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Patient adherence predicts outcome from cognitive behavioral therapy in obsessive-compulsive disorder
Open accessAbstract
OBJECTIVE: To examine the effects of patient adherence on outcome from exposure and response prevention (EX/RP) therapy in adults with obsessive-compulsive disorder (OCD). METHOD: Thirty adults with OCD were randomized to EX/RP (n = 15) or EX/RP augmented by motivational interviewing strategies (n = 15). Both treatments included 3 introductory sessions and 15 exposure sessions. Because there were no significant group differences in adherence or outcome, the groups were combined to examine the effects of patient adherence on outcome. Independent evaluators assessed OCD severity using the Yale-Brown Obsessive Compulsive Scale. Therapists assessed patient adherence to between-session EX/RP assignments at each session using the Patient EX/RP Adherence Scale (PEAS). Linear regression models were used to examine the effects of PEAS scores on outcome, adjusting for baseline severity. The relationship between patient adherence and other predictors of outcome was explored using structural equation modeling. RESULTS: Higher average PEAS ratings significantly predicted lower posttreatment OCD severity in intent-to-treat and completer samples. PEAS ratings in early sessions (5-9) also significantly predicted posttreatment OCD severity. The effects of other significant predictors of outcome in this sample (baseline OCD severity, hoarding subtype, and working alliance) were fully mediated by patient adherence. CONCLUSIONS: Patient adherence to between-session EX/RP assignments significantly predicted treatment outcome, as did early patient adherence and change in early adherence. Patient adherence mediated the effects of other predictors of outcome. Future research should develop interventions that increase adherence and then test whether increasing adherence improves outcome. If effective, these interventions could then be used to personalize care.
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“as patient treatment adherence is a known predictor of EX/RP response (27)”
From Task-based fMRI predicts response and remission to exposure therapy in obsessive-compulsive disorder (2019) · cites this paper as [27]
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“Treatment adherence is among the strongest known predictors of EX/RP response (27)”
From Task-based fMRI predicts response and remission to exposure therapy in obsessive-compulsive disorder (2019) · cites this paper as [27]
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Cites
Hamilton, M. (1960) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.23.1.56 · Cited by 32,817
SPSS and SAS procedures for estimating indirect effects in simple mediation models
Preacher, K. J., & Hayes, A. F. (2004) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03206553 · Cited by 17,383
(1976) · Medical Entomology and Zoology · Cited by 8,899
Emotional processing of fear: Exposure to corrective information.
Foa, E. B., & Kozak, M. J. (1986) · Psychological Bulletin · doi:10.1037/0033-2909.99.1.20 · Cited by 5,396
Self-citationDepartment of Health, Education, and Welfare.
Cooper, T. (1976) · Military Medicine · doi:10.1093/milmed/141.8.521 · Cited by 4,617
Development and validation of the working alliance inventory
Horvath, A. O., & Greenberg, L. S. (1989) · Journal of Counseling Psychology · doi:10.1037//0022-0167.36.2.223 · Cited by 3,520
The Yale-Brown Obsessive Compulsive Scale: II. Validity
Goodman, W. K. (1989) · Archives of General Psychiatry · doi:10.1001/archpsyc.1989.01810110054008 · Cited by 2,799
Psychometric properties of the credibility/expectancy questionnaire
Devilly, G. J., & Borkovec, T. D. (2000) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(00)00012-4 · Cited by 2,295
(1993) · PubMed · Cited by 1,900
Ostwald, P. F. (1960) · American Journal of Psychotherapy · doi:10.1176/appi.psychotherapy.1960.14.4.817 · Cited by 1,422
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Research works printed but not linked: 1
- First MB Spitzer RL Gibbon M Williams JB 1996 Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition New York, NY Biometrics Research Department, New York State Psychiatric Institute
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Items 201–217 of 217
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Lu, D. (2024) · Lecture Notes in Education Psychology and Public Media · doi:10.54254/2753-7048/48/20231501
Barber, K. E., Woods, D. W., Twohig, M. P., Saunders, S. M., Compton, S. N., & Franklin, M. E. (2025) · Behavior Therapy · doi:10.1016/j.beth.2025.01.003
Self-citationSonneveldt, I. J., Wolf, N., van Balkom, A. J. L. M., van Enckevort, L., van Genugten, C., Kampman, M., van Oppen, P., van Straten, A., Toffolo, M. B. J., & Visser, H. A. D. (2025) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2025.100936
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İnözü, M., Kargı, B., Üzümcü, E., Eroğlu, E. Ö., Usta, E., Durmuş, D. C., Tulek, G., Tulek, C., Topcu, Y., & Yıldız, M. E. (2025) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70128
Kim, H., Tyler, J., Wheaton, M. G., Park, S., Woo, C., Foa, E. B., & Simpson, H. B. (2025) · Psychological Medicine · doi:10.1017/s0033291725101906 · Cited by 1
Self-citationDíaz, D. E., Norman, L. J., Block, S. R., Iturra-Mena, A. M., Phan, K. L., Monk, C. S., & Fitzgerald, K. D. (2025) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2025.12.005
Bilevicius, E., Single, A. N., Baumgartner, C., Bui, V., Kempe, T., Schaub, M. P., Stewart, S. H., MacKillop, J., Hodgins, D. C., Wardell, J. D., et al. (2020) · Figshare · doi:10.6084/m9.figshare.13266006
Díaz, D. E., Becker, H. C., Hardi, F. A., Beltz, A. M., Bilek, E. L., Block, S. R., Phan, K. L., Monk, C. S., & Fitzgerald, K. D. (2026) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.64898/2026.01.28.26345061
Grimaldi, S. J., McManus, H., Alschuler, D. M., Mackey, B., Tyler, J., Galfalvy, H., Foa, E. B., & Simpson, H. B. (2026) · Behavior Therapy · doi:10.1016/j.beth.2026.04.001
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Ward, H. E., Moran-Meder, E., & McKay, D. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-29009-1.00140-2
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Metadata
- Authors
- Simpson, H. B., Maher, M. J., Wang, Y., Bao, Y., Foa, E. B., & Franklin, M.
- Affiliations
- Columbia University (US)
- New York State Psychiatric Institute (US)
- University of Pennsylvania (US)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2011-04
- Volume
- 79
- Issue
- 2
- Pages
- 247-252
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC3891521
- OpenAlex
- W1987664345
- Cited by
- 217
- References
- 28
- Citations by year
- 2026: 9 · 2025: 11 · 2024: 13 · 2023: 13 · 2022: 14 · 2021: 13 · 2020: 60 · 2019: 11 · 2018: 12 · 2017: 9 · 2016: 9 · 2015: 15 · 2014: 10 · 2013: 11 · 2012: 7
- FWCI
- 9.64
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R34 MH071570)
- National Alliance for Research on Schizophrenia and Depression
- 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 › Psychotherapy Techniques and Applications
- Keywords
- obsessive-compulsive disorder, patient adherence, exposure and response prevention, cognitive behavioral therapy, motivational interviewing, treatment outcomes, prognostic factors, mediation, therapeutic relationship, Yale-Brown Obsessive Compulsive Scale
- MeSH terms
- Adult, Female, Humans, Male, Middle Aged, Motivation, Obsessive-Compulsive Disorder, Patient Compliance, Severity of Illness Index, Cognitive Behavioral Therapy, Linear Models, Treatment Outcome
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