Imagery Rescripting on Guilt-Inducing Memories in OCD: A Single Case Series Study

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Obsessive-compulsive disorder (OCD) is linked to criticism, with obsessive behaviors potentially stemming from childhood strategies to avoid it.
• Patients with OCD often recall memories involving guilt-inducing reproaches, suggesting a role for these experiences in the disorder's development.

Purpose of the Study:

• To investigate the efficacy of imagery rescripting (ImRs) in reducing current obsessive-compulsive disorder (OCD) symptoms.
• To explore whether modifying the emotional valence of guilt-inducing memories can alleviate OCD symptomatology.

Main Methods:

• 18 patients diagnosed with OCD participated in the study.
• Participants underwent three sessions of imagery rescripting (ImRs) focused on guilt-inducing memories.
• Symptom severity (OCD, depression, anxiety), disgust, and fear of guilt were monitored before, during, and up to 3 months post-intervention.

Main Results:

• A significant decrease in obsessive-compulsive disorder (OCD) symptoms was observed, with Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores dropping from a mean of 25.94 to 14.11.
• At 3-month follow-up, 77.7% of participants showed a ≥35% improvement in Y-BOCS scores, and 55.5% reported clinically significant changes.
• No significant changes were detected in depression or anxiety levels.

Conclusions:

• Imagery rescripting (ImRs) intervention targeting early experiences of guilt-inducing reproaches led to clinically significant reductions in obsessive-compulsive disorder (OCD) symptoms.
• The findings support the use of ImRs as an effective treatment for OCD and align with cognitive models emphasizing the role of early life guilt experiences in OCD vulnerability.