Thampy Mareena, Sudhir Paulomi M, Kumar Ajay, Kashyap Himani, Balachander Srinivas, Narayanaswamy Janardhanan C, Reddy Y C Janardhan
Dept. of Clinical Psychology, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
Dept. of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka, India.
Indian J Psychol Med. 2025 Jul 8:02537176251347929. doi: 10.1177/02537176251347929.
Serotonin reuptake inhibitors (SSRIS) and cognitive behavior therapy (CBT), comprising exposure and response prevention (ERP), are the first line of treatment for obsessive compulsive disorders (OCD). However, many patients fail to achieve clinically significant symptom relief from traditional exposure-based therapies. This has led to research on strategies that can optimize the effects of ERP. Inhibitory learning theory (ILT) provides a novel foundation for understanding how exposure therapy reduces fear and has been mainly studied in the context of anxiety and phobia.
There is limited empirical data on applying the principles of IL, such as expectancy violation, variability, deepened extinction, labelling of affect, and removal of safety signals as mechanisms of extinction that can aid the achievement of favorable outcomes in OCD. In the absence of an existing manual, we describe the development of a novel IL-based ERP therapy intervention and the trial protocol to test its efficacy in patients with OCD.
A quasi-experimental study design with baseline, post-treatment, and follow-up assessments will be adopted. The first phase of this study includes developing and validating an IL-based ERP intervention. A sample of 24 patients diagnosed with OCD will be recruited to receive IL-based ERP as part of the study. Measures of OCD symptom severity will be used to test efficacy.
This study describes the development of an OCD-specific IL-based ERP intervention and an open-label trial to generate preliminary evidence for its utility in persons with OCD. The use of IL principles in ERP may potentially improve treatment outcomes for OCD.
5-羟色胺再摄取抑制剂（SSRI）和认知行为疗法（CBT），包括暴露与反应阻止疗法（ERP），是强迫症（OCD）的一线治疗方法。然而，许多患者未能从传统的基于暴露的疗法中获得临床上显著的症状缓解。这导致了对能够优化ERP效果的策略的研究。抑制性学习理论（ILT）为理解暴露疗法如何减轻恐惧提供了一个新的基础，并且主要是在焦虑和恐惧症的背景下进行研究的。
关于应用IL原理（如期望违背、变异性、加深消退、情感标记以及去除作为消退机制的安全信号）以帮助在OCD中取得良好结果的实证数据有限。在没有现有手册的情况下，我们描述了一种基于IL的新型ERP治疗干预措施的开发以及测试其对OCD患者疗效的试验方案。
将采用具有基线、治疗后和随访评估的准实验研究设计。本研究的第一阶段包括开发和验证基于IL的ERP干预措施。将招募24名被诊断为OCD的患者作为研究的一部分接受基于IL的ERP治疗。将使用OCD症状严重程度的测量指标来测试疗效。
本研究描述了一种针对OCD的基于IL的ERP干预措施的开发以及一项开放标签试验，以生成其对OCD患者效用的初步证据。在ERP中使用IL原理可能会潜在地改善OCD的治疗结果。
