A novel cognitive intervention for compulsive checking: Targeting maladaptive beliefs about memory

doi:10.1016/j.jbtep.2015.02.009

Journal of Behavior Therapy and Experimental Psychiatry

Volume 53, December 2016, Pages 75-83

https://doi.org/10.1016/j.jbtep.2015.02.009 Get rights and content

Highlights

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We developed a brief cognitive intervention for maladaptive beliefs about memory.
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The intervention decreased time spent checking and checking symptoms.
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Decreases in maladaptive beliefs about memory were predictive of symptom reductions.
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Compared to waitlist, the intervention also increased memory performance.

Abstract

Background and objectives

Compulsive checking is one of the most common symptoms of obsessive-compulsive disorder (OCD). Recently it has been proposed that those who check compulsively may believe their memory is poor, rather than having an actual memory impairment. The current study sought to develop and assess a brief cognitive intervention focused on improving maladaptive beliefs about memory, as they pertain to both checking symptoms and memory performance.

Methods

Participants (N = 24) with a diagnosis of OCD and clinical levels of checking symptomatology were randomly assigned either to receive two weekly 1-hour therapy sessions or to self-monitor during a similar waitlist period. Time spent checking, checking symptoms, maladaptive beliefs about memory, and visuospatial memory were assessed both pre- and post-treatment/waitlist.

Results

Results showed that compared to the waitlist condition, individuals in the treatment condition displayed significant decreases in their maladaptive beliefs about memory and checking symptoms from pre- to post-intervention. They also exhibited increased recall performance on a measure of visuospatial memory. Changes in beliefs about memory were predictors of reduced post-intervention checking, but were not predictive of increased post-intervention memory scores.

Limitations

The lack of long term follow-up data and use of a waitlist control leave questions about the stability and specificity of the intervention.

Conclusions

Findings provide preliminary evidence that strategies targeting beliefs about memory may be worthy of inclusion in cognitive-behavioural approaches to treating compulsive checking.

Section snippets

Participants

Participants (N = 24) were individuals with a diagnosis of OCD who reported significant checking and/or doubting symptoms. Doubt and checking compulsions were required to cause significant distress and/or interference and to be evident for at least one hour per day. Exclusion criteria were the presence of current substance dependence, bipolar disorder, or psychosis. Participants were recruited from a registry of individuals with OCD interested in research studies, via campus flyers, classroom

Effect of intervention on beliefs about memory

A 2 × 2 repeated measures MANCOVA was conducted, with baseline DM-BAM as a covariate, condition (treatment vs. waitlist) as the between participants variable, and time (pre- vs. post-assessment) as the within-participants variable. The two dependent variables of interest were DM-BAM and BAMI scores. Results showed that the covariate accounted for significant variance in the dependent variables, F(1,21) = 30.49, p < .001, ${η_{p}}^{2}$ = .59. There was no main effect of time, F(1,21) = 1.01, p = .33, ${η_{p}}^{2}$

Discussion

Two sessions of a cognitive intervention targeting maladaptive beliefs about memory were found to decrease these beliefs, in addition to time spent checking and associated symptoms, as well as leading to increases in memory performance. Further, we found some support for our prediction that the changes in beliefs about memory were responsible for post-assessment checking behaviour and symptoms, suggesting that the treatment effects seen were indeed due to changes in beliefs about memory. These

Sources of funding

The authors gratefully acknowledge the Canadian Institutes of Health Research Grant FRN 119283 and the National Sciences and Engineering Research Council of Canada 249 833 2007, both awarded to Adam S. Radomsky, for funding portions of this research. Neither funding agency had any role in decisions regarding the current study, including the design, data collection, analyses, writing, or decision to publish.

Acknowledgements

Special thanks to Jessica Senn for administering the neuropsychological tests, and to Sarah Schell, Kelsey Hannon, and Sasha MacNeil, for their help with recruitment, data entry, and coding.

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View full text

A novel cognitive intervention for compulsive checking: Targeting maladaptive beliefs about memory

Highlights

Abstract

Background and objectives

Methods

Results

Limitations

Conclusions

Section snippets

Participants

Effect of intervention on beliefs about memory

Discussion

Sources of funding

Acknowledgements

Clinical Psychology Review

Behaviour Research and Therapy

Clinical Psychology Review

Behaviour Research and Therapy

Behaviour Research and Therapy

Journal of Anxiety Disorders

Journal of Anxiety Disorders

Clinical Psychology Review

Journal of Behaviour Therapy and Experimental Psychiatry

Personality and Differences

Behaviour Research & Therapy

Behaviour Research and Therapy

Journal of Behavior Therapy and Experimental Psychiatry

Behaviour Research and Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Journal of Behavior Therapy and Experimental Psychiatry

Journal of Obsessive-Compulsive and Related Disorders

Behaviour Research & Therapy

Behaviour Research & Therapy

Behaviour Research and Therapy

Behaviour Research and Therapy

Cognitive and Behavioral Practice

Behaviour Research and Therapy

Biological Psychiatry