3,572
Views
18
CrossRef citations to date
0
Altmetric
Review

Exposure and Response Prevention in the Treatment of Obsessive-Compulsive Disorder: Current Perspectives

&
Pages 1167-1174 | Published online: 24 Dec 2019

References

  • Kessler RC, Wai TC, Demler O, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National comorbidity survey replication. Arch Gen Psychiatry. 2005;62(6):617–627. doi:10.1001/archpsyc.62.6.61715939839
  • Murray CJ, Lopez AD. The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020. World Health Organization; 1996.
  • Eisen JL, Mancebo MA, Pinto A, et al. Impact of obsessive-compulsive disorder on quality of life. Compr Psychiatry. 2006;47(4):270–275. doi:10.1016/j.comppsych.2005.11.00616769301
  • DuPont R, Rice D, Shiraki S, Rowland C. Economic costs of obsessive-compulsive disorder. Med Interface. 1995;8:102–109.
  • Koran LM, Simpson HB. Guideline watch (March 2013): practice guideline for the treatment of patients with obsessive-compulsive disorder. APA Pract Guidel. 2013.
  • American Psychiatric Association. Practice guideline for the treatment of patients with obsessive-compulsive disorder. Arlington, VA: American Psychiatric Association, 2010. Available fromhttp://www.psych.org/psych_pract/treatg/pg/prac_guide.cfm. Accessed December 19, 2019.
  • Mowrer OH. Learning Theory and Behavior. John Wiley & Sons Inc; 1960; doi:10.1037/10802-000
  • Grayson JB, Foa EB, Steketee G. Habituation during exposure treatment: distraction vs attention-focusing. Behav Res Ther. 1982;20(4):323–328. doi:10.1016/0005-7967(82)90091-27126114
  • Grey S, Sartory G, Rachman S. Synchronous and desynchronous changes during fear reduction. Behav Res Ther. 1979;17(2):137–147. doi:10.1016/0005-7967(79)90022-634383
  • Watson JP, Gaind R, Marks IM. Physiological habituation to continuous phobic stimulation. Behav Res Ther. 1972;10(3):269–278. doi:10.1016/0005-7967(72)90043-55047683
  • Foa EB, Grayson JB, Stekette GS, Doppelt HG, Turner RM, Latimer PR. Success and failure in the behavioral treatment of obsessive-compulsives. J Consult Clin Psychol. 1983. doi:10.1037/0022-006X.51.2.287
  • Craske MG, Kircanski K, Zelikowsky M, Mystkowski J, Chowdhury N, Baker A. Optimizing inhibitory learning during exposure therapy. Behav Res Ther. 2008;46(1):5–27. doi:10.1016/j.brat.2007.10.00318005936
  • Baker A, Mystkowski J, Culver N, Yi R, Mortazavi A, Craske MG. Does habituation matter? Emotional processing theory and exposure therapy for acrophobia. Behav Res Ther. 2010;48(11):1139–1143. doi:10.1016/j.brat.2010.07.00920723886
  • Meuret AE, Seidel A, Rosenfield B, Hofmann SG, Rosenfield D. Does fear reactivity during exposure predict panic symptom reduction? J Consult Clin Psychol. 2012;80(5):773–785. doi:10.1037/a002803222486408
  • Tsao JCI, Craske MG. Timing of treatment and return of fear: effects of massed, uniform-, and expanding-spaced exposure schedules. Behav Ther. 2000;31(3):479–497. doi:10.1016/S0005-7894(00)80026-X
  • Pavlov IP. Conditioned reflexes. An investigation of the physiological activity of the cerebral cortex. Ann Neurosci. 1927;17:136.
