ArticleBMC psychiatry2022
Mechanisms of exposure and response prevention in obsessive-compulsive disorder: effects of habituation and expectancy violation on short-term outcome in cognitive behavioral therapy.
Article in BMC psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Is Morning Exposure Therapy More Successful? Pilot Data on Exposure Process Indicators and Diurnal Cortisol in Obsessive-Compulsive Disorder or Agoraphobia.Journal of clinical medicine · 2026Article
- "It Doesn't Matter Where OCD Comes From," or Does It?Current psychiatry reports · 2026Review
- Examining Within-Session and Between-Session Change in Exposure-Meal-Related Distress During Intensive Outpatient Treatment for Eating Disorders.The International journal of eating disorders · 2026Article
- Psychological mechanism of character strengths and psychological stress affecting the athletic performance in swimmers.Scientific reports · 2025Article
- Rethinking the Subjective Units of Distress Scale: Validity and Clinical Utility of the SUDS.Clinics and practice · 2025Review
- Within-session habituation and salivary cortisol during exposure treatment in obsessive-compulsive disorder - A link and an influence of DHEA?Indian journal of psychiatry · 2024Article
- Effectiveness of One Videoconference-Based Exposure and Response Prevention Session at Home in Adjunction to Inpatient Treatment in Persons With Obsessive-Compulsive Disorder: Nonrandomized Study.JMIR mental health · 2024Article
- Intolerance of Uncertainty as a Cognitive Vulnerability for Obsessive-Compulsive Disorder: A Qualitative Review.Clinical psychology : a publication of the Division of Clinical Psychology of the American Psychological Association · 2023Article
- A Wearable Artificial Intelligence Feedback Tool (Wrist Angel) for Treatment and Research of Obsessive Compulsive Disorder: Protocol for a Nonrandomized Pilot Study.JMIR research protocols · 2023Article
- Efficacy of exposure and response prevention therapy in mixed reality for patients with obsessive-compulsive disorder: study protocol for a randomized controlled trial.BMC psychology · 2023Article
- Facing Uncertainty: A Comparison of Hierarchical and Variable Exposure Interventions for Contamination Fear.Journal of obsessive-compulsive and related disorders · 2023Article
- Does prediction error during exposure relate to clinical outcomes in cognitive behavior therapy for social anxiety disorder? A study protocol.Frontiers in psychiatry · 2022Article
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Authors and funding
5 authors.
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Abstract
backgroundExposure and response prevention is effective and recommended as the first choice for treating obsessive-compulsive disorders (OCD). Its mechanisms of action are rarely studied, but two major theories make distinct assumptions: while the emotional processing theory assumes that treatment effects are associated with habituation within and between exposure sessions, the inhibitory learning approach highlights the acquisition of additional associations, implying alternative mechanisms like expectancy violation. The present study aimed to investigate whether process variables derived from both theories predict short-term outcome.
methodIn a university outpatient unit, 110 patients (63 female) with OCD received manual-based cognitive-behavioral therapy with high standardization of the first two exposure sessions. Specifically, therapists repeated the first exposure session identically and assessed subjective units of distress as well as expectancy ratings in the course of exposure sessions. Based on these data, individual scores for habituation and distress-related expectancy violation were calculated and used for prediction of both percentage change on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and remission status after 20 therapy sessions.
resultsIn a multiple regression model for percentage change, within-session habituation during the first exposure was a significant predictor, while in a logistic regression predicting remission status, distress-related expectancy violation during the first exposure revealed significance. A path model further supported these findings.
conclusionsThe results represent first evidence for distress-related expectancy violation and confirm preliminary findings for habituation, suggesting that both processes contribute to treatment benefits of exposure in OCD, and both mechanisms appear to be independent.
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