Solem Stian, Hagen Kristen, Hansen Bjarne, Håland Åshild T, Launes Gunvor, Lewin Adam B, Storch Eric A, Vogel Patrick A
Norwegian University of Science and Technology, Trondheim, Norway
Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway
J Cogn Psychother. 2015;29(2):106-115. doi: 10.1891/0889-8391.29.2.106. Epub 2015 Jan 1.
A premise for cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD) is that appraisal of obsessions maintains OCD symptoms whereas obsessive content is less important. The main aim of this study was therefore to explore this notion using the autogenous and reactive classification of obsessive content and by assessing changes in appraisals and symptoms following CBT for OCD. More specifically, the study investigates whether recovery from OCD is associated with changes in appraisal and explores how thought content relates to appraisal and symptoms both before and CBT. Data from 156 adults with OCD completing CBT for OCD were analyzed. Changes in appraisals were related to improvement in OCD symptoms. Slightly more participants reported reactive intrusions (47%) than autogenous (29%), but combinations of the two were common (24%). These classifications of thought content were not related to levels of appraisal or change in symptoms, with the exception of patients with autogenous thoughts who appraised their intrusions as more important than others. OCD is heterogeneous regarding thought content and strength of appraisals but can be quite homogeneous in terms of CBT treatment response. Also, and in line with cognitive theory, recovery from OCD is associated with changes in appraisals.
强迫症认知行为疗法（CBT）的一个前提是，对强迫观念的评估维持了强迫症症状，而强迫观念的内容则不那么重要。因此，本研究的主要目的是通过对强迫观念内容进行自发和反应性分类，并评估强迫症CBT后评估和症状的变化来探讨这一观点。更具体地说，该研究调查了强迫症的康复是否与评估变化相关，并探讨了思维内容在CBT前后如何与评估和症状相关。对156名完成强迫症CBT的成年强迫症患者的数据进行了分析。评估的变化与强迫症症状的改善相关。报告反应性侵入的参与者（47%）略多于自发性侵入的参与者（29%），但两者的组合很常见（24%）。除了那些认为自己的侵入比其他人更重要的有自发思维的患者外，这些思维内容分类与评估水平或症状变化无关。强迫症在思维内容和评估强度方面是异质性的，但在CBT治疗反应方面可能相当同质。此外，与认知理论一致，强迫症的康复与评估变化相关。
