University of North Carolina at Chapel Hill, United States.
University of North Carolina at Chapel Hill, United States.
J Anxiety Disord. 2020 May;72:102210. doi: 10.1016/j.janxdis.2020.102210. Epub 2020 Mar 12.
Exposure and response prevention (ERP) is an effective treatment for obsessive compulsive disorder (OCD); yet, improvement rates vary and it is therefore important to examine potential predictors of outcome. The present study examined adherence with ERP homework as a predictor of (a) treatment response across OCD symptom dimensions and (b) reductions in psychological factors implicated in the maintenance of OCD. Fifty adults with OCD received manualized twice-weekly ERP as part of a treatment trial. Results indicated that treatment was effective for all OCD symptom dimensions and that greater adherence with ERP homework predicted post-treatment (but not follow-up) improvements in OCD symptoms pertaining to responsibility for harm, unacceptable obsessional thoughts, and symmetry. Adherence did not predict outcomes for contamination symptoms, however. Adherence also predicted improvement in psychological maintenance factors such as obsessive beliefs and experiential avoidance. Implications of the findings include the importance of emphasizing adherence to homework instructions, as well as the importance of considering OCD symptoms dimensionally as opposed to globally in examining predictors of treatment response.
暴露和反应预防（ERP）是一种治疗强迫症（OCD）的有效方法；然而，改善率各不相同，因此检查潜在的预后因素很重要。本研究检查了 ERP 家庭作业的依从性作为（a）治疗反应在 OCD 症状维度上的预测因子，以及（b）减少与 OCD 维持相关的心理因素。50 名强迫症成年人接受了规范化的每周两次 ERP 治疗，作为治疗试验的一部分。结果表明，治疗对所有 OCD 症状维度都有效，并且 ERP 家庭作业的更高依从性预测了治疗后（而非随访）与伤害责任、不可接受的强迫性思维和对称性相关的 OCD 症状的改善。然而，依从性并未预测污染症状的结果。依从性还预测了强迫症信念和体验回避等心理维持因素的改善。研究结果的意义包括强调遵守家庭作业说明的重要性，以及在检查治疗反应的预后因素时，将 OCD 症状从维度上而不是整体上进行考虑的重要性。
