When it's at: An examination of when cognitive change occurs during cognitive therapy for compulsive checking in obsessive-compulsive disorder.


Journal

Journal of behavior therapy and experimental psychiatry
ISSN: 1873-7943
Titre abrégé: J Behav Ther Exp Psychiatry
Pays: Netherlands
ID NLM: 0245075

Informations de publication

Date de publication:
06 2020
Historique:
received: 10 09 2018
revised: 12 11 2018
accepted: 04 12 2018
pubmed: 24 12 2018
medline: 26 1 2021
entrez: 22 12 2018
Statut: ppublish

Résumé

The cognitive theory of compulsive checking in OCD proposes that checking behaviour is maintained by maladaptive beliefs, including those related to inflated responsibility and those related to reduced memory confidence. This study examined whether and when specific interventions (as part of a new cognitive therapy for compulsive checking) addressing these cognitive targets changed feelings of responsibility and memory confidence. Participants were nine adults with a primary or secondary diagnosis of OCD who reported significant checking symptoms (at least one hour per day) on the Yale-Brown Obsessive-Compulsive Scale. A single-case multiple baseline design was used, after which participants received 12 sessions of cognitive therapy. From the start of the baseline period through to the 1 month post-treatment follow-up assessment session, participants completed daily monitoring of feelings of responsibility, memory confidence, and their time spent engaging in compulsive checking. Results revealed that feelings of responsibility significantly reduced and memory confidence significantly increased from baseline to immediately post-treatment, with very high effect sizes. Multilevel modelling revealed significant linear changes in feelings of responsibility (i.e., reductions over time) and memory confidence (i.e., increases over time) occurred following the sessions when these were addressed. Finally, we found that improvements in these over the course of the treatment significantly predicted reduced time spent checking. The small sample size limits our ability to generalize our results. Results are discussed in terms of a focus on the timing of change in cognitive therapy.

Sections du résumé

BACKGROUND AND OBJECTIVES
The cognitive theory of compulsive checking in OCD proposes that checking behaviour is maintained by maladaptive beliefs, including those related to inflated responsibility and those related to reduced memory confidence. This study examined whether and when specific interventions (as part of a new cognitive therapy for compulsive checking) addressing these cognitive targets changed feelings of responsibility and memory confidence.
METHODS
Participants were nine adults with a primary or secondary diagnosis of OCD who reported significant checking symptoms (at least one hour per day) on the Yale-Brown Obsessive-Compulsive Scale. A single-case multiple baseline design was used, after which participants received 12 sessions of cognitive therapy. From the start of the baseline period through to the 1 month post-treatment follow-up assessment session, participants completed daily monitoring of feelings of responsibility, memory confidence, and their time spent engaging in compulsive checking.
RESULTS
Results revealed that feelings of responsibility significantly reduced and memory confidence significantly increased from baseline to immediately post-treatment, with very high effect sizes. Multilevel modelling revealed significant linear changes in feelings of responsibility (i.e., reductions over time) and memory confidence (i.e., increases over time) occurred following the sessions when these were addressed. Finally, we found that improvements in these over the course of the treatment significantly predicted reduced time spent checking.
LIMITATIONS
The small sample size limits our ability to generalize our results.
CONCLUSIONS
Results are discussed in terms of a focus on the timing of change in cognitive therapy.

Identifiants

pubmed: 30573211
pii: S0005-7916(18)30254-4
doi: 10.1016/j.jbtep.2018.12.003
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

101442

Subventions

Organisme : CIHR
ID : MOP-119283
Pays : Canada

Informations de copyright

Copyright © 2018 Elsevier Ltd. All rights reserved.

Auteurs

Adam S Radomsky (AS)

Department of Psychology, Concordia University, Montreal, Canada. Electronic address: Adam.Radomsky@concordia.ca.

Shiu F Wong (SF)

Department of Psychology, Concordia University, Montreal, Canada.

Martha Giraldo-O'Meara (M)

Department of Psychology, Concordia University, Montreal, Canada.

Michel J Dugas (MJ)

Département de Psychoéducation et de Psychologie, Université du Québec en Outaouais, Canada.

Laurie A Gelfand (LA)

Department of Psychology, Concordia University, Montreal, Canada.

Gail Myhr (G)

Department of Psychiatry, McGill University, Montreal, Canada.

Sarah E Schell (SE)

Department of Psychology, Concordia University, Montreal, Canada.

Jessica M Senn (JM)

Department of Psychology, Concordia University, Montreal, Canada.

Roz Shafran (R)

Institute of Child Health, University College London, London, United Kingdom.

Maureen L Whittal (ML)

Department of Psychiatry, University of British Columbia, Vancouver, Canada.

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Classifications MeSH