Cited by 164Obsessive-Compulsive Spectrum DisordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychoanalysis and Psychopathology Research

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A systematic review of predictors and moderators of response to psychological therapies in OCD: Do we have enough empirical evidence to target treatment?

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Knopp, Jasmin, Knowles, Sarah, Bee, Penny, Lovell, Karina, Bower, Peter·2013·Clinical Psychology Review

DOI 10.1016/j.cpr.2013.08.008

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Abstract

Obsessive-compulsive disorder (OCD) is a disabling mental health condition. Despite effective psychological treatments for OCD, a significant percentage of patients fail to experience lasting benefit. Factors underlying variable treatment response are poorly understood. Moderators of outcome can help understand "for whom" and "under what circumstances" an intervention works best and thus improve service effectiveness. This paper synthesizes the evidence on predictors and moderators and assesses the quality of reporting of related analyses in psychological therapies for adults with OCD. Trials were identified through electronic searches (CENTRAL, MEDLINE, PsycINFO, EMBASE), key author, and reference list searches of relevant systematic reviews. Fifty five percent (38/69) of relevant trials reported baseline factors associated with outcome; these encompassed clinical, demographic, interpersonal, OCD symptom-specific, psychological/psychosocial, and treatment-specific variables. Predictors were commonly assessed via a validated pre-randomization measure, though few trials adopted best practice by stating a priori hypotheses or conducting a test of interaction. Potential associations emerged between worse OCD treatment outcome and the following factors: hoarding pathology, increased anxiety and OCD symptom severity, certain OCD symptom subtypes, unemployment, and being single/not married. However, the applied utility of these analyses is currently limited by methodological weaknesses.

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Althaus, D., Zaudig, M., Walter, H., Röper, G., & Butollo, W. H. (2000) · Cited by 2

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Quantity and quality of homework compliance: A meta-analysis of relations with outcome in cognitive behavior therapy
Kazantzis, N., Whittington, C., Zelencich, L., Kyrios, M., Norton, P. J., & Hofmann, S. G. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.05.002 · Cited by 280
Epidemiological and Clinical Gender Differences in OCD
Mathes, B. M., Morabito, D. M., & Schmidt, N. B. (2019) · Current Psychiatry Reports · doi:10.1007/s11920-019-1015-2 · Cited by 224
Multivariate resting-state functional connectivity predicts response to cognitive behavioral therapy in obsessive-compulsive disorder
Reggente, N., Moody, T. D., Morfini, F., Sheen, C., Rissman, J., O’Neill, J., & Feusner, J. D. (2018) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1716686115 · Cited by 154
Learning and performance outcomes of mental health staff training in de-escalation techniques for the management of violence and aggression
Price, O., Baker, J. A., Bee, P., & Lovell, K. (2015) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.114.144576 · Cited by 182
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The state of personalized treatment for anxiety disorders: A systematic review of treatment moderators
Schneider, R. L., Arch, J. J., & Wolitzky-Taylor, K. B. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.02.004 · Cited by 135

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Authors: Knopp, J., Knowles, S., Bee, P., Lovell, K., & Bower, P.
Affiliations: Manchester Academic Health Science Centre (GB)
University of Manchester (GB)
Corresponding author: Knopp, Jasmin
ORCID: Knowles, Sarah
Bee, Penny
Lovell, Karina
Bower, Peter
Venue: Clinical Psychology Review
Publisher: Elsevier BV
Published: 2013-12
Volume: 33
Issue: 8
Pages: 1067-1081
ISSN: 0272-7358 (ISSN-L)
DOI: 10.1016/j.cpr.2013.08.008
OpenAlex: W2161829398
Cited by: 164
References: 95
Citations by year: 2026: 5 · 2025: 11 · 2024: 14 · 2023: 16 · 2022: 15 · 2021: 15 · 2020: 13 · 2019: 15 · 2018: 11 · 2017: 14 · 2016: 13 · 2015: 18 · 2014: 4
FWCI: 1.71
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by-nc-nd/3.0/ (vor)
Locations: Clinical Psychology Review (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
Research Explorer (The University of Manchester) (publishedVersion, other-oa)
Funders: National Institute for Health and Care Research (SPCR-040)
NIHR School for Primary Care Research
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 › Psychoanalysis and Psychopathology Research
Keywords: obsessive-compulsive disorder, psychotherapy, treatment response, predictors of treatment outcome, moderators of treatment outcome, treatment moderators, hoarding, anxiety, symptom severity, unemployment, marital status, reporting quality
MeSH terms: Humans, Obsessive-Compulsive Disorder, Risk Factors, Severity of Illness Index, Treatment Outcome, Marital Status

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A systematic review of predictors and moderators of response to psychological therapies in OCD: Do we have enough empirical evidence to target treatment?

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