Berg Håvard, Tjelle Kristian, Hansen Bjarne, Solem Stian, Björgvinsson Thröstur, Kvale Gerd, Hagen Kristen
Department of Psychiatry, Møre and Romsdal Hospital Trust, Molde, Norway.
Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.
BMC Psychiatry. 2025 Mar 25;25(1):275. doi: 10.1186/s12888-025-06737-z.
Treatment readiness factors, such as treatment credibility and expectancy, are postulated to be predictors of outcomes within the context of cognitive behavioral therapy (CBT). Concentrated exposure therapy (cET) is a form of short-term, intensive, exposure-based CBT that has shown promising results. This study investigated whether treatment expectancy and credibility predict cET treatment outcomes in patients with difficult-to-treat (nonresponders and patients with relapse following CBT) obsessive-compulsive disorder (OCD).
A total of 163 patients underwent 4 days of cET treatment. Treatment credibility and expectancy were measured using the Credibility/Expectancy Questionnaire (CEQ) prior to the start of treatment. OCD symptom severity was measured using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) at pretreatment, posttreatment, 3-month follow-up, and 1-year follow-up. Work- and social functioning were measured before treatment and at the 1-year follow-up.
Higher CEQ scores were significantly associated with lower Y-BOCS score at posttreatment and follow-up after controlling for age, sex, and pretreatment OCD, anxiety, and depression levels. The CEQ scores were also significantly associated with work- and social functioning at the 1-year follow-up. A receiver operating characteristic analysis suggested a mean item cutoff point of 92.5 (0-100 scale) for the CEQ, and 87% of the patients classified as having high expectancy had a positive treatment response.
This study confirmed that treatment expectancy and credibility are predictors of cET outcomes in patients with OCD. Higher scores on the CEQ were linked to better treatment results, both immediately and up to one year later. These insights highlight the need to consider patients' attitudes toward treatment in the early treatment phase.
ClinicalTrials.gov identifier: NCT02656342 (First registered: 2015-11-30).
治疗准备因素，如治疗可信度和期望，被假定为认知行为疗法（CBT）背景下治疗结果的预测指标。集中暴露疗法（cET）是一种短期、强化、基于暴露的CBT形式，已显示出有前景的结果。本研究调查了治疗期望和可信度是否能预测难治性（无反应者和CBT后复发患者）强迫症（OCD）患者的cET治疗结果。
共有163名患者接受了为期4天的cET治疗。在治疗开始前，使用可信度/期望问卷（CEQ）测量治疗可信度和期望。在治疗前、治疗后、3个月随访和1年随访时，使用耶鲁-布朗强迫症量表（Y-BOCS）测量OCD症状严重程度。在治疗前和1年随访时测量工作和社会功能。
在控制年龄、性别以及治疗前OCD、焦虑和抑郁水平后，较高的CEQ得分与治疗后及随访时较低的Y-BOCS得分显著相关。CEQ得分在1年随访时也与工作和社会功能显著相关。一项受试者工作特征分析表明，CEQ的平均项目截止点为92.5（0-100量表），87%被归类为高期望的患者有积极的治疗反应。
本研究证实，治疗期望和可信度是OCD患者cET治疗结果的预测指标。CEQ得分越高，与即时及长达一年后的更好治疗结果相关。这些见解凸显了在治疗早期阶段考虑患者对治疗态度的必要性。
ClinicalTrials.gov标识符：NCT02656342（首次注册：2015年11月30日）。
