This study examined the temporal relations between obsessive beliefs, obsessions, and compulsions during treatment. Gaining a better understanding of these relations may inform targets for improving treatment response. We hypothesized that our results would support the goal-directed model of OCD whereby obsessive beliefs at time t, predict obsessions at time t + 1, which then predict compulsions at time t + 2.
Participants were adults receiving intensive/residential treatment (IRT) for OCD (N = 446). Time points examined were admission, weeks 2 and 4, and discharge, utilizing a random intercepts cross-lagged panel model.
Results supported the reciprocal model of OCD, wherein both the goal-directed and habit-driven models coexist. Most of the significant paths between OCD symptoms were found early in treatment between weeks 2 and 4.
These findings offer unique information regarding the temporal precedence of these relations, and they are consistent with prior cognitive models of OCD. The importance of targeting both obsessive beliefs and compulsions is highlighted by these findings. Future research would benefit from investigating moderators of OCD models.