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Controlled trial of exposure and response prevention in obsessive–compulsive disorder

Published online by Cambridge University Press:  03 January 2018

Merran Lindsay ,
Rocco Crino  and
Gavin Andrews
Merran Lindsay
Affiliation:
School of Psychiatry, University of New South Wales at St Vincent's Hospital, Sydney, Australia
Rocco Crino*
Affiliation:
School of Psychiatry, University of New South Wales at St Vincent's Hospital, Sydney, Australia
Gavin Andrews
Affiliation:
School of Psychiatry, University of New South Wales at St Vincent's Hospital, Sydney, Australia
*
Rocco Crino, Clinical Research Unit for Anxiety Disorders, 299 Forbes Street, Darlinghurst, NSW 2010. Australia
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Abstract

Background

Exposure and response prevention is considered a treatment of choice for obsessive–compulsive disorder (OCD). Yet there have been very few randomised controlled trials employing credible placebo conditions. This study compares exposure and response prevention with a general anxiety management intervention.

Method

Eighteen patients meeting DSM–IV criteria for OCD were randomly assigned to either exposure and response prevention or anxiety management. Both treatments involved approximately 15 hours of therapy over a three-week period.

Results

There was a significant reduction in obsessive–compulsive symptoms following treatment with exposure and response prevention, while no change occurred in the control group. This was found to be statistically significant using a composite measure of OCD symptom severity, patient ratings of interference and therapist ratings of symptom severity.

Conclusions

These findings suggest that the symptom reductions associated with behaviour therapy for OCD are a result of the specific techniques of exposure and response prevention, rather than non-specific aspects of the therapy process. General anxiety management techniques are not effective in the treatment of OCD.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 2 , August 1997 , pp. 135 - 139
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

REFERENCES

Andrews, G., Crino, R., Hunt, C., et al (1994) The Treatment of Anxiety Disorders. New York: Cambridge University Press.Google Scholar
Beck, A., Ward, C., Mendelson, M., et al (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.CrossRefGoogle ScholarPubMed
Clomipramine Collaborative Study Group (1991) Clomipramine in the treatment of patients with obsessive compulsive disorder. Archives of General Psychiatry, 48, 730–738.CrossRefGoogle Scholar
Crino, R. D. (1990) Serotonin and obsessive compulsive disorder. In Anxiety (eds McNaughton, N. & Andrews, G.), pp. 234–243. Dunedin: University of Otago Press.Google Scholar
Fals-Stewart, W., Marks, A. & Schafer, J. (1993) A comparison of behavioral group therapy and individual behavior therapy in treating obsessive–compulsive disorder. Journal of Nervous and Mental Disease, 181, 189–193.CrossRefGoogle ScholarPubMed
Foa, E. B., Steketee, G. S. & Ozarow, B. J. (1985) Behaviour therapy with obsessive–compulsives: from therapy to treatment. In Obsessive Compulsive Disorder: Psychological and Pharmacological Treatments (eds Mavissakalian, M., Turner, S. & Michelsen, L.). New York: Plenum Press.Google Scholar
Goodman, W., Price, L., Rasmussen, S., et al (1989a) The Yale–Brown obsessive compulsive scale: development, use and reliability. Archives of General Psychiatry, 46, 1006–1011.CrossRefGoogle ScholarPubMed
Goodman, W., Price, L., Rasmussen, S., et al (1989b) The Yale–Brown obsessive compulsive scale: validity. Archives of General Psychiatry, 46, 1012–1016.CrossRefGoogle Scholar
Hansen, A., Hoogduin, C., Schaap, C., et al (1992) Do drop-outs differ from successfully treated obsessive–compulsives? Behaviour Research and Therapy, 30, 547–550.CrossRefGoogle ScholarPubMed
Insel, T. R., Mueller, E. A., Alterman, I., et al (1985) Obsessive compulsive disorder and serotonin: is there a connection? Biological Psychiatry, 20, 1171–1188.CrossRefGoogle ScholarPubMed
Karno, M. & Golding, J. (1991) Obsessive Compulsive Disorder. In Psychiatric Disorders in America–The Epidemiological Catchment Area Study (eds Robins, L. & Regier, D.), pp. 204–219. New York: Macmillan.Google Scholar
Keijsers, G., Hoogduin, C. & Schaap, C. (1994) Predictors of treatment outcome in the behavioral treatment of obsessive compulsive disorder. British Journal of Psychiatry, 165, 781–786.CrossRefGoogle ScholarPubMed
Marks, I., Hodgson, R. & Rachman, S. (1975) Treatment of chronic obsessive–compulsive neurosis by in vivo exposure: two year follow-up and issues in treatment. British Journal of Psychiatry, 127, 349–364.CrossRefGoogle ScholarPubMed
Marks, I., Lalliot, P., Basoglu, M., et al (1988) Clomipramine, self-exposure, and therapist-aided exposure for obsessive compulsive rituals. British Journal of Psychiatry, 152, 522–534.CrossRefGoogle ScholarPubMed
Rabavilas, A., Boulougouris, J. & Porissaki, C. (1979) Therapist qualities related to outcome with exposure in vivo in neurotic patients. Journal of Behavior Therapy and Experimental Psychiatry, 10, 293–294.CrossRefGoogle Scholar
Rachmans, S. & Hodgson, R. (1960) Obsessions and Compulsions. New Jersey: Prentice Hall.Google Scholar
Roper, G., Rachman, S. & Marks, I. (1975) Passive and participant modelling in exposure treatment of obsessive–compulsive neurotics. Behavior Research and Therapy, 13, 271–279.CrossRefGoogle ScholarPubMed
Sanavio, E. (1988) Obsessions and compulsions: the Padua inventory. Behavior Reseorch and Therapy, 26, 169–177.CrossRefGoogle ScholarPubMed
Spieberger, C. D., Gorsuch, R. L. & Lushene, R. E. (1970) STAI Manual for the State–Trait Anxiety Inventory Palo Alto. CA: Consulting Psychologists Press.Google Scholar
Thoren, P., Asberg, M., Bertilsson, L., et al (1980) Clomipramine treatment of obsessive compulsive disorder II: Biochemical aspects. Archives of General Psychiatry, 37, 1289–1294.CrossRefGoogle ScholarPubMed
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