  • Bouton ME, King DA. Contextual control of the extinction of conditioned fear: tests for the associative value of the context. J Exp Psychol Anim Behav Process. 1983. doi:10.1037/0097-7403.9.3.248
  • Rescorla RA, Heth CD. Reinstatement of fear to an extinguished conditioned stimulus. J Exp Psychol Anim Behav Process. 1975;1(1):88–96. doi:10.1037/0097-7403.1.1.881151290
  • Abramowitz JS, Arch JJ. Strategies for improving long-term outcomes in cognitive behavioral therapy for obsessive-compulsive disorder: insights from learning theory. Cogn Behav Pract. 2014;21(1):20–31. doi:10.1016/j.cbpra.2013.06.004
  • Quirk GJ, Russo GK, Barron JL, Lebron K. The role of ventromedial prefrontal cortex in the recovery of extinguished fear. J Neurosci. 2000;20(16):6225–6231. doi:10.1523/JNEUROSCI.20-16-06225.200010934272
  • Milad MR, Wright CI, Orr SP, Pitman RK, Quirk GJ, Rauch SL. Recall of fear extinction in humans activates the ventromedial prefrontal cortex and hippocampus in concert. Biol Psychiatry. 2007;62(5):446–454. doi:10.1016/j.biopsych.2006.10.01117217927
  • Milad MR, Furtak SC, Greenberg JL, et al. Deficits in conditioned fear extinction in obsessive-compulsive disorder and neurobiological changes in the fear circuit. JAMA Psychiatry. 2013;70(6):608–618. doi:10.1001/jamapsychiatry.2013.91423740049
  • Apergis-Schoute AM, Gillan CM, Fineberg NA, Fernandez-Egea E, Sahakian BJ, Robbins TW. Neural basis of impaired safety signaling in obsessive compulsive disorder. Proc Natl Acad Sci U S A. 2017;114(12):3216–3221. doi:10.1073/pnas.160919411428265059
  • Fullana MA, Cardoner N, Alonso P, et al. Brain regions related to fear extinction in obsessive-compulsive disorder and its relation to exposure therapy outcome: a morphometric study. Psychol Med. 2014;44(4):845–856. doi:10.1017/S003329171300112823773479
  • Fullana MA, Zhu X, Alonso P, et al. Basolateral amygdala-ventromedial prefrontal cortex connectivity predicts cognitive behavioural therapy outcome in adults with obsessive-compulsive disorder. J Psychiatry Neurosci. 2017;42(6):378–385. doi:10.1503/jpn.16021528632120
  • Davis M. Role of NMDA receptors and MAP kinase in the amygdala in extinction of fear: clinical implications for exposure therapy. Eur J Neurosci. 2002;16(3):395–398. doi:10.1046/j.1460-9568.2002.02138.x12193180
  • Walker DL, Ressler KJ, Lu K-T, Davis M. Facilitation of conditioned fear extinction by systemic administration or intra-amygdala infusions of d-cycloserine as assessed with fear-potentiated startle in rats. J Neurosci. 2002;22(6):2343–2351. doi:10.1523/JNEUROSCI.22-06-02343.200211896173
  • Ledgerwood L, Richardson R, Cranney J. D-cycloserine facilitates extinction of learned fear: effects on reacquisition and generalized extinction. Biol Psychiatry. 2005;57(8):841–847. doi:10.1016/j.biopsych.2005.01.02315820704
  • Hofmann SG, Pollack MH, Otto MW. Augmentation treatment of psychotherapy for anxiety disorders with D-cycloserine. CNS Drug Rev. 2006;12(3–4):208–217. doi:10.1111/j.1527-3458.2006.00208.x17227287
  • Ressler KJ, Rothbaum BO, Tannenbaum L, et al. Cognitive enhancers as adjuncts to psychotherapy: use of D-cycloserine in phobic individuals to facilitate extinction of fear. Arch Gen Psychiatry. 2004;61(11):1136–1144. doi:10.1001/archpsyc.61.11.113615520361
  • Wilhelm S, Buhlmann U, Tolin DF, et al. Augmentation of behavior therapy with D-cycloserine for obsessive-compulsive disorder. Am J Psychiatry. 2008;165(3):335–341. doi:10.1176/appi.ajp.2007.0705077618245177
  • Storch EA, Merlo LJ, Bengtson M. et al. D-cycloserine does not enhance exposure– response prevention therapy in obsessive–compulsive disorder. Int Clin Psychopharmacol;2007 230–237. doi:10.1097/YIC.0b013e32819f848017519647
  • Andersson E, Hedman E, Enander J, et al. D-cycloserine vs placebo as adjunct to cognitive behavioral therapy for obsessive-compulsive disorder and interaction with antidepressants: a randomized clinical trial. JAMA Psychiatry. 2015;72(7):659–667. doi:10.1001/jamapsychiatry.2015.054625970252
  • Rosenfield D, Smits JAJ, Hofmann SG, et al. Changes in dosing and dose timing of D-cycloserine explain its apparent declining efficacy for augmenting exposure therapy for anxiety-related disorders: an individual participant-data meta-analysis. J Anxiety Disord. 2019:102149. doi:10.1016/j.janxdis.2019.10214931698111
  • Skolnick P. Antidepressants for the new millennium. Eur J Pharmacol. 1999;375(1–3):31–40. doi:10.1016/S0014-2999(99)00330-110443562
  • Cottraux J, Note I, Yao SN, et al. A Randomized Controlled Trial of Cognitive Therapy versus Intensive Behavior Therapy in Obsessive Compulsive Disorder. Psychother Psychosom. 2001;70:288-297.
