To gain a better understanding about which aspects of the treatment work for obsessive-compulsive disorders (OCD), the investigation of possible change factors is essential. Psychological flexibility (PsyF) has been of interest in research on successful OCD therapy for some time. Exposure interventions and cognitive strategies in cognitive behavioural therapy (CBT) for OCD may enhance PsyF. To date, however, no process studies have been published that clarify the role of PsyF as a possible change factor for the reduction of OCD symptoms.

This study investigates whether PsyF works as a mediator in successful CBT treatment of OCD.

The study recruited 112 adults diagnosed with OCD in a multi-modal in-patient treatment with specific CBT including exposure and response prevention (ERP). The Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was used to measure OCD symptoms and three self-constructed items to assess PsyF. PsyF was conceptualised as the capability of patients to accept stressful feelings and thoughts. Data were collected weekly. For statistical analysis at the process level, longitudinal multi-level models (MLMs) with random intercepts and linear growth curves were estimated to test for mediation of PsyF on Y-BOCS.

OCD symptoms decreased significantly and PsyF increased in patients throughout the course of therapy. MLM revealed that higher average values in PsyF were associated with lower Y-BOCS sum values, but only values between subjects significantly predicted the degree of obsessions and compulsions.

Although research shows that PsyF is enhanced by CBT and also shows a connection with Y-BOCS values, its role as a mediator could not be confirmed.

为了更好地了解强迫症 (OCD) 治疗的哪些方面，调查可能的变化因素至关重要。一段时间以来，心理灵活性（PsyF）一直对成功的强迫症治疗的研究感兴趣。强迫症认知行为疗法 (CBT) 中的暴露干预和认知策略可能会增强 PsyF。然而，迄今为止，尚未发表任何过程研究来阐明 PsyF 作为减少强迫症症状的可能变化因素的作用。

本研究调查 PsyF 是否作为 CBT 成功治疗强迫症的中介。

该研究招募了 112 名被诊断患有强迫症的成年人，他们接受了包括暴露和反应预防 (ERP) 在内的特定 CBT 的多模式住院治疗。Yale-Brown 强迫症量表 (Y-BOCS) 用于测量强迫症症状和三个自建项目来评估 PsyF。PsyF 被概念化为患者接受压力感受和想法的能力。每周收集数据。对于过程级别的统计分析，估计具有随机截距和线性生长曲线的纵向多级模型 (MLM) 以测试 PsyF 在 Y-BOCS 上的中介作用。

在整个治疗过程中，患者的强迫症症状显着减轻，PsyF 增加。MLM 显示 PsyF 的较高平均值与较低的 Y-BOCS 总和值相关，但只有受试者之间的值显着预测了强迫症和强迫症的程度。

尽管研究表明 CBT 增强了 PsyF 并且还显示了与 Y-BOCS 值的联系，但其作为中介的作用无法得到证实。