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Cited by 434Obsessive-Compulsive Spectrum DisordersMindfulness and Compassion InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

A randomized clinical trial of acceptance and commitment therapy versus progressive relaxation training for obsessive-compulsive disorder

Open access
Twohig, Michael P., Hayes, Steven C., Plumb, Jennifer C., Pruitt, Larry D., Collins, Angela B., Hazlett-Stevens, Holly, Woidneck, Michelle R.·2010·Journal of Consulting and Clinical Psychology
DOI 10.1037/a0020508PMC PMC2948415
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Abstract

Objective: Effective treatments for obsessive-compulsive disorder (OCD) exist, but additional treatment options are needed. The effectiveness of 8 sessions of acceptance and commitment therapy (ACT) for adult OCD was compared with progressive relaxation training (PRT). Method: Seventy-nine adults (61 female) diagnosed with OCD (mean age = 37 years; 89 Caucasian) participated in a randomized clinical trial of 8 sessions of ACT or PRT with no in-session exposure. The following assessments were completed at pretreatment, posttreatment, and 3-month follow-up by an assessor who was unaware of treatment conditions: Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Beck Depression Inventory-II, Quality of Life Scale, Acceptance and Action Questionnaire, Thought Action Fusion Scale, and Thought Control Questionnaire. Treatment Evaluation Inventory was completed at posttreatment. Results: ACT produced greater changes at posttreatment and follow-up over PRT on OCD severity (Y-BOCS: ACT pretreatment = 24.22, posttreatment = 12.76, follow-up = 11.79; PRT pretreatment = 25.4, posttreatment = 18.67, follow-up = 16.23) and produced greater change on depression among those reporting at least mild depression before treatment. Clinically significant change in OCD severity occurred more in the ACT condition than PRT (clinical response rates: ACT posttreatment = 46-56, follow-up = 46-66; PRT posttreatment = 13-18, follow-up = 16-18). Quality of life improved in both conditions but was marginally in favor of ACT at posttreatment. Treatment refusal (2.4 ACT, 7.8 PRT) and dropout (9.8 ACT, 13.2 PRT) were low in both conditions. Conclusions: ACT is worth exploring as a treatment for OCD. © 2010 American Psychological Association.

Integrity signals

Registry

Crossref · 10.1037/a0020508

Cites

47 of 47 references verified0 citation errors · 0 not checkable

Statistics

42 tests recomputed · 0 with the reported and recomputed p on opposite sides of .05

Claims the paper makes

4 of 51 cited sources checked · 2 supported · 0 flagged · accuracy not yet measured

  • Study design and conductcitation

    Thirty-eight participants per condition were needed for 80% power to detect the average between-group effect size of d = .66 in the existing ACT literature.

    “An n of 38 per condition was required for power of .8 to detect the average between group effect size (d = .66) in the existing ACT literature across all diagnoses (Hayes et al., 2006).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Hayes et al., 2006 source

      The 'Quantitative characterization of the relative strength of ACT outcomes' section (p. 15) reports an average between-condition effect size of d = .66 across the ACT outcome studies it included. Our copy does not state that 38 participants per condition were required for 80% power; that sample-size calculation is not supported by the cited paper. (LLM, conf=0.89)

      Experimental — accuracy not yet measured
  • Findingown data

    More ACT than PRT participants achieved clinically significant OCD severity change across multiple criteria.

    “Clinically significant change in OCD severity occurred more in the ACT condition than PRT using multiple criteria (clinical response rates: ACT post=46-56%, follow-up 46-66%; PRT post=13%-18%, follow-up 16-18%).”
    Quote in the paperSubstantial claim
  • Findingown data

    Among participants with at least mild depression at baseline, ACT led to larger depression reductions than PRT.

    “and produced greater change on depression among those reporting at least mild depression before treatment.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Refusal rates were low in both ACT and PRT.

    “Finally, treatment refusal (2.4% ACT, 7.8% PRT) and drop-out (9.8% ACT, 13.2% PRT) were low in both conditions.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Drop-out rates were low in both ACT and PRT.

    “drop-out (9.8% ACT, 13.2% PRT) were low in both conditions.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 56
  • Classified as probably not a substantial claim. 31

  • May combine two claims.

    Premisecitation
    § A randomized clinical trial of Acceptance and Commitment Therapy vs. Progressive Relaxation Training for obsessive compulsive disorder

    Studies show ACT affects psychological flexibility and yields positive outcomes when flexibility increases.

    “A number of studies show that ACT impacts psychological flexibility and produces positive outcomes when psychological flexibility increases (e.g., Hayes et al., 2006).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Hayes et al., 2006 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The AAQ has good convergent and discriminant validity and four-month test-retest reliability of r = .64.

    “The Acceptance and Action Questionnaire has good convergent and discriminant validity and test-retest reliability after a four month period was r =.64 (Hayes et al., 2004; Hayes et al., 2006).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Hayes et al., 2004 source
    • cites Hayes et al., 2006 source

      In Research on ACT (p. 10), the paper says that two validated AAQ versions have adequate convergent validity. Our copy does not report discriminant validity or a four-month test–retest reliability of r = .64; searches for those terms and the coefficient did not locate either result. (LLM, conf=0.87)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The TAFS total score has three-month test-retest reliability of r = .52 and shows construct validity with other measures.

