TW5: Study Evaluations for OCD

Question 1

What does it mean if a treatment is “efficacious and specific”?

Answer 1

multiple different research groups have proven that it’s better than another intervention strategy

Question 2

What does it mean if a treatment is “efficacious”?

Answer 2

multiple studies have proven that it’s better than waitlist control

Question 3

What does it mean if a treatment is “possibly efficacious”?

Answer 3

one group of researchers has found it’s better than another intervention, but it’s awaiting replication

Question 4

What are the 3 main types of interventions for OCD? give an example for the first 2

Answer 4

• predominantly behavioural: ERP
• cognitive-behavioural: CBT
• purely cognitive:

Question 5

What does a behavioural + cognitive theory of OCD say about how obsessions develop (cognitive)

Answer 5

proposes obsessions develop when a person misinterprets otherwise typical intrusive thoughts as too meaningful, or experiences thought-action fusion which increases anxiety and stress, leading them to seek safety

Question 6

What does a behavioural + cognitive theory of OCD say about how behaviours shape obsessions + compulsions?
what’s a caveat?

Answer 6

from learning theory - obsessions are previously neutral stimuli that become stressful through classical conditioning, association is maintained over time by compulsions which serve as an escape from the situation before habituation can occur.
HOWEVER obsessions can develop without any link to a traumatic event, and compulsions can increase anxiety

Question 7

Outline how ERP works as an early behavioural intervention

Answer 7

prevent from carrying out their rituals, anxiety diminishes through habituation, decrease association between intrusive thoughts + compulsions
* ERP can alter EXPECTATIONS and corrective information can override fear structures

Question 8

Outline how ERP can focus on cognitive aspects?

Answer 8

through forming alternative, less threatening explanations of OCD symptoms e.g. from “I am dangerous” to “I worry too much about being dangerous”

Question 9

What is the treatment of choice for OCD and why?

Answer 9

ERP, because it’s efficacious and specific

Question 10

What are some factors weighing against ERP being the treatment of choice for OCD?

Answer 10

• medications are easier and more readily available to prescribe
• many clinicians are reluctant/unable to perform ERP to sufficient intensity
• some patients are reluctant to engage in ERP because it provokes anxiety

Question 11

What are 2 other possibilities for ERP variations?

Answer 11

• computer-guided ERP (some finding it’s the same as with a therapist)
• family involvement in ERP

Question 12

Which subtype of OCD (in THIS article) is very difficult to treat?

Answer 12

hoarding

Question 13

Outline the varying efficacies (as in the formal levels) of:
* Satiation therapy
* ACT
* CBT
* Danger Ideation Reduction Therapy
* Stress management
* Motivational Interviewing
* EMDR
* Psychodynamic therapy

Answer 13

• Satiation: comparable to ERP from one article, maybe not transferable
• ACT: possibly efficacious
• CBT: efficacious and specific
• Danger Ideation Reduction Therapy: possibly efficacious
• Stress management: possibly efficacious
• Motivational Interviewing: possibly efficacious in combination with others
• EMDR: possibly efficacious
• Psychodynamic therapy: possibly efficacious

Question 14

Very briefly outline Danger Ideation Reduction Therapy

Answer 14

a purely cognitive method involving no exposure procedures - it targets the danger ideation and posits that if you no longer believe a situation is dangerous you will naturally no longer perform the compulsions

Specialised for contamination