Transcranial Direct Current Stimulation Augmented Exposure and Response Prevention for Obsessive-Compulsive Disorder

Not Applicable

Completed

Brief Summary: This study is investigating whether combining noninvasive brain stimulation with behavior therapy can help to improve outcomes for obsessive-compulsive disorder (OCD). Exposure and response prevention (ERP) -- a specific type of behavior therapy -- is a first line treatment for OCD. This study will test whether a form of noninvasive brain stimulation called transcranial direct current stimulation (tDCS), can help ERP work better.

Recruitment & Eligibility

Inclusion Criteria

Current primary OCD diagnosis and current Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) total score of ≥16
18-65 years of age
Ability to speak, read, write, and understand English sufficiently well to complete study procedures and provide informed consent
Right-handed
No use of psychiatric medications or stable psychiatric medication use for a minimum of 6 week prior to study entry. Psychiatric medications will be limited to the following: serotonin reuptake inhibitors (SRI; including clomipramine), combination antidepressants (including bupropion and serotonin-norepinephrine reuptake inhibitors), buspirone, benzodiazepines, and/or stimulants
Naive to tDCS

Exclusion Criteria

Active substance use disorder
Lifetime diagnosis of psychotic or bipolar mood disorder
Previous minimally adequate trial of ERP (e.g., at least 16 sessions including both therapist and self-directed exposure and response prevention)
Therapy outside the study protocol which has evidence for efficacy with OCD during the study intervention period
Active suicidal or homicidal ideation
Organic brain disease or injury
Any health problems that would interfere with study participation, including contraindications to tDCS (e.g., skin condition, mental implant in skull)
Women who are pregnant or breastfeeding. All women participants of child-bearing age are required to have a negative pregnancy test prior to treatment, and must use medically acceptable birth control during study participation. Medically acceptable birth control includes: established oral, injected, implanted, or vaginal ring hormonal contraception, an intrauterine device (IUD), two barrier contraception methods (condom or occlusive cap with spermicidal foam/gel/film/cream/suppository), or having a vasectomized partner
Use of anticonvulsant medications (including depakote, gabapentin, tegretol, dilantin, lamictal) and/or glutamate-acting agents (including n-acetylcysteine, riluzole, amantadine, memantine).

Arm && Interventions

Group	Intervention	Description
ERP plus tDCS	ERP plus tDCS	ERP plus anodal tDCS of right inferior frontal gyrus
ERP plus sham tDCS	ERP plus sham tDCS	ERP plus sham tDCS of right inferior frontal gyrus

Primary Outcome Measures

Name	Time	Method
Yale-Brown Obsessive Compulsive Scale (Y-BOCS): Total Score	Post-treatment (approximately 6.5 weeks post-baseline)	The Y-BOCS is a well-known measure for assessing OCD symptom severity. Total scores can range from 0-40, with higher scores corresponding to greater severity of symptoms.
Client Satisfaction Questionnaire-8: Total Score	Post-treatment (approximately 6.5 weeks post-baseline)	The Client Satisfaction Questionnaire-8 is measure of client satisfaction. Scores can range from 8-32, with higher scores corresponding to greater satisfaction.
Rates of Session Completion	Approximately 6.5 weeks post-baseline	Average number of intervention sessions completed

Secondary Outcome Measures

Name	Time	Method
Yale-Brown Obsessive-Compulsive Scale: Total Score	1-month follow up (Approximately 11 weeks after baseline assessment)	The Y-BOCS is a well-known measure for assessing OCD symptom severity. Total scores can range from 0-40, with higher scores corresponding to greater severity of symptoms.
Client Satisfaction Questionnaire-8: Total Score	1-month follow up (Approximately 11 weeks after baseline assessment)	The Client Satisfaction Questionnaire-8 is measure of client satisfaction. Scores can range from 8-32, with higher scores corresponding to greater satisfaction.
Rates of Retention in Intervention	Approximately 6.5 weeks post-baseline	Number of randomized participants who remained in the intervention phase of the study and completed all intervention sessions.