Cognitive behavioral treatments of obsessive–compulsive disorder. A systematic review and meta-analysis of studies published 1993–2014

Öst, Lars‐Göran; Havnen, Audun; Hansen, Bjarne; Kvale, Gerd

doi:10.1016/j.cpr.2015.06.003

Cited by 484 publications

(309 citation statements)

References 53 publications

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“…Results from comparisons of cognitive therapy and behavioral therapy for OCD support this explanation. Metaanalyses of randomized clinical trials suggest that cognitive therapy and exposure and response prevention (ERP) have approximately equivalent efficacy in the treatment of OCD (Öst et al 2015;Rosaalcazar et al 2008). However the addition of cognitive components to ERP does not increase its efficacy (Longmore and Worrell 2007).…”

Section: Discussionmentioning

confidence: 99%

Modifying Obsessive-Compulsive Beliefs about Controlling One’s Thoughts

Stech

Grisham

2017

J Psychopathol Behav Assess

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Cognitive models of obsessive-compulsive disorder propose that beliefs about the importance of and need to control thoughts (ICT) are central to the maintenance of the disorder. Cognitive Bias Modification for Interpretation (CBM-I) can be used to experimentally test this theory and may also have clinical utility as an adjunct therapeutic tool. The current study extended previous research to investigate whether two CBM-I sessions (one within and one outside the laboratory) would augment effects on obsessive-compulsive beliefs and behavior. We randomly allocated undergraduate participants high in ICT beliefs to a Positive (n = 30) or Control (n = 36) CBM-I condition and conducted multimodal assessments immediately following the first training and at one-week follow-up. As predicted, participants in the Positive condition reported a reduction in obsessive-compulsive beliefs from baseline to follow-up (partial η 2 = .42), whereas those in the Control condition did not. Participants responded more adaptively to the ICT relevant stressor task at follow-up compared to post-intervention, but there was no significant difference between conditions. Likewise, participants reported a reduction in obsessive symptoms over time that did not differ between conditions. The findings are considered in light of cognitive models of OCD, and clinical implications are discussed.

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Section: Discussionmentioning

confidence: 99%

Modifying Obsessive-Compulsive Beliefs about Controlling One’s Thoughts

Stech

Grisham

2017

J Psychopathol Behav Assess

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“…Whilst ERP is effective for OCD, around 50% of people do not recover after therapy (Öst, Havnen, Hansen, & Kvale, 2015).…”

Section: Introductionmentioning

confidence: 99%

Mindfulness-based exposure and response prevention for obsessive compulsive disorder: Findings from a pilot randomised controlled trial

Strauss

Lea

Hayward

et al. 2018

Journal of Anxiety Disorders

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Background: Only about half of people with obsessive compulsive disorder (OCD) show clinically significant improvement following the recommended therapy, exposure and response prevention (ERP), partly due to poor therapy acceptability. A mindfulness-based approach to ERP (MB-ERP) has the potential to improve acceptability and outcomes. Methods: This was an internal pilot randomised controlled trial (RCT) of group MB-ERP compared to group ERP. 37 participants meeting DSM-IV OCD criteria were randomly allocated to MB-ERP or ERP. Results: Both groups improved in OCD symptom severity. However, MB-ERP did not lead to clinically important improvements in OCD symptom severity at post-intervention compared to ERP -the minimum clinically important difference was not contained in the 95% confidence intervals. There were negligible between-group differences in engagement and MB-ERP did not appear to have broader benefits compared to ERP on depression, wellbeing or OCD-related beliefs. Conversely, MB-ERP led to medium/medium-large improvements in mindfulness compared to ERP. Conclusions: MB-ERP is unlikely to lead to clinically meaningful improvements in OCD symptom severity compared to ERP alone. We underline the importance of adhering to treatment guidelines recommending ERP for OCD. Insufficient attention may have been given to mindfulness practice/discussion in MB-ERP and further research is recommended to explore this possibility.

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“…Although previous research strongly supports the efficacy of CBT incorporating exposure and response prevention (ERP) for OCD (Deacon & Abramowitz, 2004;Foa et al, 2005;Franklin & Foa, 2011), 19-40% of individuals refuse the treatment entirely or drop out prematurely (Foa et al, 2005;Öst, Havnen, Hansen, & Kvale, 2015;Whittal, Thordarson, & McLean, 2005). Reasons for these problematic dropout rates are largely unknown, although one study found that fear of CBT was a common reason for refusal and/or dropout in individuals with OCD (Mancebo, Eisen, Sibrava, Dyck, & Rasmussen, 2011).…”

mentioning

confidence: 93%

Are all safety behaviours created equal? A comparison of novel and routinely used safety behaviours in obsessive-compulsive disorder

Levy

Radomsky

2016

Cognitive Behaviour Therapy

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Contamination fear is one of the most common symptoms of obsessive-compulsive disorder (OCD). Exposure and response prevention (ERP) is effective for OCD, but a significant minority of treatment-seeking individuals refuse ERP entirely or drop out prematurely. Research suggests that safety behaviour (SB) may enhance the acceptability of ERP; however, questions remain about how to incorporate SB into existing treatments. Clinical participants with OCD and contamination fear (N = 57) were randomized to receive an exposure session with no SB (ERP), a routinely used SB (RU), or a never-used SB (NU). Significant reductions in contamination fear severity were observed in all conditions. Although omnibus comparisons were only marginally significant, pairwise comparisons revealed some condition differences. NU demonstrated significantly lower self-reported contamination fear severity at post-exposure, as well as marginally higher treatment acceptability ratings. Findings suggest that exposure with SB may be effective and acceptable, and are discussed in terms of cognitive-behavioural theory and treatment of anxiety and related disorders.

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Cognitive behavioral treatments of obsessive–compulsive disorder. A systematic review and meta-analysis of studies published 1993–2014

Cited by 484 publications

References 53 publications

Modifying Obsessive-Compulsive Beliefs about Controlling One’s Thoughts

Modifying Obsessive-Compulsive Beliefs about Controlling One’s Thoughts

Mindfulness-based exposure and response prevention for obsessive compulsive disorder: Findings from a pilot randomised controlled trial

Are all safety behaviours created equal? A comparison of novel and routinely used safety behaviours in obsessive-compulsive disorder

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