Association between obsessive-compulsive and related disorders and experiential avoidance: A systematic review and meta-analysis

Angelakis, Ioannis; Pseftogianni, Foteini

doi:10.1016/j.jpsychires.2021.03.062

Cited by 27 publications

(10 citation statements)

References 67 publications

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“…Indeed, research is accumulating that demonstrates the role of EA in a range of suicide experiences (Chou et al, 2018;Ellis & Rufino, 2016;Roush et al, 2019;Zvolensky et al, 2015Zvolensky et al, , 2016. Furthermore, new evidence has supported the strong associations between EA and obsessive-compulsive and related disorders, including obessive-compuslive disorder, hoarding disorder, body dysmorphic disorder and hair-pulling disorder (Angelakis & Pseftogianni, 2021) which also have been strongly associated with suicide and related behaviors (e.g., Angelakis et al, 2015;Angelakis et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Experiential avoidance in non‐suicidal self‐injury and suicide experiences: A systematic review and meta‐analysis

Angelakis

Gooding

2021

Suicide & Life Threat Behav

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Introduction:This systematic review and meta-analysis aimed to (i) examine the associations between experiential avoidance (EA), non-suicidal self-injury (NSSI), and suicide experiences, and (ii) identify sample-and methodological-related variables affecting the strength of these associations. Method: Medline, Embase, PsychINFO, Web of Science, and CINAHL were searched until April 2020. Random-effect meta-analyses were applied. The I 2 statistic and the Egger's test assessed heterogeneity and publication bias. Meta-regression analyses were used to evaluate the impact of moderator variables on the strength of these associations. Results: Data from 19 independent studies based on n = 9900 participants were pooled. The analyses demonstrated a weak but significant association between EA and NSSI. None of the examined moderator variables influenced the strength of this relationship. There was an indication of publication bias, suggesting that this association may have been inflated. The associations between EA, and suicide ideation and behaviors were moderate to strong. Discussion: The current study concluded that (i) the EA model for NSSI should be revised by incorporating new evidence implicating feelings of relief in NSSI, and (ii) future studies should examine interactive factors between EA and key psychological components in the pathways to suicide experiences because these findings have direct clinical implications.

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Section: Introductionmentioning

confidence: 99%

Experiential avoidance in non‐suicidal self‐injury and suicide experiences: A systematic review and meta‐analysis

Angelakis

Gooding

2021

Suicide & Life Threat Behav

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“…Experiential avoidance, the avoidance of unpleasant inner experiences such as fear, discomfort and bodily sensations, is found to play a crucial role in the development and maintenance of obsessive compulsive symptoms [15][16][17][18][19]. Also, meta-analysis showed that this effect differed between the different subtypes of OCD, patients with the focus on obsessions and responsiblity for harm seem to benefit more from a reduction in experiential avoidance [17]. Therefore, we will examine the possible effect of experiential avoidance as a predictor for treatment outcome and investigate if this differs between subgroups of patients.…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

“…Furthermore, we will be assessing possible predictors and mediators of treatment effect. Experiential avoidance, the avoidance of unpleasant inner experiences such as fear, discomfort and bodily sensations, is found to play a crucial role in the development and maintenance of obsessive compulsive symptoms [15][16][17][18][19]. Also, meta-analysis showed that this effect differed between the different subtypes of OCD, patients with the focus on obsessions and responsiblity for harm seem to benefit more from a reduction in experiential avoidance [17].…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Personalized exposure and ESM feedback versus exposure as usual for OCD: a study protocol for a randomized controlled trial

