Cognitive Bias Modification for OCD
- Conditions
- Obsessive-Compulsive DisorderObsessive-compulsive Disorders and Symptoms
- Interventions
- Behavioral: PsychoeducationBehavioral: Cognitive bias modification for interpretation biasBehavioral: Inactive sham approach avoidance trainingBehavioral: Approach avoidance training
- Registration Number
- NCT03799419
- Lead Sponsor
- Mclean Hospital
- Brief Summary
This study will conduct the development and preliminary evaluation of Cognitive Bias Modification for Interpretation (CBM-I) and Approach Avoidance Training (AAT) as augmentations to treatment as usual for OCD and related disorders. CBM-I refers to computerized interventions designed to directly manipulate interpretation bias through repeated practice on a training task, thereby inducing cognitive changes in a relatively automatic or implicit manner. In AAT, automatic approach tendencies toward feared stimuli are re-trained. Specifically, this study will examine the feasibility, acceptability, and clinical outcomes associated with CBM-I and AAT.
Adults with obsessive compulsive disorder (OCD) and related disorders will be recruited from a treatment program for these disorders and participants will be randomly assigned to either receive: 1) eight sessions of CBM-I or eight sessions of psychoeducation as a control condition, or 2) AAT or eight sessions of an inactive (sham) version of the AAT training.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 64
- Currently receiving treatment at the McLean Hospital OCD Institute
- For CBM-I condition only: report a score of at least 131 on the Obsessive Beliefs Questionnaire-44 upon admission to the OCD Institute
- For AAT condition only: endorse score of at least 7 on the DOCS subscale #1 (contamination subscale) upon admission to the OCD Institute
- Able to complete a computer task for 20 minutes
- Consent to main OCD Institute study protocol
- Currently undergoing electroconvulsive therapy (ECT)
- Current symptoms of acute mania or psychosis
- A reported diagnosis at admission of a psychotic disorder
- History of traumatic brain injury
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Psychoeducation with treatment as usual Psychoeducation Participants in this group will receive usual treatment in the program and 8 sessions of psychoeducation Cognitive bias modification with treatment as usual Cognitive bias modification for interpretation bias Participants in this group will receive usual treatment in the program and 8 sessions of a computerized cognitive training targeting interpretation bias Inactive sham approach avoidance training Inactive sham approach avoidance training Participants in this group will receive usual treatment in the program and 8 sessions of a sham approach avoidance training Approach avoidance training with treatment as usual Approach avoidance training Participants in this group will receive usual treatment in the program and 8 sessions of a computerized cognitive training targeting automatic approach tendencies
- Primary Outcome Measures
Name Time Method Change in Average Score on Obsessive Beliefs Questionnaire Weeks 0, 2, 4, and 8 Measure of interpretation biases, specifically: Inflated Responsibility/Overestimation of Threat, Perfectionism/Intolerance of Uncertainty, and Importance/Control of Thoughts. 44-item self-report measure, items scored 1-7 and summed; greater scores indicate greater severity.
- Secondary Outcome Measures
Name Time Method Change in Average Score on Yale-Brown Obsessive Compulsive Scale Weeks 0, 4, and 8 Interviewer-rated measure of OCD symptoms. It is 19 items, with only items 1-10 scored (from 0-4). Total scores range from 0-40, with higher scores reflecting greater severity.
Exit Interview Week 4 This interview will be conducted by a member of the study staff to obtain participant feedback on satisfaction and how the intervention might be improved.
Change in Average Score on Behavioral Inhibition/Behavioral Activation Scales Weeks 0, 2, 4, and 8 24-item measure of behavioral approach and behavioral avoidance, rated 1-4 and summed.
Dimensional Obsessive-Compulsive Scale Weeks 0, 2, 4, and 8 (DOCS; Abramowitz et al., 2010) participants with contamination fears will be identified by their DOCS contamination subscale score; the DOCS is part of the admission measures in the OCD Institute's main study protocol. Additionally, we will examine these scores as an outcome measure for contamination-related obsessions and compulsions. It includes 20 items and is rated 0-4.
Change in Suicide Implicit Association Test Weeks 0, 2, and 4 Computerized task which assesses implicit thoughts about self-injury, death, and suicide.
Change in Columbia-Suicide Severity Rating Scale Weeks 0, 4, and 8 An interviewer-rated assessment of retrospective suicidality as well as recent suicidal ideation and behavior. Minimum total score 0, maximum total score 5, higher total scores indicate more suicidal ideation and/or behavior.
Change in Behavioral Approach Test Weeks 0, 2, and 4 Behavioral Approach Test (BAT) will be administered as a measure of OCD-related avoidance, based on previously validated procedures (Cougle et al., 2007; Amir, Kuckertz, \& Najmi, 2013). Participants rate peak anxiety 0-100 for each step of approaching feared stimuli.
Three different types of BAT will be implemented in order to measure avoidance with multiple types of contaminants, each with six steps on a hierarchy to be completed sequentially, providing a rating of anxiety 0-100 for each step.Change in Average Score on Depressive Symptom Index Suicidality Subscale. There are 4 items scored from 0-3 with greater numbers indicating greater severity. Weeks 0, 1, 2, 3, and 4 Self-report measure of suicidality
Credibility/Expectancy Questionnaire Week 0 Measure of treatment expectancy and rationale credibility in our study. The items are rated on 9-point scales, with a total score range of 3 to 27. Greater scores indicate greater expectations and perceptions of treatment credibility.
Trial Locations
- Locations (1)
McLean Hospital
🇺🇸Belmont, Massachusetts, United States