Is my patient too sad to approach their fear? Depression severity and imaginal exposure outcomes for patients with OCD.

Autor: Berman NC; Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, OCD and Related Disorders, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA; Psychology Department, College of the Holy Cross, 1 College St., Beaven Hall, PO Box 38A, Worcester, MA, 01610, USA. Electronic address: nberman@holycross.edu., Hezel DM; Center for Obsessive-Compulsive Treatment and Related Disorders, New York State Psychiatric Institute, Department of Psychiatry, Columbia University, 1051 Riverside Drive, Unit #69, New York, NY, 10032, USA., Wilhelm S; Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, OCD and Related Disorders, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA.
Jazyk: angličtina
Zdroj: Journal of behavior therapy and experimental psychiatry [J Behav Ther Exp Psychiatry] 2021 Mar; Vol. 70, pp. 101615. Date of Electronic Publication: 2020 Sep 06.
DOI: 10.1016/j.jbtep.2020.101615
Abstrakt: Background and Objectives: There is conflicting research on how comorbid depression impacts the treatment of obsessive compulsive disorder (OCD) with exposure with response prevention. To better understand this relationship, the current study tests theoretical claims that greater depression limits motivation to engage in exposures, restricts habituation, and interferes with adaptive learning.
Methods: Fifty-one individuals with OCD completed a diagnostic interview and self-report questionnaires assessing depression symptom severity and then participated in a standardized imaginal exposure protocol, in which they repeatedly approached an idiosyncratic fear deemed "moderately anxiety-provoking."
Results: Contrary to expectations, linear regression models indicated that depression symptom severity was not independently associated with motivation, subjective or objective within-session habituation or adaptive learning outcomes. However, the perceived likelihood of the best-case scenario occurring as a result of the exposure moderated the relationship between depression severity and motivation to engage in the exposure exercise.
Limitations: Use of a one-session exposure protocol precludes conclusions regarding how depression is associated with outcomes in a full ERP treatment.
Conclusions: Depression symptom severity was not independently associated with motivation, habituation, or adaptive learning. The observed non-significant effects suggest that degree of depression, on its own, is not a meaningful indicator of how patients with OCD will fare an exposure intervention.
(Copyright © 2020 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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