  • Foa EB, Liebowitz MR, Kozak MJ, et al. Randomized, Placebo-Controlled Trial of Exposure and Ritual Prevention, Clomipramine, and Their Combination in the Treatment of Obsessive-Compulsive Disorder.Am J Psychiatry. 2005;162(1): 151-161.
  • Olatunji BO, Davis ML, Powers MB, Smits JAJ. Cognitive-behavioral therapy for obsessive-compulsive disorder: a meta-analysis of treatment outcome and moderators. J Psychiatr Res. 2013;47(1):33–41. doi:10.1016/j.jpsychires.2012.08.02022999486
  • The Pediatric OCD Treatment Study. Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: the pediatric OCD treatment study (POTS) randomized controlled trial. J Am Med Assoc. 2004;292(16):1969–1976. doi:10.1001/jama.292.16.1969
  • Pato MT, Zohar-Kadouch R, Zohar J, Murphy DL. Return of symptoms after discontinuation of clomipramine in patients with obsessive-compulsive disorder. Am J Psychiatry. 1988. doi:10.1176/ajp.145.12.1521
  • Simpson HB, Liebowitz MR, Foa EB, et al. Post-treatment effects of exposure therapy and clomipramine in obsessive-compulsive disorder. Depress Anxiety. 2004;19(4):225–233. doi:10.1002/da.2000315274171
  • Foa EB, Kozak MJ. Psychological treatment for obsessive-compulsive disorder In: Mavissakalian MR, Prien RF, editors. Long-Term Treatments of Anxiety Disorders. Arlington, VA: American Psychiatric Association; 1996:285–309.
  • Tundo A, Salvati L, Busto G, Di Spigno D, Falcini R. Addition of cognitive-behavioral therapy for nonresponders to medication for obsessive-compulsive disorder: a naturalistic study. J Clin Psychiatry. 2007. doi:10.4088/JCP.v68n1013
  • Franklin ME, Sapyta J, Freeman JB, et al. Cognitive behavior therapy augmentation of pharmacotherapy in pediatric obsessive-compulsive disorder: the pediatric OCD treatment study II (POTS II) randomized controlled trial. J Am Med Assoc. 2011;306(11):1224–1232. doi:10.1001/jama.2011.1344
  • Calamari JE, Cassiday KL. Treating obsessive-compulsive disorder in older adults: a review of strategies. Handb Couns Psychother Older Adults. 1999:526–538.
