Adam M Reid1,2, Lauryn E Garner3, Nathaniel Van Kirk3,2, Christina Gironda4, Jason W Krompinger3,2, Brian P Brennan3,2, Brittany M Mathes5, Sadie Cole Monaghan2,6, Eric D Tifft3, Marie-Christine André7,8, Jordan Cattie9, Jesse M Crosby3,2, Jason A Elias3,2. 1. OCD Institute for Children and Adolescents, McLean Hospital, Middleborough, MA, USA. 2. Department of Psychiatry, Harvard Medical School, Boston, MA, USA. 3. Office of Clinical Assessment and Research, OCD Institute, McLean Hospital, Middleborough, MA, USA. 4. Simons School of Social Work, Boston, MA, USA. 5. Department of Psychology, Florida State University, Tallahassee, MA, USA. 6. Behavioral Health Partial Program, McLean Hospital, Middleborough, MA, USA. 7. Department of Psychology, Suffolk University, Boston, MA, USA. 8. Boston Children's Hospital, Boston, MA, USA. 9. Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA, USA.
Abstract
OBJECTIVE: Exposure and response prevention (ERP) is an effective treatment for individuals with obsessive-compulsive disorder (OCD), yet a substantial number of individuals with OCD do not fully respond to this intervention. Based on emerging experimental and clinical research on acceptance, this study sought to explore whether willingness to experience unpleasant thoughts, emotions, and bodily sensations during ERP was associated with improved treatment response. METHODS: Two hundred eighty-eight adults with OCD receiving residential ERP provided self-rated willingness and other exposure-related variables during each daily coached ERP session. Obsessive-compulsive and depressive symptom severity was assessed every week. Multilevel modeling was used to study the impact of willingness on treatment outcome during the first 6 weeks of residential care. RESULTS: Data indicated that individuals with higher willingness during ERP reported faster symptom reduction during residential treatment, even when controlling for length of stay, psychopharmacological intervention, depression, adherence, and rituals performed during ERP. These results appear to have both statistical and clinical significance. CONCLUSIONS: Willingness to fully experience unpleasant and unwanted thoughts, emotions, and bodily sensations during exposures appears to be a marker of successful exposure therapy in adults with OCD. Future research should examine how willingness may enhance extinction learning during ERP.
OBJECTIVE: Exposure and response prevention (ERP) is an effective treatment for individuals with obsessive-compulsive disorder (OCD), yet a substantial number of individuals with OCD do not fully respond to this intervention. Based on emerging experimental and clinical research on acceptance, this study sought to explore whether willingness to experience unpleasant thoughts, emotions, and bodily sensations during ERP was associated with improved treatment response. METHODS: Two hundred eighty-eight adults with OCD receiving residential ERP provided self-rated willingness and other exposure-related variables during each daily coached ERP session. Obsessive-compulsive and depressive symptom severity was assessed every week. Multilevel modeling was used to study the impact of willingness on treatment outcome during the first 6 weeks of residential care. RESULTS: Data indicated that individuals with higher willingness during ERP reported faster symptom reduction during residential treatment, even when controlling for length of stay, psychopharmacological intervention, depression, adherence, and rituals performed during ERP. These results appear to have both statistical and clinical significance. CONCLUSIONS: Willingness to fully experience unpleasant and unwanted thoughts, emotions, and bodily sensations during exposures appears to be a marker of successful exposure therapy in adults with OCD. Future research should examine how willingness may enhance extinction learning during ERP.
Authors: Robert R Selles; Davið R M A Højgaard; Tord Ivarsson; Per Hove Thomsen; Nicole Michelle McBride; Eric A Storch; Daniel Geller; Sabine Wilhelm; Lara J Farrell; Allison M Waters; Sharna Mathieu; S Evelyn Stewart Journal: J Am Acad Child Adolesc Psychiatry Date: 2019-06-20 Impact factor: 8.829
Authors: Anne Katrin Külz; Sarah Landmann; Barbara Cludius; Nina Rose; Thomas Heidenreich; Lena Jelinek; Heike Alsleben; Karina Wahl; Alexandra Philipsen; Ulrich Voderholzer; Jonathan G Maier; Steffen Moritz Journal: Eur Arch Psychiatry Clin Neurosci Date: 2018-11-16 Impact factor: 5.270
Authors: Christopher Pittenger; Brian P Brennan; Lorrin Koran; Carol A Mathews; Gerald Nestadt; Michele Pato; Katharine A Phillips; Carolyn I Rodriguez; H Blair Simpson; Petros Skapinakis; Dan J Stein; Eric A Storch Journal: Psychiatry Res Date: 2021-03-04 Impact factor: 11.225