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Updated: Sep 22, 2025

Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging
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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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Evaluation of Inference-Based Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder: A Multicenter

Frederick Aardema1,2, Stéphane Bouchard3, Diana Koszycki4,5

  • 1Department of Psychiatry and Addictology, University of Montreal, Montreal, Québec, Canada.

Psychotherapy and Psychosomatics
|May 18, 2022
PubMed
Summary

Inference-based cognitive-behavioral therapy (I-CBT) and mindfulness-based stress reduction (MBSR) effectively treat obsessive-compulsive disorder (OCD), showing similar outcomes to appraisal-based CBT. I-CBT may offer faster remission and better results for overvalued ideation.

Keywords:
Cognitive-behavioral therapyInference-based approachMindfulnessObsessive-compulsive disorderRandomized controlled trial

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Area of Science:

  • Psychiatry and Behavioral Sciences
  • Clinical Psychology
  • Cognitive Neuroscience

Background:

  • Obsessive-compulsive disorder (OCD) is a debilitating mental health condition.
  • Traditional treatments like ERP may not be suitable for all patients.
  • Inference-based cognitive-behavioral therapy (I-CBT) offers an alternative approach focusing on reasoning.
  • Dysfunctional reasoning contributes to obsessional doubts and ideas in OCD.

Purpose of the Study:

  • To evaluate the effectiveness of I-CBT for OCD.
  • To compare I-CBT with appraisal-based cognitive behavioral therapy (A-CBT).
  • To assess I-CBT against an adapted mindfulness-based stress reduction (MBSR) intervention as a control.

Main Methods:

  • A two-site, parallel-arm randomized controlled trial (RCT) was conducted.
  • 111 participants diagnosed with OCD were randomly assigned to I-CBT or A-CBT.
  • MBSR served as a non-specific active control condition.
  • The Yale-Brown Obsessive-Compulsive Scale was the primary outcome measure.

Main Results:

  • All treatments (I-CBT, A-CBT, MBSR) significantly reduced OCD severity.
  • No significant differences in overall OCD severity were found between treatments.
  • I-CBT showed significant reductions across all symptom dimensions at post-test.
  • I-CBT demonstrated greater improvement in overvalued ideation and higher remission rates than MBSR at mid-test.

Conclusions:

  • I-CBT and MBSR are effective alternative treatments for OCD, comparable to A-CBT.
  • I-CBT may provide faster remission, broader symptom dimension effectiveness, and better outcomes for overvalued ideation.
  • Further research is needed to explore additional alternative treatments for OCD.