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Inference-Based Cognitive Behavior Therapy May Beat Traditional Approach for Obsessive-Compulsive Disorder: Presented at ADAA
By Alison Palkhivala
TORONTO, ON -- April 1, 2003 -- A cognitive behavior therapy (CBT) approach that focuses on the inferences behind patients' obsessions and compulsions may be more effective than traditional CBT in selected patients with obsessive-compulsive disorder.
Kieron O'Connor, PhD, and colleagues from the Centre de Recherche Fernand-Séguin, Montreal, Quebec, Canada, randomly assigned 44 patients with obsessive-compulsive disorder to one of three treatment modalities: exposure and response prevention, cognitive therapy based on an appraisal model, or CBT directly addressing patients initial inferences, called an inference-based approach.
Results were presented here in a poster on March 29th at the 23rd Annual Conference of the Anxiety Disorders Association of America.
According to the authors, an inference-based approach "directly addresses and challenges the reasoning processes of the client that lead up to the primary inference (or intrusion)," which forms the basis of the obsessive compulsive symptoms. An example of such an inference is, "I may be contaminated by invisible forces".
All participants improved as measures of the Yale-Brown Obsessive Compulsive Scale (Y-Bocs), Padua Inventory, and Duration of Symptoms and Disturbance (DIS) diary scores following treatment.
All treatment modalities were equally effective. However, patients who had a strong conviction of the primary inferences underlying their disorder had better response to the inference-based approach than to traditional CBT based on results of Y-Bocs (P<0.043) and the Padua Inventory (P=0.014).
The inference-based approach was also more effective than traditional therapy at changing the degree of conviction associated with primary and secondary inferences among patients whose primary inferences were initially very high.
The authors concluded that an inference-based approach to treatment of obsessive-compulsive disorder "may be particularly helpful where initial intrusions (or inferences) are bizarre or when obsessional convictions are strong, as in the case of overvalued ideas."
[Study title: Evaluation of an Inference Based Approach to Treating Obsessive-Compulsive Disorder. Abstract p64]
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