  • Carmin CN, Wiegartz PS. Successful and unsuccessful treatment of obsessive-compulsive disorder in older adults. J Contemp Psychother. 2000;30(2):181–193. doi:10.1023/A:1026566729195
  • Jones MK, Wootton BM, Vaccaro LD. the efficacy of exposure and response prevention for geriatric obsessive compulsive disorder: a clinical case illustration. Case Rep Psychiatry. 2012;2012:1–5. doi:10.1155/2012/394603
  • Strauss C, Lea L, Hayward M, et al. Mindfulness-based exposure and response prevention for obsessive compulsive disorder: findings from a pilot randomised controlled trial. J Anxiety Disord. 2018;57:39–47. doi:10.1016/j.janxdis.2018.04.00729739634
  • Twohig MP, Abramowitz JS, Smith BM, et al. Adding acceptance and commitment therapy to exposure and response prevention for obsessive-compulsive disorder: a randomized controlled trial. Behav Res Ther. 2018;108:1–9. doi:10.1016/j.brat.2018.06.00529966992
  • Abramowitz JS. The psychological treatment of obsessive-compulsive disorder. Can J Psychiatry. 2006;51(7):407–416. doi:10.1177/07067437060510070216838822
  • Eddy KT, Dutra L, Bradley R, Westen D. A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder. Clin Psychol Rev. 2004;24(8):1011–1030. doi:10.1016/j.cpr.2004.08.00415533282
  • Simpson HB, Foa EB, Liebowitz MR, et al. Cognitive-behavioral therapy vs risperidone for augmenting serotonin reuptake inhibitors in obsessive-compulsive disorder a randomized clinical trial. JAMA Psychiatry. 2013;70(11):1190–1198. doi:10.1001/jamapsychiatry.2013.193224026523
  • Garcia AM, Sapyta JJ, Moore PS, et al. Predictors and moderators of treatment outcome in the pediatric obsessive compulsive treatment study (POTS I). J Am Acad Child Adolesc Psychiatry. 2010;49(10):1024–1033. doi:10.1016/j.jaac.2010.06.01320855047
  • Keeley ML, Storch EA, Merlo LJ, Geffken GR. Clinical predictors of response to cognitive-behavioral therapy for obsessive-compulsive disorder. Clin Psychol Rev. 2008;28(1):118–130. doi:10.1016/j.cpr.2007.04.00317531365
  • Mataix-Cols D, Marks IM, Greist JH, Kobak KA, Baer L. Obsessive-compulsive symptom dimensions as predictors of compliance with and response to behaviour therapy: results from a controlled trial. Psychother Psychosom. 2002;71(5):255–262. doi:10.1159/00006481212207105
  • Foa EB, Abramowitz JS, Franklin ME, Kozak MJ. Feared consequences, fixity of belief, and treatment outcome in patients with obsessive-compulsive disorder. Behav Ther. 1999;30(4):717–724. doi:10.1016/S0005-7894(99)80035-5
  • Himle JA, Van Etten ML, Janeck AS, Fischer DJ. Insight as a predictor of treatment outcome in behavioral group treatment for obsessive-compulsive disorder. Cognit Ther Res. 2006;30(5):661–666. doi:10.1007/s10608-006-9079-9
  • Williams MT, Farris SG, Turkheimer EN, et al. The impact of symptom dimensions on outcome for exposure and ritual prevention therapy in obsessive-compulsive disorder. J Anxiety Disord. 2014;28(6):553–558. doi:10.1016/j.janxdis.2014.06.00124983796
  • Abramowitz JS, Foa EB. Does comorbid major depressive disorder influence outcome of exposure and response prevention for OCD? Behav Ther. 2000;31(4):795–800. doi:10.1016/S0005-7894(00)80045-3
  • Storch EA, Lewin AB, Farrell L, et al. Does cognitive-behavioral therapy response among adults with obsessive-compulsive disorder differ as a function of certain comorbidities? J Anxiety Disord. 2010;24(6):547–552. doi:10.1016/j.janxdis.2010.03.01320399603
  • Pinto A, Liebowitz MR, Foa EB, Simpson HB. Obsessive compulsive personality disorder as a predictor of exposure and ritual prevention outcome for obsessive compulsive disorder. Behav Res Ther. 2011;49(8):453–458. doi:10.1016/j.brat.2011.04.00421600563
