Dispositional resilience in treatment‐seeking patients with obsessive‐compulsive disorder and its association with treatment outcome

Abstract

There is a lack of research on the relation between obsessive-compulsive disorder (OCD) and resilience. Dispositional resilience, as described and defined in literature on hardiness, consists of three facets, namely beliefs about having control in everyday living, having a sense of purpose or commitment, and a positive attitude toward challenges. This study explores associations between dispositional resilience (measured with the Dispositional Resilience Scale (DRS-15-R)), symptom severity, and treatment outcome in a sample of 89 patients treated with concentrated exposure therapy (cET), and compares the findings with scores from two reference groups (students and soldiers). The patient group had significantly lower resilience scores than the two reference groups. Weak correlations were observed between dispositional resilience and OCD symptoms. Differences in dispositional resilience were weakly related to remission status at follow-up (odds ratio of 1.11). Furthermore, resilience improved from pre-to post-treatment (Cohen's d of 0.65). Our results imply that patients' initial resilience score does not hinder nor facilitate treatment effects to a great extent in this format of ERP treatment.

The immediate and long-term impacts of the COVID-19 pandemic on patients with obsessive-compulsive disorder: A one-year follow-up study

“…However, studies on resilience in OCD patients are limited. In this study, we found that resilience levels in the OCD patients were lower than those in the general population ( Yu et al, 2007 ), which was consistent with a previous study ( Holm et al, 2019 ). Studies have found a negative association between resilience and negative emotion, and this correlation is mainly driven by optimism ( Chen et al, 2018 ).…”

“…Individuals among the public with high levels of mental resilience would have lower levels of anxiety and depression during the COVID-19 pandemic ( Song et al, 2020 ). OCD patients had lower dispositional resilience scores than control groups, and resilience was negatively associated with OCD symptoms ( Holm et al, 2019 ). Studies have found that resilience is associated with many psychosocial factors, such as active coping and performance, cognitive flexibility, a feeling of control, harm avoidance and social support ( Eley et al, 2013 ; Iacoviello and Charney, 2014 ).…”

State and Trait Risk and Resilience Factors Associated with COVID-19 Impact and Obsessive–Compulsive Symptom Trajectories

“…Our risk factor hypothesis was partially supported. We confirmed previous findings that emotion dysregulation, AS (under certain conditions of perceived COVID-19 impact), and low resilience are associated with OC symptom severity (Berman et al, 2018 ; Holm et al, 2019 ; Khosravani et al, 2020 ; Yap et al, 2018 ). These results map onto clinical observations that the pandemic has not affected individuals uniformly—those who lack resources to recover quickly from stressful events or those who lack awareness of emotions and are less able to mount adaptive responses to them are at highest risk of deterioration.…”

“…Individuals at highest risk and who require closer monitoring during the COVID-19 pandemic may be those who have lower resilience and higher emotion dysregulation or AS. Although we are conceptualizing these constructs as trait factors, we do not mean to imply that such dispositional factors are not malleable; resilience in particular has been shown to improve with treatment among people with OCD (Holm et al, 2019 ). In addition, several of the adaptive self-reliant coping strategies that predicted subsequent-week reductions in OC symptoms reflect skills that are taught during effective psychological treatments for OCD and depression, such as positive reframing (cognitive therapy; Wilhelm & Steketee, 2006 ), planning/active coping (behavioral activation; Lejuez et al, 2001 ), and acceptance (mindfulness; Twohig, 2009 ).…”

“…Finally, resilience —adaptability in the face of adversity (Luthar, 2006 )—may impact an individual’s ability to cope with inflated levels of anxiety and uncertainty. Importantly, ample research demonstrates that elevated emotion dysregulation, IU, and AS, as well as low levels of resiliency, are significantly associated with heightened OC symptom severity (e.g., Berman et al, 2018 ; Gentes & Ruscio, 2011 ; Holm et al, 2019 ; Wheaton et al, 2012a , 2012b ) and have been shown to exacerbate internalizing symptoms over time in longitudinal designs (Heffer & Willoughby, 2018 ; Krebs et al, 2020 ; McLaughlin et al, 2011 ; Pozza et al, 2019 ). Therefore, we anticipated that higher baseline ratings on each risk factor would be associated with worsening OC symptoms, whereas higher baseline resilience ratings would be associated with less worsening OC symptoms, in the early stages of COVID-19.…”