scholarly journals Acceptance and efficacy of a metacognitive self-help intervention in an Arabic-speaking mixed patient sample with depression and/or obsessive–compulsive disorder: A randomized controlled trial

2019 ◽  
Vol 10 (1) ◽  
pp. 204380871882068 ◽  
Author(s):  
Steffen Moritz ◽  
Schaimaa Irshaid ◽  
Annabel Beiner ◽  
Marit Hauschildt ◽  
Franziska Miegel
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Effect Size ◽  
Retention Rates ◽  
Evidence Based ◽  
Completion Rates ◽  
Large Effect Size ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Self Help ◽  
Arabic Speaking

Objective: In Arabic-speaking countries, most individuals with depression or obsessive–compulsive disorder (OCD) do not seek or receive evidence-based treatment due to a dearth of facilities, shame/self-stigma, or religious concerns. The feasibility and effectiveness of “Western” psychotherapeutic concepts have rarely been evaluated for Arabic-speaking populations. The present study examined the efficacy of My Metacognitive Training (myMCT), a trans-therapeutic self-help manual, in a mixed sample of participants with depression and/or OCD. We considered both participants with depression and/or OCD because a number of cognitive biases and dysfunctional beliefs are shared by the two disorders. Method: The myMCT manual was translated into Arabic. A total of 160 individuals with either self-reported OCD and/or self-reported depression were recruited. Individuals were assessed at baseline and then randomized either to myMCT ( n = 84) or to a wait-list control condition ( n = 76). Six weeks later, individuals were invited to the post assessment. The Beck Depression Inventory (BDI-II) served here as the primary outcome. Secondary outcomes were the Obsessive–Compulsive Inventory–Revised (OCI-R) and the self-rating version of the Yale-Brown Obsessive Compulsive Scale (OCD patients only). Individuals were reimbursed with a 17€ voucher. Results: Completion rates were similarly low in the two groups (myMCT: 37%, controls: 35%). Presumably because of the high rate of noncompletion and nonadherence (29%), the intention-to-treat analyses failed to yield a significant effect. Those who had at least started the myMCT intervention improved significantly on the BDI-II at a large effect size. A significantly larger improvement among those who had started or completed the myMCT intervention was also seen on the OCI-R at a large effect size. Conclusions: Individuals who studied the myMCT manual showed large improvement on the BDI-II, irrespective of their primary symptomatology. However, the results are seriously compromised by the low completion rates in both conditions. Importantly, evaluations using the same manual in other language populations (and with other background cultures) produced good to excellent retention rates. The study demonstrates that self-help manuals may not represent a suitable medium for large-scale dissemination of evidence-based self-help material in an Arab population and corroborates prior findings suggesting low adherence in this population. Whether smartphone apps and Internet interventions represent more viable alternatives than self-help manuals needs to be tested, as well as specific barriers preventing dissemination and completion in this population.

Self-help Application for Obsessive-Compulsive Disorder Based on Exposure and Response Prevention Technique: Prototype Design and Usability Evaluation (Preprint)

2021 ◽  
Author(s):  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Usability Testing ◽  
Usability Evaluation ◽  
Response Prevention ◽  
Evidence Based ◽  
Heuristic Evaluation ◽  
Exposure And Response Prevention ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Self Help

