Symposia
Treatment - CBT
Jennie M. Kuckertz, Ph.D.
Instructor
McLean Hospital/Harvard Medical School
Belmont, Massachusetts
Richard J. McNally, Ph.D.
Professor
Harvard University
Cambridge, MA
Bradley Riemann, Ph.D.
Chief Clinical Officer
Rogers Behavioral Health
Oconomowoc, Wisconsin
Claudia Van Borkulo, Ph.D.
Postdoctoral Research Fellow
University of Amsterdam
Amsterdam, Noord-Holland, Netherlands
Benjamin Bellet, M.S.
Doctoral Student
Harvard University
Nashville, TN
Nathaniel Van Kirk, Ph.D.
Coordinator of Clinical Assessment
McLean Hospital/Harvard Medical School
Belmont, MA
Jason Krompinger, Ph.D.
Director of Psychological Services and Clinical Research
McLean Hospital/Harvard Medical School
Belmont, MA
Martha Falkenstein, Ph.D.
Administrative Director
McLean Hospital/Harvard Medical School
Belmont, MA
Exposure and response prevention is the gold-standard treatment for obsessive compulsive disorder (OCD), yet this intervention remains inadequate for up to half patients. Thus, different approaches to identifying and intervening with non-responders are badly needed. One approach would be to better understand the functional connections among aspects of OCD symptoms and, ultimately, how to target those associations in treatment. In a large sample of patients who completed intensive treatment for OCD and related disorders (N = 1343), we examined whether differences in network structure of OCD symptom aspects existed at baseline between treatment responders versus non-responders. A network comparison test indicated a significant difference between OCD network structure for responders versus non-responders (M = .19, p = .02). Consistent differences emerged between responders and non-responders in the way in which they oriented towards their distress. This pattern of associations suggests that non-responders may have been more reactive to their distress by performing compulsions, and that this distress led to more functional interference. These findings speak to potential mechanisms through which OCD symptoms are maintained. By examining the association between baseline distress intolerance with other symptom aspects that maintain the disorder (e.g., ritualizing), clinicians can more effectively target those associations in treatment.