Predictors of latent-class trajectories of symptom change during intensive treatment of obsessive-compulsive disorder

Author

Keith Patrick Klein, Southern Illinois University CarbondaleFollow

Date of Award

9-1-2021

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Kerta, Sarah

Abstract

Obsessive-compulsive disorder (OCD) is relatively common (Ruscio, Stein, Chiu, & Kessler, 2010) and leads to significant functional impairment (World Health Organization, 2001). Research suggests that exposure and response prevention (EX/RP) is efficacious for reducing OCD symptoms (NICE, 2006); however, standard outpatient EX/RP does not effectively alleviate symptom severity among a substantial proportion of OCD patients (Abramowitz, 2006). Intensive EX/RP programs have been developed to address the needs of treatment-refractory OCD patients (Veale et al., 2016). While evidence from effectiveness studies suggests that intensive EX/RP programs lead to significant reductions in OCD symptom severity, a portion of patients do not demonstrate improvement in response to intensive treatment (e.g., Björgvinsson, Hart, et al., 2013; Boschen, Drummond, & Pillay, 2008). These findings underscore the need to identify reliable predictors of OCD patient response to intensive EX/RP to help target clinical and research efforts toward improving treatment outcomes for those least likely to respond to current treatment modalities. Therefore, the proposed study evaluated distinct trajectories of OCD symptom change across six-weeks of intensive treatment and examined factors that predict membership in those trajectory groups. Results suggested that three latent subgroups of OCD patients emerged with one demonstrating symptom relapse during intensive treatment. Further, OCD symptom severity was the only baseline factor that predicted latent-class membership. Implications and future directions of research are discussed.