BACKGROUND Obsessive-compulsive disorder (OCD) is a relatively common disorder that, due to its debilitating nature, significantly affects personal abilities, job performance, social adjustment, and interpersonal relationships. There are significant barriers to accessing evidence-based cognitive-behavioral therapy as a first-line treatment for obsessive-compulsive disorder. Mobile health applications (Apps) offer a promising way to improve access to evidence-based therapies while overcoming these barriers. OBJECTIVE This study aimed to design and evaluate a prototype of a self¬-help application for people with contamination OCD based on exposure and response prevention (ERP) technique. METHODS This work was developed in four different phases. 1) Needs assessment: Thorough literature review, reviewing existing related programs and apps, and interviewing patients and psychiatrists; 2) Create paper prototype: Considering the functional features identified in the previous phase using wireframe sketcher software. 3)Create digital prototype: developing an actual prototype using Axure RP software based on the information obtained from the evaluation of the paper prototype by expert panel. 4) Prototype usability evaluation: Through a heuristic evaluation with experts and a usability testing with patients using SUS questionnaire. RESULTS After requirement analysis, requirements were defined in the areas of information and educational elements and functional capabilities. Prototypes designed based on identified requirements include capabilities such as in-app online self-help group, assessing the severity of the symptoms of the disorder, psychological training, supportive treatment strategies, setting personalized treatment plan, tracking treatment progress through weekly reports provided, anxiety assessment, setting reminder. The results of heuristic evaluation of 5 experts showed that out of the total identified problems, the most problems are related to the” aesthetic and minimalist design” principle and the least problems are related to ”visibility of system status” and” flexibility and efficiency of use”. No problems were identified for “good error message”. Violated problem in the final application should be resolved and refinement can be made based on the experts' comments and suggestions. In usability testing with 10 patients, mean score of patients’ responses in the SUS questionnaire was 76.75 that indicates that the usability of the app prototype is good from the patient's perspective. CONCLUSIONS The results of heuristic evaluation with experts made it possible to identify how to provide information and to implement the capabilities in a way that can be more appropriate and easier for the user Furthermore, the results of the usability evaluation with potential prototype users showed the that implementing remote treatment with mobile app can be promising to help people with contamination OCD.

Self-help Application for Obsessive-Compulsive Disorder Based on Exposure and Response Prevention Technique: Prototype Design and Usability Evaluation (Preprint)

2021 ◽  
Author(s):  
Ziba Parsa
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Usability Testing ◽  
Usability Evaluation ◽  
Response Prevention ◽  
Evidence Based ◽  
Heuristic Evaluation ◽  
Exposure And Response Prevention ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Self Help

BACKGROUND Obsessive-compulsive disorder (OCD) is a relatively common disorder that, due to its debilitating nature, significantly affects personal abilities, job performance, social adjustment, and interpersonal relationships. There are significant barriers to accessing evidence-based cognitive-behavioral therapy as a first-line treatment for obsessive-compulsive disorder. Mobile health applications (Apps) offer a promising way to improve access to evidence-based therapies while overcoming these barriers. OBJECTIVE This study aimed to design and evaluate a prototype of a self¬-help application for people with contamination OCD based on exposure and response prevention (ERP) technique. METHODS This work was developed in four different phases. 1) Needs assessment: Thorough literature review, reviewing existing related programs and apps, and interviewing patients and psychiatrists; 2) Create paper prototype: Considering the functional features identified in the previous phase using wireframe sketcher software. 3)Create digital prototype: developing an actual prototype using Axure RP software based on the information obtained from the evaluation of the paper prototype by expert panel. 4) Prototype usability evaluation: Through a heuristic evaluation with experts and a usability testing with patients using SUS questionnaire. RESULTS After requirement analysis, requirements were defined in the areas of information and educational elements and functional capabilities. Prototypes designed based on identified requirements include capabilities such as in-app online self-help group, assessing the severity of the symptoms of the disorder, psychological training, supportive treatment strategies, setting personalized treatment plan, tracking treatment progress through weekly reports provided, anxiety assessment, setting reminder. The results of heuristic evaluation of 5 experts showed that out of the total identified problems, the most problems are related to the” aesthetic and minimalist design” principle and the least problems are related to ”visibility of system status” and” flexibility and efficiency of use”. No problems were identified for “good error message”. Violated problem in the final application should be resolved and refinement can be made based on the experts' comments and suggestions. In usability testing with 10 patients, mean score of patients’ responses in the SUS questionnaire was 76.75 that indicates that the usability of the app prototype is good from the patient's perspective. CONCLUSIONS The results of heuristic evaluation with experts made it possible to identify how to provide information and to implement the capabilities in a way that can be more appropriate and easier for the user Furthermore, the results of the usability evaluation with potential prototype users showed the that implementing remote treatment with mobile app can be promising to help people with contamination OCD.

