Obsessive-Compulsive Disorder (OCD)

Leading theories regarding the mechanisms of exposure for OCD focus on Pavlovian fear reduction more than operant processes. Acceptance-based exposure directly targets operant behavior. Integrating these perspectives could lead to a more robust understanding of mechanisms of change in exposure and more effective and enduring treatments. The current study investigated acceptance and regulation of distress during exposure. Participants with intrusive thoughts were randomized into three groups, Acceptance (n = 23), Regulation (n = 20), and Control (n = 21), and completed two behavioral avoidance tests (BATs) 1 week apart. Active conditions completed a 30-min exposure plus 6 days of 10-min exposures at home; Control participants watched videos of the same durations. Self-report measures were collected at both sessions, and behavioral, subjective, and physiological repeated measures data were collected during both BATs. Compared to Control, active conditions decreased OCD symptom severity, rituals, and skin conductance levels, while Acceptance showed lower skin conductance levels than Regulation and Control. Acceptance showed greater willingness and psychological flexibility than Control, while Regulation did not. Results support theorized mechanisms of change in acceptance-based exposure and suggest willingness to experience distress may paradoxically lead to decreased physiological arousal, which has important implications for treatment and future research.

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In this study, the research experience with experimental group and control group pretest and post-test and follow-up were used the population included all patients with OCD in Shiraz city. Sample was selected (90 patients based on Sample Table Cohen, 1986, quoted by Sarmad al, 1379), among the patients who were diagnosed with OCD. Sampling method based on stratified random sampling was used among the target population, i.e., patients referred to the clinic for counseling and psychological services for the city selected. After cloning, participants were randomized to experimental and control groups were included. 90 outpatients with OCD according to DSM-IV-TR criteria were randomly assigned to one of three groups based on acceptance and commitment therapy, clomipramine and combination therapy in based of acceptance and commitment therapy and clomipramine were assigned (n = 30 per group). During the study, five patients were excluded from the treatment process, and the study was performed on 25 patients in each group. Therapy ACT by Michael Twohig treatment protocol was implemented. Analysis of covariance, variance with repeated measure, and Bonferroni test showed that the percentage of recovery based on acceptance and commitment therapy compared with combination therapy as well spend a significant improvement clomipramine More meaningful experience. Acceptance and commitment therapy based on reducing the severity of symptoms, in patients with obsessive - compulsive disorder and combination therapy is more effective than treatment with clomipramine. Adding clomipramine appear to acceptance and commitment therapy does not increase its efficacy in the treatment of adults with OCD in the short term and long term.

Pediatric obsessive compulsive disorder (OCD) is a significantly impairing disorder. Given the impact of pediatric OCD, it is important to consider how to best adapt treatments for OCD, particularly for more severe youth that may not respond to traditional outpatient formats. Understanding how to implement such treatments via telehealth can improve access to care and reduce treatment burden on families. The current study therefore evaluates preliminary feasibility, acceptability, and effectiveness of delivering a pilot intensive, group-based telehealth treatment combining acceptance-based skills with exposure and response prevention (ERP) for pediatric OCD. Participants (N = 25) received two to 3 h of individual, family, and/or group treatment per day, four days per week, for a total of 10 h of treatment per week. Following the intensive outpatient program (IOP), adolescents reported large decreases in OCD symptoms, and small to large decreases in anxiety and depression. Parents reported similar outcomes, with small to large improvements in the impact of OCD on their child, anxiety, and familial accommodation. This pilot study thereby presents promising results and adds to the growing evidence base of acceptance-based interventions for adolescents with OCD, anxiety, and other mental health concerns.

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Previous research indicates that a combination of Acceptance and Commitment Therapy (ACT) and Exposure and Response Prevention (ERP) is an effective treatment for obsessive-compulsive disorder (OCD). However, there are no studies to date of ACT for OCD in Latin American populations. Because socio-cultural context influences OCD symptomatology, it is worth adapting and testing ACT for OCD in such cultures. Three patients seeking treatment for OCD at a public health center in Rio De Janeiro, Brazil were treated with 16 sessions of ACT and ERP. All participants showed decreased OCD scores from baseline to post-treatment that remained lower at follow-up, suggesting that a version of ACT for OCD adapted for a Brazilian cultural context was effective. The intervention also had positive effects on depression, quality of life, and psychological flexibility. This paper focuses on the adaptations that reflect the unique needs of Brazilian culture, as well as how to integrate ACT within existing systems of care. This study shows the effectiveness of this approach in Brazil and offers promise for future cultural adaptations of ACT in other Latin American contexts.

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It is well established that the transition to new parenthood is associated with the onset or worsening of obsessive-compulsive symptoms (OCS); however, less is known regarding specific risk factors associated with the development of postpartum OCS. The present prospective study examined experiential avoidance and interpretations of intrusive thoughts as predictors of the development of postpartum OCS in first-time mothers and fathers. Participants were 64 expecting parents (33 mothers and 31 partners—all fathers) who were followed from the 2nd or 3rd trimester of pregnancy into the postpartum. All completed measures of postpartum OCS, experiential avoidance, and interpretations of intrusive thoughts. Experiential avoidance and the pre-existing tendency to misinterpret intrusive thoughts were predictors of infant-related OCS in the early postpartum, but not at six months postpartum. These findings provide support for particular psychological risk factors in the development of infant-related OCS among first-time mothers and fathers. Implications for prevention and intervention are discussed.

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A fair amount of research exists on acceptance and commitment therapy (ACT) as a model and a treatment for anxiety disorders and OCD spectrum disorders; this paper offers a quantitative account of this research. A meta-analysis is presented examining the relationship between psychological flexibility, measured by versions of the Acceptance and Action Questionnaire (AAQ and AAQ-II) and measures of anxiety. Meta-analytic results showed positive and significant relationships between the AAQ and general measures of anxiety as well as disorder specific measures. Additionally, all outcome data to date on ACT for anxiety and OCD spectrum disorders are reviewed, as are data on mediation and moderation within ACT. Preliminary meta-analytic results show that ACT is equally effective as manualized treatments such as cognitive behavioral therapy. Future directions and limitations of the research are discussed.