Let me check that for you: Symptom accommodation in romantic partners of adults with Obsessive–Compulsive Disorder

Boeding, Sara E.; Paprocki, Christine; Baucom, Donald H.; Abramowitz, Jonathan S.; Wheaton, Michael G.; Fabricant, Laura E.; Fischer, Melanie S.

doi:10.1016/j.brat.2013.03.002

Cited by 75 publications

(69 citation statements)

References 34 publications

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“…These findings, though preliminary, suggest that accommodating behaviors may be implicated in the perpetuation of avoidance, in particular. This possibility is consistent with prior research on accommodation in a number of anxiety disorders that are characterized in large part by direct avoidance of feared stimuli (e.g., Boeding et al, 2013; Craske et al, 1989; Rapee et al, 2015). The foundation of many empirically supported treatments for anxiety disorders is exposure to feared stimuli (e.g., Deacon & Abramowitz, 2004), and most of the primary empirically supported treatments for PTSD incorporate significant elements of exposure, as well (e.g., Foa, Hembree, & Rothbaum, 2007; Resick & Schnicke, 1993).…”

Section: Discussionsupporting

confidence: 90%

“…One such behavior that has been increasingly discussed in the context of PTSD is accommodation , or partners’ behavioral adjustments in response to symptoms that attempt to minimize relationship conflict and patient distress. Partner accommodation (sometimes called enabling or over-involvement) can entail well-intentioned attempts to help those who are suffering, but it has been associated with fewer treatment gains across a number of disorders, such as OCD, agoraphobia, social anxiety, and eating disorders (Boeding et al, 2013; Craske, Burton, & Barlow, 1989; Rapee, Peters, Carpenter, & Gaston, 2015; Salerno et al, 2016). Additionally, across disorders, partner accommodation is typically positively associated with partner distress and feelings of caregiving burden (e.g., Boeding et al, 2013; Sepulveda, Kyriacou, & Treasure, 2009).…”

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confidence: 99%

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A Daily Diary Study of Posttraumatic Stress Symptoms and Romantic Partner Accommodation

et al. 2017

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Little is known about the role of romantic partner symptom accommodation in PTSD symptom maintenance. To explore the bidirectional associations of posttraumatic stress disorder (PTSD) symptoms and romantic partner symptom accommodation over time, military servicemen (n = 64) with symptoms of PTSD and their co-habiting heterosexual civilian romantic partners (n = 64) completed a 2-week daily diary study. Cross-lagged, autoregressive models assessed the stability of men’s PTSD symptoms and partners’ accommodation, as well as the prospective associations of earlier PTSD symptoms with later accommodation and vice versa. Analyses used Bayesian estimation to provide point estimates (b) and Credible Intervals (CIs). In all models, PTSD symptoms (total and individual clusters) were highly stable (b = 0.91; CI: 0.88–0.95), and accommodation was moderately stable (b = 0.48; CI: 0.40–0.54). In all models, earlier PTSD symptoms (total and clusters) were significantly, positively associated with later accommodation (b = 0.04; CI: 0.02–0.07). In contrast, earlier accommodation was significantly associated only with later situational avoidance (b = 0.02; CI: 0.00–0.07). Thus, PTSD symptoms may lead to subsequent accommodating behaviors in romantic partners, but partner accommodation seems to contribute only to survivors’ future situational avoidance symptoms. The findings reinforce the notion that PTSD symptoms have an impact on relationship behaviors, and that accommodation from partners may sustain avoidant behaviors in particular. Clinicians should attend to romantic partners’ accommodating behaviors when working with survivors.

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Section: Discussionsupporting

confidence: 90%

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confidence: 99%

A Daily Diary Study of Posttraumatic Stress Symptoms and Romantic Partner Accommodation

et al. 2017

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“…Research has documented an association between relatives' scores on the FAS and patient symptom severity and poor global functioning, rejecting attitudes toward the patient, limits on family opportunities, burden experienced by the relative, and poor family functioning (Calvocoressi et al, 1999). In addition, partner accommodation has been found to be negatively associated with relationship satisfaction among spouses of patients with OCD (Boeding et al, 2013). Family accommodation is associated with poorer treatment outcomes in both adults and children with OCD (Amir, Freshman, & Foa, 2000; Boeding et al, 2013; Storch et al, 2007), whereas improvements in family accommodation during treatment predict better treatment outcome among children with OCD (Merlo, Lehmkuhl, Geffken, & Storch, 2009).…”

