The treatment of obsessive-compulsive checking: A randomised trial comparing danger ideation reduction therapy with exposure and response prevention

Authors

  • Lisa D. Vaccaro,

    1. Discipline of Behavioural and Social Sciences in Health, The University of Sydney, Sydney, New South Wales, Australia
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  • Mairwen K. Jones,

    1. Discipline of Behavioural and Social Sciences in Health, The University of Sydney, Sydney, New South Wales, Australia
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  • Ross G. Menzies,

    Corresponding author
    1. Discipline of Behavioural and Social Sciences in Health, The University of Sydney, Sydney, New South Wales, Australia
    • Correspondence

      Ross Menzies, Discipline of Behavioural and Social Sciences in Health, University of Sydney, East Street Lidcombe, Sydney, NSW 2141, Australia.

      Email: ross.menzies@sydney.edu.au

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  • Bethany M. Wootton

    1. Department of Psychology, Centre for Emotional Health, Macquarie University, North Ryde, New South Wales, Australia
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  • Funding: This study was funded by a National Health and Medical Research Council (NHMRC) project grant and approved by the University of Sydney Human Research and Ethics Committee.
  • Conflict of interest: None.

Abstract

Standard psychological treatment of obsessive-compulsive disorder (OCD) typically involves the behavioural-based therapy exposure and response prevention (ERP). This study compared the effectiveness of ERP with the recently developed cognitive therapy-based treatment package, Danger Ideation Reduction Therapy for obsessive-compulsive checkers (DIRT-C) (Vaccaro, Jones, Menzies, and St Clare). Both treatments were delivered in 14 1-hr individual weekly sessions. Post-treatment intention-to-treat analysis revealed large statistically significant improvements for participants in both ERP (n = 22) and DIRT-C (n = 28) conditions. However, treatment effect sizes for change in OCD symptom severity at post-treatment were greater for DIRT-C than for ERP (3.74 versus 2.89). In addition, at post-treatment assessment, significantly more participants who received DIRT-C were recovered compared with those who received ERP (43% versus 14%). Similarly, at 6-month follow-up, treatment effect sizes for change in OCD symptom severity were greater for DIRT-C than for ERP (3.9 versus 2.76). This study provides further evidence of the usefulness of the DIRT-C package for people with OCD checking subtype. Future research investigating DIRT-C is warranted.

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