Predictors of dropout in self-guided internet-delivered cognitive behaviour therapy for obsessive-compulsive disorder: An exploratory study.

IF 3.8 3区 心理学 Q1 PSYCHOLOGY, CLINICAL British Journal of Clinical Psychology Pub Date : 2024-11-20 DOI:10.1111/bjc.12517
Bethany M Wootton, Maral Melkonian, Sarah McDonald, Eyal Karin, Nickolai Titov, Blake F Dear
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Abstract

Objectives: Self-guided internet-delivered cognitive behaviour therapy (ICBT) is an effective treatment for obsessive-compulsive disorder (OCD); however, there is little research investigating who dropouts of treatment. Therefore, the aim of this study was to conduct an exploratory study of predictors of dropout in self-guided ICBT for OCD. Given that definitions of dropout vary across ICBT studies, we conceptualized dropout in multiple ways: (1) early dropout (proportion of participants who did not complete the pre-treatment questionnaires); (2) proportion of participants who did not commence the intervention; (3) proportion of participants who did not complete the treatment; and (4) proportion of participants who did not complete the post-treatment questionnaires.

Method: This was a secondary data analysis of 323 participants with OCD symptoms who provided a successful screening assessment to commence an ICBT intervention. Binary logistic regression was used to predict dropout based on a number of exploratory variables.

Results: Early dropout was predicted by the country of the participant (participants in the United Kingdom and India being more likely to dropout), as well as shorter symptom duration (explaining 7% of the variance). Medication use predicted non-completion of the intervention with those taking medication for OCD being less likely to complete the treatment (explaining 3% of the variance). Completion of the post-treatment questionnaires was predicted by higher contamination symptoms, lower depressive symptoms and higher pre-treatment conscientiousness (explaining 13% of the variance). There were no significant predictors of treatment commencement.

Conclusions: The study provides important preliminary information concerning which patients with OCD may be more likely to drop out of a self-guided ICBT intervention.

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强迫症患者在自我指导的互联网认知行为疗法中辍学的预测因素:一项探索性研究。
目的:自我指导的互联网认知行为疗法(ICBT)是一种治疗强迫症(OCD)的有效方法;然而,对治疗中途退出者的调查研究却很少。因此,本研究旨在对强迫症自我指导认知行为疗法的辍学预测因素进行探索性研究。鉴于不同的 ICBT 研究对辍学的定义各不相同,我们从多个方面对辍学进行了概念化:(1)早期辍学(未完成治疗前调查问卷的参与者比例);(2)未开始干预的参与者比例;(3)未完成治疗的参与者比例;以及(4)未完成治疗后调查问卷的参与者比例:这是一项二手数据分析,研究对象是323名有强迫症症状的参与者,他们成功通过了筛查评估,并开始接受综合心理治疗干预。根据一些探索性变量,采用二元逻辑回归法预测辍学情况:受试者所在国家(英国和印度的受试者更有可能辍学)以及症状持续时间较短(解释了7%的方差)可预测早期辍学。使用药物可预测未完成干预的情况,那些服用强迫症药物的人完成治疗的可能性较低(解释了3%的差异)。较高的污染症状、较低的抑郁症状和较高的治疗前自觉性可以预测治疗后问卷的完成情况(解释了 13% 的方差)。治疗开始与否没有重要的预测因素:这项研究提供了重要的初步信息,说明哪些强迫症患者更有可能放弃自我指导的 ICBT 干预。
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来源期刊
CiteScore
5.80
自引率
3.20%
发文量
57
期刊介绍: The British Journal of Clinical Psychology publishes original research, both empirical and theoretical, on all aspects of clinical psychology: - clinical and abnormal psychology featuring descriptive or experimental studies - aetiology, assessment and treatment of the whole range of psychological disorders irrespective of age group and setting - biological influences on individual behaviour - studies of psychological interventions and treatment on individuals, dyads, families and groups
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