    “Three month test-retest reliability for the total score were r =.52, and it shows construct validity with other measures (Rassin, Merckelbach, Muris, & Schmidt, 2001).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Rassin, Merckelbach, Muris, & Schmidt, 2001 source

  • May combine two claims.

    Findingown data

    ACT led to larger reductions in OCD severity than PRT at posttreatment and at three-month follow-up.

    “ACT produced greater changes at posttreatment and follow-up over PRT on OCD severity (Y-BOCS: ACT pre=24.22, post=12.76, follow-up=11.79; PRT pre=25.4, post=18.67, follow-up=16.23)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Quality of life improved in both groups, with a marginal advantage for ACT at posttreatment.

    “Quality of life improved in both conditions but was marginally in favor of ACT at post.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    For depression, there was no significant effect of condition, but significant effects of time and condition-by-time interaction.

    “revealed a non-significant effect for treatment condition, F (1, 55.32) = .35, p = .56, but significant effects for time, F (2, 69.63) = 44.14, p < .001, and the interaction between condition and time, F (2, 69.63) = 5.61, p = .006.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    For the Thought Action Fusion Scale moral subscale, there was no significant effect of condition, a significant effect of time, and a significant condition-by-time interaction.

    “revealed a non-significant effect for treatment condition, F (1, 76.34) = 1.25, p = .27, and a significant effect for time, F (1, 71.72) = 16.32, p < .001, and the interaction of condition and time, F (1, 71.72) = 11.39, p = .001, end point outcome effect size = .73.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Number of treatment sessions was not related to follow-up decreases in Y-BOCS in either condition, but was correlated with post decreases in Y-BOCS in the ACT condition.

    “The number of treatment sessions was not related to follow-up decreases in the Y-BOCS in either the PRT condition (Spearman's rho (31) = -.12, p = .54), or the ACT condition (Spearman's rho (33) = -.15, p = .41). Post result were similar for the PRT condition, but the number of treatment sessions was correlated with post decreases in the Y-BOCS in the ACT condition (Spearman's rho (33) = -.30, p =”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    ACT participants showed an improving slope on the TAF likelihood subscale, while PRT participants showed a trend toward improvement.

    “ACT participants showed an improving slope (ACT: Estimate = -.41, SE = .09, t (135.54) = -4.46, p < .001) while PRT participants showed a trend for one (PRT: Estimate = -.17, SE = .10, t (136.00) = -1.75, p = .082).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Seventy-five percent of ACT participants rated the treatment with an average score of 4 or better, and 25% gave the highest acceptability score.

    “Seventy-five percent of the ACT participants rated the treatment with an average score of 4 or better and 25% rated it with the highest acceptability score.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    For the Thought Control Questionnaire, there was an approaching significant effect of condition, a significant effect of time, and a significant condition-by-time interaction.

    “revealed an approaching significant effect for treatment condition, F (1, 77.28) = 3.18, p = .079, and a significant effect for time, F (2, 70.43) = 17.88, p < .001, and the interaction of condition and time, F (2, 70.43) = 5.11, p = .008.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Quality of life did not differ between conditions at follow-up, but there was a trend favoring ACT at post.

    “There was no difference in improvement between conditions at follow-up (Estimated Mdiff = .18, SE = 3.14, t (63.49) = .06, p = .96, 95% CI: -6.10, 6.46, effect size = .01) but there was a trend toward a difference at post (Estimated Mdiff = 5.46, SE = 2.78, t (70.22) = 1.96, p = .054, 95% CI: -.09, 11.00, effect size = .47).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    ACT produced a significantly greater rate of Y-BOCS improvement than PRT, with a large end-point effect size (.84).

    “but the ACT condition produced a large and significant difference in rate of improvement (Estimate = .42, SE = .19, t (80.64) = 2.27, p = .026, 95% CI: .05, .80, end point outcome effect size = .84).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    For the Acceptance and Action Questionnaire, there were significant effects of condition, time, and their interaction.

    “revealed a significant effect for treatment condition, F (1, 69.78) = 7.30, p = .009, time, F (2, 66.36) = 22.14, p < .001, and their interaction, F (2, 66.35) = 5.60, p = .006.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Treatment credibility was not related to follow-up decreases in Y-BOCS in either condition, and post results showed the same pattern.

    “Credibility was not related to follow-up decreases in the Y-BOCS in either the PRT (Spearman's rho (31) = -.04, p = .83) or the ACT condition (Spearman's rho (30) = .07, p = .70). Post results showed the same pattern.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    For the Y-BOCS, there was a significant effect of time, no significant effect of condition, and a significant condition-by-time interaction.

    “There was a significant effect for time F (1, 80.64) = 115.54, p < .001, no effect for condition, F (1, 92.98) = 1.16, p = .28, and a significant interaction between condition and time, F (1, 80.64) = 5.15, p = .026.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    ACT improved significantly more on the TCQ than PRT from pre to post, with a trend toward greater improvement from pre to follow-up.

