Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, OCD and Related Disorders, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA; Psychology Department, College of the Holy Cross, 1 College St., Beaven Hall, PO Box 38A, Worcester, MA, 01610, USA.
Center for Obsessive-Compulsive Treatment and Related Disorders, New York State Psychiatric Institute, Department of Psychiatry, Columbia University, 1051 Riverside Drive, Unit #69, New York, NY, 10032, USA.
J Behav Ther Exp Psychiatry. 2021 Mar;70:101615. doi: 10.1016/j.jbtep.2020.101615. Epub 2020 Sep 6.
There is conflicting research on how comorbid depression impacts the treatment of obsessive compulsive disorder (OCD) with exposure with response prevention. To better understand this relationship, the current study tests theoretical claims that greater depression limits motivation to engage in exposures, restricts habituation, and interferes with adaptive learning.
Fifty-one individuals with OCD completed a diagnostic interview and self-report questionnaires assessing depression symptom severity and then participated in a standardized imaginal exposure protocol, in which they repeatedly approached an idiosyncratic fear deemed "moderately anxiety-provoking."
Contrary to expectations, linear regression models indicated that depression symptom severity was not independently associated with motivation, subjective or objective within-session habituation or adaptive learning outcomes. However, the perceived likelihood of the best-case scenario occurring as a result of the exposure moderated the relationship between depression severity and motivation to engage in the exposure exercise.
Use of a one-session exposure protocol precludes conclusions regarding how depression is associated with outcomes in a full ERP treatment.
Depression symptom severity was not independently associated with motivation, habituation, or adaptive learning. The observed non-significant effects suggest that degree of depression, on its own, is not a meaningful indicator of how patients with OCD will fare an exposure intervention.
关于共病抑郁如何影响暴露反应预防治疗强迫症（OCD），研究结果存在冲突。为了更好地理解这种关系，本研究检验了一些理论观点，即更严重的抑郁会限制进行暴露的动机，限制习惯化，干扰适应性学习。
51 名强迫症患者完成了诊断访谈和自我报告问卷，评估抑郁症状严重程度，然后参与了标准化的想象暴露方案，在该方案中，他们反复接近被认为“中度焦虑”的特殊恐惧。
与预期相反，线性回归模型表明，抑郁症状严重程度与动机、主观或客观的会话内习惯化或适应性学习结果无关。然而，暴露后最佳情况发生的可能性感知会调节抑郁严重程度与参与暴露练习的动机之间的关系。
使用单次暴露方案排除了关于抑郁与完整 ERP 治疗结果之间关联的结论。
抑郁症状严重程度与动机、习惯化或适应性学习无关。观察到的无显著影响表明，抑郁程度本身并不是强迫症患者进行暴露干预时表现的有意义指标。
