Dissolving the tenacity of obsessional doubt: Implications for treatment outcome

The Inference‐Based Approach (IBA) to the Treatment of Obsessive–Compulsive Disorder: An Open Trial Across Symptom Subtypes and Treatment‐Resistant Cases

“…In particular, an early randomized study investigating the efficacy of IBA reported an effect size of 1.41 that was equivalent to traditional CBT but a superior effect size of 1.86 among those with higher than normal obsessional conviction (O'Connor et al , ). Also, several treatment outcome studies have shown that improvement in levels of inferential confusion is significantly associated with successful treatment outcome (Aardema, Emmelkamp, & O'Connor, ; Aardema et al ., ), while experimental studies have shown that clinical improvement is associated with an increased ability to resolve obsessional doubt (Aardema & O'Connor, ). Studies applying IBA to OCD with OVI and body dysmorphic disorder have shown similar large effect sizes for these traditionally difficult to treat groups (Béland & O'Connor, ; Provencher et al ., ; Taillon, O'Connor, Dupuis, Lavoie, .…”

Choice Blindness, Confabulatory Introspection, and Obsessive-Compulsive Symptoms: A New Area of Investigation

“…As noted by O'Connor and Aardema, in their inference-based conceptualization of OCD, obsessions in general can be understood as inferences, where the person arrives at an obsession through reasoning ("I might be contaminated"; "I might have run over someone with my car"; Aardema & O'Connor, 2003;O'Connor, 2002;O'Connor, Aardema, & Péllissier, 2005). Such inferences of doubt typically come about through a narrative that is characterized by a distrust of the senses and an overreliance on the imagination, often in opposition to actual reality (Aardema, O'Connor, Pélissier, & Lavoie, 2009;Aardema & O'Connor, 2012). As such, limited introspective access, and its association with a tendency to arrive at inferences on a subjective basis, could potentially contribute to the formation of such obsessional inferences or beliefs.…”

An experimental re-examination of the inferential confusion hypothesis of obsessive–compulsive doubt

“…Aardema and O'Connor (2012) examined the utility of Inference Based Therapy (IBT), which is based on the inferential confusion model, for individuals with OCD. The authors found that IBT improved participants' ability to resolve obsessional doubt, which was also associated with better treatment outcome.…”