Disorders - Obsessive Compulsive Disorder
Jalal, B., Bruhl, A., O'Callaghan, C., Piercy, T., Cardinal, R. N., Ramachandran, V. S., Sahakian, B. J.
One type of obsessive-compulsive disorder (OCD) is
characterized by contamination fears and compulsive cleansing. Few effective treatments are available for this debilitating condition. Compulsive
symptoms, such as excessive washing, are believed to be mediated by cognitive inflexibility-arguably the most striking cognitive impairment in OCD.
In this study, we investigated the effects of two novel smartphone interventions on cognitive flexibility and OCD symptoms in healthy individuals
with OCD-like contamination fears. In the first intervention, participants watched a brief video recording of themselves engaging in handwashing on a
smartphone, four times a day, for a total of one week (N=31). The second intervention was similar except that participants watched themselves
repeatedly touching a disgust-inducing object (N=31). In a third (control) \"intervention\", participants watched themselves performing sequential
hand movements (N=31). As hypothesized, the two smartphone interventions, unlike the control, improved cognitive flexibility; as assessed on the
Intradimensional-Extradimensional Set Shifting task (a sensitive marker of cognitive flexibility). The two interventions, unlike the control, also
improved OCD symptoms (measured with the Obsessive-Compulsive Inventory-Revised and Yale-Brown Obsessive-Compulsive Scale). Finally, we found high
levels of adherence to the interventions. These findings have significant clinical implications for OCD.
Scientific
Reports, 8(1) : 14923
- Year: 2018
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Staugaard, C.
F., Uhre, V., Lonfeldt, N., Pretzmann, L., Vangkilde, S., Plessen, K., Pagsberg, K.
Objective: To assess the effect of cognitive behavioral therapy (CBT) for
pediatric obsessive-compulsive disorder (OCD). Method(s): We systematically reviewed data from randomized trials with children and adolescents with
OCD, comparing CBT with 1) no intervention (e.g., wait list); 2) treatment as usual (or similar terms); 3) pharmacological treatments; or 4)
alternative psychotherapeutic approaches. On July 28th, 2017, we conducted a systematic literature search, which yielded 12 eligible trials. Data
from the trials were grouped into three comparisons: CBT vs. no intervention (n = 7), CBT vs. pharmacological intervention (n = 3), CBT vs.
relaxation therapy (n = 3). We assessed the effect on symptom severity measured with the Children's Yale-Brown Obsessive Compulsive Scale. To
evaluate the quality of the trials, two independent investigators assessed risk of bias within seven domains, following the guidelines of The
Cochrane Collaboration. For further details, see our protocol on PROSPERO (CRD42017079118). Result(s): The overall results indicate that in pediatric
OCD, CBT is more favorable than no intervention (Z = 5.29, p<0. 00001), and relaxation training (Z = 7.22, p<0.00001), while no significant
difference was found, comparing CBT to pharmacological treatment (Z = 0.05, p = 0.96). However, all included trials had a high risk of bias, not only
owing to the nature of psychotherapeutic interventions, which makes blinding of participants and treatment providers effectively impossible.
Conclusion(s): The systematic review indicates that CBT is more favorable than no intervention and relaxation training, and as effective as
pharmacological treatment, for pediatric OCD. However, the quality of the evidence is low, and future trials with low risk of bias are needed.
Early Intervention in Psychiatry, 12 (Supplement
1) : 166
- Year: 2018
- Problem: Obsessive Compulsive Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Relaxation
Rouel, M., Smith, E.
Attentional biases, particularly difficulty
disengaging, have been found in contamination obsessive-compulsive disorder (OCD) and may be a maintaining factor. Attentional bias modification
(ABM) may reduce this bias and avoidance behavior. This study examined attentional biases in 54 individuals with contamination OCD symptomatology and
whether ABM reduces biases and symptoms. Participants completed one 30 min session of either ABM training or a control task and a spatial cueing task
before and after to assess attentional bias. Questionnaires and behavioral tasks were also completed. Participants returned for a follow up 1 month
later. As expected, there was evidence of difficulty disengaging from threats directly and indirectly associated with disease. Attention training led
to a reduction in this bias, which was maintained for 1 month. However, there was no improvement in avoidance or contamination fear on a behavioral
task, contamination OCD symptoms, safety behaviors and anxiety. Implications for treatment of OCD are discussed. Copyright © 2018, Springer Science
+Business Media, LLC, part of Springer Nature.
Cognitive Therapy and
Research, 42(5) : 686-698
- Year: 2018
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Ching, T. H. W., Williams, M. T.
