Falkenstein Martha J, Kelley Kara N, Dattolico Devin, Kuckertz Jennie M, Bezahler Andreas, Krompinger Jason, Webb Christian A, Beard Courtney
McLean Hospital/Harvard Medical School.
McLean Hospital/Harvard Medical School.
Behav Ther. 2022 Mar;53(2):294-309. doi: 10.1016/j.beth.2021.09.002. Epub 2021 Sep 29.
Cognitive models implicate interpretation bias in the development and maintenance of obsessive compulsive and related disorders (OCRDs), and research supports Cognitive Bias Modification for Interpretation (CBM-I) in targeting this mechanism. However, prior studies in OCRDs have been limited to nonclinical populations, adolescents, and adults in a laboratory setting. This study evaluated the feasibility and acceptability of CBM-I as an adjunctive intervention during intensive/residential treatment (IRT) for adults with OCRDs. We modified a lab-based CBM-I training for adults seeking IRT for OCRDs, and conducted a feasibility trial (N = 4) and subsequent pilot RCT; participants (N = 31) were randomized to receive CBM-I or psychoeducation. Benchmarks were met for feasibility, acceptability, and target engagement. From pre- to post-intervention, the CBM-I group showed a large effect for change in interpretation bias (d = .90), whereas this effect was trivial (d = .06) for psychoeducation. This was the first study to evaluate CBM-I in naturalistic treatment for adults seeking IRT for OCRDs. Findings support the feasibility and acceptability of CBM-I in this novel sample and setting. A larger scale RCT is needed to determine whether CBM-I can enhance OCRD treatment response.
认知模型表明,解释偏差在强迫症及相关障碍(OCRD)的发展和维持中起作用,并且研究支持针对这一机制的认知偏差修正解释(CBM-I)。然而,先前针对OCRD的研究仅限于非临床人群、青少年以及实验室环境中的成年人。本研究评估了CBM-I作为OCRD成年患者强化/住院治疗(IRT)期间辅助干预措施的可行性和可接受性。我们对寻求IRT治疗的OCRD成年患者的基于实验室的CBM-I训练进行了修改,并开展了一项可行性试验(N = 4)及后续的试点随机对照试验;参与者(N = 31)被随机分配接受CBM-I或心理教育。在可行性、可接受性和目标参与度方面均达到了基准。从干预前到干预后,CBM-I组在解释偏差变化方面显示出较大效应(d = 0.90),而心理教育的效应微不足道(d = 0.06)。这是第一项评估CBM-I在寻求IRT治疗的OCRD成年患者自然主义治疗中的研究。研究结果支持了CBM-I在这个新样本和环境中的可行性和可接受性。需要进行更大规模的随机对照试验来确定CBM-I是否能增强OCRD的治疗反应。