scholarly journals A Qualitative Study Exploring Neurodiversity Conference Themes, Representations and Evidence-Based Justifications for the Explicit Inclusion and Valuing of OCD

2021 ◽  
Vol 5 (2) ◽  
pp. 111-138
Author(s):  
Damian Mellifont
Keyword(s):  
Qualitative Study ◽  
Obsessive Compulsive Disorder ◽  
Google Scholar ◽  
Future Research ◽  
Evidence Based ◽  
Exploratory Research ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

The inclusivity of neurodiversity conferences is a new field of research. Utilising Obsessive Compulsive Disorder (OCD) as an example, this study aims to critically investigate issues of inclusivity in the flyers advertising these conferences. This exploratory research is informed by 22 conference flyers and 14 scholarly articles retrieved from respective internet and Google Scholar enquiries. These articles offered evidence-based justifications for a greater inclusion of OCD-focused content in neurodiversity conferences. The study cautions that the lack of explicit inclusion of OCD as a topic among conferences can be harmful to persons who identify with this particular type of neurodivergence. This study offers a sound base from which future research focusing upon other forms of neurodivergence and issues of neurodiversity conference inclusivity and intersectionality can develop.

scholarly journals Obsessive-compulsive disorder: does CBT with exposure and response (ERP) prevention work?

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S284-S285
Author(s):  
Jemma Reid ◽  
Naomi A Fineberg ◽  
Lynne Drummond ◽  
Keith Laws ◽  
Matteo Vismara ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Effect Size ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Obsessive Compulsive ◽  
Related Factors ◽  
Psychological Treatments ◽  
Compulsive Disorder ◽  
Control Intervention ◽  
Randomised Controlled

AimsSince the 1970s treatment for obsessive Compulsive Disorder (OCD) has consisted of the the application of drugs acting on the serotonin system of the brain or psychological treatments using graded exposure. Although there is a large number of studies on psychological treatments, they often are underpowered. Other major methodological issues include ignoring the effects of medication during the trial, using a variety of techniques and using waiting list data as controls.We decided to systematically review and perform a meta-analysis on randomised controlled trials (RCTs) of CBT with ERP (abbreviated to ERP)1.MethodThe study was preregistered in PROSPERO (CRD42019122311). RCTs incorporating ERP were examined. The primary outcome was the end-of-trial symptoms scores for OCD. In addition, factors which may have influenced the outcome including patient-related factors, type of control intervention, researcher allegiance and other potential forms of bias were examined. The moderating effects of patient-related and study-related factors including type of control intervention and risk of bias were also examined.ResultOverall, 36 studies were included in the analyses, involving 537 children/adolescents and 1483 adults (total 2020 subjects). A total of 1005 received ERP and the remainder a variety of control treatments. Initial results showed that ERP had a large effect size compared with placebo treatments. This was more marked in younger than older persons. However, whereas ERP was markedly more effective than waiting list or psychological control, this positive effect size disappeared when it was compared with other psychological treatments.When ERP was compared against psychopharmacological treatment it initially appeared significantly superior but this reduced to marginal benefit when compared with adequate doses of appropriate medication.The majority of studies were performed where there may be expected to be researcher allegiance to ERP and in these studies the effect size was large. In contrast, in the 8 studies considered to have low risk of researcher bias, ERP was found to be ineffective.ConclusionAlthough on initial sight CBT incorporating ERP seems to be highly efficacious in the treatment of OCD, further analysis revealed that this varied depending on the choice of comparator control. In addition there are considerable concerns about methodological rigour and reporting of studies using CBT with ERP. Further studies examining the role of researcher bias and allegiance are needed.Ref : 1 Jemma E Reid, Keith R Laws, Lynne Drummond, Matteo Vismara, Benedetta Grancini , Davis Mpavaenda, Naomi A Fineberg (2021) Cognitive Behavioural Therapy with Exposure and Response Prevention in the treatment of Obsessive-Compulsive Disorder: A systematic review and meta-analysis of randomised controlled trials. Comprehensive Psychiatry , in press.

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