There is little
research on treating symptoms of sexual orientation-obsessive-compulsive disorder (SO-OCD). Semantic networks represent a new cognitive approach for
understanding cognitive mechanisms of SO-OCD. Specifically, we tested whether the self-help cognitive technique of association splitting (AS)
developed from this approach would be efficacious in reducing SO-OCD symptoms and thought suppression. One hundred and twenty heterosexual
undergraduates (82 females, 38 males) were randomly assigned to either the AS or waitlist control group. At baseline and four weeks later,
participants completed items assessing SO-OCD symptoms, measures of sexual obsessions and thought suppression, and an association task in which they
generated associations to different cue words. Generated associations were coded based on SO-OCD relevance and emotional valence. Results indicated
reductions in SO-OCD-relevant associations across levels of emotional valence and SO-OCD-irrelevant negative associations, and increases in SO-OCD-
irrelevant positive and neutral associations, only in the AS group. Furthermore, there were reductions in SO-OCD symptoms, sexual obsessions, and
thought suppression only in the AS group. Importantly, these findings were obtained with overall large effect sizes. AS appears to be an efficacious
self-help technique in reducing SO-OCD symptoms, sexual obsessions, and thought suppression. Clinical implications, limitations, and suggestions for
future research are discussed.
Cognitive Behaviour Therapy, 47(3) : 229-
245
- Year: 2018
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Fatori, D., deBraganca-Pereira, C. A., Asbahr, F. R., Requena,
G., Alvarenga, P. G., deMathis, M. A., Rohde, L. A., Leckman, J. F., March, J. S., Polanczyk, G. V., Miguel, E. C., Shavitt, R. G.
Objective: This
sequential multiple assignment randomized trial (SMART) tested the effect of beginning treatment of childhood OCD with fluoxetine (FLX) or group
cognitive-behavioral therapy (GCBT) accounting for treatment failures over time. Methods: A two-stage, 28-week SMART was conducted with 83 children
and adolescents with OCD. Participants were randomly allocated to GCBT or FLX for 14 weeks. Responders to the initial treatment remained in the same
regimen for additional 14 weeks. Non-responders, defined by less than 50% reduction in baseline Yale-Brown Obsessive-Compulsive Scale (Y-BOCS)
scores, were re-randomized to either switch to or add the other treatment. Assessments were performed at baseline, 7, 14, 21, and 28 weeks. Results:
Among the 43 children randomized to FLX who completed the first stage, 15 (41.7%) responded to treatment and 21 non-responders were randomized to
switch to (N = 9) or add GCBT (N = 12). Among the 40 children randomized to GCBT who completed the first stage, 18 (51.4%) responded to treatment and
17 non-responders were randomized to switch to (N = 9) or add FLX (N = 8). Primary analysis showed that significant improvement occurred in children
initially treated with either FLX or GCBT. Each time point was statistically significant, showing a linear trend of symptom reduction. Effect sizes
were large within (0.76-0.78) and small between (-0.05) groups. Conclusions: Fluoxetine and GCBT are similarly effective initial treatments for
childhood OCD considering treatment failures over time. Consequently, provision of treatment for childhood OCD could be tailored according to the
availability of local resources. Copyright © 2018 Elsevier Ltd
Journal of Anxiety Disorders, 58 : 42-
50
- Year: 2018
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Huang, J., Nigatu, Y. T., Smail-Crevier, R., Zhang, X., Wang, J.
Common mental health problems (CMHPs), such as depression, anxiety disorder,
obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD) are internalizing disorders with high comorbidity. University and
college students are under many stressors and transitional events, and students fall within the age range when CMHPs are at their developmental peak.
Compared to the expanded effort to explore and treat CMHPs, there has been no a meta-analysis that comprehensively reviewed the interventions for
CMHPs and examined the effects of interventions for CMHPs in college students. The objective of this review is to conduct a systematic review and
meta-analysis of randomized controlled trials (RCTs) examining interventions for CMHPs among university and college students and to estimate their
post-intervention effect size (ES), as well as follow-up ES, for depression, anxiety disorder, OCD and PTSD separately. Meta-analytic procedures were
conducted in accordance with PRISMA guidelines. We reviewed 7768 abstracts from which 331 full-text articles were reviewed and 51 RCTs were included
in the analysis. We found moderate effect sizes for both depression (Hedges' g = -0.60) and anxiety disorder (Hedges' g = -0.48). There was no
evidence that existing interventions for OCD or PTSD were effective in this population. For interventions with high number of papers, we performed
subgroup analysis and found that cognitive behavioral therapy (CBT) and mindfulness-based interventions were effective for both depression and
generalized anxiety disorder (GAD), and attention/perception modification was effective for GAD; other interventions (i.e. art, exercise and peer
support) had the highest ES for both depression and GAD among university and college students. Copyright © 2018 Elsevier Ltd
Journal of Psychiatric Research, 107 : 1-
10
- Year: 2018
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Other Psychological Interventions, Mindfulness based
therapy
Hojgaard, D. R. M. A., Hybel, K. A., Mortensen, E.
