OBJECTIVES The current study evaluated the feasibility of an internet-delivered cognitive therapy (I-CT) in a self-help format with minimal therapist support for patients with obsessive-compulsive disorder (OCD) with primary taboo obsessions. Specifically, the aims were to investigate (1) whether participants were able to grasp and apply the internet-delivered cognitive framework to their own situation; (2) whether they had clinically meaningful reductions of OCD symptom severity; and (3) whether reduced negative appraisals (hypothesized mechanism of change in CT) preceded reductions in OCD symptom severity. METHOD Nineteen OCD patients with primary taboo obsessions, recruited from an OCD clinic or self-referrals, received the I-CT intervention for 10 weeks. I-CT did not contain any systematic exposure or response prevention. RESULTS Adherence and engagement with the intervention was high. Most participants (n = 13, 68%) understood and successfully applied the cognitive model to their own situation. Within-group analyses showed large reductions in OCD symptom severity at post-treatment (bootstrapped within group d = 1.67 [95% CI; 0.67 to 2.66]) measured with the Yale-Brown Obsessive-Compulsive Scale. The gains were maintained at the 6-month follow-up. Post-hoc analyses revealed that the large reductions in OCD symptom severity were driven by the participants who understood the cognitive model. Reductions in negative appraisals predicted subsequent reductions in OCD symptom severity during treatment. CONCLUSION It is possible to adapt a purely cognitive intervention to a digital guided self-help format and to achieve both cognitive change and meaningful symptom reduction. The results require confirmation in a randomized clinical trial.

中文翻译：

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对患有禁忌症患者的治疗师支持的在线认知疗法自助的初步评估。

目标 当前的研究评估了以自助形式通过互联网提供的认知疗法 (I-CT) 的可行性，对具有主要禁忌症的强迫症 (OCD) 患者提供最少的治疗师支持。具体来说，目的是调查 (1) 参与者是否能够掌握互联网提供的认知框架并将其应用于自己的情况；(2) 他们是否有具有临床意义的 OCD 症状严重程度的降低；(3) 负面评价的减少（假设的 CT 变化机制）是否先于 OCD 症状严重程度的降低。方法 从 OCD 诊所或自我转介招募的 19 名患有主要禁忌症的 OCD 患者接受了为期 10 周的 I-CT 干预。I-CT 不包含任何系统暴露或反应预防。结果 干预的依从性和参与度很高。大多数参与者 (n = 13, 68%) 理解并成功地将认知模型应用于他们自己的情况。组内分析显示，使用耶鲁-布朗强迫症量表测量，治疗后强迫症症状严重程度大幅降低（组内自举 d = 1.67 [95% CI；0.67 至 2.66]）。在 6 个月的随访中，收益得以维持。事后分析显示，强迫症症状严重程度的大幅降低是由了解认知模型的参与者推动的。负面评价的减少预示着治疗期间强迫症症状严重程度的后续减少。结论 将纯认知干预适应数字引导自助形式并实现认知改变和有意义的症状减轻是可能的。结果需要在随机临床试验中确认。