Section: Introductionmentioning

confidence: 99%

Partner accommodation in posttraumatic stress disorder: Initial testing of the Significant Others’ Responses to Trauma Scale (SORTS)

Fredman

Vorstenbosch

Wagner

et al. 2014

Journal of Anxiety Disorders

111

163

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Posttraumatic stress disorder (PTSD) is associated with myriad relationship problems and psychological distress in partners of individuals with PTSD. This study sought to develop a self-report measure of partner accommodation to PTSD (i.e., ways in which partners alter their behavior in response to patient PTSD symptoms), the Significant Others' Responses to Trauma Scale (SORTS), and to investigate its reliability and construct validity in 46 treatment-seeking couples. The SORTS demonstrated strong internal consistency and associations with individual and relationship distress. Accommodation was positively correlated with partners' ratings of patients' PTSD symptoms, patient self-reported depressive and trait anger severity, and partner self-reported depressive and state anger severity. Accommodation was negatively correlated with patient and partner relationship satisfaction and partners' perceived social support received from patients. Findings suggest that accommodation may be an attempt to adapt to living with a partner with PTSD but may have negative implications for patient and partner well-being.

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“…Parents are incorporated into treatment as a way to bolster adherence to treatment procedures and to extinguish maladaptive cycles of parental accommodation and overprotection. Despite the preponderance of FITs aimed at pediatric patients, given the previously noted evidence that OCD in adults is also associated with considerable family dysfunction and problematic levels of accommodation, several researchers have tested FITs for adult patients (Boeding et al, 2013; Grunes, Neziroglu, & McKay, 2001; Van Noppen, Steketee, McCorkle, & Pato, 1997). Although pediatric protocols almost exclusively include parents as the family member participants, FITs for adults may include spouses, siblings, or even adult children of the patients.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Clinical Trial of a Brief Family Intervention to Reduce Accommodation in Obsessive-Compulsive Disorder: A Preliminary Study

et al. 2015

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Accommodation consists of changes in family members’ behavior to prevent or reduce patients’ obsessive-compulsive disorder (OCD) rituals or distress. High levels of family accommodation are associated with more severe symptoms and functional impairment on the part of patients, and may also interfere with exposure-based treatment. The purpose of this study was to develop and test a brief, adjunctive intervention to reduce accommodation in the family members of adult OCD patients. Patients (N = 18, mean age = 35.44, 33% male, 94% Caucasian) received a course of standard individual exposure and ritual prevention (ERP) for OCD. Family members (N = 18, mean age = 41.72, 56% male, 94% Caucasian) were randomized to either receive or not receive the adjunctive intervention, consisting of two sessions of psychoeducation and skills training in reducing accommodation. Results revealed that the intervention successfully reduced scores on the clinician-rated the Family Accommodation Scale (Week 8 d = 1.05). Patients whose family members received the intervention showed greater reductions in Y-BOCS scores across treatment than patients whose family members had not (Week 8 d = 1.27), and hierarchical regression analyses revealed that change in family accommodation from baseline accounted for a significant amount of variance in later OCD symptoms (β = .45, p = .02). Results from this preliminary study suggest that this adjunctive intervention produces more rapid treatment response compared to traditional ERP alone. Accommodation is a potentially important target for improving treatment in OCD and other diagnostic groups where accommodation is likely to occur.

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Let me check that for you: Symptom accommodation in romantic partners of adults with Obsessive–Compulsive Disorder

Cited by 75 publications

References 34 publications

A Daily Diary Study of Posttraumatic Stress Symptoms and Romantic Partner Accommodation

A Daily Diary Study of Posttraumatic Stress Symptoms and Romantic Partner Accommodation

Partner accommodation in posttraumatic stress disorder: Initial testing of the Significant Others’ Responses to Trauma Scale (SORTS)

A Randomized Clinical Trial of a Brief Family Intervention to Reduce Accommodation in Obsessive-Compulsive Disorder: A Preliminary Study

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