Hoogerwerf

Greeven

Goekoop

et al. 2023

Preprint

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Background This study aims to compare personalized exposure with response prevention (ERP) using experience sampling methodology-based feedback to ERP as usual in patients with obsessive-compulsive disorder (OCD). Personalized exposure will be provided screen-to-screen in an ecologically valid (real time and real place) context by means of a smartphone application. This app will also be used to collect both objective and subjective data by means of experience sampling methodology (ESM). This ESM-data will be used to identify triggers and protective factors for symptom severity, provide personalized feedback and optimize the effect of ERP. The primary goal of this RCT is to compare the effectiveness of personalized ERP to ERP as usual in the traditional context of a therapist’s room in patients with OCD in OCD symptom severity. Since both self-efficacy and experiential avoidance are known to influence symptom-severity in OCS, a secondary goal is to examine if a possible treatment effect is mediated by self-efficacy or experiential avoidance. Methods This study involves a randomized controlled trial with 20 weekly sessions by 2 groups (ERP as usual versus personalized ERP), repeated measurements at baseline (T0), 5 weeks of treatment (T1), 10 weeks of treatment (T2), 15 weeks of treatment (T3), posttest at 20 weeks (T4), 6 weeks follow-up (T5), 3 months follow-up (T6), 6 months follow-up (T7) and a year follow-up (T8). A hundred and sixty patients with an OCD diagnosis according to DSM-5 criteria will participate. Half of the group will receive exposure with response prevention as usual, the other half will receive personalized exposure with response prevention with a smartphone application and personalized feedback sessions based on experience sampling data. Discussion This randomized controlled trial is the first to assess the influence of delivering ERP through video calling and the use of an ESM intervention on the symptom severity of OCD. Since the global pandemic COVID-19, the use of video calling to deliver psychological treatments has become more common, increasing the relevance of this study. Trial registration: ICTRP Trial NL8254 registered on 2019-12-24 url: https://trialsearch.who.int/Trial2.aspx?TrialID=NL8254

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“…Psychological inflexibility and experiential avoidance are also associated with OCS and psychological distress (Angelakis and Pseftogianni, 2021; Bond et al ., 2011). ACT, of which psychological flexibility/inflexibility is a process of change, is effective for treating OCD, as are mindfulness-based interventions (Bluett et al ., 2014; Chien et al ., 2022; Twohig et al ., 2010).…”

Section: Introductionmentioning

confidence: 99%

A pilot study of experiencing racial microaggressions, obsessive-compulsive symptoms, and the role of psychological flexibility

Browning,

Lloyd-Richardson,

Satterfield

et al. 2023

Behav. Cogn. Psychother.

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Background: Experiencing racial microaggressions has clear effects on physical and psychological health, including obsessive-compulsive disorder symptoms (OCS). More research is needed to examine this link. Psychological flexibility is an important process to examine in this work. Aims: This study aimed to examine if, while controlling for depression and anxiety, experiences of microaggressions and psychological flexibility helped explain OCD symptoms within a university-affiliated sample (undergraduate, graduate and law students). This was a pilot exploration of the relationships across themes. Method: Initial baseline data from a longitudinal study of psychological flexibility, OCD symptoms, depression, anxiety and experience of microaggressions was utilized. Correlations and regressions were utilized to examine which OCD symptom dimensions were associated with experiencing racial microaggressions in addition to anxiety and depression, and the added role of psychological flexibility was examined. Results: OCD symptoms, experiences of microaggressions and psychological flexibility were correlated. Experiences of racial microaggressions explained responsibility for harm and contamination OCD symptoms above and beyond psychological distress. Exploratory results support the relevance of psychological flexibility. Conclusion: Results support other work that experiences of racial microaggressions help explain OCS and they add some support for psychological flexibility as a relevant risk or protective factor for mental health in marginalized populations. These topics should be studied longitudinally with continued consideration of all OCD themes, larger sample sizes, intersecting identities, clinical samples, and continued exploration of psychological flexibility and mindfulness and values-based treatments.

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Association between obsessive-compulsive and related disorders and experiential avoidance: A systematic review and meta-analysis

Cited by 27 publications

References 67 publications

Experiential avoidance in non‐suicidal self‐injury and suicide experiences: A systematic review and meta‐analysis

Experiential avoidance in non‐suicidal self‐injury and suicide experiences: A systematic review and meta‐analysis

Personalized exposure and ESM feedback versus exposure as usual for OCD: a study protocol for a randomized controlled trial

A pilot study of experiencing racial microaggressions, obsessive-compulsive symptoms, and the role of psychological flexibility

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