    “The interaction occurred because ACT participants improved significantly more from pre to post than did PRT participants (Estimated Mdiff = -6.67, SE = 2.12, t (72.51) = -3.14, p = .002, 95% CI: -10.90, -2.43, effect size = .75). There was a trend toward a difference from pre to follow-up (Estimated Mdiff = -4.56, SE = 2.59, t (75.70) = 1.77, p = .082, 95% CI: -9.72, .59, effect size = .42).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Using imputed values from person-specific growth curves, ACT had significantly more clinically significant responders than PRT at post (23/41 vs 7/38) and follow-up (27/41 vs 6/38).

    “Using these values the two conditions again differed at post (ACT: 23 of 41; PRT: 7 of 38; χ2 (1) = 10.30, p < .002, two-tailed, effect size = .77) and follow-up (ACT: 27 of 41; PRT: 6 of 38; χ2 (1) = 18.24, p < .001, two-tailed, effect size = 1.10).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Both conditions showed significant within-condition improvements on the AAQ from pre to post and pre to follow-up.

    “Within condition pre to post and pre to follow-up changes were significant: effect sizes were respectively .47 and .64 in the PRT condition and 1.06 and .86 in the ACT condition.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    For quality of life, there was no significant effect of condition, a significant effect of time, and a trend toward a condition-by-time interaction.

    “revealed a non-significant effect for condition, F (1, 66.53) = 2.41, p = .126, but a significant effect for time, F (2, 64.62) = 11.44, p < .001, and trend toward an interaction between condition and time, F (2, 64.62) = 2.99, p = .057.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    ACT participants showed an improving slope on the TAF moral subscale, while PRT participants did not.

    “ACT participants showed an improving slope (ACT: Estimate = -.86, SE = .16, t (71.93) = -5.32, p < .001) but PRT participants did not (PRT: Estimate = -.07, SE = .17, t (71.52) = -.46, p = .65).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    ACT had significantly more participants showing clinically significant improvement than PRT at post (19/41 vs 5/38) and follow-up (19/41 vs 7/38).

    “The two conditions differed at post (ACT: 19 of 41; PRT: 5 of 38; χ2 (1) = 10.27, p =.002, two-tailed, effect size = .77) and follow-up (ACT: 19 of 41; PRT: 7 of 38; χ2 (1) = 6.96, p < .009, two-tailed, effect size = .62).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Within-condition changes on the TCQ were significant in ACT at both pre-post and pre-follow-up, and in PRT at pre-follow-up but not pre-post.

    “Within condition pre to post and pre to follow-up changes were .31 (p = .071) and .40 (p = .022) in the PRT condition and .80 (p < .001) and .81 (p < .001) in the ACT condition.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    For the TAF likelihood subscale, there was no significant effect of condition, a significant effect of time, and a trend toward a condition-by-time interaction.

    “revealed a non-significant effect for treatment condition, F (1, 117.43) = 1.41, p = .24, and a significant effect for time, F (1, 135.78) = 18.94, p < .001, and a trend toward an interaction of condition and time, F (1, 135.78) = 3.33, p = .07, end point outcome effect size = .31.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    ACT improved significantly more on the AAQ than PRT from pre to post, but the conditions were equivalent from pre to follow-up.

    “The interaction occurred because ACT participants improved significantly more from pre to post than did PRT participants (Estimated Mdiff = -7.73, SE = 3.09, t (70.22) = -2.50, p = .015, 95% CI: -13.90, -1.957, effect size = .59), but the two conditions were equivalent from pre to follow-up (Estimated Mdiff = -3.11, SE = 3.40, t (67.89) = -.92, p = .36, 95% CI: -9.89, 3.66, effect size = .22).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § A randomized clinical trial of Acceptance and Commitment Therapy vs. Progressive Relaxation Training for obsessive compulsive disorder

    ERP and ERP with cognitive procedures are recognized as well-supported treatments that produce clinically significant benefit for most patients.

    “Exposure with ritual prevention (ERP) and ERP with cognitive procedures (ERP/CT) are recognized as well-supported treatment methods that have a clinically significant impact on the majority of patients (Abramowitz, Taylor, & MacKay, 2009; Fisher & Wells, 2005)”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Abramowitz, Taylor, & MacKay, 2009

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Fisher & Wells, 2005 source

  • May combine two claims.

    Premisecitation
    § A randomized clinical trial of Acceptance and Commitment Therapy vs. Progressive Relaxation Training for obsessive compulsive disorder

    In that multiple-baseline study, OCD severity shifted from clinical to nonclinical range, compulsions neared zero by treatment end, and gains held at follow-up.

    “OCD severity scores moved from the clinical to the nonclinical range and results showed near zero levels of compulsions by the end of treatment, with results maintained at follow-up.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Twohig, Hayes, & Masuda, 2006b

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Treatment assignment used a random sequence of concealed slips opened after consent by someone other than the assessors.

