Treatment of obsessive morbid jealousy with cognitive analytic therapy: a mixed-methods quasi-experimental case study

Figures & data

Figure 1. Ideographic measure 1: “Today I have been feeling jealous”.

Figure 2. Ideographic measure 2: “Today I have been feeling anxious”.

Figure 3. Ideographic measure 3: “Today I have been feeling untrusting / suspicious”.

Figure 4. Ideographic measure 4: “I have been ‘over-thinking’ today”.

Figure 5. Ideographic measure 5: “Today, we have functioned as a couple … ”.

Figure 6. Ideographic measure 6: Number of images of infidelity.

Figure 7. Ideographic measure 7: Number of times I’ve checked today.

Table 1. Grand phase summaries of the idiographic measures.

	Baseline phase (2 sessions)			Treatment phase (6 sessions)			Follow-up phase
	Mean	Median	SD	Mean	Median	SD	Mean	Median	SD
Jealousy	5.81	6	1.91	4.3	3.5	2.12	2.57	2	1.03
Anxiety	7.43	8	1.33	4.99	4	2.64	2.58	2	1.79
Untrusting	7.24	8	1.73	4.89	4	2.69	2.51	2	1.78
Over thinking	7.95	8	0.92	6.73	7	2.25	4.47	4	1.91
Couple functioning	1.86	2	1.59	6.83	8	2.7	8.09	9	2.03
Infidelity imagery frequency	1.95	2	0.92	0.69	0	0.88	0.16	0	0.4
Checking frequency	1.71	2	1.01	0.5	0	0.72	0.09	0	0.28

Table 2. Summary of study phase comparisons.

		Pairwise comparison p-values
Ideographic measure	Test of main effect	Baseline – Treatment	Treatment – Follow-up	Baseline – Follow-up
Jealousy	F(2,156) = 8.63, p < .01	.165	.004*	.001**
Anxiety	F(2,156) = 10.03, p < .01	.037	.003*	.000**
Untrusting	F(2,156) = 11.26, p < .01	.040	.001**	.000**
Overthinking	F(2,156) = 10.26, p < .01	.341	.001**	.000**
Couple functioning	F(2,156) = 10.18, p < .01	.000**	.456	.000**
Infidelity imagery frequency	F(2,156) = 14.73, p < .01	.000**	.013*	.000**
Checking frequency	F(2,156) = 23.67, p < .01	.000**	.008*	.000**

*p < .05, **p < .001.

Table 3. PND and PEM non-overlapping data analysis results.

	Baseline – Treatment		Baseline – Follow-up
	Percentage of non-overlapping data (PND) %	Percentage of data exceeding median (PEM) %	Percentage of non-overlapping data (PND) %	Percentage of data exceeding median (PEM) %
Jealousy	0	74.3*	10	98.6**
Anxiety	55.7	74.3*	87.1*	97.1**
Untrusting	0	77.1*	0	97.1**
Overthinking	31.4	57.1	72.9*	91.4**
Couple functioning	61.4	82.9*	80*	95.7**
Infidelity imagery frequency	0	78.5*	0	98.6**
Checking frequency	0	90*	0	100**

Note: *Moderately effective (PND/PEM 70% to 90%), **highly effective (PND/PEM >90%).

Table 4. Nomothetic outcomes with clinical and reliable change analyses.

		Assessment to end of intervention comparison		Assessment to end of follow-up comparison
Measure	Score at assessment (clinical interpretation)	Score at end of intervention (clinical interpretation)	Change score (RCI)	Score at end of follow-up (clinical interpretation)	Change score (RCI)
BDI-II	35 (severe)	17 (mild)	18 (5.20)^a	13 (minimal)	22 (6.35)^a
BSI – global severity index	2.69 (case)	0.62 (non-case)	2.07 (6.46)^a	0.67 (non-case)	2.02 (6.31)
BSI – positive symptom total	51	26	25	28	23
BSI-positive symptom distress index	2.80	1.26	1.54	1.28	1.52
IIP-32	2.09	0.71	1.38 (3.53)^a	0.62	1.47 (3.76)^a
PJQ	99 (moderate)	56 (moderate)	43	50 (mild)	49

^a Denotes score difference exceeding RCI and therefore reliable reduction in the outcome score and where no RCI is reported that is because of the lack of necessary normative data. Numbers in bold denote a score into the non-case community sample.

Table 5. Summary of changes noted in the change interview and associated ratings.

Change	Expectancy	Likelihood	Importance
Understanding why I feel so jealous	4	1	5
Understanding the consequences of old patterns	5	1	5
Stop “baiting the hook” through instigating arguments	4	1	5
Feeling happier	4	1	5
Being able to do things separately from each other	4	1	5
Beginning to progress the grief of losing daughter	5	1	5
Reduced checking on my partner	4	1	5

Notes: Expectancy rated from 1 to 5 (very much expected, somewhat expected, neither, somewhat surprised, very much surprised); likelihood rated from 1 to 5 (very unlikely without therapy, somewhat unlikely, neither, somewhat likely, very likely to happen regardless of therapy); importance rated from 1 to 5 (not at all important, slightly, moderately, very, extremely important).