Effects of acceptance-based strategies on psychological responses to disorder-relevant stimuli in inpatients with obsessive–compulsive disorder: An experimental study

• DOI: 10.1016/j.jbtep.2023.101890
• Publication Date: 2023-07-05T06:01:13Z
• Authors: David R. Kolar; Adrian Meule; Eva M. Zisler; Caroline Schwartz; Ulrich Voderholzer
• Keywords: Exposure therapy

Preliminary findings suggest that Acceptance and Commitment Therapy-informed exposure therapy may be an effective treatment for obsessive–compulsive disorder (OCD). However, there is a lack of experimental studies that have examined immediate effects of acceptance-based strategies during exposure to disorder-relevant stimuli in persons with OCD. Thus, we tested this in 53 inpatients (64% female) with OCD. Compared to passively viewing pictures relevant to obsessive–compulsive washing, applying acceptance-based strategies lead to less unpleasantness of patients’ current feelings. Acceptance-based strategies also lead to reduced strength of obsessions and urge to perform compulsions but only when compared to a classical exposure condition during which patients were instructed to intensify their current feelings. Higher self-reported OCD symptom severity related to higher unpleasantness and strength of obsessions, particularly in the passive viewing condition. Results indicate that acceptance-based strategies during cue exposure immediately increase acceptance of and reduce unpleasant feelings. In line with the rationale of acceptance-based treatment approaches, which do not aim at immediate disorder-specific symptom reductions, effects on obsessions and compulsions may be more delayed or require repeated training sessions.