    “Treatment assignment was made by a random sequence of concealed slips, opened following the agreement to participate by a person other than the assessors (41 ACT, 38 PRT).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation
    § A randomized clinical trial of Acceptance and Commitment Therapy vs. Progressive Relaxation Training for obsessive compulsive disorder

    OCD is often complex, with most patients having comorbid mood, anxiety, or substance use disorders.

    “OCD tends to be a complex disorder with the majority of patients also having comorbid unipolar mood disorders, other anxiety disorders, or substance use disorders (Abramowitz et al., 2009)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Abramowitz et al., 2009

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisereasoning
    § A randomized clinical trial of Acceptance and Commitment Therapy vs. Progressive Relaxation Training for obsessive compulsive disorder

    ERP and ERP/CT are intensive treatments.

    “ERP and ERP/CT are intensive treatments.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    No participant openly refused after random assignment.

    “No participants overtly refused participation after random assignment.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § A randomized clinical trial of Acceptance and Commitment Therapy vs. Progressive Relaxation Training for obsessive compulsive disorder

    In a multiple-baseline study of four adults with OCD, eight weekly one-hour ACT sessions without in-session exposure significantly improved OCD severity, depression, and anxiety.

    “In a multiple baseline with four adults diagnosed with OCD (Twohig, Hayes, & Masuda, 2006b), eight weekly one-hour sessions of ACT without in-session exposure had a significant impact on OCD severity, depression, and anxiety.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Twohig, Hayes, & Masuda, 2006b

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisecitation
    § A randomized clinical trial of Acceptance and Commitment Therapy vs. Progressive Relaxation Training for obsessive compulsive disorder

    Exposure to a feared situation with sustained stay is generally therapeutic.

    “Merely the act of exposing oneself to a feared situation and staying in that situation for a meaningful period of time is generally therapeutic (Abramowitz, 1996)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Abramowitz, 1996 source

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    All randomized participants were included in the main analyses.

    “All randomized participants were included in the main analyses.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In this trial, Treatment Evaluation Inventory-Short Form alpha was .94.

    “In the present trial α =.94.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The ACT condition did not include in-session exposure exercises, and participants were not asked to approach feared stimuli or stay in their presence; treatment integrity ratings indicated that suggesting such activities outside session also never occurred.

    “ACT, as conducted in this trial, did not include in-session exposure exercises. ACT participants were not asked during treatment to approach a feared stimulus, including primary obsessions, and stay in its presence for a period of time. Based on treatment integrity ratings, suggesting that engaging in such activities would be helpful outside of session also never occurred.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Inter-rater reliability for ACT treatment integrity ratings was .94 (95% CI .90, .96) between master rater and rater 1 and .80 (95% CI .63, .90) between master rater and rater 2.

    “Inter-rater reliability across all domains assessed for integrity (described in detail below) was .94 (95% CI: .90, .96) between the master rater and rater 1 and .80 (95% CI: .63, .90) between the master rater and rater 2.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Fisher's exact tests found no significant between-condition differences in co-occurring disorders or OCD subtypes, except ACT had more symmetry/exactness concerns (p = .03).

    “Based on a Fisher's exact test none of these differences in co-occurring disorders or sub-types of OCD were significantly different (p < .05) between conditions except that those in the ACT condition had more concern with symmetry/exactness (p = .03).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The clinical significance analysis scored all refusals, dropouts, and missing data as unimproved and included them in the denominator, providing a full intent-to-treat analysis.

    “All refusals, dropouts, or missing data were scored as unimproved and included in the denominator, providing a full intent to treat analysis.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Minimal participation or passive dropout was low: 4 of 41 ACT participants (9.8%) and 5 PRT participants (13.2%) attended only 1 or 2 sessions.

    “The rates for minimal participation or passive dropout were similarly low; 4 of 41 (9.8%) ACT participants and 5 PRT participants (13.2%) attended only 1 or 2 sessions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationcitation

    The present study's duration is below the range found in the Abramowitz et al. (2009) review and represents 29-31% of the average duration of comparable protocols.

    “The present study is below the range of durations found in that review (or an earlier review by Fisher and Wells, 2005) and represents 29-31% of the average duration of comparable protocols.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Abramowitz et al., 2009

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Fisher and Wells, 2005 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The TCQ is widely used for OCD and anxiety-related disorders and has been shown to change with cognitive behavioral interventions.

    “This is a widely used measure of this construct for obsessive compulsive and anxiety related disorders and has been shown to change as a result of cognitive behavioral interventions (e.g., Reynolds & Wells, 1999).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Reynolds & Wells, 1999 source

  • May combine two claims.

    Interpretationreasoning

    The absence of exposure exercises may partly account for the good treatment acceptability results, and the present approach may offer an alternative for OCD when exposure has failed or is declined.

    “The absence of these exercises may in part account for the good results seen in treatment acceptability, and thus the present approach may offer an alternative approach to the treatment of OCD when exposure has failed or is declined.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The Y-BOCS has good interrater reliability for total scores (rs .80-.97) and two-week test-retest reliability (.81-.97).

    “The Y-BOCS has good interrater reliability for the total score (rs between .80 and .97) and two-week test-retest reliability between .81 and .97.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Goodman et al., 1989

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductown data

    Treatment refusal was very low: 1 of 41 ACT participants (2.4%) and 3 of 38 PRT participants (7.8%) did not attend Session 1.

