Jones M K, Menzies R G
Department of Behavioural Sciences, Faculty of Health Sciences, University of Sydney, Lidcombe, Australia.
Behav Res Ther. 1998 Oct;36(10):959-70. doi: 10.1016/s0005-7967(98)00057-6.
Twenty-one OCD sufferers with washing/contamination concerns took part in a controlled treatment trial at the Anxiety Disorders Clinic, University of Sydney. Eleven of the subjects received danger ideation reduction therapy (DIRT) over eight, 1 h weekly group sessions conducted by the second author. Ten subjects were placed on a wait list and did not receive DIRT or any other treatment. DIRT procedures were solely directed at decreasing danger-related expectancies concerning contamination and did not include exposure, response prevention or behavioral experiments. Components of DIRT include attentional focusing, filmed interviews, corrective information, cognitive restructuring, expert testimony, microbiological experiments and a probability of catastrophe assessment task. All subjects were assessed at pre-treatment, post-treatment and three-month follow-up using the Maudsley Obsessional-Compulsive Inventory, Leyton Obsessionality Inventory, Beck Depression Inventory and a Self Rating of Severity Scale. Changes from pre-treatment to after treatment (post-treatment and follow-up scores averaged) were significantly greater in the DIRT condition than in the control condition for all measures. No significant differences were obtained between groups on post-treatment to follow-up change on any measure. The implications of these findings for theoretical models of OCD and its management are discussed.
21名有洗涤/污染相关担忧的强迫症患者参与了悉尼大学焦虑症诊所的一项对照治疗试验。其中11名受试者在第二作者主持的为期8周、每周1小时的小组会议中接受了危险观念减少疗法（DIRT）。10名受试者被列入等待名单，未接受DIRT或任何其他治疗。DIRT程序仅旨在减少与污染相关的危险预期，不包括暴露、反应阻止或行为实验。DIRT的组成部分包括注意力集中、拍摄访谈、纠正信息、认知重建、专家证词、微生物实验和灾难可能性评估任务。所有受试者在治疗前、治疗后和三个月随访时均使用莫兹利强迫观念-强迫行为量表、莱顿强迫观念量表、贝克抑郁量表和严重程度自评量表进行评估。在所有测量指标上，DIRT组从治疗前到治疗后（治疗后和随访分数平均）的变化显著大于对照组。在任何测量指标上，两组在治疗后到随访的变化上均未获得显著差异。本文讨论了这些发现对强迫症理论模型及其管理的意义。
