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Evaluation of an inference-based approach to treating obsessive–compulsive disorder
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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“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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da Matta, R. M., & Ramos, D. G. (2020) · PSYCHOLOGIA · doi:10.2117/psysoc.2020-b009 · Cited by 1
Yan, J., Wen, F., Yu, L., Wang, F., Liu, J., Wang, M., Cui, Y., & Li, Y. (2020) · doi:10.21203/rs.3.rs-37399/v1 · Cited by 1
Katzman, M. A., Bleau, P., Blier, P., Chokka, P. R., Kjernisted, K. D., & Ameringen, M. V. (2021) · doi:10.32920/14638581.v1 · Cited by 1
Bibliography: Key IBA Publications and Other References
O’Connor, K. P., & Aardema, F. (2011) · doi:10.1002/9781119960027.biblio
Self-citationReasoning processes in the development and maintenance of obsessive-compulsive disorder
Aardema, F. (2005) · UvA-DARE (University of Amsterdam)
Self-citationDe Inference Based Approach: ontwarren van verbeelding en werkelijkheid bij obsessies
Visser, H. A. D. (2009) · GZ - Psychologie · doi:10.1007/s41480-009-0006-z
Yager, E. (2018) · Journal of Psychology Research · doi:10.17265/2159-5542/2018.06.001
Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder and Associated Disorders
Todd, G., & Branch, R. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108355605.013
Burns, W. J., Rey, J., & Burns, K. A. (2009) · Springer eBooks · doi:10.1007/978-0-387-09757-2_40
Treatment for OCD and Their Effectiveness
Lu, D. (2024) · Lecture Notes in Education Psychology and Public Media · doi:10.54254/2753-7048/48/20231501
Metadata
- 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
- 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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