L., Ivarsson, T., Nissen, J. B., Weidle, B., Melin, K., Torp, N. C., Dahl, K., Valderhaug, R., Skarphedinsson, G., Storch, E. A., Thomsen, P. H.
Our aims were to examine: (1)
classes of comorbid disorders in a sample of children and adolescents with Obsessive-Compulsive Disorder (OCD), (2) how these classes relate to
obsessive-compulsive symptom dimensions, and (3) the extent to which obsessive-compulsive symptom dimensions predict Cognitive-Behavioral Therapy
(CBT) outcome. Participants (N = 269) were assessed with the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL) and the
Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). Latent Class Analysis (LCA) was used to identify comorbidity classes. Regression
analyses were used to evaluate symptom dimensions as predictors of treatment outcome and their relation to comorbidity classes. Comorbidity was
included in the treatment outcome analyses as it can affect outcome. Comorbidity was best categorized by a three-class model and each class was
distinctively correlated with the OCD symptom dimensions. Higher scores on the symmetry/hoarding factor increased the chance of responding to CBT by
an odds ratio of 1.56 (p = 0.020) when controlled for age, gender, and comorbidity class. The harm/sexual factor (p = 0.675) and
contamination/cleaning factor (p = 0.122) did not predict CBT outcome. Three clinically relevant comorbidity subgroups in pediatric OCD were
identified. Patients who exhibited higher levels of symmetry/hoarding dimension were more prone to respond to CBT. Copyright © 2018 Elsevier B.V.
Psychiatry Research, 270 : 317-323
- Year: 2018
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Jalal, B., Bruhl, A., O'Callaghan, C., Piercy, T., Cardinal, R. N., Ramachandran, V. S., Sahakian, B. J.
One type of obsessive-compulsive disorder (OCD) is
characterized by contamination fears and compulsive cleansing. Few effective treatments are available for this debilitating condition. Compulsive
symptoms, such as excessive washing, are believed to be mediated by cognitive inflexibility-arguably the most striking cognitive impairment in OCD.
In this study, we investigated the effects of two novel smartphone interventions on cognitive flexibility and OCD symptoms in healthy individuals
with OCD-like contamination fears. In the first intervention, participants watched a brief video recording of themselves engaging in handwashing on a
smartphone, four times a day, for a total of one week (N=31). The second intervention was similar except that participants watched themselves
repeatedly touching a disgust-inducing object (N=31). In a third (control) \"intervention\", participants watched themselves performing sequential
hand movements (N=31). As hypothesized, the two smartphone interventions, unlike the control, improved cognitive flexibility; as assessed on the
Intradimensional-Extradimensional Set Shifting task (a sensitive marker of cognitive flexibility). The two interventions, unlike the control, also
improved OCD symptoms (measured with the Obsessive-Compulsive Inventory-Revised and Yale-Brown Obsessive-Compulsive Scale). Finally, we found high
levels of adherence to the interventions. These findings have significant clinical implications for OCD.
Scientific
Reports, 8(1) : 14923
- Year: 2018
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Conley, Sara L., Wu, Kevin D.
Background and
objectives: Dysfunctional interpretations of intrusive thoughts are implicated in the etiology and maintenance of Obsessive-Compulsive Disorder
(OCD). Cognitive Bias Modification training for interpretations (CBM-I) has successfully modified dysfunctional interpretations in the context of
several disorders, including OCD. However, research regarding CBM-I's impact on symptom reduction and behavior is mixed, which limits its clinical
application. Further, support for the specific efficacy of CBM-I in individuals with contamination concerns is limited. The current study aimed to
modify dysfunctional interpretations in individuals with contamination concerns, and examine the effect of the modification on both interpretation
bias and performance on a behavioral approach task (BAT). Methods: Participants (N = 74) completed a word-sentence association task by indicating
whether a threatening or benign word was related to an ambiguous scenario. The active condition received feedback designed to reduce maladaptive
interpretations; the control condition received random feedback. Results: Findings revealed that the active-but not the control-condition showed a
significant decrease in interpretation bias for threat cues. Analyses of behavioral effects indicated that when ceiling effects were accounted for,
the active condition completed more BAT steps than the control condition (p = 0.06; d = 0.45). Limitations: The current study is preliminary and
requires replication with a clinical sample. Conclusions: Completion of the CBM-I was beneficial for reducing dysfunctional interpretations relevant
to naturally-occurring contamination concerns and, importantly, this reduction may help those individuals approach feared situations. (PsycINFO
Database Record (c) 2018 APA, all rights reserved)
Journal of Behavior Therapy and Experimental Psychiatry, 59 : 56-
64
- Year: 2018
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Attention/cognitive bias
modification
Wilson, A. C., Aldao, A., Cheavens, J.
