Evaluation of a brief, online imagery rescripting intervention targeting fear-of-self in high obsessive-compulsive...

Emerging evidence suggests that rescripting aversive memories related to obsessive-compulsive disorder (OCD) may improve symptoms and OCD-relevant cognitive and affective outcomes. We aimed to validate an online, audio-guided imagery rescripting protocol by comparing it with a focused, thought-listing control. A sample of Prolific online workers (n = 112) with high OCD symptoms identified a memory associated with OCD-related experiences, then were randomly assigned to complete either the rescripting or control task. Select outcomes were re-assessed one-week post-experiment. Feared self-perceptions improved for the rescripting, but not the control condition; these improvements were maintained for idiosyncratic and state feared-self beliefs, but not trait fear-of-self. Participants in the rescripting condition also reported significantly greater reductions in state anxiety and urge to neutralise, compared to controls. No changes were observed in obsessional beliefs for either condition. There were no between-condition differences in engagement in behavioural neutralisation post-experiment. A small but significant increase in reporting OCD symptoms was found at follow-up; this did not differ between conditions and was consistent with heightened awareness of symptoms. These findings provide preliminary evidence that imagery rescripting in a standardised audio-guided format may be an effective adjunctive treatment for OCD to facilitate cognitive and affective change.