cognition
Cognitive ability
Cognitive models
cognitive theory
Cognitive therapy
exposure and ritual prevention
Female
Humans
Intolerance
Male
Mediation
Middle Aged
Models, Psychological
Nonresponse
Obsessive compulsive disorder
Obsessive-Compulsive Disorder - psychology
Obsessive-Compulsive Disorder - therapy
Perfectionism
Prevention
Psychiatry
Psychological Theory
Response prevention
Risperidone
Self Report
Severity
treatment
Treatment Outcome
Uncertainty
Young Adult
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Summary:Abstract This study examined cognitive mediators of symptom change during exposure and response prevention (EX/RP) for obsessive compulsive disorder (OCD). Based on cognitive models of OCD, obsessive beliefs were hypothesized as a mediator of symptom change. Participants were 70 patients with primary OCD receiving EX/RP either as part of a randomized controlled trial ( n = 38) or in open treatment following non-response to risperidone or placebo in the same trial ( n = 32). Blinded evaluations of OCD severity and self-report assessments of three domains of obsessive beliefs (i.e., responsibility/threat of harm, importance/control of thoughts, and perfectionism/intolerance of uncertainty) were administered during acute (weeks 0, 4 and 8) and maintenance treatment (weeks 12 and 24). Study hypotheses were examined using cross-lagged multilevel modeling. Contrary to predictions, the obsessive beliefs domains investigated did not mediate subsequent OCD symptom reduction. In addition, OCD symptoms did not significantly mediate subsequent change in obsessive beliefs. The present study did not find evidence of cognitive mediation during EX/RP for OCD, highlighting the need to investigate other plausible mediators of symptom improvement.
ISSN:0005-7894
1878-1888
DOI:10.1016/j.beth.2016.03.003