Background and objectives

There is conflicting research on how comorbid depression impacts the treatment of obsessive compulsive disorder (OCD) with exposure with response prevention. To better understand this relationship, the current study tests theoretical claims that greater depression limits motivation to engage in exposures, restricts habituation, and interferes with adaptive learning.

Methods

Fifty-one individuals with OCD completed a diagnostic interview and self-report questionnaires assessing depression symptom severity and then participated in a standardized imaginal exposure protocol, in which they repeatedly approached an idiosyncratic fear deemed “moderately anxiety-provoking.”

Results

Contrary to expectations, linear regression models indicated that depression symptom severity was not independently associated with motivation, subjective or objective within-session habituation or adaptive learning outcomes. However, the perceived likelihood of the best-case scenario occurring as a result of the exposure moderated the relationship between depression severity and motivation to engage in the exposure exercise.

Limitations

Use of a one-session exposure protocol precludes conclusions regarding how depression is associated with outcomes in a full ERP treatment.

Conclusions

Depression symptom severity was not independently associated with motivation, habituation, or adaptive learning. The observed non-significant effects suggest that degree of depression, on its own, is not a meaningful indicator of how patients with OCD will fare an exposure intervention.

中文翻译：

---

是我的病人太伤心了接近他们的恐惧？强迫症患者的抑郁严重程度和想象暴露结果。

背景和目标

关于共病抑郁症如何影响强迫症 (OCD) 治疗与反应预防暴露的研究存在矛盾。为了更好地理解这种关系，当前的研究测试了理论主张，即更严重的抑郁会限制参与暴露的动机，限制习惯，并干扰适应性学习。

方法

51 名强迫症患者完成了评估抑郁症状严重程度的诊断性访谈和自我报告问卷，然后参与了标准化的想象暴露方案，在该方案中，他们反复处理被认为“中度焦虑”的特殊恐惧。

结果

与预期相反，线性回归模型表明抑郁症状的严重程度与动机、主观或客观的会话内习惯或适应性学习结果没有独立关联。然而，由于暴露而发生的最佳情况的感知可能性缓和了抑郁严重程度与参与暴露练习的动机之间的关系。

限制

使用单次暴露协议排除了关于抑郁如何与完整 ERP 治疗结果相关的结论。

结论

抑郁症状的严重程度与动机、习惯或适应性学习不独立相关。观察到的非显着影响表明，抑郁程度本身并不是强迫症患者如何接受暴露干预的有意义的指标。