    “In the present study no participants overtly refused treatment assignment; 1 participant of the 41 the ACT condition (2.4%) and 3 of the 38 in the PRT condition (7.8%) did not attend Session 1, indicating very low passive treatment refusal.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Entering treatment credibility, acceptability, and number of sessions as covariates did not change the primary outcomes; results generally became fractionally stronger in favor of ACT.

    “Entering treatment credibility, acceptability, and number of treatment sessions as covariates did not change the primary outcomes reported here (results generally became fractionally stronger in favor of ACT).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The BDI-II has shown good internal consistency and high test-retest reliability.

    “The BDI-II has shown good internal consistency, and high test-retest reliability.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Beck, 1996

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductown data

    PRT therapists' overall adherence to the manual and overall competence were highly rated (M = 4.60, SD = .73 and M = 4.65, SD = .57, respectively).

    “On a five-point scale, PRT therapists’ overall adherence to the manual and overall competence were highly rated (M = 4.60, SD = .73 and M = 4.65, SD = .57 respectively).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In this trial, QOLS alpha was .89.

    “In the present trial α =.89.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In this trial, AAQ alpha was .74.

    “In the present trial α =.74.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In this trial, TAFS alpha was .92, moral subscale alpha .91, and likelihood subscale alpha .95.

    “In the present trial α =.92; TAF moral subscale α = .91; TAF likelihood subscale α = .95.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The QOLS has shown internal consistency (alpha .89-.92) and good temporal stability (rs .78-.84 over three weeks).

    “It has been found to be internally consistent (αs between .89 and .92), with good temporal stability (rs between .78 to .84 over three weeks) (Burckhardt et al., 1989).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Burckhardt et al., 1989 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In this trial, BDI-II alpha was .90.

    “In the present trial α =.90.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The TCQ has good test-retest reliability (r = .83).

    “Test-retest reliability is good (r =.83).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wells & Davies, 1994 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Kappa above .70 has been found for most clinical disorders, and SCID validity is generally noted from its similarity to the DSM.

    “In general, Kappa > .70 has been found for most clinical disorders and validity is generally noted based on the SCID's similarity to the DSM (Summerfeldt & Antony, 2004).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Summerfeldt & Antony, 2004

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationown data

    The tested ACT for OCD protocol is notable for its short duration (8 one-hour sessions) and for the efficiency of results per unit of effort.

    “The ACT for OCD protocol that was tested in this investigation is perhaps most notable for its short duration (8 one-hour sessions), and thus, for the efficiency of the results produced on a per unit of effort basis.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In this trial, Y-BOCS Cronbach's alpha at pretreatment was .79.

    “In the present trial Cronbach's α at pre was .79.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In this trial, TCQ alpha was .82.

    “In the present trial α =.82.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The SCID is considered the gold standard for psychiatric diagnosis and has shown largely consistent diagnostic reliability across studies.

    “The SCID is considered the gold standard in psychiatric diagnosis and has shown largely consistent diagnostic reliability across studies (Segal, Hersen, & Van Hasselt, 1994).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Segal, Hersen, & Van Hasselt, 1994 source

  • May combine two claims.

    Study design and conductown data

    Inter-rater reliability for PRT treatment integrity ratings was .98 (95% CI .93, .98) between master rater and rater 1 and .95 (95% CI .82, .96) with rater 2.

    “Inter-rater reliability across all domains assessed for integrity (described in detail below) between the master rater and rater 1 was .98 (95% CI: .93, .98), and rater 2 was .95 (95% CI: .82, .96).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The PRT protocol was briefer than suggested by its authors.

    “Also, the PRT protocol was briefer than suggested by the authors (Bernstein et al., 2000).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bernstein et al., 2000

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    ACT researchers have argued that ACT is an exposure-based approach, and doing exposure procedurally within ACT is generally suggested for anxiety disorders.

    “ACT researchers have long argued that ACT is an exposure based approach (see Hayes, 1987) and doing exposure in a procedural sense within an ACT approach is generally suggested for anxiety disorders (Eifert & Forsyth, 2005), even though it was eschewed for strategic reasons in the present study.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Hayes, 1987

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Eifert & Forsyth, 2005

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Premisenone given

    In an ACT model, repertoire-narrowing stimuli include not only external events but also fused thoughts, avoided emotions, and experiences that induce inflexible attentional processes.

    “In an ACT model, these repertoire narrowing stimuli are not just external events, but also fused thoughts, avoided emotions, experiences that induce inflexible attentional processes, and so on.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Preliminary data indicate that ACT methods can make exposure more acceptable and less aversive in individuals with panic disorder.

    “There are some preliminary data that ACT methods can make exposure more acceptable and less aversive in individuals diagnosed with panic disorder (Levitt et al., 2004), and the same might be true with OCD.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Levitt et al., 2004 source

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    The absence of in-session exposure in a procedural sense does not mean that exposure in a broader sense was unimportant to the results.

