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考察强迫症中的抑郁症状:体验回避的作用。

Examining depression symptoms within OCD: the role of experiential avoidance.

机构信息

Department of Psychology, University of Massachusetts Dartmouth, 285 Old Westport Road, North Dartmouth, MA02747, USA.

McLean Hospital OCD Institute, 115 Mill Street, Mail Stop #207, Belmont, MA02478, USA.

出版信息

Behav Cogn Psychother. 2022 Jul;50(4):367-380. doi: 10.1017/S1352465821000497. Epub 2021 Dec 20.

DOI:10.1017/S1352465821000497
PMID:34924099
Abstract

BACKGROUND

Obsessive compulsive disorder (OCD) and depression commonly co-occur. Past research has evaluated underlying mechanisms of depression in the context of other diagnoses, but few to no studies have done this within OCD.

AIMS

This study examines the relationships between distress tolerance (DT), experiential avoidance (EA), depression, and OCD symptom severity across intensive/residential treatment (IRT) for OCD. It was hypothesized that all variables would be significantly moderately related and EA would emerge as a potential contributing factor to change in depression and OCD symptoms across IRT for OCD.

METHOD

The sample included 311 participants with a primary diagnosis of OCD seeking IRT. Correlations were performed between all variables at both admission and discharge. A two-step hierarchical regression with change in OCD symptoms and change in DT in the first block and change in EA in the second block examined if change in EA explained change in depression above and beyond change in OCD and DT ability.

RESULTS

At both admission and discharge, higher EA, lower DT, and higher OCD symptom severity were significantly associated with more depressive symptoms. Change in EA explained a significant amount of variance in change in depression above and beyond change in OCD symptom severity and change in DT.

CONCLUSIONS

This study expands past results within an OCD sample, emphasizing EA as an important treatment target in OCD. Future studies could utilize samples from other treatment contexts, use a measure of EA specific to OCD, and utilize a longitudinal model that takes temporal precedence into account.

摘要

背景

强迫症(OCD)和抑郁症通常同时发生。过去的研究已经在其他诊断的背景下评估了抑郁症的潜在机制,但在 OCD 中很少有研究这样做。

目的

本研究考察了在 OCD 的强化/住院治疗(IRT)中,苦恼容忍度(DT)、体验回避(EA)、抑郁和 OCD 症状严重程度之间的关系。假设所有变量都将呈显著中度相关,EA 将成为 OCD 的 IRT 中抑郁和 OCD 症状变化的潜在影响因素。

方法

该样本包括 311 名患有 OCD 的参与者,他们寻求 IRT。在入院和出院时对所有变量进行相关性分析。在第一块中,以 OCD 症状和 DT 的变化为自变量,以 EA 的变化为因变量进行二步分层回归,以检验 EA 的变化是否能解释 OCD 和 DT 能力变化之外的抑郁变化。

结果

在入院和出院时,较高的 EA、较低的 DT 和较高的 OCD 症状严重程度与更多的抑郁症状显著相关。EA 的变化在 OCD 症状严重程度和 DT 的变化之外,能显著解释抑郁变化的更多方差。

结论

本研究在 OCD 样本中扩展了过去的结果,强调 EA 是 OCD 治疗的一个重要目标。未来的研究可以使用来自其他治疗环境的样本,使用针对 OCD 的 EA 测量方法,并采用考虑时间优先性的纵向模型。

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