Background: Disgust is a strong and persistent emotion that frequently occurs during exposure-based treatments for contamination-based obsessive compulsive disorder (C-OCD). This study aimed to examine the efficacy of augmenting cognitive behavioral therapy (CBT) with a novel type of anti-disgust cognitive intervention in reducing the severity of OCD, disgust propensity/sensitivity, and refusal rate of exposure and response prevention, while simultaneously increasing acceptance of disgust. Materials and Methods: Fifty-five individuals with C-OCD (mean age 28.1 years, SD = 3.52; 77% female) were randomly assigned to 15 weekly sessions of anti-disgust plus CBT (AD-CBT) or CBT alone. They were evaluated for outcomes four times (pretreatment, prior to exposure and response prevention (ERP) sessions, posttreatment, and three-month follow-up), and mixed-design ANOVAs were used to analyze the data. Results: The findings indicated that when compared to CBT alone, AD-CBT significantly reduced OCD severity, disgust propensity/sensitivity, and concurrently increased disgust acceptance (p < 0.001). Additionally, engaging in an anti-disgust cognitive intervention was associated with lower ERP refusal rate (4% vs. 16%). The superiority of AD-CBT over CBT persisted through the three-month follow-up period. Conclusions: The current study suggests that supplementing CBT for C-OCD with an anti-disgust cognitive intervention significantly increased acceptance of disgust and decreased the refusal rate of ERP, OCD severity, and disgust-related factors.
Background & Aim: This study aimed at comparing efficacy of cognitive behavioral therapy, Zolpidem 10 mg, and waiting list group on illness perception and sleep efficiency in individuals with chronic insomnia disorder. Materials & Methods: Participants included 74 (female = 43) individuals with chronic insomnia disorder who were recruited from 2018 December to 2020 February by purposive sampling (inclusive & exclusive criteria). Then, patients randomly allocated to one of the three conditions, including cognitive behavioral therapy (N=25), pharmacotherapy (Zolpidem 10 mg.; N=29), and the waiting list (N=20). All patients were assessed three times at pretreatment, post-treatment, and 3-month follow-up by the Persian version of Brief Illness Perception Questionnaire and Sleep Efficiency Index. The data were analyzed by mixed analysis of variance with Bonferroni post-hoc test and repeated measure analysis of variance. Ethical Considerations: All stages of the research have been carried after taking supervising and approving of Kharazmi University's ethics in research committee. Findings: The patients who received cognitive behavioral therapy compared to patients in waiting list group, obtained significantly lower scores in illness perception and sleep efficiency during post-treatment and 3-month follow-up. Efficacy of pharmacotherapy only observed during post-treatment but there were no significant differences between pharmacotherapy and waiting list patients during 3-month follow-up. Conclusion: Cognitive behavioral therapy for insomnia reduced significantly illness perceptions and sleep efficiency during 3 months. All the treatment gains remain stable even 3 months later treatment ends. In addition, not receiving any treatment in waiting list and gradually discontinued the treatment in pharmacotherapy group leads to decreasing of sleep efficiency and increasing of illness perception.
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