Despite the substantial impairments in life functioning associated with obsessive-compulsive disorder (OCD), treatment outcome evaluations have focused almost exclusively on symptom reduction, a focus that may be too narrow to determine whether clinically significant change has occurred. Quality of life (QOL) impairment was evaluated in a clinical OCD sample (N=188) using a multidimensional life satisfaction measure. Relationships between treatment response and QOL change also were evaluated with a subsample of participants (n=120). Congruent with previous studies of OCD, substantial pretreatment QOL impairment was found across all life domains. Distinct treatment change subgroups were identified: a group reporting strong symptom reduction and very good QOL gains, a second group with significant symptom reduction but less robust QOL improvements, and a third group with limited symptom gains and QOL decreases. Implications for understanding OCD-related impairment and the clinical significance of treatment outcomes are discussed.
Anxiety sensitivity (AS), a cognitive risk factor for anxiety disorders, was evaluated in a homogeneous obsessive-compulsive disorder (OCD) sample. A total of 280 individuals with OCD completed measures. Evaluation of the Anxiety Sensitivity Index revealed a latent structure that was congruent with previous studies showing a single higher order and three lower order factors, although greater variance was accounted for by the general factor than in a previous study. AS was significantly associated with OCD symptom severity after controlling for other putative cognitive risk factors, although the additional variance explained was small. Variability in the relationship of AS to OCD symptom severity was found across OCD symptom subgroups. Results suggest that AS might be an important aspect of OCD-relevant cognition for specific OCD subgroups, and the need for experimental evaluation is discussed.
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