Cited by 102Obsessive-Compulsive Spectrum DisordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPerfectionism, Procrastination, Anxiety Studies

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Mechanisms of change in cognitive therapy for obsessive compulsive disorder: Role of maladaptive beliefs and schemas

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Wilhelm, Sabine, Berman, Noah C., Keshaviah, Aparna, Schwartz, Rachel A., Steketee, Gail·2015·Behaviour Research and Therapy

DOI 10.1016/j.brat.2014.12.006PMC PMC4313532

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Abstract

The present study aimed to identify mechanisms of change in individuals with moderately severe obsessive-compulsive disorder (OCD) receiving cognitive therapy (CT). Thirty-six adults with OCD received CT over 24 weeks. At weeks 0, 4/6, 12, 16/18, and 24, independent evaluators assessed OCD severity, along with obsessive beliefs and maladaptive schemas. To examine mechanisms of change, we utilized a time-varying lagged regression model with a random intercept and slope. Results indicated that perfectionism and certainty obsessive beliefs and maladaptive schemas related to dependency and incompetence significantly mediated (improved) treatment response. In conclusion, cognitive changes in perfectionism/certainty beliefs and maladaptive schemas related to dependency/incompetence precede behavioral symptom reduction for OCD patients. Targeting these mechanisms in future OCD treatment trials will emphasize the most relevant processes and facilitate maximum improvement.

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Self-citation

Authors: Wilhelm, S., Berman, N. C., Keshaviah, A., Schwartz, R. A., & Steketee, G.
Affiliations: Harvard University (US)
Boston University (US)
Corresponding author: Wilhelm, Sabine
ORCID: Wilhelm, Sabine
Berman, Noah C.
Keshaviah, Aparna
Schwartz, Rachel A.
Steketee, Gail
Venue: Behaviour Research and Therapy
Publisher: Elsevier BV
Published: 2015-02
Volume: 65
Pages: 5-10
ISSN: 0005-7967 (ISSN-L)
DOI: 10.1016/j.brat.2014.12.006
PMC: PMC4313532
OpenAlex: W2020581855
Cited by: 102
References: 41
Citations by year: 2026: 8 · 2025: 7 · 2024: 6 · 2023: 14 · 2022: 5 · 2021: 8 · 2020: 8 · 2019: 14 · 2018: 11 · 2017: 6 · 2016: 9 · 2015: 6
FWCI: 8.28
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Behaviour Research and Therapy (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: NIMH (R21 MH058804)
Topics: Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Perfectionism, Procrastination, Anxiety Studies
Keywords: obsessive-compulsive disorder, cognitive therapy, mechanisms of change, maladaptive schemas, obsessive beliefs, perfectionism, treatment response, symptom relief
MeSH terms: Adult, Cognition, Culture, Female, Humans, Male, Obsessive-Compulsive Disorder, Psychiatric Status Rating Scales, Cognitive Behavioral Therapy, Treatment Outcome, Young Adult

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Mechanisms of change in cognitive therapy for obsessive compulsive disorder: Role of maladaptive beliefs and schemas

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