Change Factors in the Process of Cognitive‐Behavioural Therapy for Obsessive–Compulsive Disorder

Schwartz, Caroline; Hilbert, Sven; Schubert, Christiane; Schlegl, Sandra; Freyer, Tobias; Löwe, Bernd; Osen, Bernhard; Voderholzer, Ulrich

doi:10.1002/cpp.2045

Cited by 14 publications

(14 citation statements)

References 32 publications

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“…A large number of studies showing that low self-esteem increases the risk of mental health problem, such as depression, anxiety ( 14 , 49 ). In addition, low self-esteem was reported to be a risk factor for OCD, and enhancing self-esteem could significantly reduces OCD symptoms ( 50 ). Meanwhile, self-esteem played a mediating role in the relationship between left-behind experience and obsessive-compulsive symptoms ( 51 ).…”

Section: Discussionmentioning

confidence: 99%

The Influence of Self-Esteem and Psychological Flexibility on Medical College Students' Mental Health: A Cross-Sectional Study

et al. 2022

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BackgroundMental health problems has become a major public health issue among medical students. Self-esteem and psychological flexibility were important associated factors for mental health, but their relations have not been discussed in medical students. The present study aimed to assess the status of mental health problems among medical students and identified whether psychological flexibility had a mediating role in the effects of self-esteem on the top three most common psychological symptoms.MethodsA total of 810 undergraduate students from 18 classes comprised in the sample. Nine dimensions of psychological symptoms was assessed by the Symptom Checklist-90-revised (SCL-90-R). Self-esteem was measured by the Self-esteem Scale (SES) and psychological flexibility was evaluated by the Acceptance and Action Questionnaire 2nd Edition (AAQ-II) and Cognitive Fusion Questionnaire (CFQ-F). Univariate analysis and logistic regression analysis were used to determine the relationship among the top three common psychological symptoms, self-esteem, psychological flexibility, and participants' characteristics. The mediating effect of psychological flexibility between self-esteem and psychological symptoms was detected by bootstrap method.Results57.8% of the medical undergraduate students reported positive at least one of the nine psychological symptom dimensions assessed by the SCL-90-R and 13.8% of students had moderate or more severe symptoms. The symptoms of obsessive-compulsiveness, interpersonal sensitivity, and depression were the three most common psychological symptoms among the medical students. Meanwhile, self-esteem and psychological flexibility were negatively associated to the symptoms of obsessive-compulsiveness, interpersonal sensitivity, and depression. And, almost 50% effects of self-esteem on these three symptoms in medical students exert indirect effects through psychological flexibility.ConclusionsPsychological distress was quite common in the Chinese medical students. The three most common psychological symptoms were successively obsessive-compulsiveness, interpersonal sensitivity, and depression. Low self-esteem and psychological inflexibility might be the risk factors for these top three symptoms, and psychological flexibility might play a mediating role in the effects of self-esteem on these psychological symptoms.

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Section: Discussionmentioning

confidence: 99%

The Influence of Self-Esteem and Psychological Flexibility on Medical College Students' Mental Health: A Cross-Sectional Study

et al. 2022

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“…Beyond the dose of ERP and its implementation in varied contexts, patient characteristics, including mastery experience (Schwartz et al, 2017) or self-efficacy, which describe people's beliefs about their capabilities to achieve designated levels of performance, may influence the outcome of OCD treatment. During ERP, patients' realisation that they are able to refrain from acting out compulsions might increase their self-efficacy.…”

Section: Introductionmentioning

confidence: 99%

Frequency and level of self-efficacy predict the effectiveness of therapist- and self-guided exposure in obsessive compulsive disorder

Voderholzer

Hilbert

Fischer

et al. 2020

Behav. Cogn. Psychother.

