RESUMO
BACKGROUND AND OBJECTIVES: Criticism is thought to play an important role in obsessive-compulsive disorder (OCD), and obsessive behaviors have been considered as childhood strategies to avoid criticism. Often, patients with OCD report memories characterized by guilt-inducing reproaches. Starting from these assumptions, the aim of this study is to test whether intervening in memories of guilt-inducing reproaches can reduce current OCD symptoms. The emotional valence of painful memories may be modified through imagery rescripting (ImRs), an experiential technique that has shown promising results. METHODS: After monitoring a baseline of symptoms, 18 OCD patients underwent three sessions of ImRs, followed by monitoring for up to 3 months. Indexes of OCD, depression, anxiety, disgust, and fear of guilt were collected. RESULTS: Patients reported a significant decrease in OCD symptoms. The mean value on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) changed from 25.94 to 14.11. At the 3-month follow-up, 14 of the 18 participants (77.7%) achieved an improvement of ≥35% on the Y-BOCS. Thirteen patients reported a reliable improvement, with ten reporting a clinically significant change (reliable change index = 9.94). Four reached the asymptomatic criterion. Clinically significant changes were not detected for depression and anxiety. CONCLUSIONS: Our findings suggest that after ImRs intervention focusing on patients' early experiences of guilt-inducing reproaches there were clinically significant changes in OCD symptomatology. The data support the role of ImRs in reducing OCD symptoms and the previous cognitive models of OCD, highlighting the role of guilt-related early life experiences in vulnerability to OCD.
RESUMO
The aim of this study was to evaluate the efficacy of a cognitive rehabilitation intervention performed in an Alzheimer's Day Care Center for 12 months on patients suffering from Alzheimer's-type dementia with moderate cognitive impairment. In the cognitive rehabilitation treatment of moderate cognitive impairment, the leading cognitive stimulation techniques are reality orientation therapy and cognitive training. While these techniques are meant to treat different cognitive environments, there is scarce documentation in literature about their joint use. For this purpose, the therapy was administered to two groups of patients: the experimental group was composed of four subjects and received cognitive rehabilitation (cognitive training plus reality orientation therapy); the control group was composed of five subjects and received aspecific stimulation. To assess subjects' responses the Milan Overall Dementia Assessment and the Mini-Mental State Examination were used for the cognitive domain, while the Geriatric Depression Scale was used for the affective sphere. The results indicated that the subjects submitted to cognitive rehabilitation obtain statistically significant results compared to the control group from the 9 months of treatment, in clinical terms; they maintain their cognitive performance, while no significant differences were found between the two groups as far as the affective domain is concerned.
