Change in obsessive beliefs as predictor and mediator of symptom change during treatment of obsessive-compulsive disorder – a process-outcome study. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Diedrich, Alice; Sckopke, Philipp; Schwartz, Caroline; Schlegl, Sandra; Osen, Bernhard; Stierle, Christian; Voderholzer, Ulrich
• Is Part Of: BMC psychiatry. Volume 16:Issue 1(2016)
• Page Start: 1
• Page End: 10
• Publication Date: 2016-12
• Subjects: Obsessive-compulsive disorder -- Inpatient treatment -- Cognitive behavioral therapy -- Obsessive beliefs -- Mediator -- Change mechanism; Psychiatry -- Periodicals; 616.89005
• DOI: 10.1186/s12888-016-0914-6
• Languages: English
• ISSNs: 1471-244X

Abstract

Abstract Background Cognitive models of obsessive-compulsive disorder suggest that changes in obsessive beliefs are a key mechanism of treatments for obsessive-compulsive disorder. Thus, in the present process-outcome study, we tested whether changes in obsessive beliefs during a primarily cognitive behavioral inpatient treatment predicted treatment outcome and whether these changes mediated symptom changes over the course of treatment. Methods Seventy-one consecutively admitted inpatients with obsessive-compulsive disorder were assessed with the Yale-Brown Obsessive-Compulsive Scale and the Obsessive Beliefs Questionnaire at treatment intake, after six weeks of treatment and at discharge, and with the Beck-Depression-Inventory-II at intake and discharge. Results Changes in obsessive beliefs during the first six weeks of treatment predicted obsessive-compulsive symptoms at discharge when controlling for obsessive-compulsive and depressive symptoms at intake in a hierarchical regression analysis. Multilevel mediation analyses showed that reductions in obsessive beliefs partially mediated improvements in obsessive-compulsive symptoms over time. Conclusions Our findings indicate that decreasing obsessive beliefs in inpatient cognitive behavioral therapy for obsessive-compulsive disorder might be a promising treatment approach.