  • Besser A, Flett GL, Hewitt PL. Perfectionism, cognition, and affect in response to performance failure vs. success. J Ration Emotive Cogn Behav Ther. 2004;22(4):301–328. doi:10.1023/B:JORE.0000047313.35872.5c
  • Zuroff DC, Blatt SJ, Sotsky SM, Krupnick JL, Sanislow III CA, Simmens S. Relation of therapeutic alliance and perfectionism to outcome in brief outpatient treatment of depression. J Consult Clin Psychol Psychol Assoc Inc. 2000;68(1):114–124. doi:10.1037/0022-006X,68.1.114
  • Flygare O, Andersson E, Ringberg H, et al. Adapted cognitive behavior therapy for obsessive–compulsive disorder with co-occurring autism spectrum disorder: a clinical effectiveness study. Autism. 2019. doi:10.1177/1362361319856974
  • Tundo A, Necci R. Cognitive-behavioural therapy for obsessive-compulsive disorder co-occurring with psychosis: systematic review of evidence. World J Psychiatry. 2016. doi:10.5498/wjp.v6.i4.449
  • Abramowitz JS, Baucom DH, Wheaton MG, et al. Enhancing exposure and response prevention for OCD: a couple-based approach. Behav Modif. 2013;37(2):189–210. doi:10.1177/014544551244459622619395
  • Storch EA, Geffken GR, Merlo LJ, et al. Family accommodation in pediatric obsessive–compulsive disorder. J Clin Child Adolesc Psychol. 2007;36(2):207–216. doi:10.1080/1537441070127792917484693
  • Francazio SK, Flessner CA, Boisseau CL, et al. Parental accommodation predicts symptom severity at long-term follow-up in children with obsessive–compulsive disorder: a preliminary investigation. J Child Fam Stud. 2016;25(8):2562–2570. doi:10.1007/s10826-016-0408-728989268
  • Lewin AB, Park JM, Jones AM, et al. Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: a pilot randomized controlled trial. Behav Res Ther. 2014;56(1):30–38. doi:10.1016/j.brat.2014.02.00124657310
  • Simpson HB, Marcus SM, Zuckoff A, Franklin M, Foa EB. Patient adherence to cognitive-behavioral therapy predicts long-term outcome in obsessive-compulsive disorder. J Clin Psychiatry. 2012;73(9):1265–1266. doi:10.4088/JCP.12l0787923059155
  • Wheaton MG, Galfalvy H, Steinman SA, Wall MM, Foa EB, Simpson HB. Patient adherence and treatment outcome with exposure and response prevention for OCD: which components of adherence matter and who becomes well? Behav Res Ther. 2016;85:6–12. doi:10.1016/j.brat.2016.07.01027497840
  • Abramowitz JS. Variants of exposure and response prevention in the treatment of obsessive-compulsive disorder: a meta-analysis. Behav Ther. 1996;27:583–600. doi:10.1016/S0005-7894(96)80045-1
  • Gillihan SJ, Williams MT, Malcoun E, Yadin E, Foa EB. Common pitfalls in exposure and response prevention (EX/RP) for OCD. J Obsessive Compuls Relat Disord. 2012;1(4):251–257. doi:10.1016/j.jocrd.2012.05.00222924159
  • Mancebo MC, Eisen JL, Sibrava NJ, Dyck IR, Rasmussen SA. Patient utilization of cognitive-behavioral therapy for OCD. Behav Ther. 2011;42(3):399–412. doi:10.1016/j.beth.2010.10.00221658523
  • Farrell NR, Deacon BJ, Kemp JJ, Dixon LJ, Sy JT. Do negative beliefs about exposure therapy cause its suboptimal delivery? An experimental investigation. J Anxiety Disord. 2013;27(8):763–771. doi:10.1016/j.janxdis.2013.03.00723602351
  • Olatunji BO, Deacon BJ, Abramowitz JS. The cruelest cure? Ethical issues in the implementation of exposure-based treatments. Cogn Behav Pract. 2009;16(2):172–180. doi:10.1016/j.cbpra.2008.07.003
  • Pittig A, Kotter R, Hoyer J. The struggle of behavioral therapists with exposure: self-reported practicability, negative beliefs, and therapist distress about exposure-based interventions. Behav Ther. 2019;50(2):353–366. doi:10.1016/j.beth.2018.07.00330824251
  • Marques L, LeBlanc NJ, Wegarden HM, Timpano KR, Jenike M, Wilhelm S. Barriers to treatment and service utilization in an internet sample of individuals with obsessive-compulsive symptoms. Depress Anxiety. 2010;27(5):470–475. doi:10.1002/da.2069420455248
