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Cited by 109Obsessive-Compulsive Spectrum DisordersAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychoanalysis and Psychopathology Research

Evaluation of an inference-based approach to treating obsessive–compulsive disorder

O'Connor, K. P., Aardema, F., Bouthillier, D., Fournier, S., Guay, S., Robillard, S., Pélissier, M. C., Landry, P. +3 more·2005·Cognitive Behaviour Therapy
DOI 10.1080/16506070510041211
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Abstract

This study evaluated an inference-based approach (IBA) to the treatment of obsessive-compulsive disorder (OCD) by comparing its efficacy with a treatment based on the cognitive appraisal model (CAM) and exposure and response prevention (ERP). IBA considers initial intrusions in OCD (e.g. "Maybe the door is open", "My hands could be dirty") as idiosyncratic inferences about possible states of affairs arrived at through inductive reasoning. In IBA such primary inferences represent the starting point of obsessional doubt, and the reasoning maintaining the doubt forms the focus for therapy. This is unlike CAM, which regards appraisals of intrusions as the maintaining factors in OCD. Fifty-four OCD participants, of whom 44 completed, were randomly allocated to CAM, ERP or IBA. After 20 weeks of treatment all groups showed a significant reduction in scores on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Padua Inventory. Participants with high levels of obsessional conviction showed greater benefit from IBA than CAM. Appraisals of intrusions changed in all treatment conditions. Strength of primary inference was not correlated with symptom measures except in the case of strong obsessional conviction. Strength of primary inference correlated significantly with the Y-BOCS insight item. Treatment matching for high and low conviction levels to IBA and CAM, respectively, may optimize therapy outcome.

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Crossref · 10.1080/16506070510041211

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  • Majority of trials comparing CBT to ERP found no differences between modalities in symptom reduction.

    “the majority of the trials comparing CBT to ERP have found no differences between these two modalities in terms of symptom reduction (Emmelkamp & Beens, 1991; O’Connor et al., 2005; Vogel et al., 2004; Whittal et al., 2005).”

    From An update on the efficacy of psychological treatments for obsessive-compulsive disorder in adults (2013) · cites this paper as O’Connor et al., 2005

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Authors
O'Connor, K. P., Aardema, F., Bouthillier, D., Fournier, S., Guay, S., Robillard, S., Pélissier, M. C., Landry, P., Todorov, C., Tremblay, M., & Pitre, D.
Affiliations
  • Hôpital du Sacré-Cœur de Montréal (CA)
  • Institut universitaire en santé mentale de Montréal (CA)
  • Hôpital Notre-Dame (CA)
ORCID
Venue
Cognitive Behaviour Therapy
Publisher
Informa UK Limited
Published
2005-09-05
Volume
34
Issue
3
Pages
148-163
ISSN
  • 1650-6073 (ISSN-L)
  • 1651-2316
DOI
10.1080/16506070510041211
OpenAlex
W1980764277
Cited by
109
References
55
Citations by year
2026: 6 · 2025: 3 · 2024: 7 · 2023: 3 · 2022: 5 · 2021: 8 · 2020: 6 · 2019: 3 · 2018: 6 · 2017: 5 · 2016: 5 · 2015: 6 · 2014: 9 · 2013: 5 · 2012: 4
FWCI
5.01
Type
journal article
Language
en
Open access
closed
Locations
  • Cognitive Behaviour Therapy (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Yale University
  • Fonds de recherche du Québec
  • Fonds de Recherche du Québec - Santé
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, exposure and response prevention, intrusive thoughts, inductive reasoning, treatment matching, treatment outcomes
MeSH terms
Adult, Analysis of Variance, Desensitization, Psychologic, Female, Follow-Up Studies, Humans, Male, Obsessive-Compulsive Disorder, Thinking, Cognitive Behavioral Therapy

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