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Cognitive Therapy and Research

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20-06-2020 | Original Article

Anxiety Sensitivity Accelerates the Temporal Changes in Obsessions and Compulsions During Cognitive Behavioral Therapy

Auteurs: Judith M. Laposa, Lance L. Hawley, Kevin J. Grimm, Danielle E. Katz, Neil A. Rector

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 6/2020

Abstract

Background

Although obsessive compulsive disorder (OCD) is effectively treated by cognitive behavior therapy (CBT), less is known about mechanisms underlying treatment response. Anxiety sensitivity (AS) may impact symptom change (velocity) and the rate of change in velocity (acceleration) during CBT for OCD. Latent Difference Score (LDS) analysis was used to show path-analytic dynamic modelling of OCD symptom velocity and acceleration during CBT, as a function of baseline AS.

Method

Eighty-four participants with a principal diagnosis of OCD completed 12 weeks of CBT group therapy, and measures assessing AS at pre-treatment, and obsession and compulsion severity at pre-treatment, sessions 4, 8, and end of treatment.

Results

LDS velocity models demonstrated that higher levels of baseline AS were associated with subsequent elevations in obsessions throughout treatment, and obsession scores were temporally associated with subsequent changes in compulsion scores. An LDS acceleration model demonstrated that higher levels of baseline AS scores were associated with rapid increases in the severity of obsessions, whereas lower AS scores were associated with rapid decreases in the severity of obsessions.

Discussion

These results have implications for theoretical and treatment modelling of obsessions and compulsions, as well as AS, in OCD.

Conclusion

Higher levels of baseline AS negatively impact response to CBT for OCD.

vorige artikel Are Catastrophic Misinterpretations of Bodily Sensations Typical for Patients with Panic Disorder? An Experimental Study of Patients with Panic Disorder or Other Anxiety Disorders and Healthy Controls

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One participant’s diagnostic assessment was completed with the Structured Clinical Interview for DSM-5 (First, Williams et al. 2015). Due to administrative changes in the clinic, after having a full psychiatric consultation where psychosis and problematic alcohol/substance use were screened out, 6% received a SCID IV that did not include somatoform and eating disorder modules, and 7% had a SCID IV that had the mood and anxiety modules (includes OCD and PTSD) only.

E[ΔΔYBOCS-C(t)_n] = α_ybocs-c x E[s_ybocs-c,_n] + β_s x E[ΔYBOCS-C (t − 1)_n] + γ_ybocs-oΔ x E[ΔYBOCS-O (t − 1)_n] + γ_ybocs-o x E[YBOCS-O (t − 1)_n].

Here, the second-order difference E[ΔΔYBOCS-C(t)_n] is dependent on a constant component, prior difference of the same variable, prior difference of the other variable, and prior true score of the other variable.

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Titel: Anxiety Sensitivity Accelerates the Temporal Changes in Obsessions and Compulsions During Cognitive Behavioral Therapy
Auteurs: Judith M. Laposa
Lance L. Hawley
Kevin J. Grimm
Danielle E. Katz
Neil A. Rector
Publicatiedatum: 20-06-2020
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 6/2020
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-020-10121-4

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Abstract

Background

Method

Results

Discussion

Conclusion

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