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Background: While exposure and response prevention (ERP) is the most effective treatment for obsessive compulsive disorder (OCD), less is known about the specific mechanisms underlying symptom change after ERP. Aims: We tested the hypothesis that the frequency of self- and therapist-guided ERP related to the extent of symptom reduction and that this link is mediated by increased self-efficacy. Method: In a sample of 377 in-patients with a primary diagnosis of OCD receiving in-patient CBT, we assessed symptoms (YBOCS-SR) and self-efficacy (General Self-Efficacy Scale), before and after treatment, as well as the frequency of therapist- and self-guided ERP sessions. Results: Patients with more therapist-guided ERP sessions during treatment showed more symptom reduction and the association of self-guided ERP on outcome was mediated by enhanced self-efficacy. Conclusions: These findings highlight the importance of both therapist- and self-guided ERP sessions and suggest that therapists should conduct a sufficient number of ERP sessions to optimise treatment.

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“…Most of the studies employed EX/RP intervention in various formats, from short and intensive [daily and lasting < 4 weeks; ( 64 )] to more standard plans with weekly or twice-weekly sessions lasting between 4 and 8 weeks ( 58 , 59 , 65 – 71 ). Among these studies, four used a combined CBT protocol: the Pediatric OCD Treatment ( 64 , 72 ), a CBT program that included both group and dyadic psychotherapy sessions ( 69 ), and the web-based ICBT ( 65 , 68 ). All combined programs included a mix of psychoeducation, cognitive training, and EX/RP.…”

Section: Resultsmentioning

confidence: 99%

“…Most of the studies employed independent evaluators for the rating, i.e., clinical psychologists, blind to treatment conditions and treatment outcomes. Only one study adopted both the clinician and self-report versions [Y-BOCS-SR; ( 69 )]. Two studies also administered the Obsessive-Compulsive Inventory revised [OCI-R; 68 , 70 , 77 )], and one used the Maudsley Obsessive-Compulsive Inventory [MOCI; ( 78 )].…”

Section: Resultsmentioning

confidence: 99%

The therapeutic alliance in cognitive-behavioral therapy for obsessive-compulsive disorder: A systematic review and meta-analysis

Strappini

Socci

Saliani³

et al. 2022

Front. Psychiatry

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BackgroundThe therapeutic alliance has been recognized as one of the most researched key elements of treatment across different therapeutic approaches and diagnostic domains. Despite its importance, our current understanding of its clinical relevance in patients with obsessive-compulsive disorder (OCD) is still debated. This study aimed to examine empirical evidence on the effect of alliance on treatment outcomes in Cognitive Behavioral Therapy (CBT) in patients with OCD in a systematic review and meta-analysis.MethodsOriginal peer-reviewed articles until March 2022 were included if they were (1) written in English; (2) included a clinical group with a current primary OCD diagnosis; (3) involved individual CBT; (4) used a validated therapeutic alliance scale that was related to the outcome measurement; (5) reported an effect size.ResultsThirteen studies were included, six of which contained sufficient statistical information to be included in the meta-analysis. A total of 897 patients took part in all reviewed studies. We found a modest effect of alliance on post-treatment outcome [Tau2 = −0.1562 (C.I. 95%: −0.2542 to −0.0582)].DiscussionThe results show the existence of considerable variability and methodological inconsistencies across studies. We discuss the role of methodological factors that could account for this divergence, the research limitations, and the implications for current research.Systematic review registration[https://osf.io/dxez5/?view_only=bc2deaa7f0794c8dbef440255b2d4b3b].

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Change Factors in the Process of Cognitive‐Behavioural Therapy for Obsessive–Compulsive Disorder

Cited by 14 publications

References 32 publications

The Influence of Self-Esteem and Psychological Flexibility on Medical College Students' Mental Health: A Cross-Sectional Study

The Influence of Self-Esteem and Psychological Flexibility on Medical College Students' Mental Health: A Cross-Sectional Study

Frequency and level of self-efficacy predict the effectiveness of therapist- and self-guided exposure in obsessive compulsive disorder

The therapeutic alliance in cognitive-behavioral therapy for obsessive-compulsive disorder: A systematic review and meta-analysis

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