A Translational Study of the Mechanisms of Exposure Therapy for Obsessions: Gradual vs. Variable Exposure Intensity
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- Change from baseline in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score at 3-month follow-up (week 14)
研究概览
简要总结
The current study sought to translate laboratory research on learning and memory to better understand the mechanisms and methods for implementing exposure therapy for unwanted obsessional thoughts. Specifically, we compared the processes and the short- and long-term outcomes of: (a) gradual exposure (EXP-G), emphasizing hierarchical exposure completion, versus (b) variable exposure (EXP-V), emphasizing variability in exposure intensity.
详细描述
Although preliminary research suggests that learning to tolerate varying levels of fear during exposure enhances outcomes for some anxiety-related problems, no previous study has examined this possibility in the context of unwanted obsessions. Adults with a moderately distressing obsessional thought were randomly assigned to four twice-weekly sessions of either: (a) gradual exposure (EXP-G), emphasizing hierarchical exposure completion, or (b) variable exposure (EXP-V), emphasizing variability in exposure intensity.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
Independent evaluators were blind to the exposure condition participants were assigned to.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •At least 18 years old
- •Willing to attend and audiotape all study sessions
- •Fluent in English
- •Presence of one or more obsessional thoughts that cause marked distress
- •If on a psychiatric medication (e.g., SSRI), willing to remain at a fixed dose while participating in the study (and stabilized on medication for 30 days before beginning the intervention).
排除标准
- •Previous cognitive behavioral therapy (CBT) for anxiety
- •Current suicidal ideation
- •Current substance use disorder
- •Current mania or psychosis
- •Currently taking an anxiolytic (e.g., Ativan) or stimulant (e.g., Ritalin) medication
- •Heart, respiratory, or neurological condition
- •Current pregnancy
研究组 & 干预措施
Gradual Exposure Group
The gradual exposure group received the Gradual Exposure (EXP-G) Intervention.
干预措施: Gradual Exposure (EXP-G) (Behavioral)
Variable Exposure Group
The variable exposure group received the Variable Exposure (EXP-V) Intervention.
干预措施: Variable Exposure (EXP-V) (Behavioral)
结局指标
主要结局
Change from baseline in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score at 3-month follow-up (week 14)
时间窗: Baseline (week 0) and 3-month follow-up (week 14)
The Y-BOCS is a clinician-administered interview that assesses obsessive compulsive disorder (OCD) symptom severity over the past week. This measure will be used to assess change over the course of the intervention at four time-points throughout the study (over approximately 3.5 months total).
次要结局
- Changes from baseline in Dimensional Obsessive-Compulsive Scale-Unacceptable Thoughts (DOCS-UT) at 3-month follow-up (week 14)(Baseline (week 0) and 3-month follow-up (week 14))
- Changes from baseline in Dimensional Obsessive-Compulsive Scale-Unacceptable Thoughts (DOCS-UT) at post-treatment (week 2)(Baseline (week 0) and post-treatment (week 2))
- Change from baseline in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score at post-treatment (week 2)(Baseline (week 0) and post-treatment (week 2))
- Changes from baseline in Behavioral Approach Test (BAT) Mean Subjective Units of Distress (SUDS) at post-treatment (week 2)(Baseline (week 0) and post-treatment (week 2))
- Changes from baseline in Behavioral Approach Test (BAT) Number of Steps Completed at post-treatment (week 2)(Baseline (week 0) and post-treatment (week 2))
- Changes from baseline in Behavioral Approach Test (BAT) Mean Subjective Units of Distress (SUDS) at 3-month follow-up (week 14)(Baseline (week 0) and 3-month follow-up (week 14))
- Changes from baseline in Behavioral Approach Test (BAT) Number of Steps Completed at 3-month follow-up (week 14)(Baseline (week 0) and 3-month follow-up (week 14))
研究者
Jon Abramowitz, PhD
Professor, Clinical Psychology, Department of Psychology and Neuroscience
University of North Carolina, Chapel Hill