    “The absence of in-session exposure in a procedural sense does not mean that exposure in a broader sense was unimportant to the results seen.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Study design and conductreasoning

    The ACT and PRT conditions could have been matched better if PRT participants had been asked to use relaxation in response to obsessions, as ACT participants used ACT strategies when obsessions were present.

    “Also, the ACT and PRT conditions could have been matched better if the participants in the PRT condition were asked to use relaxation in response to obsessions because ACT participants used ACT strategies when obsessions were present.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Assessors were blinded, but penetration of the blind was not formally assessed.

    “Assessors were blinded, but penetration of the blind was not formally assessed.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The sample was not ethnically diverse (88.6% Caucasian), so extension of results in this area should be done with caution.

    “It should also be noted that the sample drawn for this investigation was not ethnically diverse (88.6% Caucasian), thus, extension of the present results in this area should be done with caution.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    ACT looks promising as a treatment for OCD, but much more work is needed.

    “ACT looks promising as a treatment for OCD, but clearly much more work is needed to develop this approach.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationown data

    The values-based actions in this study might be little more than a procedural variant of exposure, but if so, it appears to be one with very high acceptability.

    “This might be little more than a procedural variant of exposure–if so, it appears to be one with a very high level of acceptability.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    ACT theory views exposure as organized, values-based contact with previously repertoire-narrowing stimuli to produce greater psychological flexibility.

    “At the level of process, ACT theory views exposure as organized, values-based contact with previously repertoire narrowing stimuli for the purpose of producing greater psychological flexibility (Hayes, Strosahl, & Wilson, in press).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Hayes, Strosahl, & Wilson, in press

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductnone given

    The quality of life measure was entirely self-report, and the main outcome measure, while externally rated, focused entirely on symptom severity.

    “The quality of life measure was entirely self-report and the main outcome measure, while externally rated, was entirely focused on symptom severity.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Because the same assessor was used for all participants at all time points, participants were not blind to the timing of assessments.

    “Additionally, because the same assessor was used for all participants at all time points to maintain consistency in assessments, the participants were not blind to the timing of assessments.”
    Quote in the paperNot a substantial claim
73 of 73

  • The paper relies on this without support.

    At the time of the study, no randomized controlled trial of ACT for OCD had been published.

    “To date, however, there is no published randomized controlled trial on ACT for OCD.”

  • The paper relies on this without support.

    For many participants, compulsions interfered with living according to one or more valued domains.

    “For many participants, engaging in compulsions had been a barrier to living in accordance with one or more valued domains.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Case studies, multiple-baseline studies, and a single randomized trial provide early evidence that ACT is effective for anxiety disorders.

    “Case studies, multiple-baseline treatment studies and a single randomized clinical trial provide nascent evidence that ACT is an effective treatment for anxiety disorders”

    From Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders (2012) · cites this paper as Twohig et al., 2010

    The Introduction (page not provided) describes a prior multiple-baseline study in four adults with OCD, and the Discussion (page not provided) reports that this randomized trial found greater improvement in OCD symptoms with ACT than with progressive relaxation training. The paper does not establish the claimed case-study evidence or effectiveness across anxiety disorders generally; its trial findings concern OCD. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Some data suggest that conventional CBT and ABBT produce comparable decreases in EA.

    “On the other hand, there is some evidence that traditional CBT is as effective as ABBT in reducing EA (Arch et al., 2012b; Twohig et al., 2010), which suggests that EA could be considered as a common mechanism.”

    From Reductions in experiential avoidance as a mediator of change in symptom outcome and quality of life in acceptance-based behavior therapy and applied relaxation for generalized anxiety disorder (2016) · cites this paper as Twohig et al., 2010

    The Method’s Process Results report significant improvement on the Acceptance and Action Questionnaire in both groups and no significant difference between them from pretreatment to follow-up. But this trial compared ACT with progressive relaxation training, not traditional CBT; ACT also improved significantly more than relaxation training immediately after treatment. It therefore does not establish comparable reductions in experiential avoidance with CBT and ABBT. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Acceptance and commitment therapy is effective for treating OCD, as are mindfulness-based interventions.

    “ACT, of which psychological flexibility/inflexibility is a process of change, is effective for treating OCD, as are mindfulness-based interventions (Bluett et al., 2014;Chien et al., 2022;Twohig et al., 2010).”

    From A pilot study of experiencing racial microaggressions, obsessive-compulsive symptoms, and the role of psychological flexibility (2023) · cites this paper as Twohig et al., 2010

    The Discussion reports greater improvement in OCD symptoms with ACT than with progressive relaxation training, and the paper describes psychological flexibility as an ACT process. The Method section says the ACT protocol included mindfulness exercises, but the study did not evaluate mindfulness-based interventions as separate treatments for OCD, so it does not support that part of the sentence. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Greater increases in decentering were found across ACT relative to CBT or relaxation training, but findings are equivocal with others reporting non-significant effects of intervention-type on decentering.

    “Greater increases in decentering were found across ACT relative to CBT73,89 or relaxation training80.”

