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2 results

  • Changes in harm avoidance and incompleteness across group CBT for OCD and their relationship with symptom change

  • Christina Puccinelli, Karen Rowa, Laura J. Summerfeldt, Randi E. McCabe
  • Journal:
    Behavioural and Cognitive Psychotherapy / Volume 52 / Issue 6 / November 2024
    Published online by Cambridge University Press:
    11 September 2024, pp. 666-680
    Print publication:
    November 2024
    • Article
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  • Background:

    Obsessive-compulsive disorder (OCD) symptoms are hypothesized to be driven by two core motivations: harm avoidance and incompleteness. While cognitive-behavioural therapy (CBT) is an effective treatment for OCD, many posit that OCD presentations characterized by high incompleteness may be harder to treat. The relationship between the core motivations and treatment outcomes remains to be further explored.

    Aims:

    To investigate if harm avoidance and incompleteness decrease across group CBT and to examine the relationship between treatment outcomes and both baseline and changes in harm avoidance and incompleteness throughout treatment.

    Method:

    A naturalistic sample of 65 adult out-patients with OCD completed self-report questionnaires measuring OCD symptom severity and the core motivations before, during, and after 12 weeks of group CBT for OCD.

    Results:

    Harm avoidance and incompleteness scores significantly decreased from pre- to post-treatment. Pre-treatment harm avoidance and incompleteness levels did not predict post-treatment symptom severity, but changes in the core motivations throughout treatment were significant predictors of treatment outcome. Specifically, reductions in harm avoidance across treatment and reductions in incompleteness early in treatment, were associated with better treatment outcomes.

    Conclusions:

    Participants who completed group CBT for OCD experienced modest reductions in the core motivations thought to maintain OCD symptoms and these changes predicted better outcomes. However, pre-treatment levels of harm avoidance and incompleteness do not appear to moderate treatment outcome.

  • The Relationship Between Obsessive-Compulsive Symptoms, Perfectionism, and Anxiety Sensitivity for Not Just Right Experiences

  • Lauren D. Irwin, Mairwen K. Jones
  • Journal:
    Behaviour Change / Volume 34 / Issue 3 / September 2017
    Published online by Cambridge University Press:
    22 August 2017, pp. 134-155

  • The obsessive-compulsive core dimensions model posits that compulsions are driven by harm avoidance, or to counteract a sense of incompleteness, known as ‘not just right experiences’ (NJREs). Evidence suggests NJREs are associated with obsessive-compulsive disorder (OCD) symptoms and maladaptive perfectionism. However, manipulations of NJREs have focused on the visual system, and have not been examined in the context of arousal fears associated with anxiety sensitivity (AS). This study examined the relationship between OC symptoms, perfectionism, and AS using in vivo manipulations of NJREs across visual, auditory, and tactile sensory modalities. Using a 2 (NJRE vs. JRE) × 2 (AS vs. no AS) between-subjects design, participants (N = 132) completed behavioural tasks designed to elicit NJREs and assess task discomfort and urge to counteract sensory-specific stimuli. Strong relationships were observed between task ratings and self-report measures of NJREs, incompleteness, OCD symptoms, maladaptive perfectionism, and AS. Those in the NJRE conditions gave significantly higher task ratings compared to JRE conditions; however, there was no main effect for AS. While maladaptive perfectionism and AS were significant predictors of task performance, there was no interaction between the two. The results confirm and extend research suggesting a strong association between NJREs and incompleteness motivations, as well as sensory-affective disturbance in OCD.