Institute of Psychology, Westfälische Wilhelms-University Münster, Münster, Germany.
Christoph-Dornier-Stiftung, Münster, Germany.
Clin Psychol Psychother. 2019 Nov;26(6):695-706. doi: 10.1002/cpp.2392. Epub 2019 Aug 14.
As part of a larger clinical trial, this ecological momentary assessment (EMA) study pursued the main goal of demonstrating that the EMA method is sensitive to treatment effects of detached mindfulness and cognitive restructuring for obsessive-compulsive disorder (OCD). A second goal was to provide a descriptive analysis of OCD symptoms and influencing factors in participants' everyday lives. Thirty-nine participants were included in the final analyses. EMA sampling involved a smartphone and comprised 4 days with 10 random prompts per day both before (Pre-Treatment EMA) and after the completion of a 2-week clinical intervention of either detached mindfulness or cognitive restructuring (Post-Treatment EMA) that participants had been randomly allocated to. The EMA questionnaire included items on the frequency of obsessions, subjective burden due to obsessions, perceived current stress, emotions, and on the frequency of compulsions and other dysfunctional behaviors. Descriptive Pre-Treatment EMA results highlight the importance of compulsions and emotional states of tension/discomfort in OCD. Pre-Post comparisons showed a significant reduction of avoidance behavior, obsessions, and burden due to obsessions, with a nonsignificant trend also indicating a reduction of compulsions. There was no pre to post effect concerning emotions. This study adds to the existing research on OCD symptoms and offers further evidence in confirmation of established theoretical models of OCD. Also, our results can be taken as evidence for treatment sensitivity of the EMA method in OCD. Further research is needed to replicate, broaden, and generalize our results.
作为一项更大规模临床试验的一部分，这项基于自然的实时评估（EMA）研究旨在证明 EMA 方法对于分离式正念和认知重构治疗强迫症（OCD）的疗效具有敏感性。第二个目标是对参与者日常生活中的 OCD 症状和影响因素进行描述性分析。最终有 39 名参与者纳入了分析。EMA 采样涉及智能手机，在接受为期 2 周的分离式正念或认知重构临床干预之前（治疗前 EMA）和之后（治疗后 EMA），参与者被随机分配，每天进行 10 次随机提示，共进行 4 天。EMA 问卷包括强迫观念的频率、强迫观念引起的主观负担、感知到的当前压力、情绪以及强迫观念和其他功能失调行为的频率等项目。治疗前 EMA 的描述性结果突出了强迫症中强迫观念和紧张/不适情绪的重要性。预-后比较显示，回避行为、强迫观念和强迫观念引起的负担显著减少，虽然有一个非显著的趋势也表明强迫观念减少，但情绪没有出现从治疗前到治疗后的变化。本研究增加了关于 OCD 症状的现有研究，并进一步证实了 OCD 的既定理论模型。此外，我们的结果可以作为 EMA 方法在 OCD 治疗中具有敏感性的证据。需要进一步的研究来复制、扩展和推广我们的结果。
