Effects of acceptance-based strategies on psychological responses to disorder-relevant stimuli in inpatients with obsessive–compulsive disorder: An experimental study

Background and objectives

Preliminary findings suggest that acceptance and commitment therapy-informed exposure therapy may be an effective treatment for obsessive–compulsive disorder (OCD). However, there is a lack of experimental studies that have examined immediate effects of acceptance-based strategies during exposure to disorder-relevant stimuli in persons with OCD.

Methods

Fifty-three inpatients (64% female) with OCD participated in an experimental study during which they were exposed to obsessive–compulsive washing-relevant pictures and were instructed to either passively view these pictures for 5 s (neutral condition), to accept their feelings (acceptance condition) or to intensify their feelings (exposure condition) for 90 s each.

Results

The acceptance condition led to higher acceptance and lower unpleasantness of patients’ current feelings compared to the neutral condition and to lower strength of obsessions and urge to perform compulsions but only when compared to the exposure condition. Higher self-reported OCD symptom severity related to higher unpleasantness and strength of obsessions, particularly in the neutral condition.

Limitations

Future studies need to test whether the current findings translate to other stimuli and other forms of obsessions and compulsions. Due to the short duration, the exposure condition might have only mimicked the early phase of exposure and response prevention.

Conclusions

Acceptance-based strategies during cue exposure immediately increase acceptance of and reduce unpleasant feelings. In line with the rationale of acceptance-based treatment approaches, which do not aim at immediate disorder-specific symptom reductions, effects on obsessions and compulsions may be more delayed or require repeated training sessions.