  • Pinto A, Mancebo MC, Eisen JL, Pagano ME, Rasmussen SA. The Brown Longitudinal Obsessive Compulsive Study: clinical features and symptoms of the sample at intake. J Clin Psychiatry. 2006;67(5): 703-711.16841619
  • Tolin DF, Diefenbach GJ, Maltby N, Hannan S. Stepped care for obsessive-compulsive disorder: a pilot study. Cogn Behav Pract. 2005;12(4):403–414. doi:10.1016/S1077-7229(05)80068-9
  • Tolin DF, Diefenbach GJ, Gilliam CM. Stepped care versus standard cognitive-behavioral therapy for obsessive-compulsive disorder: a preliminary study of efficacy and costs. Depress Anxiety. 2011;28(4):314–323. doi:10.1002/da.2080421381157
  • Greist JH, Marks IM, Baer L, et al. Behavior therapy for obsessive-compulsive disorder guided by a computer or by a clinician compared with relaxation as a control. J Clin Psychiatry. 2002;63(2):138–145. doi:10.4088/JCP.v63n020911874215
  • Boisseau CL, Schwartzman CM, Lawton J, Mancebo MC. App-guided exposure and response prevention for obsessive compulsive disorder: an open pilot trial. Cogn Behav Ther. 2017;46:447–458. doi:10.1080/16506073.2017.132168328565937
  • Havnen A, Hansen B, Öst LG, Kvale G. Concentrated ERP delivered in a group setting: an effectiveness study. J Obsessive Compuls Relat Disord. 2014;3(4):319–324. doi:10.1016/j.jocrd.2014.08.002
  • Kvale G, Hansen B, Björgvinsson T, et al. Successfully treating 90 patients with obsessive compulsive disorder in eight days: the Bergen 4-day treatment. BMC Psychiatry. 2018;18(1):323. doi:10.1186/s12888-018-1887-430286745
  • Launes G, Laukvik IL, Sunde T, et al. The Bergen 4-day treatment for obsessive-compulsive disorder: does it work in a new clinical setting? Front Psychol. 2019;10. doi:10.3389/fpsyg.2019.01069
  • Hansen B, Kvale G, Hagen K, Havnen A, Öst L-G. The Bergen 4-day treatment for OCD: four years follow-up of concentrated ERP in a clinical mental health setting. Cogn Behav Ther. 2019;48(2):89–105. doi:10.1080/16506073.2018.147844730088441
  • Cummings JR, Allen L, Clennon J, Ji X, Druss BG. Geographic access to specialty mental health care across high-and low-income US communities. JAMA Psychiatry. 2017;74(5):476–484. doi:10.1001/jamapsychiatry.2017.030328384733
  • Mancebo MC, Steketee G, Muroff J, Rasmussen S, Zlotnick C. Behavioral therapy teams for adults with OCD in a community mental health center: an open trial. J Obsessive Compuls Relat Disord. 2017;13:18–23. doi:10.1016/j.jocrd.2017.03.002
  • Barlow DH, Allen LB, Choate ML. Toward a unified treatment for emotional disorders. Behav Ther. 2004;35(2):205–230. doi:10.1016/S0005-7894(04)80036-4
  • Boisseau CL, Farchione TJ, Fairholme CP, Ellard KK, Barlow DH. The development of the unified protocol for the transdiagnostic treatment of emotional disorders: a case study. Cogn Behav Pract. 2010;17(1):102–113. doi:10.1016/j.cbpra.2009.09.00323997572
  • Farchione TJ, Fairholme CP, Ellard KK, et al. Unified protocol for transdiagnostic treatment of emotional disorders: a randomized controlled trial. Behav Ther. 2012;43(3):666–678. doi:10.1016/j.beth.2012.01.00122697453
  • Barlow DH, Farchione TJ, Bullis JR, et al. The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders: a randomized clinical trial. JAMA Psychiatry. 2017;74(9):875–884. doi:10.1001/jamapsychiatry.2017.216428768327
  • Steele SJ, Farchione TJ, Cassiello-Robbins C, et al. Efficacy of the unified protocol for transdiagnostic treatment of comorbid psychopathology accompanying emotional disorders compared to treatments targeting single disorders. J Psychiatr Res. 2018;104:211–216. doi:10.1016/j.jpsychires.2018.08.00530103069