    From Decentering as a core component in the psychological treatment and prevention of youth anxiety and depression: a narrative review and insight report (2021) · cites this paper as [80]

    The Method’s Process Results report greater pre-to-post improvement with ACT than with progressive relaxation training on psychological flexibility and thought-control measures. The ACT protocol describes exercises resembling decentering, but the paper does not report a decentering measure or a comparative increase in decentering itself. This verdict concerns the relaxation-training comparison; the cited paper did not compare ACT with CBT. (LLM, conf=0.77)

    Experimental — accuracy not yet measured

  • The current intervention is founded on Acceptance and Commitment Therapy (ACT), which has demonstrated efficacy for treating anxiety.

    “The current intervention is founded on a theory-driven, evidence-based behavioral approach, Acceptance and Commitment Therapy (ACT), with demonstrated efficacy for treating anxiety [49–53].”

    From A randomized controlled trial of a group acceptance-based intervention for cancer survivors experiencing anxiety at re-entry ('Valued Living'): Study protocol (2019) · cites this paper as [51]

    The Introduction describes ACT as a theory-driven approach to anxiety, and the Primary Outcome: Y-BOCS section reports significantly greater improvement with ACT than with progressive relaxation training. But this trial studied adults with obsessive-compulsive disorder; it does not establish efficacy for treating anxiety broadly. Page numbers are unavailable in our copy. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

Statistics that don’t add up

Each reported p-value recomputed from its test statistic and degrees of freedom.

  • Inconsistent p-value: χ2 (1) = 10.27, p = .002

    Minor

    The paper reports p = .002 here; recomputing from the test statistic and its degrees of freedom gives p = .001. The check cannot tell whether the statistic or the p-value is the misprint.

    Reported p = .002 · recomputed p = .001

1 of 1

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Doesn’t add upχ²(1) = 10.27reported p = .002 · recomputed p = .001

    “χ2 (1) = 10.27, p = .002”

  • ConsistentF(1, 80.64) = 115.54reported p < .001 · recomputed p < .001

    “F (1, 80.64) = 115.54, p < .001”

  • ConsistentF(1, 92.98) = 1.16reported p = .28 · recomputed p = .284

    “F (1, 92.98) = 1.16, p = .28”

  • ConsistentF(1, 80.64) = 5.15reported p = .026 · recomputed p = .026

    “F (1, 80.64) = 5.15, p = .026”

  • Consistentt(80.9) = -9.4reported p < .001 · recomputed p < .001

    “t (80.90) = -9.40, p < .001”

  • Consistentt(80.4) = -5.88reported p < .001 · recomputed p < .001

    “t (80.40) = -5.88, p < .001”

  • Consistentt(80.64) = 2.27reported p = .026 · recomputed p = .026

    “t (80.64) = 2.27, p = .026”

  • Consistentχ²(1) = 6.96reported p < .009 · recomputed p = .008

    “χ2 (1) = 6.96, p < .009”

  • Consistentχ²(1) = 10.3reported p < .002 · recomputed p = .001

    “χ2 (1) = 10.30, p < .002”

  • Consistentχ²(1) = 18.24reported p < .001 · recomputed p < .001

    “χ2 (1) = 18.24, p < .001”

  • ConsistentF(1, 55.32) = 0.35reported p = .56 · recomputed p = .557

    “F (1, 55.32) = .35, p = .56”

  • ConsistentF(2, 69.63) = 44.14reported p < .001 · recomputed p < .001

    “F (2, 69.63) = 44.14, p < .001”

  • ConsistentF(2, 69.63) = 5.61reported p = .006 · recomputed p = .005

    “F (2, 69.63) = 5.61, p = .006”

  • Consistentt(59.65) = -3.23reported p = .002 · recomputed p = .002

    “t (59.65) = -3.23, p = .002”

  • Consistentt(62.82) = -2.06reported p = .044 · recomputed p = .044

    “t (62.82) = -2.06, p = .044”

  • ConsistentF(1, 66.53) = 2.41reported p = .126 · recomputed p = .125

    “F (1, 66.53) = 2.41, p = .126”

  • ConsistentF(2, 64.62) = 11.44reported p < .001 · recomputed p < .001

    “F (2, 64.62) = 11.44, p < .001”

  • ConsistentF(2, 64.62) = 2.99reported p = .057 · recomputed p = .057

    “F (2, 64.62) = 2.99, p = .057”

  • Consistentt(63.49) = 0.06reported p = .96 · recomputed p = .952

    “t (63.49) = .06, p = .96”

  • Consistentt(70.22) = 1.96reported p = .054 · recomputed p = .054

    “t (70.22) = 1.96, p = .054”

  • ConsistentF(1, 69.78) = 7.3reported p = .009 · recomputed p = .009

    “F (1, 69.78) = 7.30, p = .009”

  • ConsistentF(2, 66.36) = 22.14reported p < .001 · recomputed p < .001

    “F (2, 66.36) = 22.14, p < .001”

  • ConsistentF(2, 66.35) = 5.6reported p = .006 · recomputed p = .006

    “F (2, 66.35) = 5.60, p = .006”

  • Consistentt(70.22) = -2.5reported p = .015 · recomputed p = .015

    “t (70.22) = -2.50, p = .015”