Objectives: A large body of work suggests that cognitive reappraisal is an
effective strategy for modifying emotional intensity. In addition, its habitual use has been linked to adaptive psychological functioning,
operationalized as low levels of symptoms of psychopathology. However, little is known about the impact of cognitive reappraisal on behavioral
aspects of mental disorders. For example, the experience of fear is often accompanied by the behavioral urge to avoid the feared stimuli. Although
there is evidence to suggest that cognitive reappraisal reduces fear in the moment, there is less information about the impact on behavioral
correlates. Method: To that end, we recruited 90 participants who experienced substantial contamination concerns (i.e., obsessive-compulsive disorder
symptoms) and asked them to participate in exposure tasks that consisted of gradually coming into contact with contaminated objects (i.e., approach
behavior). We randomly assigned participants to one of three conditions: (1) reappraise the emotion-eliciting stimulus, (2) reappraise their
emotional response, or (3) no specific emotion regulation instructions. Results: Reappraising the stimulus, but not reappraising the emotional
response, led to significantly greater behavioral approach (p = .02) than the no-instruction condition during exposure. There were no significant
differences in subjective state anxiety between any of the conditions. Conclusion: These findings suggest that certain types of reappraisal may lead
to greater approach behavior during exposure even in the absence of subjective emotional changes. More broadly, they underscore the importance of
examining the role of emotion regulation strategies (including different types of reappraisal) on the behavioral aspects of mental disorders.
(PsycINFO Database Record (c) 2018 APA, all rights reserved)
Journal of Clinical Psychology, 74(9) : 1583-1593
- Year: 2018
- Problem: Obsessive Compulsive Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Other Psychological Interventions
Abuwalla, Z., Clark, M. D., Burke, B., Tannenbaum, V., Patel, S., Mitacek, R., Gladstone, T., Van-Voorhees, B.
Introduction This rapid review identifies and summarizes the effectiveness of
preventative telemental health interventions. It investigates studies conducted between 2010 and 2016 that improve mood and anxiety with long-term
follow-up. Methods A literature search of three major databases was performed by four reviewers. After citation tracing, 3604 studies were
discovered, and twenty of these met the inclusion criteria. Data from the papers were abstracted, assessed for quality, and effect sizes were
calculated. Results Salient information was discussed using the Behavioural Vaccine Model of mental illness prevention. This included key concepts
such as efficacy, duration of benefits, sociocultural relevance, professional guidance, peer-to-peer support, adherence, delivery and safety.
Conclusion This review suggests there are clear prolonged benefits to using technology in youth mental illness prevention. Although this is a rapidly
growing area of investigation in countries around the globe, there is still a dearth of research with long-term follow-up. Future studies should aim
to boost engagement by increasing motivational guidance in order to recruit at-risk youth of all demographics into these promising intervention
programs. Copyright © 2017
Internet
Interventions, 11 : 20-29
- Year: 2018
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Skills training, Attention/cognitive bias
modification, Technology, interventions delivered using technology (e.g. online, SMS)
Mechler, K., Hage, A., Schweinfurth, N., Glennon, J. C., Dijkhuizen, R. M., Murphy, D., Durston, S., et al., TACTICS Consortium
Objective: Research has implicated glutamatergic projections between the
various frontal subregions in the pathogenesis of compulsivity and impulsivity. Reducing striatal glutamate release, or antagonising the action of
glutamate at its receptors, may therefore represent viable treatment strategies. Several glutamatergic agents with regulatory approval for other
indications are available and may be of potential benefit in the treatment of compulsivity/impulsivity in psychiatric disorders in paediatric
patients. Method(s): This review was performed according to PRISMA guidelines and evaluates available scientific literature concerning the use of
glutamatergic agents in these patients, in order to determine their reported effectiveness/efficacy and tolerability/safety. Result(s): Out of a
total of 1,426 publications, 21 trials examining six glutamatergic substances in patients with obsessive-compulsive disorder, autism spectrum
disorders, and attention deficit/hyperactivity disorder were included. Conclusion(s): Trial designs as well as results were heterogeneous and thus
comparability was limited. Available data support the hypothesis that glutamatergic agents are of potential value in the treatment of
compulsivity/impulsivity in children and adolescents. Based on the data reviewed, memantine and N-acetylcysteine suggest the best risk-benefit
profile for future trials. Riluzole should primarily be further investigated in adults. Clinical research of this nature is a key element of the
TACTICS Consortium project funded by the European Union (FP7). Copyright © 2017 Hogrefe.
Zeitschrift
fur Kinder- und Jugendpsychiatrie und Psychotherapie, 46(3) : 246-263
- Year: 2018
- Problem: Obsessive Compulsive Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions