Exposure therapy for obsessive–compulsive disorder: An optimizing inhibitory learning approach

2015 ◽  
Vol 6 ◽  
pp. 174-182 ◽  
Author(s):  
Joanna J. Arch ◽  
Jonathan S. Abramowitz
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Exposure Therapy ◽  
Learning Approach ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Inhibitory Learning

The Inhibitory Learning Approach to Exposure and Response Prevention for Obsessive-Compulsive Disorder

2021 ◽  
pp. 270-284
Author(s):  
Samantha N. Hellberg ◽  
Heidi J. Ojalehto ◽  
Jennifer L. Buchholz ◽  
Jonathan S. Abramowitz
Keyword(s):  
Conceptual Framework ◽  
Obsessive Compulsive Disorder ◽  
Response Prevention ◽  
Learning Approach ◽  
Exposure And Response Prevention ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Symptom Remission ◽  
Treatment Gains ◽  
Inhibitory Learning

Exposure and response prevention (ERP) is the most effective treatment for obsessive-compulsive disorder (OCD), with robust symptom gains consistently observed. Yet, both research and clinical practice indicate ERP is not equally efficacious for all individuals with OCD, and a considerable portion fail to achieve full symptom remission or experience relapse despite substantial short-term gains. To this end, inhibitory learning theory (ILT) has emerged as an empirically driven conceptual framework for implementing ERP with the goal of optimizing the efficiency and durability of treatment gains. This chapter reviews the conceptual framework for ERP, illustrates ERP through a case example in which common pitfalls were encountered, defines ILT, and illustrates the use of ILT to address these pitfalls.

That Was Easy! Expectancy Violations During Exposure and Response Prevention for Childhood Obsessive-Compulsive Disorder

2018 ◽  
Vol 44 (3) ◽  
pp. 319-342 ◽  
Author(s):  
Andrew G. Guzick ◽  
Adam M. Reid ◽  
Amanda M. Balkhi ◽  
Gary R. Geffken ◽  
Joseph P. H. McNamara
Keyword(s):  
Treatment Outcome ◽  
Obsessive Compulsive Disorder ◽  
Exposure Therapy ◽  
Behavioral Therapy ◽  
Exposure And Response Prevention ◽  
Expectancy Violations ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Exposure Tasks ◽  
Inhibitory Learning

Violating expectancies during exposure therapy is proposed to promote inhibitory learning and improved treatment outcomes. Because people tend to overestimate how distressing emotionally challenging situations will be, violating expectations of distress may be an intuitive way to promote treatment outcome during exposure-based cognitive-behavioral therapy (CBT). This study evaluated overpredictions of distress during exposure tasks in 33 youth with obsessive-compulsive disorder (OCD; ages 8-17) participating in CBT. Youth with more variable prediction accuracy and a higher proportion of overpredictions experienced more rapid symptom reduction, b = −0.29, p = .002. Underpredictions were less common toward the end of therapy as youth experienced less severe OCD, b = 0.12, p= .001. Findings suggest that although youth often accurately predict the intensity of exposure, overpredictions are common as well. The frequency of these overpredictions promoted treatment outcome, supporting expectancy violations as one indicator of inhibitory learning during exposure therapy.

Response

2013 ◽  
pp. 246-248
Author(s):  
Jonathan S. Abramowitz ◽  
Brittain Mahaffey
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Exposure Therapy ◽  
Case Description ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

In her commentary on our case description of Cassie, Dr. Beidel very thoughtfully raises a number of important points regarding the treatment of obsessive-compulsive disorder (OCD). And we agree with all of them. Dr. Beidel, however, raises two issues in particular that we wish to comment on further: (a) the origins of obsessional fears, and (b) the use of distraction in exposure therapy....

Inducing and manipulating sensations of incompleteness

2020 ◽  
Vol 84 (3) ◽  
pp. 237-263
Author(s):  
William Taboas ◽  
Dean McKay
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Emotional Processing ◽  
Harm Avoidance ◽  
Obsessive Compulsive ◽  
Expectancy Violation ◽  
Compulsive Disorder ◽  
Improved Outcomes ◽  
Behavioral Tasks ◽  
Inhibitory Learning ◽  
The Relationship

Incompleteness (INC) and Harm Avoidance (HA) are known core dimensions of obsessive-compulsive disorder (OCD). Emotional processing and inhibitory learning (IL) have both been proposed as viable mechanisms of exposure for the alleviation of HA, yet the relationship with INC remains unclear. This study evaluated differential manipulation responses to induced INC. The authors specifically tested whether targeting the key component of IL, expectancy violation generated by the discrepancy between an articulated prediction and the actual exposure experience, would lead to improved outcomes. A sample of undergraduates (N = 68) completed a series of behavioral tasks to induce INC, followed by manipulations (exposure with or without articulated predictions) to reduce INC reactions. Results show that modest changes were observed following reduction manipulations following INC induction. Furthermore, heightened HA predicted the changes of induced sensations. Mediation tests showed that articulation of predicted sensations mediated pre- to postreduction ratings. Clinical and research implications are discussed.

Post-treatment effects of exposure therapy and clomipramine in obsessive-compulsive disorder

2004 ◽  
Vol 19 (4) ◽  
pp. 225-233 ◽  
Author(s):  
H. Blair Simpson ◽  
Michael R. Liebowitz ◽  
Edna B. Foa ◽  
Michael J. Kozak ◽  
Andrew B. Schmidt ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Treatment Effects ◽  
Exposure Therapy ◽  
Post Treatment ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

scholarly journals Efficacy of the Cognitive and Exposure Therapy in the Treatment of Obsessive-Compulsive Disorder

2013 ◽  
Vol 11 ◽  
pp. 1-9
Author(s):  
Hiva Mahmoodi ◽  
Hasan Gharibi ◽  
Mohamad Khaledian
Keyword(s):  
Cognitive Therapy ◽  
Obsessive Compulsive Disorder ◽  
Exposure Therapy ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Obsessive Compulsive ◽  
Statistical Population ◽  
Compulsive Disorder ◽  
Significant Difference ◽  
Experimental Group

The aim of this study was the investigation of the efficacy of the Cognitive and Exposure therapy on the treatment of obsessive- compulsive disorder. This study is experimental expanded with multiple group pre-test, post-test. The statistical population of this study are included all patients with OCD, referred to clinical centers, hospitals and private clinics and counseling centers in Saghez and Boukan citiesat the age of 40-20 years. The statistical sample of this study is included 45 patientswith Obsessive Compulsive Disorder, Who were selected randomly. Cognitive therapy was administered for the first experimental group and the second experimental group receives exposure therapy while the control group received no treatment. Subscales Madsly questionnaire was usedfor data gathering for OCD. For data analysis, multivariate analysis of covariance (MANCOVA) and least significant difference test to compare scores differences between pretest - posttest variables in the experimental and control groups was used. Findings showed that Cognitive and Aversion Therapy on the control group has a significant impact on the improvement of obsession, check out, washing, slowness and obsessive doubts. The results showed that Whittal Cognitive Therapy more impact on the reduction of obsessions in comparsion with Exposure therapy.

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