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Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging

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Change in obsessive-compulsive symptoms mediates subsequent change in depressive symptoms during exposure and

Laurie J Zandberg¹, Yinyin Zang¹, Carmen P McLean¹

¹Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.

Behaviour Research and Therapy

|April 1, 2015

Abstract

Objective:

The current study examines the temporal relationship between changes in obsessive-compulsive symptoms and changes in depressive symptoms during exposure and response prevention (EX/RP) therapy for obsessive-compulsive disorder (OCD).

Method:

Participants were 40 adults (53% female) who received EX/RP in a randomized controlled trial comparing serotonin reuptake inhibitor (SRI) augmentation strategies. Participants completed clinician-administered assessments of OCD (Yale-Brown Obsessive Compulsive Scale) and depressive symptoms (Hamilton Depression Rating Scale) every four weeks from baseline to 32-week follow-up.

Results:

Lagged multilevel mediational analyses indicated that change in OCD symptoms accounted for 65% of subsequent change in depressive symptoms. In contrast, change in depressive symptoms only partially mediated subsequent change in OCD symptoms, accounting for 20% of the variance in outcome.

Conclusions:

These data indicate that reductions in co-morbid depressive symptoms during EX/RP for OCD are largely driven by reductions in obsessive-compulsive symptoms.

Keywords:

CBT Depression Exposure and response prevention Mediation Obsessive-compulsive disorder

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