What Drives OCD Symptom Change During CBT Treatment? Temporal Relationships Among Obsessions and Compulsions. Issue 1 (January 2019)

• Record Type: Journal Article
• Authors: Laposa, Judith M.; Hawley, Lance L.; Grimm, Kevin J.; Katz, Danielle E.; Rector, Neil A.
• Is Part Of: Behavior therapy. Volume 50:Issue 1(2019)
• Page Start: 87
• Page End: 100
• Publication Date: 2019-01
• Subjects: obsessive-compulsive disorder -- cognitive behavior therapy -- obsession -- compulsion; Behavior therapy -- Periodicals; 616.8914205
• DOI: 10.1016/j.beth.2018.03.012
• Languages: English
• ISSNs: 0005-7894

Abstract

Abstract: Cognitive behavior therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD). However, less is known about how obsessions and compulsions change during treatment, either in tandem, sequentially, or independently. The current study used latent difference score analysis to show path-analytic dynamic modeling of OCD symptom change during CBT. Four competing models of the temporal relationship between obsessions and compulsions were examined: no coupling (obsessions and compulsions are not dynamically related), goal directed (obsessions lead to subsequent changes in compulsions), habit driven (compulsions lead to subsequent changes in obsessions), and reciprocal. Treatment seeking participants ( N = 84) with a principal diagnosis of OCD completed 12 weeks of CBT group therapy and completed measures assessing obsession and compulsion severity at pretreatment, Sessions 4 and 8, and end of treatment. Bivariate results supported the goal directed traditional CBT model, where obsession scores are temporally associated with subsequent changes in compulsion scores. These results have implications for theoretical and treatment modelling of obsessions and compulsions in OCD treatment. Highlights: We tested four temporal relationships among obsessions and compulsions during CBT for OCD Latent difference score analyses supported a goal-directed model of OCD symptom change Obsessions were temporally associated with subsequent changes in compulsions