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Longitudinal Relations of Obsessive Beliefs, Obsessions, and Compulsions During Treatment for Obsessive Compulsive Disorder

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Abstract

Background

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.

Methods

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

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.

Conclusions

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.

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Data Availability

Data available on request from the authors.

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Acknowledgements

We wish to thank past staff/research assistants in the Office of Clinical Assessment and Research (OCAR) at McLean Hospital’s OCD Institute for their involvement in the collection of study data, and Erin Dodig, BA for her contributions to the literature review. We would also like to recognize Diane Davey, RN, MBA for her contributions to the development and ongoing support of the OCD Institute’s research program.

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Authors and Affiliations

  1. McLean Hospital/Harvard Medical School, Belmont, MA, USA

    Martha J. Falkenstein, Meghan Schreck, Sriramya Potluri, Jacob A. Nota, Kara N. Kelley, Courtney Beard & Jason A. Elias

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  1. Martha J. Falkenstein
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Correspondence to Martha J. Falkenstein.

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Conflict of Interest

Falkenstein, Schreck, Potluri, Nota, Kelley, Beard, and Elias declare that they have no conflict of interest.

Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee, Partners Human Research Committee, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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No animal studies were carried out by the authors for this article.

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Falkenstein, M.J., Schreck, M., Potluri, S. et al. Longitudinal Relations of Obsessive Beliefs, Obsessions, and Compulsions During Treatment for Obsessive Compulsive Disorder. Cogn Ther Res 44, 846–857 (2020). https://doi.org/10.1007/s10608-020-10093-5

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