Efficacy of Personalized-Computerized Inhibitory Training program (PCIT) combined with exposure and response prevention on treatment outcomes in patients with contamination obsessive-compulsive disorder.

BACKGROUND: Cognitive behavioral therapy (CBT) including exposure and response prevention (ERP) is the most effective and first-line treatment for obsessive-compulsive disorder (OCD). However, a significant number of people leave it or do not respond to it effectively. The present study aimed to examine the efficacy of personalized-computerized inhibitory training (P-CIT) program combined with ERP on treatment outcomes in patients with contamination OCD. MATERIALS AND METHODS: The present research method was based on an experimental design with pre-test, post-test, and the two intervention and control groups. Thirty patients with contamination OCD were randomly assigned to the two groups of intervention and control based on the inclusion and exclusion criteria. The measures used in this study were Yale-Brown Scale, Stroop task, World Health Organization's Quality of Life Questionnaire, Structured Clinical Interview for DSM-5, and Depression Anxiety and Stress Scales -21. RESULTS: The results showed a significant reduction in severity of symptoms (F = 0.75, P < 001) and severity of anxiety (F = 0.75, P < 001) for the intervention group. Furthermore, task control (F = 12.44, P < 001), mental health (F = 28.32, P < 001), physical health (F = 2.48, P < 001), and overall quality of life (F = 0.19, P = 001) improved in the intervention group after the intervention. CONCLUSION: When P-CIT is exerted along with ERP, it may enhance inhibition of compulsions and increase the efficacy of ERP through improved task control, thereby resulting in reduced symptom severity and improved treatment outcomes in patients with contamination OCD.

Virtual reality exposure and response prevention in the treatment of obsessive-compulsive disorder in patients with contamination subtype in comparison with in vivo exposure therapy: a randomized clinical controlled trial.

BACKGROUND: Obsessive-Compulsive Disorder (OCD) is characterized by disturbing and unwanted thoughts as well as repetitive and time-consuming behaviors that interfere with performance. Cognitive Behavior Therapy (CBT) has shown to have beneficial effects on reducing OCD symptoms as the first line of treatment. Moreover, Virtual Reality (VR) has been a more feasible and accessible intervention for OCD in recent years. Regarding the point, the objective of this study was to evaluate the effectiveness of virtual reality exposure and response prevention (VRERP) in the treatment of the OCD contamination subtype. METHODS: A total number of 36 adults with OCD-contamination subtype were registered and randomly assigned to the intervention and control groups. The intervention group received a 60-min CBT including a "contaminated" virtual environment while the control group received CBT as a standardized treatment. Out of these, 29 patients completed the treatment in 12 weekly sessions. The patients completed the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Obsessive Beliefs Questionnaire-44(OBQ-44), and World Health Organization Disability Assessment Scale-2 (WHODAS-2) at week 0, week 12 and after 3 months follow-up. RESULTS: Based on the results of the repeated measure analysis of variances, the total score of obsession and compulsion subscales of Y-BOCS significantly decreased as a primary outcome in the intervention group (F = 60.97, P < 0.001, partial eta squared = 0.82; F = 20.46, P < 0.001, partial eta squared = 0.61; F = 29.57, P < 0.001, partial eta squared = 0.69; respectively). The total score of BDI-II and BAI was reduced in both groups but there was no significant difference between them (BDI-II: F = 0.54, P = 0.47, partial eta squared = 0.02; BAI: F = 3.12, P = 0.06, partial eta squared = 0.19). However, there was a significant difference in the OBQ-44 (F = 16.78, P < 0.001, partial eta squared = 0.56) and the total WHODAS-2 score between the groups (F = 14.64, P < 0.001, partial eta squared = 0.53). CONCLUSIONS: This study demonstrated the effectiveness of VRERP in the treatment of the OCD-contamination subtype. Therefore, VRERP can be used in CBT as an alternative exposure tool. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT ID: IRCT20210214050353N1 , Registered on 16/10/2021.

The psychometric properties of the of the Persian version of the Screen for adult anxiety related disorders (SCAARED) in patients with anxiety disorders.

BACKGROUND: The aim of this study was to investigate the psychometric properties of the Persian version of the Screen for adult anxiety related disorders (SCAARED) in Tehran. METHOD: The present study was a descriptive-survey method and a cross-sectional method. The present research population consists of patients referring to hospitals and psychiatric clinics in Tehran, as well as male and female students in Tehran. The sample of the present study included 300 participants (150 patients with a diagnosis of anxiety disorders and 150 non-clinical samples), who were selected by random sampling method. Inclusion criteria included age 18 to 50, minimum diploma, lack of mental retardation, and lack of acute physical illnesses such as cancer or severe pain. The participants, after completing the demographic questionnaire and conducting a Structured Clinical Interview for DSM-5 Disorders-Clinical Version (SCID-5-CV), completed the SCAARED and the Personal Wellbeing Index-Adults (PWI-A). Finally, face and content validity and construct validity, test-retest reliability, Cronbach's alpha, and factor analysis were used. RESULTS: The results of the present study confirmed the face validity and content of the present scale. A review of Cronbach's standardized alpha showed that SCAARED has a reliability of 0.966, and therefore, the Persian version of these questionnaires is a reliable tool. Also, the results showed a correlation between the two implementations of the questionnaire; in addition to the strong correlation at the level (p < .01) between the factors of the questionnaire and the factors with the total score, there was a strong correlation between the first and second implementation in four factors and the overall score. Therefore, it can be concluded that the SCAARED has good test-retest reliability. Also, there is a positive correlation between the factors and the overall score of the SCAARED with anxiety disorders based on Structured Clinical Interview for DSM-5 Disorders (p < .01), which indicates the favorable convergent validity of the SCAARED questionnaire. There is a negative correlation between the factors and the overall score of the SCAARED with the PWI-A at the level (p < .01), which indicates the favorable divergent validity of the SCAARED, and the results of exploratory factor analysis of the questionnaire were confirmed. CONCLUSION: The Persian version of the SCAARED is a tool with appropriate validity and reliability.