Cognitive Bias Modification for OCD

Cognitive Bias Modification as an Adjunctive Treatment for Treatment-Refractory OCD

This study will conduct the development and preliminary evaluation of Cognitive Bias Modification for Interpretation (CBM-I) and Approach Avoidance Training (AAT) as augmentations to treatment as usual for OCD and related disorders. CBM-I refers to computerized interventions designed to directly manipulate interpretation bias through repeated practice on a training task, thereby inducing cognitive changes in a relatively automatic or implicit manner. In AAT, automatic approach tendencies toward feared stimuli are re-trained. Specifically, this study will examine the feasibility, acceptability, and clinical outcomes associated with CBM-I and AAT.

Adults with obsessive compulsive disorder (OCD) and related disorders will be recruited from a treatment program for these disorders and participants will be randomly assigned to either receive: 1) eight sessions of CBM-I or eight sessions of psychoeducation as a control condition, or 2) AAT or eight sessions of an inactive (sham) version of the AAT training.

Inclusion Criteria:

• Currently receiving treatment at the McLean Hospital OCD Institute
• For CBM-I condition only: report a score of at least 131 on the Obsessive Beliefs Questionnaire-44 upon admission to the OCD Institute
• For AAT condition only: endorse score of at least 7 on the DOCS subscale #1 (contamination subscale) upon admission to the OCD Institute
• Able to complete a computer task for 20 minutes
• Consent to main OCD Institute study protocol

Exclusion Criteria:

• Currently undergoing electroconvulsive therapy (ECT)
• Current symptoms of acute mania or psychosis
• A reported diagnosis at admission of a psychotic disorder
• History of traumatic brain injury