  • Consistentt(67.89) = -0.92reported p = .36 · recomputed p = .361

    “t (67.89) = -.92, p = .36”

  • ConsistentF(1, 77.28) = 3.18reported p = .079 · recomputed p = .078

    “F (1, 77.28) = 3.18, p = .079”

  • ConsistentF(2, 70.43) = 17.88reported p < .001 · recomputed p < .001

    “F (2, 70.43) = 17.88, p < .001”

  • ConsistentF(2, 70.43) = 5.11reported p = .008 · recomputed p = .008

    “F (2, 70.43) = 5.11, p = .008”

  • Consistentt(72.51) = -3.14reported p = .002 · recomputed p = .002

    “t (72.51) = -3.14, p = .002”

  • Consistentt(75.7) = 1.77reported p = .082 · recomputed p = .081

    “t (75.70) = 1.77, p = .082”

  • ConsistentF(1, 76.34) = 1.25reported p = .27 · recomputed p = .267

    “F (1, 76.34) = 1.25, p = .27”

  • ConsistentF(1, 71.72) = 16.32reported p < .001 · recomputed p < .001

    “F (1, 71.72) = 16.32, p < .001”

  • ConsistentF(1, 71.72) = 11.39reported p = .001 · recomputed p = .001

    “F (1, 71.72) = 11.39, p = .001”

  • Consistentt(71.93) = -5.32reported p < .001 · recomputed p < .001

    “t (71.93) = -5.32, p < .001”

  • Consistentt(71.52) = -0.46reported p = .65 · recomputed p = .647

    “t (71.52) = -.46, p = .65”

  • ConsistentF(1, 117.43) = 1.41reported p = .24 · recomputed p = .237

    “F (1, 117.43) = 1.41, p = .24”

  • ConsistentF(1, 135.78) = 18.94reported p < .001 · recomputed p < .001

    “F (1, 135.78) = 18.94, p < .001”

  • ConsistentF(1, 135.78) = 3.33reported p = .07 · recomputed p = .070

    “F (1, 135.78) = 3.33, p = .07”

  • Consistentt(135.54) = -4.46reported p < .001 · recomputed p < .001

    “t (135.54) = -4.46, p < .001”

  • Consistentt(136) = -1.75reported p = .082 · recomputed p = .082

    “t (136.00) = -1.75, p = .082”

  • Consistentt(65) = 3.57reported p = .001 · recomputed p < .001

    “t (65) = 3.57, p = .001”

  • ConsistentF(1, 64) = 5.25reported p = .025 · recomputed p = .025

    “F (1,64) = 5.25, p = .025”

42 of 42

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Sample size by sex does not match reported participant total

    Major

    The abstract says 79 adults participated and 66% were female, but the participant section gives 61% women in the study. These percentages cannot both describe the same sample unless the denominator or one of the percentages is different.

  • Comorbidity percentage conflicts with diagnosis counts

    Minor

    The listed counts total 36 participants with at least one additional diagnosis, or about 46% of the 79 participants, rather than the stated 51%.

  • Two different percentages are given for female participants

    Minor

    The abstract reports 66% female participants, while the participant description reports 61% for the same study sample.

  • Thought-control test statistic has the wrong sign

    Minor

    The reported negative estimated difference divided by its positive standard error gives a negative t statistic, not the positive statistic printed for the follow-up comparison.

    Reported 1.77 · recomputed -1.760618

4 of 4

Cites

Flagged first, then by citations

2 of the 49 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H., & Woidneck, M. R.
Affiliations
  • Utah State University (US)
  • University of Nevada, Reno (US)
ORCID
Venue
Journal of Consulting and Clinical Psychology
Publisher
American Psychological Association (APA)
Published
2010-10
Volume
78
Issue
5
Pages
705-716
ISSN
  • 0022-006X (ISSN-L)
  • 1939-2117
DOI
10.1037/a0020508
PMC
PMC2948415
OpenAlex
W2132781604
Cited by
434
References
49
Citations by year
2026: 16 · 2025: 39 · 2024: 26 · 2023: 31 · 2022: 24 · 2021: 27 · 2020: 17 · 2019: 31 · 2018: 25 · 2017: 33 · 2016: 16 · 2015: 25 · 2014: 32 · 2013: 31 · 2012: 38
FWCI
31.17
Type
journal article
Language
en
Open access
Locations
  • Journal of Consulting and Clinical Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Digital Commons - USU (Utah State University) (submittedVersion)
Funders
National Institute of Mental Health (R21 MH074968)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
obsessive-compulsive disorder, acceptance and commitment therapy, progressive muscle relaxation, cognitive behavioral therapy, depression, quality of life, thought-action fusion, thought control, treatment refusal, dropout
MeSH terms
Adaptation, Psychological, Adolescent, Adult, Aged, Anxiety, Awareness, Depressive Disorder, Fear, Female, Follow-Up Studies, Humans, Implosive Therapy, Male, Middle Aged, Obsessive-Compulsive Disorder, Personality Inventory, Psychometrics, Quality of Life, Relaxation Therapy, Reproducibility of Results, Comorbidity, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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